I have a 16 year old TB mare that last foaled in '99. According to previous owner, was bred back in '99, reabsorbed, bred a second time and yeast infection was discovered. Was treated most of the year for that. Was cultured in March and biopsy done. Her vet said mare has an average chance of conceiving. Bred her for the first time this year 16 days ago, no baby. History of this breeding is: Prior to moving to repro vet's facility (July), mare was cultured and flushed with Gentamycin as a precaution as culture in March showed light multi-flora anestrus. Ovulated earlier than expected, so wasn't bred. The July culture came back as Strep Aureous and (Psuedomonas). Mare was recultured and had cytology done- both clean. Mare was given lutalyse to bring her back in. She was given HCG the day before breeding. She had Oxytocin injections and post Gentamycin flushes for two days post breeding. Ultrasound confirmed follicle and ovulation. Mare was put on Regumate at 5 days. Ultrasound for PG showed something in the left horn (she ovulated on that side) my vet said was scar tissue and the repro vet didn't know what it was. Said she'd never seen scar tissue on an ultrasound before. Afer all of this, my question is this: What now? Is there something I'm missing? Biopsy was done anestrus in March by previous owner and came back as well within B. My vet said something about DMSO infusion and upgrading the uterus one level? Thanks in advance.
Posted on Monday, August 07, 2000 - 09:48 am:
As this mare has only been bred once this season, I would not be hitting the panic button and using something like DMSO yet!
I can't really comment on the "scar tissue", but it does seem an unlikely location for it. What form did it take? Is the ultrasonographer absolutely sure that it is not a conceptus? Another possibility would be a resorbing conceptus. Pregnancies that have "fixed" high in a uterine horn are not usually viable, so this too is a possibility.
Has this mare re-entered estrus yet? If not, I would have another ultrasound performed to confirm she is definitely not pregnant. If she is now in estrus, I would feel inclined to breed again, and follow the same protocols you did before, except perhaps to us a less irritant antibiotic for the post-breeding infusion. The Aminoglycosides, of which Gentamycin is one, are fairly irritant to the uterus. You may wish to try something like Ticarcillin.
Repeat the Oxytocin therapy - and use it agressively. There is a protocol laid out on this site for it and can be found by clicking here.
Good luck, and let us know how you make out!
Posted on Tuesday, August 08, 2000 - 05:10 am:
Thanks Jos! Mare was ultrasounded at 15 days by two different vets. The area in question is about the size of a quarter. Both said she wasn't PG. My local vet said he thought it was scar tissue, the repro vet didn't know what it was. At this point, she is back with the repro vet, off Regumate and was given Prostin at what would have been day 16. She is pooling some fluid at this point and was flushed and Oxytocin was to be given the next day. I had previously read your article regarding it's use and discussed it with the repro vet. I will keep you informed. Thanks!
Posted on Tuesday, August 08, 2000 - 06:59 am:
Don't hesitate to use Oxytocin several times a day pre-breeding when she is in estrus. The half-life of Oxytocin is only 12 minutes, so in one hour it is almost completely inactive in the body. I would feel inclined to use it twice a day for the 3 days pre-breeding (just don't use it for a couple of hours prior to the actual breeding, or for four hours after), and not flush. Then follow up the breeding with the protocol in the article (including a flush/infusion).
Sometimes more can be achieved by preparing the uterus for semen deposit than by trying to create an hospitable environment after it's already there.
You also want to carry out a "minimum contamination breeding" - ideally AI, and only once. Every time you breed, there is an inflammatory response in the uterus - it's natural - but in these older mares with the delayed uterine clearance, which is what it sounds your mare has, it can cause major problems, so the fewer times you breed the better.
Thanks again Jos! Just spoke with repro vet and they are breeding today, so too late for the aggressive pre-breeding Oxytocin. She has been flushed with saline and given Oxytocin for a couple days prior. Culture and cytology again came back clean. She will be bred AI, but with raw semen. They collect the stallion, so it's as close to a live breeding as possible. She's been given Ovuplant to induce ovulation on the right side (follicles are 3.5 on left and just under 4 on the right). They were planning on checking her for ovulation Thursday am. and rebreeding if necessary. The stallion was to arrive at 11am. Will call about the oxytocin 4 hours after breeding. Should she still get the flush? And with what? 6 hours after breeding she should get more Oxytocin and then every 6 hours for two more times? (I did ask about the anomaly in the left uterine horn and was told it wasn't there any longer.)
Posted on Tuesday, August 08, 2000 - 12:46 pm:
Yes, she should still be flushed, but I would suggest that you follow with the Oxytocin at 4 hours post-breeding first, and again 6 hours later; followed by the infusion/flush between 4 and 6 hours after that; pause for 6 hours, then 2 more doses of Oxytocin 6 hours apart.
We like to use a non-aminoglycoside antibiotic - Typically Ticarcillin (6 grams) or "Timentin" as straight Ticarcillin is no longer available in Canada (6g Ticarcillin/200mg Clavulinic Acid); or Potassium Penicillin G (5 million IU). We use these in an intra-uterine infusion of about 50 cc of saline or sterile water, rather than in a high volume lavage.
Sounds like the structure in the horn could well have been a disintegrating conceptus.
Hi Jos. Just an update. No foal from two ovulations. Found fluid in the uterus. Repro vet said no fluid when she came home, but my vet says there is now. Stucture that was in the left horn is not there, but funny looking stuff in the right now. Pulled her off Regumate and called it quits for this year. Anything that should be done? My vet says let her rest, give her til late January/early February and do a biopsy and see where we're at. Looked at the results of a biopsy done in March anestrus: "Endometrial Fibrosis. Characteristics are well within the parameters for a Doig C. If biopsied during estrus there would probably be less fibrosis and the biopsy might well fall into the Doig B classification." Thanks, Robin
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