Mixed-Effects Modelling of the Risk Factors Associated with Multiple Pregnancies in Thoroughbred Mares

Simple Summary

Multiple pregnancies (MPs), or twins/triplets, are commonly diagnosed in pregnant mares. Whilst some studies have identified factors associated with an increased risk of MPs, they have only looked at each factor individually and not accounted for the effects of factors when they occur together. This study used statistical modelling to identify risk factors for MPs, looking at 27 factors as well as the contribution of the mare, stallion (both proxies for genetics), farm, and veterinarian. We found that multiple ovulations and the use of a drug that mimics prostaglandin F2α to induce oestrus, both increased the risk of a mare having an MP. Mares that had a foal that same year, had a uterine cyst, or who did not get pregnant on the first cycle they were bred on were at a decreased risk of having an MP. Factors that impact the early embryonic environment are more important influences of multiple pregnancies when compared to the genetics of the mare. The increased incidence of MP but not MOs over the previous decades may well reflect improved management of the endometrium as opposed to selection of mares with increased risk for MPs. A limitation of the study is the reliance on clinical records being completed accurately.

Abstract

Multiple pregnancies (MPs) are commonly diagnosed during breeding management of mares. Whilst some studies have reported on factors associated with the risk of MPs, few have utilised multivariable data analysis to control for confounding variables. A prospective cohort study of Thoroughbred broodmares was conducted with information collected on 27 factors. Mixed-effects logistic regression was used to determine risk factors for MPs. Mare, stallion, stud, and veterinarian were evaluated as random effects. The prevalence of MPs in 1754 mares and 2245 pregnancies was 16.06% (95% confidence interval [CI] = 14.54, 17.58). Multiple ovulations (OR = 15.57, 95% CI = 11.88, 20.53) and treatment with cloprostenol (OR = 1.35, 95% CI = 1.015, 1.80) were associated with increased odds of MPs following multivariable analysis. Mares that foaled at the start of the breeding season (OR = 0.66, 95% CI = 0.47, 0.94), conceived at the second or more oestrus cycles (OR = 0.60, 95% CI= 0.43, 0.84), or identified with a uterine cyst (OR = 0.63, 95% CI = 0.40, 0.97) were at reduced odds of conceiving MPs. Mare, stallion, stud, and veterinarian were not associated with MPs. These findings provide possible explanations as to why the prevalence of MPs but not MOs have increased over the last decade.

Doppler Ultrasound in the Reproduction of Mares

Doppler ultrasonographic (US) is a method that provides real-time information on vascular architecture and hemodynamic aspects of blood vessels. It can determine the presence, direction, and speed of blood flow, being subdivided into the categories of color Doppler (color flow and power flow) and pulsed Doppler. The objective of this chapter was to compile data from several studies addressing the use of US Doppler correlated with pathophysiological phenomena of equine reproduction. Initially we decided to describe the technique, advantages, and disadvantages of each Doppler mode. Then the applicability of US Doppler in mares related to equine reproduction. Thus, within this chapter, you will find the form of use and descriptions of studies carried out on vascular perfusion of the follicular dynamics, the corpus luteum, the uterine segments, which we have divided into post-insemination evaluation, endometritis diagnosis and pregnancy diagnosis. So, we hope that this chapter will expand the knowledge about US Doppler and increase the number of veterinarians who will introduce the technique into their practical routine.

Female age and parity in horses: how and why does it matter?

Although puberty can occur as early as 14-15months of age, depending on breed and use, the reproductive career of mares may continue to advanced ages. Once mares are used as broodmares, they will usually produce foals once a year until they become unfertile, and their productivity can be enhanced and/or prolonged through embryo technologies. There is a general consensus that old mares are less fertile, but maternal age and parity are confounding factors because nulliparous mares are usually younger and older mares are multiparous in most studies. This review shows that age critically affects cyclicity, folliculogenesis, oocyte and embryo quality as well as presence of oviductal masses and uterine tract function. Maternal parity has a non-linear effect. Primiparity has a major influence on placental and foal development, with smaller foals at the first gestation that remain smaller postnatally. After the first gestation, endometrial quality and uterine clearance capacities decline progressively with increasing parity and age, whilst placental and foal birthweight and milk production increase. These combined effects should be carefully balanced when breeding mares, in particular when choosing and caring for recipients and their foals.

