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Help For Next Year? JOS?

Sometimes the pregnancy doesn't go as expected and the foal is lost. Here you can share information and perhaps learn why it happened and/or how to prevent a reocurrence.

Moderator: Jos

Help For Next Year? JOS?

Postby silverlining » Tue Aug 28, 2012 12:12 pm

I need some advice for next year as I'm now out of time and money for this year after a long and stressful breeding season.

I spent the year trying to get my Maiden 13 year old Arabian mare in foal. We tried AI 5 times over 3 cycles. The 3rd cycle we inseminated 3 times and finally she took. She was confirmed with twins at day 15, pinched a twin on day 16, checked again on day 34, no foal...

Below is the whole rundown of what we did... I'm so sad, but I'd love some ideas or advice for next year.

1st Cycle (I didn't change her work load or anything, she's typically ridden 5 days a week, she's a 2nd level dressage horse):

6/6 - Checked via ultrasound, coming into heat with a 30 on the left. (ordered semen to be flown in for 6/8)
6/7 - Given shot of HCG at 8 pm
6/8 - Picked up semen at airport, follicle was a 40 and soft, ultrasounded and inseminated at 7 pm, Hyman needed to be broken, cervix wasn't open, vet manually opened.
6/9 - Oxytocin at 9 am and 6 pm. Checked at 330 pm via ultrasounded, ovulated over night.
6/21 - Checked via ultrasound, open.

2nd Cycle (Made a very careful effort to not stress her, worked very lightly):

6/26 - Checked via ultrasound, coming into heat with a 35 on the right. (ordered semen for 6/30)
6/30 - Inseminated, cervix was open enough but not very open
7/1 - Oxytocin at 9 am and 6 pm. Checked at 12 pm, had ovulated, given caslick surgery
7/6 - 7/17 - 35 ml ReguMate daily dosed into mouth not food.
7/17 - Checked via ultrasound, starting to come into heat again.

3rd Cycle (Didn't ride at all, only lunging with side reins):

7/20 - Checked via ultrasound, 35 on right. (we hadn't planned to check her until 7/23 but she was showing to her gelding boyfriend so I had the vet come out earlier to check her) Had Semen overnighted.
7/21 - Inseminated (left caslick in, cervix wide open)
7/22 - Inseminated again (ultrasound check showed she hadn't ovulated and was now growing a 35 on the left as well)
7/23 - Checked again via ultrasound, now had 2 40's - we sent for more semen to be overnighted. She was given HCG
7/24 - Checked again via ultrasound, had VERY recently (he thought within the last 2 hrs, ovulated on the right and left was soft and ready any minute) Inseminated again. 5 Oxytocin injections given, 1 every 6 hours beginning 6 hrs after insemination.
8/7 - Checked via ultrasound... TWINS... tried to pinch one, they were close and her tone wasn't super, gave shot of progesterone? (i believe)
8/8 - Checked via ultrasound... easily pinched one twin. - also given banamine
8/ 27 - Checked via ultrasound (day 34)... 2 good CL's, good tone, no baby to be found.

Needless to say we are too late in the season for anything else this year. But I'd love some advice on how to help our chances for next year. I'm totally wanting to believe that he missed the baby, but I know that's not realistic, he's well known in this area and has been recommended by this site in other posts... What are peoples thoughts? I'll try to remember and answer any questions... no biopsy or culture has been done of uterus thus far. - I realize that would be somewhere to start.
silverlining
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Re: Help For Next Year? JOS?

Postby Jos » Tue Aug 28, 2012 6:40 pm

I think that the first thing that becomes immediately clear to me is that at no point (according to your records) has the mare evaluated for the possibility of a uterine pathogen via a uterine swab culture and cytology. Even though the mare is (was) a maiden, that does not preclude her from the possibility of having a uterine pathogen present. I have seen maiden mares with a Caslick's procedure off the track have a Pseudomonas aeruginosa infection present! As you have bred the mare several times already, and are therefore already "out of pocket" to some (a great!) extent, it might be worth spending a little extra money on the initial diagnostic and going with an endometrial biopsy and culture right from the start, as that will tell you more about the condition of the uterine lining itself. Again, even though she was a maiden, that does not mean that she will automatically have a pristine uterine condition, and if she has had a long-term infection, there may be changes to the cellular condition as well.

You indicate that there were some instances of the cervix not being completely relaxed during estrus, and this can lead to issues related to fluid retention. Manual dilation of the cervix is valuable, possibly associated with topical treatment of a PGE cream to assist in relaxation. Similarly, estrogen early in estrus can also assist.

