Jos, I know this has been covered a zillion times out here and I have read the Regumate article.... My little bitty brain isn't really good at this sort of stuff and there seems to be a lot of conflicting opinions....
Both my mares up at Gumz Farms (KY) are now PREGNANT. They have both had two ultrasounds (one at 16 days and one at 28 days) and preganancy has been confirmed with the detection of the heartbeat, etc.
The one mare (who is NOT my "problem child" and maybe this is part of what is just "flooring" me) is being kept on Regumate and they are advising me she will need to stay on Regumate to maintain the pregnancy.
The exact statement they have now made to me twice is: Serenade By Skip is still on Regumate. We did a progesterone screen on her and it came back at 2.8ng/mL indicating that she does need to stay on Regumate.
Is this just something that we need to keep testing for when we get her home? Is there some point/level where she can go off it. My understanding is that this is the second time they have tested her and she was 2.8 on the previous test too.
These are my lunge-line futurity babies for 2010 and I want to be as totally careful and correct with these pregnancies as possible.
Hormone profiles vary throughout the day, and from day to day, so a single evaluation is not necessarily going to be an accurate representation of what is going on. If she had been retested 3 hours later, she may well have had adequate levels. And that raises another point - what is an "adequate level"? 4 ng/ml has been suggested as the lower threshold limit, but there is research out there that suggests that pregnancies will maintain perfectly OK on 2 ng/ml. Additionally, mares that are put on progestin supplementation tend to suppress endogenous secretion, so by giving a mare Regumate you may cause her progesterone levels to be lower (and Regumate does not assay as progesterone, as it's not).
When to cease using it? Well, if you've read the article about Regumate use then you'll know that the fetal-placental unit secretes progestins from about 120 days onwards - indeed, an ovariectomized mare can be given progestins up to 120 days after having an embryo transfered into her, and then from that point on will maintain the pregnancy with no trouble and no ovaries!
There is no answer to your question. At least, I'm not going to give you one... That call is all yours! I will say this though - we don't use Regumate except in very rare instances where we know there is a specific problem such as an incompetent cervix, and we have excellent pregnancy and live foaling rates... We do however use a fair amount of oxytocin to make sure that the uterus is nicely cleaned out after breeding - no fluids left behind to cause a low-grade endometritis that might impact CL function and interfere with progesterone secretion. And oxytocin is a lot cheaper than Regumate...
Jos, Update---- Okay, I have decided to continue this mare on Regumate up to approximately Day 120. We have tested her levels on numerous occasions and haven't been able to get anything over 2.8; therefore ---- I have purchased my big ole 1000 ml bottle of Regumate.
I have over $10,000 in stud fees, mare care, etc. to get these mares preggo so I am just going to go ahead and say another $250 or so isn't a big deal in order to try and be "safe" with the one.
Next question---- I will be giving her 10 cc/daily thru Day 120; that being said, I wouldn't think that you would just quit giving it to her on Day 120, like BAM! Stop! Shouldn't one sort of "ease" her off of it, like over the course of 10 days or so, maybe say 1 cc less per day until she is done (thru Day 130)?
I am thinking of such things as steriods, etc. and you don't just WHAM, stop giving those things (No matter what Rick Dutrow claims
I would think you would "ease" her off of them. My vet sort of just shrugs his shoulders and says, well....if you want to keep buying Regumate (which isn't an issue).
Catherine, I was told that if you ease off like you say, it's easier on the mare. I kept my mare on ReguMate the whole pregnancy, only because I also had over $10,000 in expenses and wasn't about to let hundreds keep me from doing everything possible to keep the pregnancy going.
It was more of insurance and my peace of mind, than anything else.
My vet suggested to reduce the amount by 1 cc every couple of days until the mare is completely off the ReguMate.
After reading the article on using Regumate [or not as the case may be] I have a question. If the previous owner kept the mare on Regumate and the mare just foaled in April, do I have to do it also? The article suggests that use of Regumate may make the mare dependent on it. Would just one year of use mean the mare could be dependent now? I prefer not to use it, of course. The mare settled on the first breeding so I am sure she is fertile. It has been suggested to me that I put the mare on Regumate for a few days before and after taking her on a two hour trailer ride to an Inspection in the middle of July. Actually they said to use Regumate and Banamine to help her deal with stress and heat. I am looking for some sort of cooling sheet that would stay cool for several hours. Anyone have any ideas on any of these ideas: Regumate dependence; Regumate for a few days, Banamine for the trip? Any advice is welcome
Long-term progestin therapy has been suggested as suppressing endogenous progesterone levels in mares over a long-term period after cessation of treatment. This has been seen for example in competition mares kept on progestin therapy for many years to suppress estrus behaviour.