Endometrial angiogenesis induced by uterine insufflation with an oxygen-ozone gas mixture in mares

Ozone (O₃ ) therapy has been used to improve peripheral tissue oxygenation in humans and domestic animals. The goal of the present study was to characterize histological changes in the endometria of healthy equines following tissue exposure to gas mixtures enriched with different concentrations of O₃ . Cycling mares without endometrial degeneration were divided into three groups according to treatment (n = 9 mares/group). The uteri from the O₃ , ½O₃ and control groups were insufflated for 3 min with gas containing 42, 21 and 0 μg O₃ ml^-1 , respectively. Treatments were performed every three days from D0 to D6. Endometrial samples were collected immediately before the first treatment and 24 hr after the last treatment. The following nine histological parameters were evaluated: (i) the number of endometrial blood vessels, (ii) endometrial vascular degree (EVD), (iii) increase rate of blood vessels, (iv) increase rate of EVD, (v) glandular total area, (vi) glandular lumen area, (vii) intraglandular secretion area, (viii) glandular epithelial height and (ix) luminal epithelial height. In the O₃ group, a positive effect from treatment (p < .01) was detected for all vascular parameters (i, ii, iii and iv), glandular total area, intraglandular secretion area and glandular epithelial height. Compared to the control group, the ½O₃ group had greater (p < .01) EVD (84.1 ± 12%) and a higher increase rate of blood vessels (151.9 ± 47.1%). Uterine insufflation with low or intermediate concentrations of the O₂ -O₃ gas mixture induced endometrial angiogenesis. Morphometry, but not morphology, of the endometrial glands was affected by local O₃ therapy. These findings would be of great significance for the development of new therapies for infertility in mares.

Uterine hemodynamic patterns, oxidative stress, and chromoendoscopy in mares with endometritis

This study aimed to evaluate the use of Doppler ultrasound for determining alterations in uterine thickness and uterine arteries, use of chromohysteroscopy in evaluating endometritis with biopsies, and the impact of endometritis on oxidative and hormonal status. Twenty Arabian mares were divided into control and endometritis groups. Each underwent a physical examination, Doppler ultrasound, chromoendoscopy, and uterine biopsy. Blood samples from each animal were collected for hematologic, hormonal, and oxidative analysis. Results revealed a significant increase in estradiol, malondialdehyde (MDA), and nitric oxide metabolites (NOMs) associated with a significant decrease in progesterone and total antioxidant capacity (TAC) in the endometritis group. There was a significant difference in uterine thickness in the endometritis group. Uterine blood flow analyzed by color mode showed a significant increase in the endometritis group, while the spectral mode showed a significant increase in Doppler velocities and blood flow rate accompanied by a significant decrease in Doppler indices. The endometritis group showed ridged, bluish color in the endometrial wall, indicating hyperemia. Biopsy showed mononuclear inflammatory cells and edema in the endometrial interstitial tissue with sloughing of the epithelial lining. Conclusion: Endometritis in mares is associated with oxidative processes and presents with an increase in MDA and NOMs and a decrease in TAC. Doppler ultrasound improved endometritis diagnosis because it showed alterations in uterine vascularization. Chromoendoscopy improved the accuracy in taking biopsy samples because it allows the practitioner to select appropriate areas for biopsy to improve histopathological diagnostic outcomes. Therefore, this technique is worthy of further study in the field of veterinary equine reproduction.

