FREE SHIPPING over $40
OVER 9000 FIVE-STAR REVIEWS
5% OFF ALL SUBSCRIPTIONS
100% HAPPINESS GUARANTEE
Analyze Diet
0
Home / Equine Research Bank / Reproduction / Equine endometritis: a review of challenges and new approach...
Reproduction (Cambridge, England)2020; 160(5); R95-R110; doi: 10.1530/REP-19-0478

Equine endometritis: a review of challenges and new approaches.

Abstract: Endometritis in the mare begins as a normal physiological inflammatory response to breeding that involves both a mechanical and immunological response pathway activated to rid the uterus of semen and bacteria. With successful resolution of this inflammation, the mare's uterus will provide a hospitable environment for the development of the semi-allogenic conceptus. If the mare fails to resolve this inflammatory response within 48 h of breeding, she will become susceptible to persistent breeding-induced endometritis (PBIE) which will have detrimental effects on her fertility. This condition can then predispose the mare to bacterial or fungal endometritis leading to further degeneration of the endometrium. Optimisation of the mare's fertility requires a fine balance between allowing the natural immune response of the endometrium to its exposure to allogenic semen to run its course, and yet preventing its progression to PBIE or the involvement of infectious agents. This review discusses the challenges presented by PBIE, latent infections, biofilms, fungal infections and the need to utilise diagnostic methods available and implement targeted treatments to optimise fertility in the mare.
Get Full Text
Publication Date: 2020-08-18 PubMed ID: 32805710DOI: 10.1530/REP-19-0478Google Scholar: Lookup
The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
LinkedInCopy
  • Journal Article
  • Review

Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

The research article presents a detailed review of the challenges associated with equine endometritis and explores novel approaches and treatments. It investigates the physiological impacts of the disorder on a mare’s fertility, with focus on breeding-induced endometritis and its potential complications.

Introduction to Endometritis in Mares

  • Endometritis is an inflammatory response in mares that usually happens after breeding. This response involves mechanical and immunological pathways, which help in removing semen and bacteria from the uterus to create a favourable environment for embryo development.
  • If the inflammation isn’t resolved within 48 hours of breeding, the mare could develop persistent breeding-induced endometritis (PBIE), which seriously impacts her fertility.
  • Furthermore, PBIE can make the mare vulnerable to fungal and bacterial endometritis, leading to more damage to the endometrium.

Challenges in Endometritis Management

  • The primary challenge in managing endometritis is to find an equilibrium between the natural immune response of the uterus and preventing its progression to PBIE or any involvement of infectious agents.
  • This task presents multiple difficulties like PBIE, latent infections, the formation of biofilms, and fungal infections, which complicate the diagnosis and treatment of endometritis.
  • Furthermore, these challenges need to be addressed while ensuring that the mare’s fertility doesn’t get impacted negatively.

New Approaches for Endometritis Treatment

  • The study discusses the importance of improved diagnostic methods and the implementation of targeted treatments to enhance fertility in mares affected by endometritis.
  • These treatment approaches aim at preventing the progression of the normal inflammatory response after breeding to PBIE or any infectious conditions.
  • Overall, the study posits the necessity for further research in this domain to improve our understanding and management of endometritis in mares, thereby, enhancing their fertility.

Cite This Article

APA
H A Morris L, M McCue P, Aurich C. (2020). Equine endometritis: a review of challenges and new approaches. Reproduction, 160(5), R95-R110. https://doi.org/10.1530/REP-19-0478

Publication

Reproduction (Cambridge, England)
ISSN: 1741-7899
NlmUniqueID: 100966036
Country: England
Language: English
Volume: 160
Issue: 5
Pages: R95-R110
PII: REP-19-0478

Researcher Affiliations

H A Morris, Lee
  • EquiBreed NZ Ltd, Te Awamutu, New Zealand.
M McCue, P
  • Department of Clinical Sciences, Colorado State University, Fort Collins, Colorado, USA.
Aurich, Christine
  • Centre for Artificial Insemination and Embryo Transfer, Vetmeduni Vienna, Vienna, Austria.

