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Repro Gurus?? Breeding Advice...Mare with IIB Biopsy Score....WWYD??

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  • Repro Gurus?? Breeding Advice...Mare with IIB Biopsy Score....WWYD??

    So, I have an 11 yr old maiden mare. I got her this last fall from a friend who hasn't had any success with her and she thought that I should give it a go. She was bred the last three years (fresh cooled) and caught right away , first try every time. She lost all of the pregnancies, one at 30 days, 45 days and then at 10 months. The previous owner did not have access to a good vet so wasn't able to do a biopsy ect. I did one when I got her, as well as a cytology and a culture. Cytology was normal, Biopsy score IIB due to endometriitis. Culture showed some bacterial growth but not much, vet thought maybe from contamination. Vet thought we should flush her with an antibiotic anyways, which we did. This was about four months ago.

    I go back and forth between just breeding her (and doing everything I can to help her conceive and carry) or just doing an ET. I am thinking obviously flushing post insemination and following the oxytocin protocol as well as a caslix. Is there anything else I can do? My vet thinks she should be on antibiotics and regumate the whole pregnancy but honestly that seems a bit extreme to me. Wwyd if this were your mare? I guess I am hoping that with a bit more management she will be able to carry to term?

    I was planning on breeding her via frozen (deep horn) with a smaller than normal dose of frozen to try and prevent post breeding inflammation though obviously catching doesn't really seem to be the problem. Or should I stick to fresh?

    Hard to make a decision here, any thoughts would be greatly appreciated. Kathy, would love your opinion!!
    www.svhanoverians.com

    "Simple: Breeding,Training, Riding". Wolfram Wittig.
  • Original Poster

    #2
    Also, does she sound like she could benefit from a DMSO lavage??
    www.svhanoverians.com

    "Simple: Breeding,Training, Riding". Wolfram Wittig.

    Comment


    • #3
      I had a mare (have the mare still actually). She foaled out a colt in 2003. Normal delivery/pregnancy. I tried once in 2003 to get her back in foal. No success. Tried several times in 2004 with no success. Tried again several times in 2005 no success. Tried once or twice in 2006 no success. Had a biopsy and she was a IIB. I was told by 4 vets that she was done, and her IIB was on the higher scale and was almost worse. I was told she would never get preg again and to not bother. Last ditch effort, did a DMSO lavage, inseminated next heat cycle, and did oxytocin. She was preg (with my Emma who is now herself preg! ). One insemination. On 30 day foal heat bred her with one dose and she was preg for 2008. Had 2009 off. Bred one dose for a 2010 filly. Had 2011 off. Bred her (on a whim since she was in season and I was breeding one of my other mares and had an extra dose of my stallion's semen on hand - no scans to see where she was in her cycle, nothing, just put it in her AND she was 21 years old) for a 2012 colt, one dose. This is obviously a very "loose" accounting - we did tests along the way, tried various lavages, etc. The biopsy was the first we did, but we did cultures along the way, but they were inconclusive. I credit the DMSO lavage with her getting in foal. That being said, talk to your vet first and foremost!
      Emerald Acres standing the ATA, Trakehner Verband, sBs, RPSI, and ISR/OLD NA Approved Stallion, Tatendrang. Visit us at our Facebook Farm Page as well!

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      • #4
        For me, personally, I would have her re-cultured right before you plan on breeding her, to make sure she truly isn't infected. Then I would use fresh-cooled; I wouldn't go right to frozen semen on this type of mare. Then follow up with the oxytocin and see what happens. If it doesn't work out then I would try the DMSO lavage. The only reason I would try one, well-managed cycle with fresh-cooled before going straight to the DMSO lavage is that there is always a small risk of causing more inflammation with the DMSO lavage and if you don't need it then you shouldn't risk it. That being said, I've seen several mares do great with a DMSO treatment, but I always use it as a last resort. Mares who conceive but then lose the pregnancy are very difficult and sometimes ET is the only resort. I WOULD not go to Regumate or antibiotics without a very, very good reason. And I can't think of a single good reason to use systemic antibiotics for the duration of a pregnancy in a case like this.
        Already excited about our 2016 foals! Expecting babies by Indoctro, Diamant de Semilly, Zirocco Blue and Calido!
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        • #5
          Originally posted by Hillside H Ranch View Post
          For me, personally, I would have her re-cultured right before you plan on breeding her, to make sure she truly isn't infected. Then I would use fresh-cooled; I wouldn't go right to frozen semen on this type of mare. Then follow up with the oxytocin and see what happens. If it doesn't work out then I would try the DMSO lavage. The only reason I would try one, well-managed cycle with fresh-cooled before going straight to the DMSO lavage is that there is always a small risk of causing more inflammation with the DMSO lavage and if you don't need it then you shouldn't risk it. That being said, I've seen several mares do great with a DMSO treatment, but I always use it as a last resort. Mares who conceive but then lose the pregnancy are very difficult and sometimes ET is the only resort. I WOULD not go to Regumate or antibiotics without a very, very good reason. And I can't think of a single good reason to use systemic antibiotics for the duration of a pregnancy in a case like this.
          This.
          Kendra -- Runningwater Warmbloods
          Home of EM Raleska (Rascalino/ Warkant) and Donatella M (Furstenball/ Jazz Time)
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          • #6
            I am in the midst of breeding a very similar mare (gets pregnant, loses pregnancy before 60 days). We just did three days of 5% DMSO in a 60cc infusion, three days in a row. Negative culture. All else looks great and one shot of oxytocin about 8hrs post-infusion shows no fluid retained the next day. We will be breeding with fresh on the next cycle.

