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First AI Try Failed

Equine-Reproduction.com Bulletin Board » Breeding Problem Mares - Volume 1 » First AI Try Failed « Previous Next »


Author Message
 

Sharon Malmberg
Breeding Stock
Username: Ryu2832

Post Number: 118
Registered: 02-2006
Posted on Wednesday, May 10, 2006 - 11:00 pm:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

Well, the first try at AI with my mare has failed. We did an U/S today, day 15, no vesicle, a lot of inflamation, and a ton of fluid.

The vet took a sample for a culture, and flushed with Ringers (+ I think antibiotic). No activity on the ovaries due to the progesterone shot on day 8.

The mare got 1cc of Oxytocin 2x a day in the rump for five days post breeding starting 6hr post insemination, and was teased with the mini stallion everyday(she was ignoring him by the evening of insemination), and a progesterone shot on day 8.

The vet is thinking that she is not mounting a sufficient immune response early enough in the uterus to keep it clean after insemination.

We are discussing using a newer product that is put into the uterus to stimulate immune response (I don't know the name). And we are discussing prophylactic use of antibiotics administered IM to suppress infection after insemination. We are also discussing upping the dose of oxytocin to 1.5cc IM, or adminstering 0.5cc IV.


Any thoughts? Help!
 

Jos
Board Administrator
Username: Jos

Post Number: 10649
Registered: 10-1999
Posted on Wednesday, May 10, 2006 - 11:55 pm:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

I would start by altering your oxytocin protocol to the one that we have had good success with and recommend (follow that link). The use of oxytocin 2x per day has been shown to be insufficient in delayed uterine clearance mares. You wil note that the above protocol treats 4x per day starting 4 hours after breeding for as long as until 3½ days post-ovulation. Do not initially increase the dosage - it has been shown that 20 iu (typically 1-ml) results in a more systematic (and therefore effective) clearance than greater doses (Leblanc et. al.). Once ovulation has occurred though, you may want to increase the dosage to 20-30iu as the oxytocin receptors lose their efficiency. IV vs. IM really makes little difference, as oxytocin is such a small molecule that it is rapidly distributed through the body no matter what route of administration is used.

If there is a question about immune compromise, I would have concerns about giving a progestin. Progestins further suppress immune function and reduce ability to clear uterine fluids. Progesterone incidentally will not necessarily suppress follicular activity.

If there is significant fluid (>3cm in depth) present >24 hours post-breeding, it may be valuable to perform a uterine lavage at that time, followed by oxytocin treatment.
 

Susannah Hart
Weanling
Username: Glennedynmorgans

Post Number: 21
Registered: 10-2005
Posted on Thursday, May 11, 2006 - 10:56 am:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

Jos,

My mare did not have significant fluid present post breeding, but we had been having difficulty getting her in foal even though all of the other factors seemed to be in place. We did the lavage/oxytocin treatment with her and she is now 316 days pregnant! She caught on the fourth insemination in two years (2 each breeding season). When she is bred this year, I will have her lavaged again and then follow through with the oxytocin again. It was inexpensive and did the trick!

-Susie
 

Sharon Malmberg
Breeding Stock
Username: Ryu2832

Post Number: 120
Registered: 02-2006
Posted on Thursday, May 11, 2006 - 10:57 am:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

I tried the 4xper day last year, and we still had fluid. It doesn't seem that oxytocin alone is going to do the trick--or for this mare 1cc isn't enough.
 

Jos
Board Administrator
Username: Jos

Post Number: 10651
Registered: 10-1999
Posted on Thursday, May 11, 2006 - 01:05 pm:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

Some mares seem to benefit from oxytocin in the absence of fluid. We routinely use it in "problem" mares.

Increasing the dosage of oxytocin to more than 1 ml - as I noted above - has been shown to be detrimental to the clearance process. Ask your veterinrian to review the research on the subject performed by Dr. Michelle Leblanc before increasing the dosage. As also noted, if the fluid is >3cm in depth, lavage associated with the oxytocin will be more beneficial.

