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Preventive Measures for Placentitis?

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  • Preventive Measures for Placentitis?

    I haven't bred this particular mare yet but am planning on doing so in the next few months, she has already had one really bad delivery due to placentitis and I want to prevent a second.
    I have already cultured/biopsied her and everything is completely normal. I do plan on one more culture before we breed.
    Yes, she has already been caslicked. I'm lucky to be located between several equine reproductive clinics, Premier Breeding will be doing the actual breeding but I am about an hour away from Royal Vista & CSU. I'm looking for recommendations. Do you ultra sound every month/two weeks/week and at what point & starting when? Are ultrasounds a great indicator? Do you start on SMZ at a certain point, regardless? I'm just looking for what works and what doesn't.

    Thanks so much!!!

  • #2
    For what it's worth, my mare that is currently experiencing premature lactation and what we think is placentitis has always cultured clean and has had only the very best biopsy results. All her mare parts are tight and tidy and no discharge. We don't really know why she is bagging up now as the vet exam didn't show anything. We are still treating as placentitis. This is a frozen baby we hope to see someday. Hope to see some comments here about preventive measures, and I wish I could offer something to your inquiry.
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    • #3
      One of my mares had a nasty case of aspergillus placentitis, which was hell to clean up.
      In her case this is what we found:
      1. When doing a culture, take samples in several different areas of the uterus. Best to flush out the uterus and then culture the brew that comes out.
      2. Avoid hormonal manipulation. In my mare's case the hormones to make her come in heat and those to make her ovulate is what messed her up.
      The foal miraculously survived but was born at day 322, dysmature, small and it was a red bag delivery. It took us the whole rest of the year to treat the infection, but it worked.
      The next year she got pregnant with no problem and carried to term a large healthy colt. We did not use any hormonal manipulation.
      Surprisingly the placentitis foal grew up to be a large, healthy now almost three years old, never sick a day in his life !
      Good luck !
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      • #4
        Have only ever had one case of suspected placentitis so did a little research on preventative measures at the time.

        All that I could really find, addressed rigerous hygene at the time of insemination. AI being an invasive procedure can obviously introduce bacteria to the uterus which can develop slowly over a course of many months infecting the placenta, the use of antibiotics post insemination which apparently a number of equine reproduction vets are doing routinely now (?) is one prevantative measure that seems to be practiced by a number of equine reproduction vets.

        Sadly in our case the mare whilst treated long term 275 - 411 days for placentitis, ended up foaling twins. One deceased the size of a cat which had evidently died at 275 days and the other which weighed aproximately 20kgs survived but had to be PTS at aproximately 3 months of age.

        Our vet was unable to detect the twin, the mare had been scanned at 15, 30 and 60 days with a singleton, rectally examined when showed signs of aborting, scanned multiple times over many weeks in the lead up to foaling.

        Fingers crossed all goes well for your mare Indy Lou. In hind sight now I'm not sure I would interfere with nature again unless the vet had a confirmed diagnosis of placentitis.

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        • Original Poster

          #5
          Originally posted by Elfe View Post
          One of my mares had a nasty case of aspergillus placentitis, which was hell to clean up.
          In her case this is what we found:
          1. When doing a culture, take samples in several different areas of the uterus. Best to flush out the uterus and then culture the brew that comes out.
          2. Avoid hormonal manipulation. In my mare's case the hormones to make her come in heat and those to make her ovulate is what messed her up.
          The foal miraculously survived but was born at day 322, dysmature, small and it was a red bag delivery. It took us the whole rest of the year to treat the infection, but it worked.
          The next year she got pregnant with no problem and carried to term a large healthy colt. We did not use any hormonal manipulation.
          Surprisingly the placentitis foal grew up to be a large, healthy now almost three years old, never sick a day in his life !
          Good luck !
          Could you explain why/how hormonal manipulation mess her up?
          I think if this mare does start to show signs of placentitis, I'm not comfortable using regumate again.

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          • #6
            Originally posted by L&L View Post
            Have only ever had one case of suspected placentitis so did a little research on preventative measures at the time.

            All that I could really find, addressed rigerous hygene at the time of insemination. AI being an invasive procedure can obviously introduce bacteria to the uterus which can develop slowly over a course of many months infecting the placenta, the use of antibiotics post insemination which apparently a number of equine reproduction vets are doing routinely now (?) is one prevantative measure that seems to be practiced by a number of equine reproduction vets.
            Best thing is to be very aggressive about prevention; like L&L posted. As an RN, I took the CSU class and learned how to do my AI. Later, when I observed many vets do "field" AI, I was appalled at how casual they were about using aseptic technique. Afew even made fun of me and pointed out "horses live in mud".

