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Use of Providone Iodine in lavage

Equine-Reproduction.com Bulletin Board » Breeding Problem Mares - Volume 2 » Use of Providone Iodine in lavage « Previous Next »


Author Message
 

Rachael W
Nursing Foal
Username: Lee

Post Number: 18
Registered: 06-2006
Posted on Friday, August 10, 2007 - 01:28 pm:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

An article written by a Dr Steven Brinkso on How to Perform Uterine Lavage, discusses the use of adding 5ml of 10% Providone Iodine per liter of saline solution as a treatment for mares with endometritis.
Has anyone tried this and were there resulting issues?
 

Jos
Board Administrator
Username: Admin

Post Number: 1494
Registered: 10-1999
Posted on Friday, August 10, 2007 - 10:21 pm:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

We frequently use a Betadine solution lavage (with other ingredients) in problem mares that warrant it with good success.
 

Rachael W
Nursing Foal
Username: Lee

Post Number: 19
Registered: 06-2006
Posted on Saturday, August 11, 2007 - 09:51 am:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

Okay - now you are prompting my next question! What other ingredients?
This is a mare that has been bred 2x with frozen and no success. She is not exhibiting good uterine tone. She is only 7 yrs old and has had 3 foals to date (barren this year). I had a culture and cytology done on her and they came back within normal limits. I have lavaged her after breeding each time and used the oxy protocol. She had a terrible reaction to the 2nd breeding however.
The vet that did the culture has suggested that I lavage prior to and post breeding this time and to use estrumate (up to 24 hrs post).

Do you have any other suggestions of things I could try?

I am breeding with frozen again. I know the semen is good and the mare in the past has been an easy breeder.
At the moment, she has a lot of edema coming in to heat but the follicle development is somewhat delayed. She used to ovulate on 50mm's and the last couple of cycles they have been more in the size of 42-45mm.
Thank you
 

cathy Cook
Breeding Stock
Username: Razmacat

Post Number: 355
Registered: 08-2005
Posted on Saturday, August 11, 2007 - 11:15 am:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

If you use Estrumate make sure she has not ovulated or that is a breeding down the tubes. If your mare is lacking tone, that screams Regumate 5 days post ovulation, make sure at 5 days post ovulation you ultrasound her to make sure she is clear of fluid before starting the Regumate.
 

Jos
Board Administrator
Username: Admin

Post Number: 1495
Registered: 10-1999
Posted on Saturday, August 11, 2007 - 11:18 am:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

You probably wouldn't want to use an irritant in the lavage such as iodine (or any other of the secret ingredients :-)) in this situation unless there are other factors that I am not aware of that would suggest its use. You want to keep the uterus "quiet" not create an immune response (which is what the irritants do).

If you have access to a stallion, I would collect semen, centrifuge it as hard as possible to remove the sperm (or most of them) and then freeze the remnant, which is primarily seminal plasma, in your regular household freezer. Do not use any extender or cryopreservant at any point in the processing. Freeze and thaw it 3 (three) times, and then on the final thaw, infuse about 5-10 ml into the mare's uterus at the same time as breeding. Seminal plasma has an ability to control uterine inflammatory response, but is removed during the processing of semen. The freeze/thaw processing without any cryopreservant will destroy any remaining sperm.

Still plan on lavaging and using the oxytocin protocol in addition to the seminal plasma treatment.

If the uterus is not showing signs of fluid pre-breeding, then probably there is little advantage to a lavage pre-breeding. If there is fluid present pre-breeding however, that opens a whole new chapter not dealt with above.

Post-breeding lavages should be performed no sooner than 4 hours post-breeding. You can lavage at that point and follow immediately with oxytocin.

Follicular diameter changes mean nothing - mares will change diameter at the time of ovulation, especially the closer to the height of the breeding season one gets.

Do be aware though that after 2 failed cycles that uterus is starting to get pretty tired for the season... :-(
 

Jos
Board Administrator
Username: Admin

Post Number: 1496
Registered: 10-1999
Posted on Saturday, August 11, 2007 - 11:26 am:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

"If you use Estrumate make sure she has not ovulated or that is a breeding down the tubes." Estrumate can be used safely up to 24 hours post-ovulation, and in fact some researchers suggest it is fine until 48 hours, although we prefer to err on the side of caution with 24 hours when using it. It's use will not cause the breeding to be "down the tubes"...

Regumate is not a "cure all". One is better off finding out why the uterine tone is poor rather than succumbing to a knee-jerk reach-for-the-Regumate reaction. We use very little Regumate, and have an outstanding pregnancy rate - especially with problem mares. When I say "very little", statistically speaking a few years ago we kept track of breeding older mares and we bred 40 mares that were in their 20's. We had an 80% pregnancy rate (above average) and 2 mares lost their pregnancies before foaling (which would be a pretty standard loss rate). Only one mare received Regumate! And that was because she had a torn cervix...

I know that there is a strong trend to Regumate use as a "snake oil cure-all" in problem mares, but I and other specialists (including most theriogenologists) will continue to lock horns and protest the over-use of the product... :-)
 

Rachael W
Nursing Foal
Username: Lee

Post Number: 20
Registered: 06-2006
Posted on Sunday, August 12, 2007 - 10:17 am:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

Thank you for all of the information Jos.
This is fascinating.

Would fresh semen - without it being extended or altered, have the same effect as what you are describing above with the seminal plasma that is created? Is this why there is generally less reaction to fresh semen?

She hasn't been bred since June - as the last cycle went at 42mm and I wasn't prepared for it and the prior cycle didnt'have satisfactory tone to be using frozen. She had her rest!!
 