Acute endometritis induced by Escherichia coli in mares evaluated through color doppler ultrasonography

ABSTRACT The objectives of this study were to characterize the endometritis induced in mares using color Doppler ultrasonography and traditional exams. Experiment 1. Mares (n=20) were submitted to intrauterine inoculation with Escherichia coli. Uterine evaluation was performed at M0 and M1. Experiment 2. Animals were divided into two groups: control group (n=10), and treated group (n=10) using phytotherapeutic solution. In both groups, the uterine evaluation was performed at time T1, T2, and T3. Experiment 3: Uterine evaluation was compared after antibiotic therapy, phytotherapy, and M0. For statistical analysis, the Tukey test, t Student, and Anova test were applied. Experiment 1. The mean values of vascularization at M1 were significantly higher than those obtained at M0 (P<0.05). Bacterial growth was observed in all samples collected. Experiment 2. The mean value of vascularization at time T1 in both groups was significantly higher (P<0.05) compared to M2 and M3. Experiment 3. After antibiotic therapy, the vascularization of the body and uterine horns was not equivalent to the vascularization presented at M0. We can conclude that it was not possible to correlate results obtained by color Doppler ultrasonography with the traditional findings for the diagnosis of endometritis.

Power Doppler can detect the presence of 7-8 day conceptuses prior to flushing in an equine embryo transfer program

In order to determine whether differences in uterine blood flow between pregnant and non-pregnant mares can be used to predict the presence of the equine embryo prior to flushing in an embryo transfer program, power Doppler ultrasonography was used on a total of 52 mares on days 7 or 8 post-ovulation. Computer analysis of Doppler images was subsequently performed using ImageJ v1.48 software. Vascular perfusion of the endometrium was analyzed using spot meter techniques, measuring mean pixel intensity and area of blood flow. Mares with positive flushings presented a higher uterine blood flow area (one embryo: 54.01 ± 2.27 mm² or two embryos: 61.01 ± 6.73 mm²) prior to embryo recovery compared to barren mares (21.77 ± 2.22 mm²) (p≤0.05). However, significant differences in vascular perfusion were not detected between single or twin pregnancies. Blood flow area appears to be a good predictor for differentiation between pregnant and non-pregnant mares with an AUC: 0.869; p≤0.001 and an optimal cut-off value of 37.21 mm². Both the mare's age and day of embryo recovery caused effects on uterine vascular perfusion. According to Youden's J statistics the uterine blood flow area of young pregnant mares was greater than 25.4 mm² on day 7 (with a sensitivity of 75% and a specificity of 87.5%) and greater than 21.02 mm² on day 8 post-ovulation (with a sensitivity of 93.8% and a specificity of 100%). The uterine blood flow area in adult pregnant mares was greater than 41.4 mm² on day 7 (with a sensitivity of 80% and a specificity of 85.5%) and greater than 35.55 mm² on day 8 after ovulation (with a sensitivity of 97.2% and a specificity of 85.7%). Evaluation on day 8 is therefore considered to be more reliable. Older and middle aged pregnant mares (5-18 years old) had increased uterine vascularization compared to young pregnant mares (2-5 years old) (p≤0.001). Conversely, older barren mares showed higher endometrial vascularity (35.06 ± 2.56 mm²) than young (17.21 ± 1.26 mm²) and middle aged non-pregnant mares (23.84 ± 1.50 mm²) (p≤0.05). We hypothesized that the higher blood flow area seen in older barren mares may be a consequence of a subclinical endometritis due to repeated flushing for embryo recovery. The results of the present study indicate that power Doppler ultrasound combined with computer assisted analysis of images are reliable techniques to detect early pregnancy prior to embryo recovery.

Power and colour Doppler ultrasonography for evaluation of the ovarian and uterine haemodynamics of infertile mares

The present study was undertaken to investigate the haemodynamics of the ovary and uterus in infertile mares using power and colour Doppler ultrasonography. Forty-seven Arabian mares were handled in the current work through several examinations. Based on the breeding history complaints, physical, vaginal examination and Doppler examination, 12 mares were found to be suffering from abnormal ovarian structures (Experiment I). In addition, nine mares with normal cyclic activity were kept as control. Another 16 mares were found to suffer from abnormal uterine conditions and 10 mares with normal uterine findings served as control (Experiment II). Blood flows to the anovulatory follicle, ovarian inactivity, granulosa cell tumour were compared to those to the dominant follicle and luteal blood flow. Uterine blood flow of cysts, abnormal uterine fluids (endometritis) during estrus and diestrus were compared to normal uterine vascularisation during estrus, diestrus and post-mating. Results showed that granulosa cell tumour had the highest red colour blood flow and total colour blood flow area. Blue colour blood flow area of the corpus luteum was higher compared to the dominant follicle and inactive ovary. Uteri with uterine cyst and abnormal uterine fluids during estrus of infertile mares had high red colour blood flow, blue colour blood flow and power blood flow areas compared to normal uterus during estrus. It could be concluded that Doppler ultrasound could distinguish between normal ovaries with normal or abnormal structures. Moreover, the increased uterine blood flow area of mares with abnormal fluids in their uteri (endometritis) and uterine cysts could be distinguished by comparison to the normal uterine blood flow during estrus.