I would not have used Regumate in this mare, particularly as the pathogenic status of the uterus has not been evaluated. Regumate (and other progestins) can promote uterine pathogenic growth and create a major issue. Indeed, if this mare has been shown in the past and treated with Regumate during that show career, it is quite possibly a part of the problem. Even if I were to use Regumate, 35 ml is an excessively high dose.

I note that oxytocin was used, but a couple of doses is in adequate. We outline our oxytocin protocol in that linked article, with details of treatment schedule, dosage and duration.

Overall, my feelings are that perhaps the mare was not managed as effectively as she might have been (and I'm not casting slurs at you here, just stating an opinion! :) ), and that if she is managed a little tighter you might have a better success rate this coming season. If you have access to a veterinarian that specialized in equine reproduction, the use of them may be beneficial. That she did indeed get pregnant (with twins) when she was managed more tightly with the use of repeated oxytocin treatments (closer to the protocol) suggests where the issues may lie.
We're always happy to try and help, but don't forget to check the articles section
of the website too, which has a search engine to help you look for answers!
:)
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Re: Help For Next Year? JOS?

Postby silverlining » Tue Aug 28, 2012 6:57 pm

I will start next season with a culture and cytology. I asked about doing that this year based on some of what I read here and I regret not forcing the issue with the vet. He said since she was maiden that she would have a grade 1 and we wouldn't learn much. (its a hard balance to trust who you've hired vs what you're reading on the internet) The vet is considered a very reputable reproduction specialist in this area and has been recommended by your site in the past.

In all the post ovulation ultrasound's the vet noted there was no fluid and good tone, but to my untrained eyes the ultrasound is just a bunch of gray lines.

I am now second guessing the amount of Regumate that I stated was used, and should double check what was written down for me... But I believe it was 35 ml. Even then the vet said she was "breaking through it". - She has only been lightly shown and was never on any Regumate during her life.
**I APOLOGIZE - I DOUBLE CHECKED MY RECORDS - 15 CC'S WERE GIVEN DAILY NOT 35**

It seems that only the 3rd cycle we did "enough" oxytocin. 5 injections once every six hours started six hours after insemination.

I'm disappointed I didn't consult "the internet" more rigorously earlier in the season, but I guess there is always next year... :(
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Re: Help For Next Year? JOS?

Postby Jos » Tue Aug 28, 2012 7:41 pm

You can start with a culture and cytology, but you'll get more information from the biopsy and culture. The latter might be overkill, particularly as there was a pregnancy established on the last cycle, but it also might be worth comparing the costs of the two, and if not too much difference, going with the biopsy and culture. The vet might have been trying to save you some money, but certainly after 2 failed cycles I'd have been looking to do some more in-depth diagnostic work... When lecturing, I always point out that one of the definitions of insanity is doing the same thing over and over and expecting a different outcome each time!! :)

We don't only treat mares with the oxytocin protocol that have fluid. We will categorize mares with a risk factor, and mares that are in the higher risk factor group get the protocol. "Risk" increases with age, number of foals, poor reproductive conformation, repetitive breeding, use of frozen semen etc. I would say that probably 75% of mares we breed get oxytocin - it won't hurt and it's cheap, but it can make a huge difference.

15 cc of Regumate makes more sense, although we rarely use it (follow that link to see our thought processes!). :)

I hope next year goes better for you! Good luck!
We're always happy to try and help, but don't forget to check the articles section
of the website too, which has a search engine to help you look for answers!
:)
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Re: Help For Next Year? JOS?

Postby silverlining » Tue Aug 28, 2012 7:50 pm

Thank you for your advice - Hopefully with a little more knowledge I'll have better luck next time. I really appreciate your time and getting back to me!! If we could only set the clock back a month and squeeze in another try ... ;)
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Re: Help For Next Year? JOS?

Postby mynutmeg » Fri Aug 31, 2012 3:20 pm

The only thing I would say is that I would have her rescanned - my mare was scanned at about 42 days with lots of fluid to be seen but no baby anywhere to be seen, when she was rescanned a couple of weeks later there was a baby there. While it's a slim chance she may be hiding it so giving the costs already outlayed it wouldn't be a big deal to rescan and just make sure, especially if there was still fluid on her last scan :-)
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Re: Help For Next Year? JOS?