Jos
Board Administrator
Username: Admin

Post Number: 1497
Registered: 10-1999
Posted on Sunday, August 12, 2007 - 10:53 am:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

The so-called "reaction to the extender" that we see mentioned not infrequently on the Internet is in fact a myth and typically is evidence of a mare that has delayed uterine clearance issues that are not being correctly managed. Unless the seminal plasma has been removed from extended semen, you are unlikley to see any difference between fresh and extended semen. There is however another important function of seminal plasma that will present an issue, and that is to protect the sperm from PMN's (neutrophils) that are present in the normal post-breeding inflammatory response. If one breeds a mare and elicits the inflammatory reponse and then breeds her again with extended semen within about 24 hours (while the inflammatory response is still active), the PMN's will bind to the sperm and prevent (the majority of) them from gaining access to the oviducts.

I'm a little puzzled by your observation that you didn't breed the mare as she "didn't have satisfactory tone to be using frozen"... At what stage of estrous were you evaluating tone? It would not be a defining factor in my decision to breed or not.
 

Rachael W
Weanling
Username: Lee

Post Number: 21
Registered: 06-2006
Posted on Sunday, August 12, 2007 - 08:04 pm:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

The evaluation of tone was based on breeding this mare 3 times in past years (with success) and by the time of ovulation - all edema had subsided and it looked great. Perhaps calling it 'tone' is not the right adjective - but her uterine body seemed sloppy and it atill had a small amount of fluid, just a step down from a pinwheel formation. It just didn't seem right and definitely wasn't the same view on the u/s as previous years.

Hindsight being the painful thing that it is- I probably should have given her oxy at that moment and waited an hour and bred her.

They do throw something new in every year though, I have to say.
 

Jos
Board Administrator
Username: Admin

Post Number: 1498
Registered: 10-1999
Posted on Sunday, August 12, 2007 - 09:21 pm:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

OK.. here are some salient points that might make you view things a little differently and will hopefully assist you in the future:
  • Uterine edema is normally present and peaks about 36 hours prior to ovulation and then subsides;
  • It is uterine edema that causes the "cartwheel" pattern seen on u/s;
  • One would expect the "cartwheel" pattern to be present but dissipate prior to ovulation in the normal mare;
  • Uterine tone is caused by progesterone. Progesterone is secreted by the CL, which is absent during estrus - hence there should not be tone to the uterus at any time during estrus;
  • Uterine fluid is a seperate issue completely and needs to be dealt with. The oxytocin protocol we promote has proven successful for many.
 

Rachael W
Weanling
Username: Lee

Post Number: 22
Registered: 06-2006
Posted on Monday, August 13, 2007 - 07:04 am:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

Thank you for your patience!

what would your action be, when the cartwheel pattern has not totally dissipated? This is breeding with frozen post ovulation. Administer oxytocin and wait 30 minutes to an hour and then breed?

I have followed the oxytocin protocol in your article and feel that has been one of the main reasons my mares have caught in the past 2 yrs. This year however, has been a particularly frustrating and non productive event.
 

Jos
Board Administrator
Username: Admin

Post Number: 1500
Registered: 10-1999
Posted on Monday, August 13, 2007 - 01:30 pm:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

If uterine edema has not dissipated by the time of ovulation, that is suggestive of a mare with delayed uterine clearance issues. I would therefore breed and manage closely for those issues.

Oxytocin should not be used within the about 2 hours prior to breeding or the four hours after. Doing so is likely to interfere with gamete motility (i.e. sperm getting up to the oviducts).

Some mares require oxytocin therapy prior to breeding as well as post-breeding. Those highly susceptible mares we will treat qid for 2 or 3 days prior to breeding, and then continue through until 3½ days after ovulation. This means that highly susceptible mares may be on oxytocin every 6 hours for as much as 6 or 7 days. We try to get them on a 6 and 12 rotation - 6 am; 12 pm; 6 pm; 12 am. We will then plan on breeding at 2 pm - 2 hours after their last oxytocin dose and 4 hours prior to the next dose (I suppose one could also breed at 8 am or 8 pm alternatively).

Some mares benefit from the addition of Estrumate "piggybacked" in between the oxytocin treatments on a 12 hour interval - if on the 6/12 rotation for the oxytocin, one could give the Estrumate at 9 am and 9 pm (or 3 am/pm if you're particularly masochistic! :-)).

I should also ask - if you are breeding post-ovulation, are you getting the semen into the mare within the 6 hours post-ovulation? Past 6 hours there will be an increase in EED - which is what you may be seeing.
 

Rachael W
Weanling
Username: Lee

Post Number: 23
Registered: 06-2006
Posted on Wednesday, August 15, 2007 - 02:56 am:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

Thanks again.
Yes-when the follicle starts to soften, they are in the stocks every 5 hrs, then when the follicle is starting to lose shape - it gets down to every 2-3 hrs. I feed them when they are in the stocks - so they tend to gain weight during all of this!
The Estrumate I have indicates that each 2ml = 500 microgram(I think this is what that symbol is representing). From this - would 0.5ml be appropriate dosage for uterine clearance purposes?
 

Jos
Board Administrator
Username: Admin

Post Number: 1503
Registered: 10-1999
Posted on Wednesday, August 15, 2007 - 11:50 am:   Edit Post Delete Post    Move Post (Moderator/Admin Only)

Up to 250 µg is the dosage recommended, so up to 1 ml at that concentration would be suitable. Note that oxytocin receptors (related to uterine contractility) tend to become less sensitive post-ovulation, which is why one would increase the oxytocin dosage to 20 iu from 10 iu post-ovulation (and it is likely there is relativity between oxytocin and prostaglandin receptors). It would therefore be reasonable to take the Estrumate dosage to the maximum recommended level of 250 µg post-ovulation.



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