Is a biobsy more accurate than a culture+cytology when trying to detect a uterine infection or fibrosis? Would combining the three of them provide even more accurate information? Might be a silly question but does the mare have to be in estrus (relaxed cervix) to perform any of these tests?
The vet didn't perform a biopsy as I asked last year, and did a couple infusions (gentamicyn and iodine if I'm not mistaken) as a preventive aid on a mare that is a confirmed pneumovagina. But from what I've read from other posts, this could have made things worse if there was no infection going on.
Plus, from what I've read, an infusion should be a small amount of liquid (usually > 100ml). Is it normal then that this vet infused the mare with 1L each time?!? I'm not talking about a lavage here but an infusion.
Result is no pregnancy last year and hoping the mare can still carry a foal to term. This year will be my last year trying to breed this mare. I found a vet who is willing to perform a biopsy or whatever I ask.
I want to run the uterine tests soon in the season to treat an infection if needed. She will then be caslicked to keep things clean before breeding and we might use an ocytocin protocol if needed.
A biopsy looks specifically at the endometrial and endometrial surface cellular presence and condition, whereas a culture and cytology looks at bacterial presence (on the endometrial surface) and inflammatory cell presence. Consequently, they are looking at slightly different things. The maximal evaluation is going to be achieved with a biopsy and culture.
An endometrial swab is most commonly take during estrus when the cervix is relaxed, although it can be taken during diestrus with a tight cervix, but Prostaglandin F2α should be given after to cause the mare to come into estrus in case any contaminant is introduced during the swabbing procedure. A biopsy is most interested in the cellular condition likely to be present during pregnancy, so sampling during diestrus gives the closest comparison (with the above caveat about subsequent Prostaglandin F2α use), although sampling can be carried out at any time during the cycle.
An infusion typically places a smaller amount of a liquid into the uterus (50-100 ml) and leaves it there to find it's own way out. A lavage uses a greater volume of fluid (1-2 litres) and not only puts the fluid in but also drains it out again.
Use of Gentamycin and iodine on an unidentified "possible" pathogenic presence would be risky and may cause a subsequent superinfection.
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