Effect of hCG application at different moments of the estrous cycle on corpus luteum and uterine vascularization and serum progesterone concentration in mares

Establishment of pregnancy after embryo transfer is the ultimate goal of an embryo transfer program and increasing pregnancy rates and reducing pregnancy loss are mandatory. The utilization of treatments to improve conception rates in recipient mares has been the focus of several research groups over the last years and the results are controversial. Some studies using human chorionic gonadotrophin (hCG) found promising results. Our hypothesis was that hCG administration would cause an additional stimulation on luteal function, uterine and luteal vascularization and progesterone concentration, and the mares would have increased uterine and cervix tone. Therefore, in the present study the effects of hCG administration to induce ovulation, on day 0 (day of ovulation) or day 5 postovulation were evaluated on corpus luteum characteristics, reproductive tract vascularization, and serum progesterone concentration from ovulation until day 15 postovulation. Groups were: G1: (control) - no hCG; G2: 2500 IU of hCG to induce ovulation when a follicle greater than 35mm and uterine edema were detected; G3: 2500 IU hCG on day 0; G4: 2500 IU hCG on day 5 postovulation. Twelve mares were randomly assigned to each group, during consecutive cycles, in a Latin Square experimental design, in a total of 48 cycles. Doppler ultrasound evaluations were performed daily from day 0 until day 15 postovulation, including mesometrial vascularity, endometrial vascularity and corpus luteum vascularity. Blood samples were collected for serum progesterone concentration. Data was analyzed using the Proc Glimmix SAS Procedure for nonparametric variables and Proc Mixed for parametric parameters. There was no treatment effect for all variables studied (P > 0.05). Characteristics were only affected by day (P < 0.05). It can be concluded that hCG administration at the time points suggested in the current study did not alter the characteristics evaluated.

Treated and untreated anovulation associated with ovarian and uterine blood flow in Arabian mares (a case study)

To investigate the development of treated and untreated hormonal anovulatory follicles (AnOV) associated with uterine and ovarian vascularization, rectal Doppler ultrasound of seven Arabian mares was performed before and after the development of an AnOV. In addition to measuring the diameter, area and volume of the follicle, daily colour and power Doppler scans were analysed in order to measure red, blue and power blood flow areas in pixels. Serum levels of estradiol (E2), progesterone (P4), leptin, insulin-like growth factor-I (IGF-1) and nitric oxide (NO) were measured as well. The diameter (cm), area (cm2), volume (cm3), area in pixels, antral area in pixels, circumference, and percentage change in circulation of the AnOV progressively increased (P<0.0001) after the disappearance of uterine oedema compared to the values obtained during oedema. The blue, total colour and power areas of the AnOV increased after the disappearance of uterine oedema (P<0.0001). When the antral area was excluded, the percentage of the granulosa layer in the colour and power Doppler decreased after the disappearance of uterine oedema. The ipsilateral uterine horn and uterine body had significantly (P<0.0001) high blue and red blood flow vascularization areas in the presence of uterine oedema. The AnOV was associated with low P4, IGF-1 (P<0.001), and leptin (P<0.05). Treatment of the AnOV follicle with GnRH resulted in its luteinization and induced ovulation 9 and 30 days later. It can be concluded that an abrupt increase in blood flow due to decreased progesterone and E2 and increased IGF-1 causes anovulation. The absence of oestrous behaviour and high uterine-oedema-associated follicular and ipsilateral uterine horn vascularization are predictors of ovulation failure.