            The two cases of placentitis I have experienced were from different causes and neither mare repeated the experience. I think the first was from repeated AI attempts in that season (some 3 frozen attempts & 2 chilled attempts by 2 different vets in one season).

            That case was discovered late in the pregnancy (7-8th month?). I discovered a bag and milk dripping. She was started on SMZ (and maybe Regumate -- it was a long time ago) for several weeks, then stopped. She delivered a normal, healthy foal in a normal time frame.

            However, exam of the placenta revealed the infection was in the non-pregnant horn (so it was not "ascending placentitis" which is the norm) that that could be what saved the pregnancy. Three other foals were born to this mare and no other infections.

            The other mare was a maiden and bred live cover. It was a pasture breeding and the vet felt perhaps she was overbred.

            I discovered her dripping milk about 6 weeks before her due date and she aborted before I could even get the vet out.

            I DO get a baseline ultrasound of the placenta about 90-120 days, but any mare who repeatedly gets placentitis has serious issues and probably should not be re-bred, unless it's via ET.

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            • #7
              Originally posted by Elfe View Post
              2. Avoid hormonal manipulation. In my mare's case the hormones to make her come in heat and those to make her ovulate is what messed her up.
              Hormonal manipulation cannot cause a uterine infection. Using AI (chilled & frozen) on all my WB mares, I manipulate all my mares with hormones each season.

              I've had 2 cases of placentitis. One was in a mare who had no hormonal manipulation and was bred LC...just as Nature intended. She aborted because of the infection. So one has nothing to do with the other. What causes placentitis is introduction of pathogens into the uterus/placenta. Period.
              Last edited by Kyzteke; Feb. 21, 2012, 01:03 PM.

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              • Original Poster

                #8
                With a "normal" mare with a healthy reprod tract and a expert reproductive vet, it should be unlikely to have a repeat of placentitis?!

                My mares history:
                This will only be her third pregnancy.
                The first she aborted twins around 8 months gestation (even with multiple checks). We than immediately rebreed (which is where I think my mistake was or atleast I hope it was). That pregnancy she was diagnoised with placentitis around day 305 we than put her on regumate & SMZ. The foal was delivered around 318 and survived but was a very expensive & stressful situation, so I would like to avoid a repeat.
                But as I said everything has checked out clean for her & I do plan on doing one more culture before we breed.

                So the question is, would it be worth trying again? If so, would there be additional measures to take or things to watch out for?

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                • #9
                  Originally posted by jenbrin View Post
                  Could you explain why/how hormonal manipulation mess her up?
                  I think if this mare does start to show signs of placentitis, I'm not comfortable using regumate again.
                  Originally posted by Kyzteke View Post
                  Hormonal manipulation cannot cause a uterine infection. Using AI (chilled & frozen) on all my WB mares, I manipulate all my mares with hormones each season.

                  I've had 2 cases of placentitis. One was in a mare who had no hormonal manipulation and was bred LC...just as Nature intended. She aborted because of the infection. So one has nothing to do with the other. What causes placentitis is introduction of pathogens into the uterus/placenta. Period.
                  The way it was explained to me is that in some mares the hormonal manipulation messes with their immune system, making them more susceptible to infection. So it is not the hormones themselves that produce the infection, just the uterine environment that ensues.
                  Please keep in mind that not all mares are the same. For this particular mare it was pretty obvious since she was cycled and recycled at least three different consecutive times and not only did she get infected she also produced anovulatory follicles each time. Stopped all hormones and got pregnant on one insemination with no problem.
                  Keep in mind that fungal infections can also be the result of antibiotic treatment.
                  As far as I am concerned, at least for this particular mare, no hormones. Since her heats and ovulations are quite normal and predictable, there is no reason to mess with hormones. If I decide to use frozen she will have to go to a clinic and be checked every six hours until she ovulates. Small price to pay compared to what it cost me the other way !
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                  • #10
                    Originally posted by L&L View Post