MeSH Terms

  • Animals
  • Disease Susceptibility
  • Endometritis / microbiology
  • Endometritis / prevention & control
  • Endometritis / veterinary
  • Female
  • Fertility
  • Horse Diseases / immunology
  • Horse Diseases / microbiology
  • Horse Diseases / therapy
  • Horses

Citations

This article has been cited 43 times.
  1. Tyrnenopoulou P, Fthenakis GC. Clinical Aspects of Bacterial Distribution and Antibiotic Resistance in the Reproductive System of Equids. Antibiotics (Basel) 2023 Mar 28;12(4).
    doi: 10.3390/antibiotics12040664pubmed: 37107026google scholar: lookup
  2. Scarlet D, Malama E, Fischer S, Knutti B, Bollwein H. Relationship between Clinical Uterine Findings, Therapy, and Fertility in the Mare. Vet Sci 2023 Mar 29;10(4).
    doi: 10.3390/vetsci10040259pubmed: 37104414google scholar: lookup
  3. Schouten I, Bernys-Karolys A, Schneider P, Dror T, Ofer L, Shimoni C, Nissim-Eliraz E, Shpigel NY, Schlesinger S. Mesenchymal stromal cells modulate infection and inflammation in the uterus and mammary gland. BMC Vet Res 2023 Mar 30;19(1):64.
    doi: 10.1186/s12917-023-03616-1pubmed: 36997964google scholar: lookup
  4. Lange-Consiglio A, Gaspari G, Funghi F, Capra E, Cretich M, Frigerio R, Bosi G, Cremonesi F. Amniotic Mesenchymal-Derived Extracellular Vesicles and Their Role in the Prevention of Persistent Post-Breeding Induced Endometritis. Int J Mol Sci 2023 Mar 8;24(6).
    doi: 10.3390/ijms24065166pubmed: 36982240google scholar: lookup
  5. Köhne M, Hofbauer L, Böttcher D, Tönissen A, Hegger A, Görgens A, Ulrich R, Sieme H. Comparison of systemic trimethoprim-sulfadimethoxine treatment and intrauterine ozone application as possible therapies for bacterial endometritis in equine practice. Front Vet Sci 2023;10:1102149.
    doi: 10.3389/fvets.2023.1102149pubmed: 36777673google scholar: lookup
  6. Zdrojkowski Ł, Jasiński T, Ferreira-Dias G, Pawliński B, Domino M. The Role of NF-κB in Endometrial Diseases in Humans and Animals: A Review. Int J Mol Sci 2023 Feb 2;24(3).
    doi: 10.3390/ijms24032901pubmed: 36769226google scholar: lookup
  7. Poole RK, Soffa DR, McAnally BE, Smith MS, Hickman-Brown KJ, Stockland EL. Reproductive Microbiomes in Domestic Livestock: Insights Utilizing 16S rRNA Gene Amplicon Community Sequencing. Animals (Basel) 2023 Jan 31;13(3).
    doi: 10.3390/ani13030485pubmed: 36766374google scholar: lookup
  8. Cecchini Gualandi S, Di Palma T, Boni R. Serological and Uterine Biomarkers for Detecting Endometritis in Mares. Animals (Basel) 2023 Jan 11;13(2).
    doi: 10.3390/ani13020253pubmed: 36670793google scholar: lookup
  9. Thomson P, Pareja J, Núñez A, Santibáñez R, Castro R. Characterization of microbial communities and predicted metabolic pathways in the uterus of healthy mares. Open Vet J 2022 Nov-Dec;12(6):797-805.
    doi: 10.5455/OVJ.2022.v12.i6.3pubmed: 36650865google scholar: lookup
  10. Freccero F, Mislei B, Bucci D, Dondi F, Mari G. Effects of Intra-Uterine Fluid Accumulation after Artificial Insemination on Luteal Function in Mares. Animals (Basel) 2022 Dec 23;13(1).
    doi: 10.3390/ani13010067pubmed: 36611677google scholar: lookup
  11. Boni R, Cecchini Gualandi S. Relationship between Oxidative Stress and Endometritis: Exploiting Knowledge Gained in Mares and Cows. Animals (Basel) 2022 Sep 13;12(18).