A Review of Medical Doppler Ultrasonography of Blood Flow in General and Especially in Common Carotid Artery

Medical Doppler ultrasound is usually utilized in the clinical adjusting to evaluate and estimate blood flow in both the major (large) and the minor (tiny) vessels of the body. The normal and abnormal sign waveforms can be shown by spectral Doppler technique. The sign waveform is individual to each vessel. Thus, it is significant for the operator and the clinicians to understand the normal and abnormal diagnostic in a spectral Doppler show. The aim of this review is to explain the physical principles behind the medical Doppler ultrasound, also, to use some of the mathematical formulas utilized in the medical Doppler ultrasound examination. Furthermore, we discussed the color and spectral flow model of Doppler ultrasound. Finally, we explained spectral Doppler sign waveforms to show both the normal and abnormal signs waveforms that are individual to the common carotid artery, because these signs are important for both the radiologist and sonographer to perceive both the normal and abnormal in a spectral Doppler show.

Vascularização uterina de éguas prenhes de jumento e de garanhão monitoradas por ultrassonografia Doppler

RESUMO: Este estudo teve como objetivo analisar e descrever os achados ultrassonográficos do útero de éguas gestantes de diferentes idades, de jumento e garanhão, utilizando a técnica de ultrassonografia Doppler Espectral, visando caracterizar os índices de resistência (RI) e pulsatilidade (PI) até 154 dias de gestação. Foram utilizadas 20 éguas em idade reprodutiva, sem raça definida. As avaliações foram realizadas nas artérias uterinas. Não foi constatada interação entre os valores de RI e PI obtidos nos cornos uterinos (que iniciaram ou não a gestação) com o tempo da gestação (P>0,05), desta forma os dados foram discutidos separadamente. Não foram encontradas diferenças entre as avaliações de RI e PI quando comparado os cornos que iniciaram ou não a gestação (P>0,05). Verificou-se efeito de tempo (P<0,05) sobre o PI, onde no D70 foi constatada a menor média quando comparado aos tempos D0, D7, D14 e D21. Não f oi encontrado efeito de tempo sobre o RI (P>0,05). As éguas gestantes de jumento apresentaram maior vascularização uterina no corno não gestante, que as éguas gestantes do garanhão. Com exceção do RI no lado não gravídico, foi verificado efeito de idade da fêmea sobre o lado da gestação (P<0,05), onde as éguas idosas, tanto no corno que iniciou a gestação e o contralateral, tiveram PI e RI mais altos, ou seja, menos vascularizados. Concluiu-se que a vascularização uterina não apresentou diferença entre os cornos uterinos. Há um aumento da vascularização uterina no 70º dia de gestação. Éguas gestantes de jumentos apresentaram maior vascularização uterina, quando comparada às éguas gestantes de garanhões. Éguas com idade acima de 15 anos apresentaram menor vascularização uterina, quando comparadas com idade inferior a 15 anos.

Transrectal Doppler sonography of uterine blood flow in ewes during pregnancy

In sheep, there is a lack of information on the behaviour of hemodynamic indices and parameters of blood flow velocity of the uterine artery during pregnancy, making it impossible to determine the real meaning of the values found and their probable relevance in normal physiological or pathological states. The objective of the present study was to evaluate the blood flow velocity parameters and hemodynamic indices of the uterine artery in ewes (18) during pregnancy (33). Based on non-invasive colour Doppler sonography, we evaluated the peak systolic velocity (PS), end diastolic velocity (ED), time-averaged maximum and minimum velocity in a cardiac cycle (TAMAX and TAMEAN), pulsatility index (PI), resistance index (RI), systolic/diastolic ratio (S/D), heart rate (HR), arterial diameter (AD) and the blood flow volume (BFV). Examinations started on day 28 and continued at two-week intervals until parturition. The Doppler parameters and the diameter of the uterine artery underwent significant changes during pregnancy. In the evaluated animals, indices related to resistance of the uterine artery, namely the impedance of blood flow, decreased throughout the initial, middle and late stages of gestation (PI: 1.15, 1.04, 0.97; RI: 0.61, 0.59, 0.57; S/D: 2.68, 2.52, 2.39, respectively) (p < 0.05). In contrast, the contents related to higher uterine irrigation increased during gestation (PS, ED, TAMAX, TAMEAN, HR, AD and BFV) (p < 0.05). No differences were found between the means of the variables in relation to the right and left uterine arteries and between single and multiple pregnancies in the hemodynamic indices. The present study is the first to demonstrate changes in uterine hemodynamics throughout pregnancy in sheep.

