Diagnostic and Treatment Practices of Equine Endometritis-A Questionnaire.
Abstract: Endometritis is a major cause for impaired fertility in mares. The objectives of this study were to collect information on diagnostic and treatment practices performed by veterinarians and to investigate possible effects of professional experience, caseload, and geographical location on the practitioners' management of endometritis cases. For this purpose, equine practitioners ( = 680) were asked to fill out an online survey (34 questions). The online survey yielded 117 responses by veterinarians practicing in all parts of Germany. Most respondents came from Lower Saxony and managed <20 mares per year. For the diagnosis of chronic infectious endometritis, uterine sampling for microbiological examination was performed manually with a swab by the majority of practitioners whereas only few used the speculum technique. The incidence of antibiotic resistant pathogens was reported to be <5% by almost all respondents. Most practitioners relied on systemic antibiotic treatment with trimethoprim-sulfadiazine. Only occasionally veterinarians used intrauterine antibiotic therapy. Uterine lavages were performed routinely by almost half of the respondents in case of positive uterine cultures, mostly with 0.9% saline solution. Irritant solutions (e.g., iodine, chlorhexidine, kerosene) were used less often. Collection of an endometrial culture after completion of the treatment was common practice. While only a very limited association of the geographical location of practitioner (e.g., on selection of mares for endometrial culture, < 0.05) was observed, the number of managed mares affected the answers notably (e.g., for use of irritating intrauterine treatment, < 0.05). The management of persistent breeding induced endometritis (PBIE) was influenced by the number of managed mares (e.g., for use of oxytocin, < 0.05) and 29.6% of respondents administered antibiotics as part of their PBIE management. In summary, treatment strategies in the field vary considerably and include also non-evidence-based methods, but most German practitioners apply the recommended suitable treatments. Following the guidelines for antibiotic usage, most veterinarians administer antibiotics dependent on endometrial culture results but do not use cytology, low-volume lavage, or biopsy routinely. Antibiotic resistant uterine pathogens are reported to be isolated infrequently and equine practitioners prefer systemic to local antibiotic treatment of endometritis.
Copyright © 2020 Köhne, Kuhlmann, Tönißen, Martinsson and Sieme.
Publication Date: 2020-09-02 PubMed ID: 32984410PubMed Central: PMC7492380DOI: 10.3389/fvets.2020.00547Google Scholar: Lookup
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- Journal Article
Summary
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The research study investigates diagnostic and treatment practices adopted for Equine Endometritis by veterinarians and assesses the impact of professional experience, number of cases handled, and geographical location on their management strategy. The findings revealed variations in engagement practices and strategies and highlighted that majority engaged with recommended suitable treatments.
Research Methodology
- The study was conducted through an online survey of 34 questions distributed to 680 equine practitioners.
- Participants for this study included practitioners from all parts of Germany, with the majority being from Lower Saxony handling less than 20 mares a year.
- The goal of the study was to understand the diagnosis and treatment practices adopted by veterinarians for chronic infectious endometritis.
Findings and Observations
- For diagnosing chronic infectious endometritis, most practitioners performed uterine sampling for microbiological examination manually with a swab. However, a minor portion used the speculum technique.
- The incidence of antibiotic-resistant pathogens was reported less than 5% by the majority of respondents.
- Most of the practitioners primarily relied on systemic antibiotic treatment with trimethoprim-sulfadiazine, rarely adopting intrauterine antibiotic therapy.
- Almost half of the practitioners performed uterine lavages routinely in case of positive uterine cultures, mostly with a 0.9% saline solution. Irritant solutions like iodine, chlorhexidine, and kerosene were less preferred.
- An endometrial culture collection after the end of the treatment was a common practice among respondents.
Impacts of Geographical Location and Caseload
- While there was a limited association between the geographical location of the practitioner and the selection of mares for endometrial culture, the number of mares managed significantly influenced the responses regarding the use of irritating intrauterine treatment.
- The management of persistent breeding induced endometritis (PBIE) was also impacted by the number of managed mares and more than a quarter of respondents used antibiotics as part of their PBIE management.
Summary and Conclusion
- The study concluded that treatment strategies in the field vary greatly and also include non-evidence-based methods.
- Antibiotic-resistant uterine pathogens are reported to be isolated infrequently and equine practitioners prefer systemic over local antibiotic treatment of endometritis.
- While deviation from evidence-based methods was observed, most German practitioners were found to apply recommended suitable treatments, following guidelines for antibiotic usage primarily based on endometrial culture results.
Cite This Article
APA
Köhne M, Kuhlmann M, Tönißen A, Martinsson G, Sieme H.
(2020).
Diagnostic and Treatment Practices of Equine Endometritis-A Questionnaire.
Front Vet Sci, 7, 547.
https://doi.org/10.3389/fvets.2020.00547 Publication
Researcher Affiliations
- Clinic for Horses - Unit for Reproductive Medicine, University of Veterinary Medicine Hannover, Foundation, Hanover, Germany.
- Lower Saxony State Stud, Celle, Germany.
- Clinic for Horses - Unit for Reproductive Medicine, University of Veterinary Medicine Hannover, Foundation, Hanover, Germany.
- Lower Saxony State Stud, Celle, Germany.
- Clinic for Horses - Unit for Reproductive Medicine, University of Veterinary Medicine Hannover, Foundation, Hanover, Germany.
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