Postby Jos » Fri Aug 31, 2012 3:51 pm

One of the first rules if evaluating a mare prior to breeding is to confirm she is not pregnant prior to invading the cervix/uterus. A well-trained, responsible and experienced veterinarian will always do this. Having said that, we have had vets sent to our courses by their State Vet Boards as part of remedial training because they caused an abortion by not checking (and a complaint was filed...) :(

It is however difficult to miss a ~40 day pregnancy unless there are multiple cysts present. The fetus doesn't head over the pelvic brim until around 60 days at the earliest, and usually later than that (70-90 days).

Hopefully your vet is experienced and capable and will do the pregnancy check before further diagnostics anyway...
We're always happy to try and help, but don't forget to check the articles section
of the website too, which has a search engine to help you look for answers!
:)
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Re: Help For Next Year? JOS?

Postby silverlining » Fri Aug 31, 2012 4:14 pm

When she was checked at 34 days he stated that she still had both CL's and her tone was good, and he pointed to a little cloudy part that he said "used to be where the foal was" but it wasn't there anymore.

Correct me if I'm wrong Jos -

I figure she must have lost the pregnancy recently (within 7 days) because the CL's were still there, and that she definitely hadn't formed the endometrial cups yet. (I didn't ask the vet if they were there, but if they are normally formed around day 35 and she wasn't pregnant at day 34..)

So She * SHOULD * in theory come back into heat this season...(she's pretty obvious) If I watch her for the next 14 days and she doesn't come back into heat, (its been already 5 days since the 34 day check) I think I'll try a WeeTest38 and see what it says. Since she shouldn't have formed the cups yet when the vet said she wasn't pregnant, she shouldn't have just formed the cups and lost the pregnancy after... So if the Wee Test says preg, then I'll have the vet come back out and rescan, we would be at day 55 ish around then, so hopefully it would still be visible via ultrasound by then?
silverlining
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Re: Help For Next Year? JOS?

Postby Jos » Fri Aug 31, 2012 6:20 pm

The endometrial cups form around 36 days, not at 36 days, consequently checking at 34 days does not necessarily mean there hasn't been early eCG production. Furthermore the endometrial cups are not distinctly visible per ultrasound, and further furthermore, CLs can remain visible long after they have stopped secreting progesterone. In a cycling mare, it is not unusual to see a CL present even though the mare is in raging estrus - it simply means that the CL is no longer secreting progesterone, but the tissue structure has not yet regressed.

In other words, save the absence of an obvious embryo, there was nothing definitively indicative of an absence of pregnancy...

As far as her returning to estrus - if the secretion of eCG has not commenced, then yes, she should return to estrus (unless she goes into winter or lactational - if she has a foal at foot - anestrus). However... as noted above, it's an "around" not "at" situation, which is why we recommend that if one is going to give PGF2α with an intent of ending a pregnancy (for example if there are twins present that will not resolve to a singleton), it should be done no later than 28 days. This allows a few days for the CL to cease progesterone production and allow the hormonal cascade to kick into gear prior to the possibility or endometrial cups and eCG becoming present. If for example one waits until 33 days, and there is a 3 day lag before the CL is completely destroyed (as far as secretion is concerned) the mare's body may still be thinking it's pregnant at 35 days, and those endometrial cups may become active anyway... This does therefore raise the question as to the validity of doing a WeeFoal test, as that tests for eCG presence. Really, the only reliable result you could get would be a definitive negative. If you got a positive result, it would not necessarily mean that the mare was pregnant, merely that there was eCG present.

If she comes back into estrus and her cervix relaxes, then that is definitive. However, if she comes back into estrus and either you don't check the cervix or it is not relaxed, remember that around 10% of pregnant mares still display estrus.

Mare is a four-lettered word!! :~)
We're always happy to try and help, but don't forget to check the articles section
of the website too, which has a search engine to help you look for answers!
:)
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Re: Help For Next Year? JOS?

Postby silverlining » Fri Aug 31, 2012 8:54 pm

Jos wrote:Mare is a four-lettered word!! :~)


True Story!! Man oh Man. Ok, his is very interesting I didn't know all this about the endometrial cups.... so if I get a WeeFoal NO... then I won't think about it again, any WeeFoal yes, I call the vet and have him re ultrasound. :) This mare has a way of making everything more complicated and dramatic than necessary... (she's never had a baby before, but I've had her 10 years and all her training was "NO NO NO I WON'T DO IT!!" for a few days.... Followed by "oh jeese why didn't you just ask for that the first time this is so easy!!??" so it wouldn't surprise me in the least that she would be trying to torture me...

That said, I have myself prepared for her to either come back into heat or for the WeeFoal to be a no. The vet is well known in CT for repro and hasn't missed anything on an U/S yet so I'm sure I'm just wishful thinking.
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