The effect of isosorbide dinitrate on uterine and ovarian blood flow in cycling and early pregnant mares: A pilot study

Poor uterine perfusion has been proposed as a cause of infertility in mares. The objective of this study was to investigate the effect of isosorbide dinitrate (ISDN), a nitric oxide donor, on uterine and ovarian blood flow resistance during diestrus and early pregnancy in mares. Six Trotter mares, aged 7 to 14 years, were examined daily during the first 11 days of three diestrous periods, and five of those mares were also examined during the first 11 days of two pregnancies. Six mares randomly received a placebo, a low dose (30 mg, ISDN30), or a high dose of ISDN (60 mg, ISDN60) through three nonconsecutive cycles. The treatments were administered orally, every 12 hours from Day 1 to 11 of the cycle (Day 0 = ovulation). Five of the 6 mares received a placebo or 60 mg of ISDN orally every 12 hours from Day 1 to 11 of pregnancy. The mares were short cycled on Day 12 of each trial. Transrectal color Doppler was used to determine blood flow resistance semiquantitatively and expressed as pulsatility index. Mean pulsatility index of both uterine arteries combined and of the dominant (ipsilateral to the CL) ovarian artery was lower (treatment effects: P ≤ 0.01; time effects: P ≤ 0.002) in mares receiving 30 mg or 60 mg of ISDN compared with placebo-treated mares. Blood flow resistance in the dominant ovarian artery was lower in ISDN-treated pregnant mares than in placebo-treated pregnant and cycling mares (treatment effect: P = 0.04; time effect: P = 0.003). Isosorbide dinitrate increases uterine and ovarian perfusion in cycling mares and ovarian perfusion in early pregnant mares. Further studies are needed to investigate these effects in relation to fertility of the mare.

Is uterine blood flow influenced by hCG and mare age?

Doppler ultrasonography is a noninvasive technique which enables us to follow the physiologic and physiopathologic changes in blood flow in tissues. It is becoming an essential tool in veterinary medicine, especially in theriogenology. Twenty-seven Arabian mares were grouped by age ('young', 3-10 y, n=15; 'old', 19-23 y, n=12). The uterine arteries of the mares were examined using Doppler ultrasonography when an ovarian follicle ≥35mm was visible (Day -1). After these measurements, human chorionic gonadotropin (hCG; 2500IU) was administered to 14 mares selected randomly. One day later (Day 0) Doppler ultrasonography was repeated and then the dominant follicles were aspirated to collect follicular fluid in all groups. On the next day (Day +1), Doppler indices of the uterine artery blood flow were measured again. Blood samples were also collected just prior to ultrasonography, for measuring serum estradiol and progesterone levels. We found that preovulatory hCG administration had no significant effects on uterine artery blood flow indices, or serum or follicular fluid estradiol concentrations. The uterine artery resistance index might decrease in young mares after ovulation, possibly because of increased uterine perfusion.

How ultrasound technologies have expanded and revolutionized research in reproduction in large animals

Gray-scale ultrasonic imaging (UI) was introduced in 1980 and initially was used to examine clinically the reproductive tract of mares. By 1983 in mares and 1984 in heifers/cows, UI had become a tool for basic research. In each species, transrectal gray-scale UI has been used extensively to characterize follicle dynamics and investigate the gonadotropic control and hormonal role of the follicles. However, the use of transrectal UI has also disclosed and characterized many other aspects of reproduction in each species, including (1) endometrial echotexture as a biological indicator of circulating estradiol concentrations, (2) relative location of the genital tubercle for fetal gender diagnosis by Days 50 to 60, and (3) timing of follicle evacuation during ovulation. Discoveries in mares include (1) embryo mobility wherein the spherical conceptus (6-16 mm) travels to all parts of the uterus on Days 11 to 15, (2) how one embryo of a twin set eliminates the other without self-inflicted damage, and (3) serration of the granulosum of the preovulatory follicle opposite to the future rupture site as an indicator of imminent ovulation. Studies with color-Doppler UI have shown that vascular perfusion of the endometrium follows the equine embryo back and forth between uterine horns and follows the expansion of the bovine allantochorion throughout each horn. In heifers, blood flow in the CL increases during the ascending portion of an individual pulse of PGF2α metabolite and then decreases. These examples highlight the power of UI in reproduction research. Without UI, it is likely that these and many other findings would still be unknown.

