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For those of you who are unfamiliar with VIN CE, below you will find samples of 2 different Message Board discussions and a short excerpt from the transcript of the real-time conference room session for the Equine Reproduction course.

From the message boards ...

Thread: Uterine Lavage
Created by Simon Otto:
There was lots of discussion re uterine lavage around the time of breeding. I have a few questions:

  1. How many days post-ovulation can you lavage for? (I believe I have used q12h up to 5 days, but it has been a while).
  2. Should we give oxytocin if we are performing a lavage immediately pre-breeding?
Response by Michelle LeBlanc:
I lavage the uterus once daily for 2 to 3 days after ovulation. I am concerned that repeated manipulations through the vagina may induce an iatrogenic infection -- as the vagina contains large quantities of bacteria. If a mare still has fluid in her uterus 2 to 3 days after ovulation, pregnancy rates decrease. Oxytocin loses its effectiveness 3 to 4 days after ovulation, as the number of oxytocin receptors decrease after ovulation.
Additional Question from Robert Lynch:
When is uterine fluid a problem? In the 2003 AAEP proceedings Dr. Brinsko described a 2cm depth of fluid at estrus as significant. When can this fluid be ignored or managed with ecbolics alone and when is lavage necessary?
Response by Michelle LeBlanc:
I take into consideration the type of mare that I am breeding, when I evaluate uterine fluid. If there is a small amount of fluid (less than 0.5 cm in a mare with a foal at side), I don't lavage before breeding, but I will after breeding. If it is a maiden mare that will be bred with frozen semen and her cervix is tight, I lavage before breeding and start her on Estrumate. If there is fluid in a barren mare, or a mare that had bacteria isolated from her uterus the cycle before, I consider it a problem and will lavage the uterus and sometimes re-culture. In my opinion, you need to put all your findings together and consider the age, status of the mare, and type of semen to be used when dealing with mares that have uterine fluid.

Thread: Mannose Treatment
Created by Jennifer Schwind:
I'd like opinions from the collective concerning Mannose uterine treatment. I used this on my own mare (with a persistantly Strep infected uterus) last year causing a purulent vaginal discharge, and I used it again this year to get reflux of increasingly cloudy to overtly purulent(-looking) material. Eventually the reflux cleared, I also treated with appropriate antibiotics, and the post-treatment culture was negative. I was, needless to write, concerned about the discharge and wondered if others had this experience?
Posted by Lee Webb:
Started using Mannose this season. Am very pleased with results on resistant infections, especially candida. Have used the product pre and post breeding in roughly 12 mares with no side effects. Did you do a cytology on the discharge/check for fungal organisms? Is this mare a urine pooler?
Posted by Becky Lundgren:
For those unfamiliar with mannose treatment, here is some background information -

Use of specific sugars to inhibit bacterial adherence to equine endometrium in vitro.
Am J Vet Res 61[4]:446-9 2000 Apr
King SS, Young DA, Nequin LG, Carnevale EM OBJECTIVE: To determine whether specific sugars inhibit adhesion of Streptococcus zooepidemicus, Pseudomonas aeruginosa, and Escherichia coli to equine endometrial epithelial cells in vitro. SAMPLE POPULATION: Endometrial biopsy specimens collected during estrus from 7 healthy mares. PROCEDURE: Endometrial specimens on glass slides were incubated for 30 minutes at 4 C with suspensions of S. zooepidemicus, P. aeruginosa, or E. coli in phosphate-buffered saline solution (PBSS) alone or with various concentrations of D-(+)-mannose, N-acetyl-D-glucosamine, N-acetyl-D-galactosamine, D-(+)-glucose, galactose, or N-acetyl-neuraminic acid. Inhibition of bacterial adherence was determined by comparing adhesion of bacteria (i.e., percentage of glandular epithelial cells with adherent bacteria) suspended in each sugar solution with that of bacteria suspended in PBSS. RESULTS: Mannose and N-acetyl-D-galactosamine inhibited adhesion of E. coli and P. aeruginosa to epithelial cells, whereas only mannose inhibited adhesion of S. zooepidemicus. The other sugars did not affect bacterial adherence. CONCLUSIONS AND CLINICAL RELEVANCE: Mannose and N-acetyl-D-galactosamine appear to play a role in adhesion of S. zooepidemicus, P. aeruginosa, and E. coli to equine endometrium. In horses with uterine infections, use of sugars to competitively displace bacteria from attachment sites on cells may provide an adjunct to antibiotic treatment.
Response by Michelle LeBlanc:
It is important that the mannose be removed from the uterus after a short period of time. It is a sugar that bacteria will attach to as it is a source of energy for the bacteria. If the Mannose is left in the mare's uterus for more than 30 minutes to an hour, the supplemental energy from the Mannose may result in bacterial multiplcation. Vaginal discharge appears to be pus. This discharge may be generated from the white blood cells, or the continued presence of bacteria. It is important that the concentration of Mannose is appropriate (see the reference in the reply above) for the bacteria that you are treating.
Posted by Jennifer Schwind:
Dr. LeBlanc, Thank you for that piece of info. When I used Mannose on my mare last year, I did not remove it immediately. This year, I infused it, then refluxed immediately. I was 'impressed' with the appearance of the reflux. As I stated in my original post, the mare did culture negative after treatment, so it was successful.
Posted by Jennifer Schwind:
Dr. Webb, This mare did not have a fungal infection nor is she a urine pooler. I did not do a cytology on the reflux, especially on the fourth treatment that appeared so bad. But as I wrote, the mare did culture negative after treatment. Another point is that when I did a saline lavage of the uterus after the last treatment with Mannose, the reflux was clear. Thanks for your expertise.

From the Real-Time Conference session...
If you won't be able to attend one of the real-time sessions for your CE course, you can read the full transcript of the session in the course library later. Here's a short excerpt from the recent Equine Reproduction: Infertility Topics joint VIN CE and AAEP course.

KathyJames: I think we'll start things off tonight with a question for Dr. Zent... I am interested in synchronizing my broodmare's estrus cycle. How is the best way to do this?
WalterZent: The gold standard for estrus synchronization is the use of progesterone and estradiol injections. The mare must be cycling in order for any synchronization to work. Progesterone and estrogen (P&E) is given for 10 days at a rate of 150 mg of progesterone in oil and 10 mg of estradiol in oil daily. Prostaglandin in given on the 10th day and the mare will usually ovulate between the 19th and 21st day from the start of treatment. Regumate can be given orally but it will not give as tight a synchronization.
JohnSteiner: I'd like to follow up on that with Dr. Zent. Can you explain the criteria that you use in the selection of mares to implement this synchronization technique?
WalterZent: I typically base the use of this technique on my rectal palpation findings with mares producing structures of 25 mm or greater to achieve successful results.

I have a question for everyone here tonight. How many of you have used progesterone and estradiol to synchronize your mares in private practice? Please answer Yes or No.

NO - 55
WalterZent: It appears that not many people are using this method. Why aren't people using it?
WalterZent: Interesting comments. Thank you.




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