    doi: 10.3390/ani12182403pubmed: 36139263google scholar: lookup
  12. Li J, Zhu Y, Mi J, Zhao Y, Holyoak GR, Yi Z, Wu R, Wang Z, Zeng S. Endometrial and vaginal microbiome in donkeys with and without clinical endometritis. Front Microbiol 2022;13:884574.
    doi: 10.3389/fmicb.2022.884574pubmed: 35979491google scholar: lookup
  13. Wang XZ, Song XJ, Liu C, Xing C, Wu T, Zhang Y, Su J, Hao JY, Chen XY, Zhang ZY, Li YH, Liu YY. Active components and molecular mechanism of Syringa oblata Lindl. in the treatment of endometritis based on pharmacology network prediction. Front Vet Sci 2022;9:885952.
    doi: 10.3389/fvets.2022.885952pubmed: 35937303google scholar: lookup
  14. Magnusson U. Antimicrobial use and resistance in food-producing animals-How can we protect the efficacy of antibiotics for reproductive diseases?. Reprod Domest Anim 2022 Sep;57 Suppl 4(Suppl 4):13-20.
    doi: 10.1111/rda.14170pubmed: 35668646google scholar: lookup
  15. Mahmoud SF, Fayez M, Swelum AA, Alswat AS, Alkafafy M, Alzahrani OM, Alsunaini SJ, Almuslem A, Al Amer AS, Yusuf S. Genetic Diversity, Biofilm Formation, and Antibiotic Resistance of Pseudomonas aeruginosa Isolated from Cow, Camel, and Mare with Clinical Endometritis. Vet Sci 2022 May 16;9(5).
    doi: 10.3390/vetsci9050239pubmed: 35622767google scholar: lookup
  16. D'Agostino A, Di Palma T, Cecchini Gualandi S, Boni R. Fluorescence Spectroscopy for the Diagnosis of Endometritis in the Mare. Animals (Basel) 2022 Apr 29;12(9).
    doi: 10.3390/ani12091157pubmed: 35565583google scholar: lookup
  17. Katila T, Ferreira-Dias G. Evolution of the Concepts of Endometrosis, Post Breeding Endometritis, and Susceptibility of Mares. Animals (Basel) 2022 Mar 19;12(6).
    doi: 10.3390/ani12060779pubmed: 35327176google scholar: lookup
  18. Jasiński T, Zdrojkowski Ł, Kautz E, Juszczuk-Kubiak E, Ferreira-Dias G, Domino M. The NF-κB-signalling pathway in mare's endometrium infiltrated with the inflammatory cells. Reprod Domest Anim 2022 Jun;57(6):598-610.
    doi: 10.1111/rda.14099pubmed: 35182075google scholar: lookup
  19. Morrell JM, Rocha A. A Novel Approach to Minimising Acute Equine Endometritis That May Help to Prevent the Development of the Chronic State. Front Vet Sci 2021;8:799619.
    doi: 10.3389/fvets.2021.799619pubmed: 35071389google scholar: lookup
  20. Ibrahim S, Hedia M, Taqi MO, Derbala MK, Mahmoud KGM, Ahmed Y, Sosa AS, Saber YHA, Hasanain MH, Nawito MF, Seidel GE. Extracellular vesicles in low volume uterine lavage and serum: novel and promising biomarker for endometritis in Arabian mares. BMC Vet Res 2022 Jan 18;18(1):42.
    doi: 10.1186/s12917-022-03137-3pubmed: 35042518google scholar: lookup
  21. Karam KM, Alebady AS, Alhilfi HO, Al-Delemi DH. Comparative study utilizing different post-breeding treatment regimens in cyclic Arabian mares. Vet World 2021 Nov;14(11):2863-2868.
    doi: 10.14202/vetworld.2021.2863-2868pubmed: 35017832google scholar: lookup
  22. Malaluang P, Wilén E, Lindahl J, Hansson I, Morrell JM. Antimicrobial Resistance in Equine Reproduction. Animals (Basel) 2021 Oct 22;11(11).
    doi: 10.3390/ani11113035pubmed: 34827768google scholar: lookup