Clinical and subclinical endometritis in the mare: both threats to fertility

Endometritis, a major cause of mare infertility arising from failure to remove bacteria, spermatozoa and inflammatory exudate post-breeding, is often undiagnosed. Defects in genital anatomy, myometrial contractions, lymphatic drainage, mucociliary clearance, cervical function, plus vascular degeneration and inflamm-ageing underlie susceptibility to endometritis. Diagnosis is made through detecting uterine fluid, vaginitis, vaginal discharge, short inter-oestrous intervals, inflammatory uterine cytology and positive uterine culture. However, these signs may be absent in subclinical cases. Hypersecretion of an irritating, watery, neutrophilic exudate underlies classic, easy-to-detect streptococcal endometritis. In contrast, biofilm production, tenacious exudate and focal infection may characterize subclinical endometritis, commonly caused by Gram-negative organisms, fungi and staphylococci. Signs of subclinical endometritis include excessive oedema post-mating and a white line between endometrial folds on ultrasound. In addition, cultures of uterine biopsy tissue or of small volume uterine lavage are twice as sensitive as guarded swabs in detecting Gram-negative organisms, while uterine cytology is twice as sensitive as culture in detecting endometritis. Uterine biopsy may detect deep inflammatory and degenerative changes, such as disruption of the elastic fibres of uterine vessels (elastosis), while endoscopy reveals focal lesions invisible on ultrasound. Mares with subclinical endometritis require careful monitoring by ultrasound post-breeding. Treatments that may be added to traditional therapies, such as post-breeding uterine lavage, oxytocin and intrauterine antibiotics, include lavage 1-h before mating, carbetocin, cloprostenol, cervical dilators, systemic antibiotics, intrauterine chelators (EDTA-Tris), mucolytics (DMSO, kerosene, N-acetylcysteine), corticosteroids (prednisolone, dexamethasone) and immunomodulators (cell wall extracts of Mycobacterium phlei and Propionibacterium acnes).

Reproductive efficiency of Thoroughbred mares under Indian subtropical conditions: A retrospective survey over 7 years

Service records of 253 mares (1181 mare-years) spanning over 7 consecutive years, from nine organized Thoroughbred stud farms, situated in the subtropical northwestern India were retrospectively analyzed to assess their reproductive performance. The overall per cycle pregnancy rate at Day 16 and overall foaling rates were 50.30% and 68.95%, respectively, and were significantly higher in mares aged 3-7 years than > or =18 years old mares. The late embryonic losses (9.86%) that occurred between Days 16 and 39 post-ovulation contributed more than 50% of the overall detected pregnancy losses (19.11%). The overall percent detected pregnancy losses were lower in mares at ages 3-7 years compared to those at ages > or =18 years (14.78% vs. 46.43%, respectively; P<0.0001). Chronic barren and habitual aborter mares tended to affect reproductive efficiency of mares. Fifty percent of the mares that experienced > or =2 consecutive abortions or barren years, again stayed aborted or barren in the next seasons, respectively. No effect of numbers of matings per oestrus was observed on overall fertility. Neither the induction of oestrus nor ovulation by exogenous hormonal treatment had any effect on most of the analyzed reproductive parameters. Regarding breeding month or years, the reproductive efficiency did not differ significantly. The incidence of multiple pregnancies was 5.40% and percent late embryonic loses were higher (P=0.0016) in twin (21.98%) than singleton (8.64%) pregnancies. In conclusion, comparatively lower fertility rates were recorded in Thoroughbred mares bred under Indian subtropical climatic conditions than those reported from temperate regions that might be due to difference in breeding management rather than prevailing environment.