This is a 17 year old, Arabian mare, who prior to 2007, had no breeding problems. She was purchased in foal in 2007, and aborted that foal at about 7 or 8 months. In 2008, she was aggressively treated for a number of things, and cleaned up. 2009 comes, she gets in foal easily, but does not maintain the pregnancy.
We did a culture, which was clean, and then a biopsy. I would like to get a foal from this mare, but have not been given any encouragement of the likelihood of that from the veterinarian. He stated that she was a good candidate for ET, but that simply isn't an option for me. I would like to know what you see in this report and if you know of anything that might help... apart from doing an ET.
DIAGNOSIS: Uterus: Moderate to marked chronic lymphoplasmacytic and mildly neutrophillic endometritis with hemosiderosis and luminal crystalline debris. Kenny Grade III.
DIAGNOSIS COMMENTS: At the time of biopsy, this is a grad III endometrium and prognosis for implantation and term gestation is considered to be guarded. Inflammation was primarily lymphocytes and plasma cells and no bacteria were noted along the lumen. Consider culture for thoroughness. There was hemosiderosis in the lamina propria consistent with early embryonic loss and significant amount of golden pigmented debris along the luminal surface. Does the animal have a discharge or abnormal lochia? (my note... no discharge) The amount of periglandular fibrosis is moderate to marked (trichrome). A better prognosis may be possible in this case if the inflammatory response and liminal debris can be controlled. Recommend an additional biopsy prior to future breediing attempts. End Quote
This biopsy was just done, immediately after receipt of a clean culture. Why would we need to turn around and do it again? I have spent thousands on this mare, and still would try something else within reason. I just can't justify throwing more good money after bad, if my odds of success are small. For what it's worth, this mare is being bred by live cover. Any help or suggestions would be greatly appreciated.
Honestly, for a Grade III uterus, I'd give up if you can't put a whole lot more money into her. They have a very small chance of getting in foal, AND maintaining the pregnancy. That biopsy report is consistent with the pregnancy loss. My vet basically told me to give up on my mare with a grade IIB, unless I was willing to throw a ton of money into her... which may happen... and still that's better than a Grade III.
Do you know her foaling history (how many, any complications, etc..)?
She has had 4 foals, 1999, 2000, 2001 and 2003. Thank you Samantha. As far as I know, that is all. It's a shame, as shes a very lovely mare with a beautiful pedigree. I felt that she would be a wonderful cross with my stallion. I'm with you, no point in throwing more money away. Maybe I can find someone who would want her for ET. That, I think, is my only option.
BTW, I was successful in getting a foal from a IIB, years ago. The mare had a lot of scar tissue in the uterus. After numerous TS attempts, I did live cover, put her on Regumate, and she had her one and only foal. She lives in Saudi Arabia now, as does her daughter. The daughter was small. I always felt that her size was the result of placenta deficiency.
A grade III biopsy score has a likelihood of live foal production of <10%. As Samantha has noted, you would probably be well advised to retire the mare as a broodmare, as you are likely to spend a lot more money on her and still have nothing to show for it.
If you decide to continue, you need to start back at the basics with some more diagnostics. A uterine swab not infrequently misses pathogens (or picks up contaminants) which is why is is essential that a cytology smear support the findings of a culture. The biopsy takes the place of the cytology smear, and has not supported the findings of your "clean" culture, so start again. You would probably be better having a low-volume lavage performed (50-100 ml sterile saline), capture the fluid on the way back out in a sterile receptacle, centrifuge it, and run your culture on the sediment. Make sure to culture not only for bacteria, but also fungal/yeast presence. The fact that there are neutrophils present is indicative of an active inflammatory response to something. You now need to find out what the "something" is and go from there.
Not only to you have something actively going on in the uterus, but there is also a long-term issue in the periglandular fibrosis. This is likely to negatively impact the pregnancy once placentation is initiated. In addition to identification and treatment of any pathogen present, if this were my mare I would also perform the uterine lavage with DMSO/Betadine that is referenced elsewhere on this board (search for "Betadine") as the DMSO may - note "may" - positively impact the fibrosis.
I would not breed this mare live cover! You want to perform a minimum contamination breeding by AI for optimal success.
If this were my mare I wouldn't plan on spending too much more money on attempting to get her pregnant...
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