Ok, this is going to be a bit long so I apologize in advance!
I recently had a reproductive exam done on a new mare and would really appreciate insight into the results and what/how to proceed with her.
The mare is an 11 year old maiden mare, she was bred and caught first try the last three years in a row. The first year she lost the embryo within 60 days, the second year she carried to 10 months and aborted and this year she caught and then lost it by 30 days. All three times she was bred with fresh cooled but no post or pre breeding management was done. She belonged to a friend of mine who simply did not have access to decent vets and was frustrated with trying.
So a few weeks ago I had her cultured and a cytology and a biopsy done as well as an ultrasound to look for cysts ect. US showed nothing unusual. The vet (not a repro vet) told me that there were "signs of inflammation" and suggested we flush with Gentamycin now and then see how things look in the spring prior to breeding (she just left a quick phone message and is now away on holidays). Her Kenny score came back a IIB. Here is a summary of the report I had faxed to me:
The cytocentrifugation and sediment smears prepared from the submitted fluid sample do not display any evidence of any significant numbers of nucleated cells. There is no evidence of any inflammatory cells nor microorganisms. There is no evidence of any fecal like material.
Microscopic findings: Fluid analysis and cytology are most consistent with a pure transudate type fluid.
(Aerobic culture and MIC)
Prelim #1 : Light growth of potential pathogens to be identified.
Prelim #2 : Light growth of Gram Negative organisms.
Final report: Light growth of Enterobacter Species
No Anaerobes in 3 or 4 days.
Microscopic findings: Mild to moderate, chronic lymphoplasmacytic endometritis, with prominent hemosiderosis and mild eosinophilia- Kenny Grade IIB
Fair, probably good for successful implantation and term gestation.
Microscopic changes in this endometrium are primarily those of inflammation. The number of hemosiderophages does support previous abortions, foaling or early embryonic loss. There were a few neutrophils however, the organisms were not noted along with endometrial surface. Negative culture attempts could be considered prior to winter anestrus. The nested glands reveal relatively mild periglandular fibrosis given this mares age. Interepret reproductive history and current reproductive findings. A better prognosis is anticipated if the inflammation and hemosiderosis can be controlled.
So, it doesn't sound horrible to me as it sounds like there is minimal fibrosis?...if we can get the inflammation under control then she should have a better chance? Is the inflammation likely caused by the previous embryonic losses/abortions...or an infection? The vet that flushed her with the Gentamycin (should we have done that?) told me he would keep her on regumate and antibiotics her ENTIRE pregnancy to give me the best chance...but he also was not the vet that did the repro exam, he was just going off of her history of abortion.
Arggg...sorry this is so long...I am just really confused as to what exactly I should be doing, what my chances are of getting this mare to carry a foal. Should I be using frozen semen? Can I try an ET? Sorry again this post is so long and I appreciate any advice!!
By definition a grade IIB biopsy gives you a 10-50% chance of the mare getting pregnant and carrying to term. This mare is obviously not having a problem getting pregnant, but she is having problems holding on to the pregnancy. Those things make me think poor uterine condition, or a cervical problem. There is always a small chance that each loss was unrelated to the others (placentitis, illness, random pregnancy loss, etc). However, in a mare with a IIB biopsy and 3 abortions, I would question her ability to carry a pregnancy. It doesn't look like she has an infection; the cytology doesn't show any signs of an infection and the light mixed growth on the culture is likely a contaminant. If you have ruled out a cervical issue, then I would not use Regumate on the mare. If this were a progesterone issue, then the mare would not get pregnant. So my suggestions would be to rule-out a cervical issue and if that checks out fine then consider doing an ET. There is always the possiblity that her inflammation will naturally decrease through the winter and thus you could try to breed her in the spring and see what happens at that point. Or re-biopsy and re-culture and go from there. So many variables!
Thanks guys. I do have access to a good repro vet (used to use Roxy fwiw) though I have been doing my own breeding and would just like some feedback from anyone here that is familiar with interpreting these reports and managing mares like this. Obviously I will consult more with my vet prior to breeding. Hillside, would the vet have noticed a cervical issue upon flushing her? Two vets flushed her and neither commented on anything?
My plan was to try to do an ET with her early next spring and then to breed her again with the goal of trying to have her carry it herself. I am a bit worried though that I might make her uterus angry with the breeding, flushing ect that goes with doing an ET?? Should I avoid using frozen semen on this mare, even for the ET?
Rodawn, no the placenta was not examined...I doubt fescue because the owner is very knowledgeable and experienced with feeding and caring for broodies.