  23. Ibrahim S, Hedia M, Taqi MO, Derbala MK, Mahmoud KGM, Ahmed Y, Ismail S, El-Belely M. Alterations in the Expression Profile of Serum miR-155, miR-223, miR-17, miR-200a, miR-205, as well as Levels of Interleukin 6, and Prostaglandins during Endometritis in Arabian Mares. Vet Sci 2021 Jun 4;8(6).
    doi: 10.3390/vetsci8060098pubmed: 34199703google scholar: lookup
  24. Mazzuchini MP, Canisso IF. The Apparent pH Stability of Antibiotic Preparations Used for Uterine Infusions in Mares. Animals (Basel) 2026 Jan 26;16(3).
    doi: 10.3390/ani16030382pubmed: 41681363google scholar: lookup
  25. Yang L, Xie Y, Zhong G, Liu D, Zhu Y, Li J. Prevalence of antimicrobial resistance in equine-associated Pseudomonas aeruginosa: a systematic review and meta-analysis. BMC Vet Res 2025 Dec 22;22(1):44.
    doi: 10.1186/s12917-025-05190-0pubmed: 41430701google scholar: lookup
  26. Ferreira CSC, Pinna AE, Dos Santos IPF, Dias MCR, Dos Santos NSL, Bragueroli SDS, Quintino PM, Almeida GB, Penna BA, da Rocha EMDS, de Souza GN, Barbosa CG, de Jesus VLT, Jacob JCF. Powerflow Doppler Ultrasonography in the Evaluation of Mares with and Without Endometritis. Vet Sci 2025 Sep 28;12(10).
    doi: 10.3390/vetsci12100941pubmed: 41150081google scholar: lookup
  27. Köhne M, Hüsch R, Peh E, Hirnet J, Tönissen A, Müsken M, Plötz M, Kittler S, Sieme H. Newly isolated bacteriophages show efficacy and phage-antibiotic synergy in vitro against the equine genital pathogens Klebsiella pneumoniae and Pseudomonas aeruginosa. BMC Vet Res 2025 Oct 3;21(1):568.
    doi: 10.1186/s12917-025-04989-1pubmed: 41044673google scholar: lookup
  28. Alfatlawy HJ. Microbial profile of post-breeding endometritis in Arabian mares from the Al-Hira District, Iraq. Open Vet J 2025;15(8):3670-3676.
    doi: 10.5455/OVJ.2025.v15.i8.30pubmed: 41035988google scholar: lookup
  29. Méndez-Pérez L, Wong YS, Ibáñez BO, Martinez-Hormaza I, Rodríguez-Álvarez L, Castro FO. Bidirectional Interaction Between PGE(2)-Preconditioned Mesenchymal Stem Cells and Myofibroblasts Mediates Anti-Fibrotic Effects: A Proteomic Investigation into Equine Endometrial Fibrosis Reversal. Proteomes 2025 Sep 8;13(3).
    doi: 10.3390/proteomes13030041pubmed: 40981201google scholar: lookup
  30. Yáñez Ramil U, Jezierska S, Krupa M, Bogado Pascottini O. Fundamentals of microbiome-based therapies for reproductive tract inflammatory diseases in domestic animals. Anim Reprod 2025;22(3):e20250030.
    doi: 10.1590/1984-3143-AR2025-0030pubmed: 40933872google scholar: lookup
  31. Hardefeldt L, Thomas K, Page S, Norris J, Browning G, El Hage C, Stewart A, Gilkerson J, Muscatello G, Verwilghen D, van Galen G, Bauquier J, Cuming R, Reynolds B, Whittaker C, Wilkes E, Clulow J, Burden C, Begg L. Antimicrobial prescribing guidelines for horses in Australia. Aust Vet J 2025 Dec;103(12):781-889.
    doi: 10.1111/avj.70003pubmed: 40903020google scholar: lookup
  32. Fehin B, Scott CJ, Arango-Sabogal JC, de Mestre AM, Mouncey R. Associations between endometrial swab bacteriology and cytology findings and live foal rates in Thoroughbred broodmares in the United Kingdom. Equine Vet J 2026 Mar;58(2):348-358.
    doi: 10.1111/evj.70086pubmed: 40888035google scholar: lookup
