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Older maiden with uterine fluid AND >20d pregnant?

Discuss all kinds of problems encountered in breeding mares from not standing for live cover, through to not getting pregnant for unknown reasons!

Moderator: Jos

Older maiden with uterine fluid AND >20d pregnant?

Postby Gaedingur » Fri Jul 22, 2016 1:55 pm

Hello, longtime lurker but first time poster.

History:
I have a 16yo maiden Icelandic mare that I have sent to a nearby breeding farm for live cover. AI is not an option with this particular stallion and rarely used in this breed. Most Icelandic horses are pasture bred, but this particular farm does breeding in-hand to prevent injuries to mare or stallion.

Mare has never been bred before this summer and is otherwise healthy. I had a "quickie" exam done on her when I bought her (basically palpating her uterus/ovaries to verify no obvious reproductive tract abnormality) but she did not have a full pre-breeding exam with culture/cytology.

On her first estrus, the stallion was unable to penetrate her. We hypothesize that this was due to a very tight cervix and possibly still being in a transitional heat cycle.

Next estrus right after the summer solstice, we got a successful single covering. She had a day or so of light bleeding but no fever or subsequent symptoms. We presume the bleeding was from her hymen.

Three weeks later, she had not returned to heat so the vet came out to do an ultrasound preg check. The vet reported a normal-looking conceptus in the left horn, but also "significant amounts" of uterine fluid. (I did not get an actual measurement in cm, but she described it as "2/3 of the uterus has some fluid visible".)

Since everything I've read (many threads on here, and almost every article on the main website) continually emphasizes that intraluminal fluid is a problem for the embryo, I decided to have the vet abort the current pregnancy (using Lutalyse) and the vet left us with some vials of oxytocin to clear fluid out post-breeding once the mare comes back into heat.

Lutalyse was given 6 days ago, which was day 21 for that embryo, and the mare has still not flushed the pregnancy or come back into heat. We are having the vet out again early next week, by then it will be day 28-30 from the first and only covering.

Other misc details: The vet is not a repro specialist. The breeding farm is in a remote'ish location and scheduling vets out is a bit difficult. I want to make sure I am educated ahead of time so that we can make a right and timely decision for this mare.

My questions, which are many:
1. IF the next ultrasound shows that the current embryo is still alive and developing normally for 28-30d age:
[*]Is fluid really a problem after successful fixation or after a certain gestational age? I seem to recall reading that it interferes with fixation and is a major cause of mares not "catching".
[*]Should the fluid be drained/cleared? Can this be done without disrupting the embryo up in the horn?
[*]Will there be a higher likelihood of other problems (like placentitis) if the fluid is left alone and the pregnancy actually makes it to term?
[*]Basically, is it doomed regardless? I normally don't mind taking a "wait and see" approach but I know that this pregnancy must be terminated earlier than 40 days (before cups) if we are to have a chance of trying again this season.

2. If the current embryo is no longer developing/doomed:
[*]What's the best method at this point to clean her out so that we can try again this summer? I do not know the dose of lutalyse that the vet used last week, but it obviously wasn't enough. I'm thinking uterine lavage (and maybe antibiotics?) to fully remove fluids and products of conception.
[*]If she comes back into heat, the plan would be a single live covering as early in estrus as the mare will stand for, then do oxytocin shots every 6h. Scan for successful fluid clearance 2(?) days after covering, and if necessary do a lavage to prep the uterus for the embryo popping down the chute on day 5. Is this a sound plan?


Any insight you can provide is much appreciated. Thanks in advance! :)
Gaedingur
Neonate
 
Posts: 2
Joined: Fri Jul 22, 2016 1:47 pm

Re: Older maiden with uterine fluid AND >20d pregnant?

Postby Jos » Tue Aug 30, 2016 5:18 pm

Gaedingur wrote:1. IF the next ultrasound shows that the current embryo is still alive and developing normally for 28-30d age:
[*]Is fluid really a problem after successful fixation or after a certain gestational age?


Presuming that the fluid identified was not the yolk sac, bit rather free fluid in the uterus, then yes. That is a problem.

[*]Should the fluid be drained/cleared? Can this be done without disrupting the embryo up in the horn?


It can't be done without disrupting the pregnancy.

