Post-breeding endometritis in the mare

doi:10.1016/S0378-4320(00)00110-X

Animal Reproduction Science

Volumes 60–61, 2 July 2000, Pages 221-232

https://doi.org/10.1016/S0378-4320(00)00110-X Get rights and content

Abstract

Post-breeding endometritis is a major cause of subfertility in the mare. Endometritis is a normal event in the immediate period after mating, but the presence of ultransonographically visible uterine fluid more than 12 h later is thought to be evidence of uterine pathology. In mares that are free of venerally transmitted endometritis, treatment is aimed at removing the intraluminal fluid. If the endometritis persists past day 5, when the embryo enters the uterine lumen, the cytotoxic environment will not be compatible with pregnancy. Reproductive anatomy, defective myometrial contractility, lowered immune defences, overproduction of mucus, inadequate lymphatic drainage, or a combination of these factors will predispose the mare to post-breeding endometritis.

Introduction

Fertility varies markedly among mares. Apart from poor management and incorrect timing of mating, probably the most important reason for low pregnancy rates is endometritis/endometrosis. A survey of 1149 veterinarians in the United States ranked endometritis as the third most frequently occurring medical problem in adult horses (Traub-Dargatz et al., 1991). Until relatively recently, mares were classified as resistant or susceptible to endometritis based on their ability to eliminate uterine infection within a certain period of time after challenge Hughes and Loy, 1969, Peterson et al., 1969 and/or on their endometrial biopsy scores (Kenney and Doig, 1986). Mares with high biopsy scores which had evidence of inflammatory cell infiltration or endometrial fibrosis, or mares which failed to eliminate uterine infection were referred to as susceptible to endometritis. However, the multifactorial nature of the condition has now resulted in subdivision of endometritis into four categories, based on aetiology and pathophysiology Troedsson et al., 1995, Troedsson, 1997b. These are: (1) endometrosis (chronic degenerative endometritis), (2) sexually transmitted diseases, (3) persistent mating-induced endometritis (PMIE), and (4) chronic infectious endometritis. These categories are not, however absolute and mares may change categories between or even within breeding seasons, or may fit into more than one category.

Section snippets

Endometrosis

Endometrosis is a chronic degenerative condition of the endometrium and is thought to be irreversible Kenney and Doig, 1986, Allen, 1993. It is not a post-breeding condition and will not be dealt with in this review, although severe changes can be associated with delayed uterine clearance (Troedsson et al., 1993a) and may result from repeated uterine inflammation or ageing (Allen, 1993).

Sexually transmitted diseases

Sexually transmitted diseases are those acute infections which are induced after mating mares with stallions which are inapparent penile carriers of Taylorella equigenitalis, certain unspecified serotypes of Pseudomonas aeruginosa, and Klebsiella pneumoniae capsule types 1, 2 and 5 (Platt et al., 1977). T. equigenitalis is a highly contagious pathogen which caused infertility in Thoroughbred mares in the UK in 1977 (Powell et al., 1978). When first diagnosed the organism caused severe acute

Persistent mating-induced endometritis

Endometritis is a normal physiological event after mating, but if the inflammation persists, the resulting environment is not compatible with establishment of pregnancy. The inflammation is often, but not always, accompanied by accumulation of intrauterine fluid. Intrauterine fluid accumulation in mares was first reported by Knudsen (1964) using rectal palpation, however more recently transrectal ultrasonography has been employed to detect intrauterine fluid Ginther and Pierson, 1984, Adams et

Chronic uterine infection

Clinical experience would show that mares which are affected by PMIE initially in the breeding season, can develop into mares with chronic uterine infection. Alternatively, mares which have no previous history of PMIE can present with a uterine infection. The major pathogens involved in equine endometritis are Streptococcus zooepidemicus, Escherichia coli, or yeasts (Dimock and Edwards, 1928) although anaerobes may play a role (Ricketts and Mackintosh, 1987). In the USA, P. aeruginosa and K.

Diagnosis of post-breeding endometritis

A detailed breeding history should be obtained. Mares should then be carefully evaluated prior to breeding to check that the perineal and vulvar anatomy is normal, the cervix opens in oestrus and closes in dioestrus, that no free intrauterine fluid is present on transrectal ultrasonography, and that endometrial smear and culture contain neither neutrophils nor a significant growth of known uterine pathogens.

Unfortunately, mares can present as reproductively normal at the start of the breeding

Treatment

The majority of mares with intrauterine fluid after breeding have negative culture results but have many neutrophils present in an endometrial smear. Treatment is generally aimed at assisting the uterus to physically clear contaminants and inflammatory products. Because of the association between semen in the uterus and PMIE, it is generally accepted that mares should be mated only once during oestrus. It is recommended to perform large volume lavage at 6 to 12 h after mating in susceptible

Conclusion

Post-breeding endometritis is still the subject of much research. Major challenges which now face researchers include development of practical ways of determining susceptibility to PMIE prior to breeding which are easily accessible to the veterinary practitioner, and identification of the precise cause of the defect in uterine contractility in mares with PMIE.

