b'WHATS PLAGUING YOUR PROBLEM MARE?soundness exam to assess perineal and vulval conformation, check the ovaries and uterus via transrectal palpation, and ultrasound the reproductive tract. Palpa-tion and ultrasound will reveal the mares estrous cycle stage and indicate the op-timal time to collect samples for uterine culture and cytology or even a uterine biopsy to identify infection. The Top Troublemaker: Endometritis Two types of endometritis (inflamma-tion or infection of the uterus) are among the most common problems associated with getting mares pregnant: persistent SHELLEY PAULSONmating-induced endometritis and infec-tious endometritis. After being bred, mares naturally devel-op a mating-induced endometritis. This The reproductive, or breeding soundness, exam includes assessing the perineum and vulva, doing a is a normal, short-lived inflammatorytransrectal palpation, and performing an ultrasound of the reproductive tract.response to sperm deposited in the uterus that helps get rid of the dead sperm, bac- endometrial tissue itself, she says. Diag- appropriate therapies, the bacteria might teria, and inflammatory debris. nostic tests veterinarians can use to locatebe producing biofilm. In recent years A normal mare will have an inflamma- and ID the pathogens include: researchers have been diligently studying tory response, uterine contractions, andto identify abnor- these problematic bacterial communities Endometrial biopsyher uterus will clear within 24 hours post- malities such as inflammation, in- and how to eliminate them.breeding, says Wolfsdorf. Some mares,creased density of endometrial glands,Mares with chronic endometritis however, are more susceptible to endo- scarring around the glands, and degreemay have certain strains of bacteria that metritis if they have a saggy uterus andof scar tissue. Veterinarians gradeproduce an extracellular polysaccharide may not have (an) appropriate immunebiopsies on a scale of one to three, withmatrix, which forms a scaffolding on response post-breeding. Those mares arethree being most severe. This gradewhich the bacteria colony can grow, incapable of adequately contracting theirgives a predictive indexthe likelihoodsays Wolfsdorf, referring to the biofilms uterus. This sets them up for a persis- of the mare being able to carry a foal tomakeup. This matrix hides bacteria and tent mating-induced endometritis, antermbut can also provide other infor- makes them more resistant to antibiotics environment that makes embryo survivalmation, such as abnormalities withinand the mares own immune response.difficult to impossible. the endometrium, Wolfsdorf says. Biofilm keeps the mares immune sys-With those mares, sometimes all to identify bacteria liv- tem from recognizing the presence of the Biopsy culture you need to do is administer oxytocin,ing deep in the tissue. If a mare hasbacteria, says McCue. It also decreases which helps contract the uterus, or aa deep-seated infection, we can usetheir metabolic rate, and antibiotics are uterine lavage and then give oxytocin toa mucolytic that helps break downless effective if the bacteria are not repli-help flush it out, she continues. If thismucus or a (growth medium) productcating. Antibiotics also dont penetrate as doesnt help, the mare may need furthercalled bActivate, which activates dor- well through the biofilm.treatments. These can include platelet- mant Streptococcus that can live withinBiofilm has been a hot topic for sever-rich plasma, acupuncture, or other, morethe endometrium, stimulating them toal years, and there are some medications intense therapies. become metabolically active so we canthat can help eliminate biofilm, he adds. Infectious endometritis, on the othertreat them, says Wolfsdorf. Mixing a combination of antibiotics and hand, is usually associated with older , in which thenonantibiotic therapies has been effective Hysteroscopic exammares with saggy uterine or poor perinealveterinarian uses an endoscope to lookto get rid of both the biofilm and the conformation due to having many foals.inside the uterus. This can help iden- bacteria within the biofilm. Two of the Bacteria from outside can get into thetify fluid, adhesions, old C-section scarssubstances utilized to break down biofilm vagina and go up through the cervix intothat may be a nidus (focus of infec- are Tris-EDTA and DMSO, which subse-the uterus. Sometimes these pathogenstion), or foreign bodies, she explains.quently allow the antibiotic to penetrate can hide, with bacteria or fungal organ- We can also look at the openings ofand kill the bacteria living within.isms such as yeast causing endometritisthe oviducts into the uterus. If your veterinarian identifies a biofilm or inflammation deep within the uterus.using a biofilm assay, he or she can de-They may be hidden in mucus orBattling Biofilm termine which antibiotic to prescribe and in biofilm (a protective coating over aIf your veterinarian isnt making prog- which products will help break down that colony of bacteria) or deep within theress treating a mares infection using thespecific biofilm. 22January 2020The Horse|TheHorse.comProblemMares USE.indd 22 12/3/19 3:34 PM'