Shorter term progestin supplementation of pregnant mares to allegedly "support" endogenous progestin levels has been shown to suppress endogenous secretion over a short-term period, thereby exacerbating the need to "support" with exogenous progestins.
Unfortunately there is no definitive answer to your question available without serial testing (3 or 4 times a day for 3 or 4 days in a row) as to whether you "need" to use progestin supplementation. If there was no obvious and defined reason for its use previously (e.g. incompetent cervix; levels confirmed <2 ng/ml for several sequential days etc.) the chances are good that you do not need it, but that leads to the eternal conundrum - if I were to say "you definitely do not need it" and your mare loses the pregnancy, who do you look to blame?
Stress in pregnant mares as a result of trailering has been demonstrated as not being significant enough to cause pregnancy loss under research conditions. Having said that, raising the internal core temperature of the mare, especially during early pregnancy has been demonstrated as capable of causing pregnancy loss, so in that type of a situation, in hot weather with a mare that stresses during transport, the transport itself may not be an issue, but the heating of the body core temperature may be. Unfortunately, giving a mare Regumate is not going to impact reduction of the core temperature...
In other stress situations (injury, sickness etc.) short-term progestin therapy has been shown to be beneficial in assisting pregnancy maintenance, and I am a firm believer of its use there.
As noted above though, there is really no single answer to your questions, all one can do is put facts before you and allow you to make your mind up based upon them, which I hope I have done here.
Thanks, Jos. It didn't make sense to think that Regumate would help for just a few days. I have found some "coldflex" sheets that can be used to maintain core temp. I hope to be able to adapt them to the mare. They are used on burn victims to reduce the heat in deep tissues. I think I can use this on the 2 hour trailer ride. I am looking into it for the July trip...
Well, we went to the Inspection; the weather was awful [97 degrees]. Now we are back and the question is whether taking the mare off the regumate will have a negative effect on her 51 day pregnancy. We put her on Regumate at the advice of the vet for a "few days before the trailering to the Inspection". I planned to stop the Regumate tomorrow but now worry that stopping abruptly could hurt the embryo. Maybe 6 days of Regumate will have no effect...I am hoping but would love some advice!
There's no research or definitive answer to your question. As previously noted, most mares don't need the progestin therapy anyway, so stopping it doesn't make any difference. If you are uncomfortable going "cold turkey", then "weaning" is a possibility - halve the dose every two or three days.
Jos I have a 24 year old mare that hasn't had a foal in two years. She is in great shape. So when I went to get her bred this year she was put on Progesterone (P4LA) by the vet. I give it IM every 7 to 10 days. After 150 days she started swelling up where the shot was given in the neck. The vet said that I will have to give the shot in her rear leg on a inside muscle. I don't like to give shots anyway, so can you change from the shot form to a oral form this late in the pregnancy? Want to keep her on the progesterone but don't want the shots. She is confermed in foal at 150 days.
Posted on Thursday, September 04, 2008 - 02:47 pm:
BET Pharmacy have a 30-day Altrenogest that you may want to discuss use of with your veterinarian. It is injectable, but only once every 30 days. It does tend to produce a localized reaction, but again, it's only every 30 days...
It is now generally not recommended to give injections in the neck, as there tends to be a greater risk if there is a reaction in that location, as drainage is poor. It's maybe not as much of an issue with a "thin" liquid such as oxytocin or prostaglandin, but with a thicker solution such as progesterone or altrenogest, other locations tend to be better. The location that we use the most (and allows for rotation) are the chest muscles - one on one side one day, and then the other on the next day. You might want to check with your vet about the use of the "rear leg on a inside muscle", as I suspect they mean the back of the leg muscle, not the inside (which would be pretty dangerous for the person giving it!).
You might want to review the article about Regumate use. One item of note that you may want to consider is that unless you are dealing with a specific issue such as Placentitis or an incompetent cervix, the feto-placental unit is secreting progestins (having taken over from the CL's present up to about 120 days), and research has shown that in the absence of specific issues (such as just mentioned) progestin supplementation is not necessary. Note that progesterone levels are meant to decline from about 90 days of pregnancy onwards, and to bottom out by about 150 days.
To answer your question specifically - there is no reason why you could not replace injectable progesterone with oral altrenogest ("Regumate"), but a better question to ask may be do you really need it?
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