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Citation Excerpt :
Differential diagnosis is required to distinguish T. asinigenitalis infection with CEM [11]. P. aeruginosa, K. pneumoniae and S. zooepidemicus are the most commonly isolated bacteria in clinical cases of endometritis in mares [3] and detections of these bacteria in horses have been reported in many countries, worldwide [2, 12–16]. Alterations of the bacterial strain on the exterior genitalia may allow the growth of such opportunistic bacteria and elaborate a range of toxins that could cumulatively damage the endometrium, contributing to reduced resistance to bacterial infection [3, 17].
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Post-breeding endometritis in the mare

Abstract

Introduction

Section snippets

Endometrosis

Sexually transmitted diseases

Persistent mating-induced endometritis

Chronic uterine infection

Diagnosis of post-breeding endometritis

Treatment

Conclusion

Theriogenology

Theriogenology

Theriogenology

Theriogenology

Theriogenology

Theriogenology

Theriogenology

Theriogenology

Theriogenology

Theriogenology

Theriogenology

Theriogenology

Theriogenology

Vet. Immunol. Immunopathol.

Res. Vet. Sci.

Effect of uterine inflammation and ultrasonically-detected uterine pathology on fertility in the mare

J. Reprod. Fertil., Suppl.

Investigations into the use of exogenous oxytocin for promoting uterine drainage in mares susceptible to endometritis

Vet. Rec.

Cyclical accumulation of uterine fluid in mares with lowered resistance to endometritis

Vet. Rec.

Proceedings of the John P. Hughes International Workshop on Equine Endometritis

Equine Vet. J.

Factors affecting phagocytosis of bacteria by neutrophils in the mares's uterus

J. Reprod. Fertil., Suppl.

Immunohistochemical localisation of adrenergic and peptidergic nerves in the uterus of the mare

J. Reprod. Fertil., Abstr. Ser.

Chemotactic properties and protein of equine uterine fluid

Am. J. Vet. Res.

Opsonization of bacteria by uterine secretions of cyclic mares

Am. J. Reprod. Immunol.

Relationship between prostaglandin and uterine clearance of radiocolloid in the mare

Biol. Reprod. Mono.

Relationship between plasma keto-13, 14-dihydro PGF2α (PGFM) and uterine clearance of radiocolloid after oxytocin administration in reproductively normal mares and those with delayed in uterine clearance

Proc. Soc. Theriogenol., Baltimore

Phagocytic and killing capacities of uterine-derived polymorphonuclear leukocytes from mares resistant and susceptible to chronic endometritis

Am. J. Vet. Res.

Uterine contractions in nonpregnant and early pregnant mares and jennies as determined by ultrasonography

J. Anim. Sci.

Pathology and bacteriology of the reproductive organs of mares in relation to sterility of the reproductive organs of mares in relation to sterility

Res. Bull. Kentucky Agricultural Experimental Station, Lexington

Factors affecting uterine clearance of inoculated materials in mares

J. Reprod. Fertil., Suppl.

Influence of estrus cycle stage on adhesion of Streptococcus zooepidemicus to equine endometrium

Am. J. Vet. Res.

Studies of intraoital colonization in women with recurrent infections: VII. The role of bacterial adherence

J. Urol.

Opsonins of Streptococcus in uterine flushings of mares susceptible and resistant to endometritis; control of secretion and partial characterization

Am. J. Vet. Res.

Investigations on the effect of intrauterine inoculation of Streptococcus zooepidemicus in the mare

Proc. 15th Ann. Conv. Am. Assoc. Equine Pract.

Onset and duration of uterine inflammatory response of mares after insemination with fresh semen

Biol. Reprod. Mono.

Neutrophils in uterine fluid after insemination with fresh live spermatozoa or with killed spermatozoa

Pferdeheilkunde

Equine endometrial biopsy

Partial dilatation of the uterus as a cause of sterility in the mare

Cornell Vet.

The influence of early post-breeding uterine lavage on uterine fluid accumulation in the mare highly susceptible to acute endometritis

Pferdeheilkunde

Identification and opsonic activity of immunoglobulins recognizing Streptococcus zooepidemicus antigens in uterine fluids of mares

J. Reprod. Fertil., Suppl.

The equine endometrium and the pathophysiology of endometritis

Proc. Reprod. Pathol.

Lymphatic clearance of India ink in reproductively normal mares and mares susceptible to endometritis

Biol. Reprod. Mono. Ser.

Scintigraphic measurement of uterine clearance in normal mares and mares with recurrent endometritis

Equine Vet. J.

The functional competence of uterine-derived polymorphonuclear neutrophils (PMN) from mares resistant and susceptible to chronic uterine infection: a sequential migration analysis

Relationship between plasma keto-13, 14-dihydro PGF_2α (PGFM) and uterine clearance of radiocolloid after oxytocin administration in reproductively normal mares and those with delayed in uterine clearance