Have you had a culture and cytology performed on this mare? Culture alone is useless, and I would be suspicious of a pathogen being the cause of your troubles, especially a fungus or yeast.
 

Daniel Crouse
Weanling
Username: Sneakers17

Post Number: 43
Registered: 02-2006
Posted on Thursday, May 11, 2006 - 05:55 pm:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

one question what is the fluid called again? I knew it but can't remember.
 

Sharon Malmberg
Breeding Stock
Username: Ryu2832

Post Number: 121
Registered: 02-2006
Posted on Friday, May 12, 2006 - 11:20 am:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

The vet wants to take the mare to her clinic for the next breeding so she can more closely monitor by U/S, and be able to do lavages whenever it's needed.

The mare doesn't travel well, and hates to be stalled for more than 2 days in a row--but I don't think I have any better options. Hopefully she wouldn't be there more than a week.
 

Sharon Malmberg
Breeding Stock
Username: Ryu2832

Post Number: 128
Registered: 02-2006
Posted on Thursday, June 01, 2006 - 09:34 am:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

We smeared and cultured again after treating her for the first infection, and she has another infection with a different pathogen

She's had 5 lavages (5 days) with antibiotic(2l, 1l then 500ml manose, 3l, 2l, 1l). The manose really loosened the crud up and moved it out. She's been getting oxytocin 1.5ml 3x/day and it has taken care of the retained fluid problem(4x on the weekends, but I am at work during the day on week days). The last two lavages were draining clear. She was given a product called 'Settle' with the last liter on the 3rd lavage.

We are going to smear and culture Tues the 6th and do an U/S. We did an U/S a week ago (she should have had a follicle started), and there was no follicular activity. The fear is that she has stopped cycling regularly. She was given a shot, like Lutylse but not--starts with a C, on the 29th to try and get her going again.

The mare has excellent repro. conformation. The vet is somewhat at a loss as to how the mare keeps getting dirty. I work in a lab using sterile technique--and I don't see the vet doing anything that sends up any flags. I stood and watched her do everything, and she was completely by the book on cleaning the mare externally and handling the equipment.

Now I am running up against the stallion owners collection deadline. We have three weeks left to get her bred or she is going to go open another year!

I can't believe this....
 

Jos
Board Administrator
Username: Jos

Post Number: 10715
Registered: 10-1999
Posted on Thursday, June 01, 2006 - 01:40 pm:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

When you say "smeared" are you referring to a swab being taken or a cytology smear slide being prepared from the swab and read? If the latter, what does it show?
 

Sharon Malmberg
Breeding Stock
Username: Ryu2832

Post Number: 129
Registered: 02-2006
Posted on Thursday, June 01, 2006 - 02:25 pm:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

They are preparing a cytology smear slide and checking it before they send the culture swab off.

It is showing tons of neutrofils. The U/S on the 10th was very cloudy, tons of edema (4-5cm).
 

Jos
Board Administrator
Username: Jos

Post Number: 10718
Registered: 10-1999
Posted on Thursday, June 01, 2006 - 03:18 pm:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

Have they checked for presence of yeast? A bacteriology culture may not identify yeast growth. Yeast cells may be present on the cytology smear, but it may well be worth specifically requesting a culture growth for yeast.
 

Sharon Malmberg
Breeding Stock
Username: Ryu2832

Post Number: 130
Registered: 02-2006
Posted on Thursday, June 01, 2006 - 08:35 pm:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

I can ask if they have been, and I will request it specifically for the culture on the 6th.

The lab has been taking 10-11 days to get back results--is that normal?

To top it off, my vet was badly injured by an ill-trained yearling colt on Monday. I don't know when she's going to be ready for active duty. I have the backup vet (he takes care of my dogs, and has a smaller equine practice) coming out on the 6th.

Thanks for the help!
 