[*]Will there be a higher likelihood of other problems (like placentitis) if the fluid is left alone and the pregnancy actually makes it to term?


As it's unlikely that the pregnancy will be maintained, this is somewhat of a moot point.

[*]Basically, is it doomed regardless? I normally don't mind taking a "wait and see" approach but I know that this pregnancy must be terminated earlier than 40 days (before cups) if we are to have a chance of trying again this season.


It's unlikely the pregnancy is still there after the prostaglandin. It's not uncommon for mares who lose their pregnancy after maternal recognition (about days 10-12 post breeding ovulation) to be a little out of sync and take longer to return to estrus. The magic day for endometrial cups is generally considered day 35/36, but the issue of the delayed return means that it is recommended that termination be performed no later than day 28.

2. If the current embryo is no longer developing/doomed:
[*]What's the best method at this point to clean her out so that we can try again this summer? I do not know the dose of lutalyse that the vet used last week, but it obviously wasn't enough. I'm thinking uterine lavage (and maybe antibiotics?) to fully remove fluids and products of conception.


See above for most of that. You're not going to see anything coming out of the mare - or at least it is very unlikely that you will. The chances are that when the mare catches up and returns to estrus, anything left will be cleared. Remember that nothing is attached at this point - placentation isn't started until about day 40.

[*]If she comes back into heat, the plan would be a single live covering as early in estrus as the mare will stand for, then do oxytocin shots every 6h. Scan for successful fluid clearance 2(?) days after covering, and if necessary do a lavage to prep the uterus for the embryo popping down the chute on day 5. Is this a sound plan?


Other than only breeding once early in the cycle, all sounds reasonable. Mares typically ovulate in the last 24-48 hours of standing (receptive) estrus, but will stand for 5-7 days. Sperm on the other hand are only viable for up to about 72 hours (although sometimes longer), so there's a risk of breeding too early and having no viable sperm present at the time of ovulation.

I suspect this is all academic now, as this was posted a while ago, but slipped through the cracks, for which our apologies. We monitor this board periodically, but for future reference, the Facebook EquineRepro Group is monitored by many all the time. I hope you made out OK. :)
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!
:)
User avatar
Jos
Senior Stallion or Mare
 
Posts: 3948
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Re: Older maiden with uterine fluid AND >20d pregnant?

Postby Gaedingur » Tue Aug 30, 2016 5:44 pm

Hello, I very much appreciate the reply, however belated.

Here is an update on the current situation:
As expected, the lutalyze did terminate the previous "pregnancy" (or whatever was left of it). We scanned the mare about a week later and the fluid was all gone and another follicle was coming up.

When that follicle ripened, she was bred once (live cover) on that follicle and came out of heat the next day. Vet came and scanned again 2d post-breeding and found "a little" fluid and gave a single shot of oxytocin. (I had been pushing the stud owner to do the oxytocin protocol with shots very 6h post-breeding but this mare is terrible about injections and basically they refused to endanger their staff trying to do as many shots as that would require. So, not ideal, but what's done is done.)

Mare has been on Regumate (10cc daily) since 2d post-breeding.

Last week we had her scanned again (15d post-breed) and there was a possible pregnancy black blob in the left horn and still some fluid mostly in the right horn. We are going to re-scan next week (31d post-breed) to see if it is still there and developing into anything viable, but I am not holding my breath.
Gaedingur
Neonate
 
Posts: 2
Joined: Fri Jul 22, 2016 1:47 pm

Re: Older maiden with uterine fluid AND >20d pregnant?

Postby Jos » Tue Aug 30, 2016 9:39 pm

Well, fingers crossed! :)

For future reference, one can use insulin syringes and needles to give the oxytocin - a very small and fine needle, with which most mares hardly even twitch when they receive the shot. As you will know from the article on the website, it needs to be given every 6 hours (and started 4-6 hours after breeding!), and we rarely have any issues using this method.

I am unsure if you are located in the US ("WA" could be Western Australia or Washington state! :) ), but if you are, BET Pharmacy in Lexington have a biorelease oxytocin formulation which only needs to be given twice a day and works well with most mares needing oxytocin to aid clearance.
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!
:)
User avatar
Jos
Senior Stallion or Mare
 
Posts: 3948
Joined: Sun Jun 10, 2012 12:11 am


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