  33. Herzog F, Crissman KR, Beckers KF, Zhou G, Liu CC, Sones JL. Lactobacillus Genus Complex Probiotic-Induced Changes on the Equine Clitoral Microbiome. Vet Sci 2025 Mar 3;12(3).
    doi: 10.3390/vetsci12030232pubmed: 40266944google scholar: lookup
  34. da Silva-Álvarez E, Gómez-Arrones V, Correa-Fiz F, Martín-Cano FE, Gaitskell-Phillips G, Carrasco JJ, Rey J, Aparicio IM, Peña FJ, Alonso JM, Ortega-Ferrusola C. Metagenomic and proteomic analyses reveal similar reproductive microbial profiles and shared functional pathways in uterine immune regulation in mares and jennies. PLoS One 2025;20(4):e0321389.
    doi: 10.1371/journal.pone.0321389pubmed: 40238748google scholar: lookup
  35. Mazzuchini MP, Lisboa FP, de Castro JI, Alvarenga MA, Segabinazzi LGTM, Canisso IF. In vitro antimicrobial activity of non-traditional therapies for infectious endometritis in mares. Equine Vet J 2025 Jul;57(4):1118-1126.
    doi: 10.1111/evj.14423pubmed: 39431554google scholar: lookup
  36. Wang Z, Zeng S, Wang Y, Wang T, Qu H, Zhu Y, Li J. Reproductive Disorders in Donkeys: Current Evidence and Update. Animals (Basel) 2024 Aug 28;14(17).
    doi: 10.3390/ani14172494pubmed: 39272279google scholar: lookup
  37. Gil-Miranda A, Macnicol J, Orellana-Guerrero D, Samper JC, Gomez DE. Reproductive Tract Microbiota of Mares. Vet Sci 2024 Jul 18;11(7).
    doi: 10.3390/vetsci11070324pubmed: 39058008google scholar: lookup
  38. Gil-Miranda A, Caddey B, Orellana-Guerrero D, Smith H, Samper JC, Gomez DE. Vaginal and Uterine Microbiota of Healthy Maiden Mares during Estrus. Vet Sci 2024 Jul 18;11(7).
    doi: 10.3390/vetsci11070323pubmed: 39058007google scholar: lookup
  39. Zhang X, Gao Y, Mai Z, Li Y, Wang J, Zhao X, Zhang Y. Untargeted Metabolomic Analysis Reveals Plasma Differences between Mares with Endometritis and Healthy Ones. Animals (Basel) 2024 Jun 29;14(13).
    doi: 10.3390/ani14131933pubmed: 38998045google scholar: lookup
  40. Prete CD, Nocera FP, Piegari G, Palumbo V, Martino L, Cocchia N, Paciello O, Montano C, Pasolini MP. Use of cytobrush for bacteriological and cytological diagnosis of endometritis in mares. Vet World 2024 Feb;17(2):398-406.
    doi: 10.14202/vetworld.2024.398-406pubmed: 38595673google scholar: lookup
  41. Mouncey R, Arango-Sabogal JC, Rathbone P, Scott CJ, de Mestre AM. Prevalence of Microbial Isolates Cultured from Endometrial Swab Samples Collected from United Kingdom Thoroughbred Mares from 2014 to 2020. Vet Sci 2024 Feb 9;11(2).
    doi: 10.3390/vetsci11020082pubmed: 38393100google scholar: lookup
  42. Virendra A, Gulavane SU, Ahmed ZA, Reddy R, Chaudhari RJ, Gaikwad SM, Shelar RR, Ingole SD, Thorat VD, Khanam A, Khan FA. Metagenomic analysis unravels novel taxonomic differences in the uterine microbiome between healthy mares and mares with endometritis. Vet Med Sci 2024 Mar;10(2):e1369.
    doi: 10.1002/vms3.1369pubmed: 38357732google scholar: lookup
  43. Heil BA, van Heule M, Thompson SK, Kearns TA, Oberhaus EL, King G, Daels P, Dini P, Sones JL. Effect of Sampling Method on Detection of the Equine Uterine Microbiome during Estrus. Vet Sci 2023 Nov 8;10(11).
    doi: 10.3390/vetsci10110644pubmed: 37999467google scholar: lookup
Subscribe to our newsletter
Join 99,357 horse owners like you who receive our email updates on horse health and nutrition.