Jos
Board Administrator
Username: Jos

Post Number: 10723
Registered: 10-1999
Posted on Friday, June 02, 2006 - 12:27 am:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

Growing the culture usually takes about 72 hours (3 days). If it takes two days for the sample to get there (courier), and then the results are mailed back, that could add up to 10 days or so, but it would be longer than I would like if it were the lab I was working with...
 

Sharon Malmberg
Breeding Stock
Username: Ryu2832

Post Number: 131
Registered: 02-2006
Posted on Friday, June 02, 2006 - 08:53 am:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

They're in state, so shipping is 1 day max, and they are faxing results back...I think it's taking too long--we miss a cycle everytime we culture.

So frustrated...
 

Rousseau
Weanling
Username: Epona5

Post Number: 34
Registered: 01-2006
Posted on Friday, June 02, 2006 - 01:21 pm:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

could you verify your oxytocin dosage, and speak in IU rather than ml, I am in Europe, and here the oxytocin comes in 10 IU for 1 ml, so 2 to 2.5 ml is the dose, just a thought...
 

Jos
Board Administrator
Username: Jos

Post Number: 10728
Registered: 10-1999
Posted on Friday, June 02, 2006 - 01:55 pm:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

It does seem a long time then. You might want to ask your vet why it's taking so long, and if there is another lab. to send them to that is faster in turnaround.
 

Jos
Board Administrator
Username: Jos

Post Number: 10730
Registered: 10-1999
Posted on Friday, June 02, 2006 - 02:24 pm:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

The article on this site that discusses the oxytocin protocol gives the treatment dosages in i.u.

In North America the typical oxytocin concentration in the veterinary product is 20 i.u./ml (human products - pitocin - are different).
 

Sharon Malmberg
Breeding Stock
Username: Ryu2832

Post Number: 132
Registered: 02-2006
Posted on Monday, June 05, 2006 - 09:12 am:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

The three previous cultures did not have a yeast culture done. I've talked to the vet, and let her know I wanted the yeast culture done.

Also, I have heard that short cycling can increase the EED percentage depending on the size of the follicle when it's given--any truth to that?

Thanks,
Sharon
 

Jos
Board Administrator
Username: Jos

Post Number: 10736
Registered: 10-1999
Posted on Monday, June 05, 2006 - 01:27 pm:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

No truth to the EED story that I'm aware of.

What is true is that if prostaglandin is given when there is a follicle >2 cm in diameter present on the ovary, a rapid onset of estrus may occur (more rapid than anticipated), and in some cases this results in an ovulation as early as 24 hours after administration of the drug. These cycles that result from a rapid onset carry about 50% of the pregnancy rate that the "regular" onset period cycles do. This is not related to EED, but in all probability condition of the uterus not being suitable to accept (and eliminate excess) semen, having not gone through several days of "conditioning" (there are other likely reasons too, but that's an easy one to explain).
 

Sharon Malmberg
Breeding Stock
Username: Ryu2832

Post Number: 134
Registered: 02-2006
Posted on Wednesday, June 07, 2006 - 09:23 am:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

Well, we got the mare cultured. Hopefully will have results back in 72hrs (using a different lab) and are checking for yeast.

The U/S looked good. She's got three follicles started, no extra fluid, the cervix is still pretty firm. Looks like we might not have to short cycle, hopefully she won't hang us on a weekend again.

I think I would like to try a 6hr post breeding lavage with Gent. this time. Then go to the oxytocin protocol.
 

Jos
Board Administrator
Username: Jos

Post Number: 10746
Registered: 10-1999
Posted on Wednesday, June 07, 2006 - 07:28 pm:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

Why are you considering using Gentamycin? It tends to be a highly irritating antibiotic and one I prefer not to use on a breeding cycle if I can avoid it. Is there an indication that an antibiotic lavage is required? If not, you run the risk of creating problems. If you treat the mare with an antibiotic - any antibiotic - and she has a yeast infection, you will be likely to cause a yeast "bloom" as antibiotics stimulate problems with yeasts.
 