                    Fingers crossed all goes well for your mare Indy Lou. In hind sight now I'm not sure I would interfere with nature again unless the vet had a confirmed diagnosis of placentitis.
                    Thank you. Truth be told, I am very ambivalent about treating in this instance, and go back and forth in my mind quite a bit. I'm taking it one day at a time. I think my vet is ambivalent also, but she presented options with study results, etc. etc. like she always does. And one study that was cited re: mares who were experimentally induced with pathogens to cause a placentitis had the same outcomes percentage-wise for treatment vs non-treatment. Where's that crystal ball?
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                    • #11
                      Originally posted by Indy-lou View Post
                      We don't really know why she is bagging up now as the vet exam didn't show anything. We are still treating as placentitis. This is a frozen baby we hope to see someday. Hope to see some comments here about preventive measures, and I wish I could offer something to your inquiry.
                      Twins? You can also do a CTUP measurement to see if it is placentitis. Although not definitive, it can help determining. Good luck!
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                      • #12
                        Originally posted by Elfe View Post
                        2. Avoid hormonal manipulation. In my mare's case the hormones to make her come in heat and those to make her ovulate is what messed her up.
                        The hormones used to short cycle a mare and to accelerate ovulation would not cause issues with placentitis/infection. Prostaglandin is used to short cycle and is a naturally occurring hormone that the mare releases to resolve the CL herself. The hormones used to stimulate ovulation do nothing more than that - cause the follicle to mature more quickly, but again would have NO influence on causing an infection or impacting a placentitis. One that CAN cause issues is Regumate or progesterone. Both of those, if given inappropriately can most emphatically cause an issue. If given before things have cleared out of the uterus sufficiently, e.g., earlier than three days post ovulation - they can cause the cervix to close down prematurely and thereby effectively trapping unwanted debris in the uterus.

                        Just wanted to be really clear on the above.
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                        • #13
                          With mares that are "compromised" (incompetent cervix, repeated bouts of placentitis, etc.) we typically will put them on a prophylactic course of an antibiotic such as SMZ's one out of every four weeks throughout the pregnancy. Discuss this option with your vet if you own such a mare. It is NOT a preventive treatment program simply to relieve a mare owner's stress over the possibility of placentitis, however. Good luck to all and hope the above helps!
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                          • #14
                            I found this article very informative

                            Wish there was one, :/ very tough call.

                            I can only pass comment on my own experience. The regumate categorically reversed impending labour (swollen bag, running milk, total muscle relaxation extended vulva etc) and in light of the condition the dead twin was in when it did finally present itself at a gestation period of 411 days the antibiotics and anti-imflammatories must have certainly played a role in keeping infection to a minimum, the placenta was certainly not very healthy looking either. :/

                            I honestly don't know what I would do if a similar situation were to arise again. Can only keep my fingers and toes crossed for you.

                            p.s how many days gestation is she?

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                            • #15
                              L & L, my mare is now 263 days gestation. Other than fine one day and lactating the next, the mare hasn't been distressed at all. All parts tight and tidy, appetite normal (the day this mare stops eating is the day we gas up the backhoe). Very different from the no-doubt- it- was- placentitis experience with another mare, who had a discharge and was very uncomfortable. When that mare finally did abort, what we saw made us wonder how she made it that far. So, this is very different so far.
                              Kathy, we did check this mare 4x up to 60 days for twins, but it's still possible.
                              I've been wondering if there are any studies or diagnostics for ingested mycotoxins. My thought is, maybe she got hold of some mold in the hay (I am very diligent about checking, but my husband less so, and he does the AM feeding), but also because the weather here has been unseasonably warm and while the grass isn't up much, there are sprouts here and there. I don't expect an answer...just throwing that out. My guess is that a there are a lot of mycotoxin related abortions out there and no way to diagnose that's what it was. Anyway, we're only 3.5 days into this "adventure", and I will certainly keep you posted. It does help with the anxiety and helplessness to just be able to talk about here.
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                              • #16
                                Kathy, I just checked to be sure, and the CTUP for this mare on Saturday was 7. Vet said WNL.
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                                • #17
                                  Originally posted by jenbrin View Post
                                  I haven't bred this particular mare yet but am planning on doing so in the next few months, she has already had one really bad delivery due to placentitis and I want to prevent a second.
                                  I have already cultured/biopsied her and everything is completely normal. I do plan on one more culture before we breed.
                                  Yes, she has already been caslicked. I'm lucky to be located between several equine reproductive clinics, Premier Breeding will be doing the actual breeding but I am about an hour away from Royal Vista & CSU. I'm looking for recommendations. Do you ultra sound every month/two weeks/week and at what point & starting when? Are ultrasounds a great indicator? Do you start on SMZ at a certain point, regardless? I'm just looking for what works and what doesn't.

                                  Thanks so much!!!
                                  Jill Thayer at Royal Vista is amazing. I would do whatever she recommends.

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                                  • #18
                                    The one placentitis I've had experience with (after 30-40 foals), was a mare who bagged up, waxed and delivered all in the same day.
                                    Foal was about 315 days, tiny but did just fine, thankfully. I did lose the mare four weeks later to a terrible colic episode in a horrible heat wave.

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