Get a large bucket I prefer stainless steel. A transfer pump and an NG tube and some Betadine solution.
Fill the bucket with hot water or buffered saline ~50 degrees centigrade and add 3 to 5% betadine solution.
The equipment does not need to be sterile but good aseptic procedure should be followed.
Clean the mare as you would if you were going to inseminate her.
Insert the NG tube along with your hand through the cervix and pump the solution in until you can feel the folds of the uterus smooth out. This usually takes 2-3 liters on a barren mare and 3-5 liters on a post foaling mare. Then remove the tube from the pump and let the solution aspirate out via siphon. (I do this into a clean white plastic bucket so you can examine the aspirate for debris). You will feel the uterus involute around your had so rapidly that it will almost suck the OB sleeve off. Aspirate as much as possible out, and if the mare appears to be cramping from the distention of the uterus. I usually give 10ml Banamine IV just to make her more comfortable. I repeat this procedure every other day or until I can no longer pass my whole hand through the cervix. The resulting improvement in tone and lack of debris on ultrasound is quite profound. I then breed the mare on the subsequent cycle or short cycle her. I have found this approach so effective that it is the first thing that I do if I have a mare that will not conceive on the first or second exposure. Or if she shows fluid in the uterus on ultrasound.
Note: I have found it helpful to dedicate an NG tube for this purpose and I drill holes across the end of the tube. This seems to help prevent sucking up tissue into the end of the tube when performing this procedure. It probably don't matter, but making hickeys in the uterine wall just seems to me to be counter productive. I however, do NOT use Oxytocin in conjunction with this procedure because of the extent that the cervix is open there could be the chance of inducing a prolapse.
More than one Theriogenologist has told me that I was nuts for doing this. But what the heck it works for me. And I have found no negatives associated with the procedure other than some occasional cramping, that has been easily dealt with.
I have, on occasion flushed a foal heat mare on one day and inseminated her on the next when she had a viable follicle, and had her conceive from that exposure.
Opinions or differing views invited.
Posted on Thursday, January 04, 2001 - 06:47 am:
The protocol is sound, the medium and requirement level may not be.
Betadine is a moderate irritant, so essentially you are initiating an irritant therapy as a first line of defense. It is certainly true that there is a place for this in the Theriogenologists toolbox, but I would not reach for it as the primary tool.
You are not diagnosing, or even supposing the cause of the mare not settling (at least from the above description) and it is quite likely that it is something of a minor and more common nature, rather than something that is more serious such as mild-acute or severe-chronic endometritis, with varying degrees of fibrosis, for which this treatment might be appropriate.
Before reaching for the above, I would attempt to establish a cause for non-pregnancy. Probably the most common cause of which is a low to moderate presence of fluid in the uterus as a result of delayed uterine clearance either of (normal) post-breeding inflammatory response and/or fluid present in the uterus pre-breeding. The treatment above may well work for that, but so would 10 international units (usually one-half milliliter)of Oxytocin! I think that perhaps you might like to review the article that appears here and try that first.
Another intermediate step is the uterine antibiotic infusion, coupled with the Oxytocin therapy (it is outlined in the article).
My next line of defense would be to try a uterine lavage with a minimal irritant, such as saline.
If all that failed, I would probably contemplate moving to a treatment more closely related to that which you are describing.
You comment that you do not give Oxytocin because of the risk of prolapse, but you do not take into account the fact that the degree of stimulation of the cervix and endometrium that your treatment is going to achieve will result in the release of large amounts of endogenous Prostaglandin by the endometrium, which will in fact have pretty much the same effect as Oxytocin! Your success in using this protocol in post-partum mares is probably as much as a result of the Prostaglandin release initiated (causing uterine involution) as the lavage itself!
Personally I tend to subscribe to the view that little is better, and the least is best!
Jos perhaps I should clarify. The protocol described was poorly formatted, it actually was a copy of a e-mail that I sent to a vet in Colorado who had several problem mares that he had not been able to settle by other conventional means. I have used all the standard protocols over the years and most of the time have had good success with them. However this seems to be effective on those problem mares, who for what ever reason have not responded to the standard approaches. I agree with your description of the probable hormonal response, and it's for that very reason that I do not use Oxytocin in this instance. Crudely put, it would in my estimation be the equivalent of an excessive dose of Oxytocin in this instance and the potential problems that it could cause I would rather not deal with.
However I have been using Oxytocin both pre and post insemination for a number of years now and feel that it is a very effective approach with those mares that fall into the poor clearance category, and in fact I do use it post insemination on these mares as well just to insure that they do not retain any unneeded fluid post breeding. However I do not use it in conjunction with this treatment.
What I find interesting about it is that it has resulted in pregnancies in mares where nothing else has worked. This is not just a few problem cases but perhaps 40 or 50. Unfortunately I have not had the presence of mind to carefully document these cases so that the reasons could be more carefully studied. Since most of them have been mares who have gone for a long time without maintaining a pregnancy to term. I am doing that now and at some point perhaps someone will take a look at it and offer a definitive assessment of the value or lack there of. One case in particular was a 6 year old maiden mare who had been bred starting at the age of three and no one had been able to get her to maintain a pregnancy beyond 35 days. She had been evaluated at both New Bolten center and Mid Atlantic Equine referral reproduction center. All of which were unable to find a reason for this. I used this protocol on her and the result was positive. Now, I'm willing to accept that she may very well have achieved this same result had I not done anything, other than breed her. However the fact that she did after this treatment sure makes one think in that direction.
I will agree as I stated before that a number of therio people not the least of which is Steve Slusher of OK state have told me essentially the same thing that you have. However the results force me to keep coming back to this in cases where I feel it's appropriate.
Posted on Friday, January 05, 2001 - 12:54 am:
Now that you have clarified your use of this, I feel much more comfortable. In the circumstances you have now outlined, it is actually a standard procedure and has been written up in many veterinary text books. McKinnon and Voss' "Equine Reproduction", which is probably the leading veterinary text book on the subject at the moment, carries illustrations of the procedure as well as references to it in several different chapters. Other liquids are also used in a similar manner, for example hypertonic saline.
It is not, though, (as I now know, you know!) a first-line defense!
I have a problem with a late breeding. I took my friends mare to a breeder who stands a stallion that will NOT collect, only live cover. I took the mare with a 40 follicle, A-B cervix and was definitly in season. The mare is older and has not done live cover for 7 years. She did not tease well,in that I mean she didn,t break down for the stallion. I requested she tease her to a stallion who was a bit more aggressive and she had better results. However, she did not breed her because she did not feel she was ready. The mare was ultrasounded yesterday and has a cl, no longer in season. I am not familiar with live cover and have no idea what to do. I asked that she be given a prostin shot in a week after a vet check but if the woman is not going to breed her I am just wasting time and money. Is it possible that this mare just does'nt show well to the stallion? What then? Please help, I am not familiar enough with what has to go on before you breed the mare live cover. TIA.
Posted on Wednesday, October 03, 2001 - 12:22 pm:
Fallon- Your observations are on track. Teasing is a most important acpect of live cover. Not only is the stallion a factor, but the handler and their methods are as well. At this time in the year, many mares have a repressed reaction to the stallion, and a smaller window of opportunity to breed. The breeding manager must be aggressive and observant when teasing the mare.
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