Sharon Malmberg
Breeding Stock
Username: Ryu2832

Post Number: 136
Registered: 02-2006
Posted on Thursday, June 08, 2006 - 09:31 am:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

I guess I was't specifically wanting to use Gent. I sould have stated lavage with antibiotic. My vet nixed the idea of any post breeding lavages, so we won't be doing any.

I just think that we are doing the same cycle with the same result over and over. We clean her up, inseminate, she gets infected, repeat.

Granted we don't know if it's a yeast problem yet. Lets say it's not--isn't it time to try something else?

I guess it was The Dirty Mare article that got me thinking in this direction.
 

Jos
Board Administrator
Username: Jos

Post Number: 10752
Registered: 10-1999
Posted on Thursday, June 08, 2006 - 11:40 am:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

I think you need to do good diagnostic work before treating at random! :-) You've started on the diagnostic road with the new culture, so hang in there!
 

Sharon Malmberg
Breeding Stock
Username: Ryu2832

Post Number: 139
Registered: 02-2006
Posted on Monday, June 12, 2006 - 11:35 am:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

She has come back clean for bacteria and yeast. I am cautiously optimistic that the last round of treatment knocked out whatever was the problem.

She has a 3.2 this morning, and it is the 'driest' I have ever seen her uterus. The vet would like to see a little more edema and a 3.5 tomorrow.

I've got my lucky bottle of oxytocin ready, and I am ready to make a pincushion out of her rump!
 

Jos
Board Administrator
Username: Jos

Post Number: 10779
Registered: 10-1999
Posted on Monday, June 12, 2006 - 11:42 am:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

Use 1-ml insulin syringes (available from drug stores, although you may need a prescription from your vet in some States); and use the muscles in her chest, or even her neck. Insulin syringes have such a small needle that most mares don't even notice the prick more than they would a fly bite, and therefore don't mind it (much).
 

Jos
Board Administrator
Username: Jos

Post Number: 10780
Registered: 10-1999
Posted on Monday, June 12, 2006 - 11:45 am:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

I should add in reviewing this thread, the the neutrophils found on the cytology slide were there for a reason - has any causative agent (pathogen, foreign body etc) been found and eliminated?
 

Sharon Malmberg
Breeding Stock
Username: Ryu2832

Post Number: 140
Registered: 02-2006
Posted on Monday, June 12, 2006 - 04:41 pm:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

We cultured 5 times this season. We found bacteria the 1st, 3rd, and 4th cultures. It was a different bacteria each time.

As far as answering the question as to why she was failing to clear fluid and getting infected in the first place, I don't think we have really answered that. And maybe still haven't solved the problem. The Oxytocin seems to be working on her at 1.5cc IM. We've have very good clearance during this last series of lavages.

We've been working on getting her clean for 1.5 months. She's got a good follicle, good looking uterus and a 'clean' culture--you got to go for it, don't you?

My bet would be that she had a very stubborn low grade infection she was fighting off for who knows how long. She was on Regumate 10 out of 11 months with her last foal--maybe it was for placentitis that never got cleared up after. Hence the small amount of fluid always present in her uterus even when she was supposed to be 'clean', and the number of neutrofils always present.

I did not see any foreign bodies in the evacuated lavage fluid. I suppose it is possible that there was a small foreign body causing problems, but nothing was identified by U/S.

The vet was very aggressive with her treatment for the last infection and my hope is that we have finally whipped whatever it was. (My checking account certain hopes we got it this time!)

She is excellent about her shots IV and IM, she's got that going for her at least. Just to be different she prefers her IM injections in the rump. I usually use a 1inch 22gauge on the apple of her rump near the tail. She lets me walk up and stick her, no fuss. I went a little nuts at the vet supply store and bought 50 syringes/needles this last time. (I think it's a siege mentality finally setting in.)

I wish there was a Eureka! moment, but we don't have one yet.
 

Sharon Malmberg
Breeding Stock
Username: Ryu2832

Post Number: 141
Registered: 02-2006
Posted on Tuesday, June 13, 2006 - 10:22 am:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

Her follicle has stalled out at 3.2 (same as yesterday)...we might not get this done.



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