            I've been doing lots of reading about biofilm and work done by Michelle LeBlanc (now at Rood and Riddle) on endometritis. Very interesting stuff! (Google is your friend.)

            From this source: http://www.sefarm.com/breeding-info/432-dirty-mares
            "It has been proposed that endometrial biofilms that appear to be nonresponsive to conventional treatment are responsible for chronic endometritis. A bacterial biofilm is a complex aggregation of microorganisms growing on a solid substrate, such as the uterine lining. The biofilms' complex structure greatly increases the resistance to antibiotic therapy. The presence of biofilms has been described in the mouth and in the bladder of people and has recently been suggested to occur in the uterus of the horse. This still needs to be documented, however. Researchers in Denmark have offered an alternative explanation for persistent bacterial endometritis. These veterinarians suggest that bacteria can persist in the endometrial glands and the uterine wall in a dormant state, which would increase their resistance to antibiotic therapy.To overcome some of the obstacles for effective antibiotics therapy in the uterus, supplemental treatments have been suggested:
            • A 30% dimethyl sulfoxide (DMSO) solution and acetylcysteine in a 20% solution have been added to uterine lavage fluids in mares with suspected biofilms in the uterus to break down mucus or clear biofilms.
            • Ethylenediaminetetraacetic acid (EDTA, a chelating agent)-tris has been shown to be effective in decreasing the viability of P. aeruginosa from horses.
            • Veterinarians have infused a variety of other solutions to treat infectious endometritis such as iodine, chlorhexidine, hypertonic saline, kerosene, and hydrogen peroxide. Many of these are strong irritants and can damage the endometrium. Therefore, veterinarians should use these treatments with caution.
            • Treatment with immunostimulatory agents has been reported to improve pregnancy rates in mares with persistent endometritis, but the mechanism is not fully understood."


            Has anyone tried Bactivate?
            http://horsetalk.co.nz/2013/03/17/tr...fertile-mares/
            Kendra -- Runningwater Warmbloods
            Home of EM Raleska (Rascalino/ Warkant) and Donatella M (Furstenball/ Jazz Time)
            'Like' us on Facebook

            Comment


            • #7
              Originally posted by RunningwaterWBs View Post
              I've been doing lots of reading about biofilm and work done by Michelle LeBlanc (now at Rood and Riddle) on endometritis. Very interesting stuff! (Google is your friend.)

              From this source: http://www.sefarm.com/breeding-info/432-dirty-mares
              "It has been proposed that endometrial biofilms that appear to be nonresponsive to conventional treatment are responsible for chronic endometritis. A bacterial biofilm is a complex aggregation of microorganisms growing on a solid substrate, such as the uterine lining. The biofilms' complex structure greatly increases the resistance to antibiotic therapy. The presence of biofilms has been described in the mouth and in the bladder of people and has recently been suggested to occur in the uterus of the horse. This still needs to be documented, however. Researchers in Denmark have offered an alternative explanation for persistent bacterial endometritis. These veterinarians suggest that bacteria can persist in the endometrial glands and the uterine wall in a dormant state, which would increase their resistance to antibiotic therapy.To overcome some of the obstacles for effective antibiotics therapy in the uterus, supplemental treatments have been suggested:
              • A 30% dimethyl sulfoxide (DMSO) solution and acetylcysteine in a 20% solution have been added to uterine lavage fluids in mares with suspected biofilms in the uterus to break down mucus or clear biofilms.
              • Ethylenediaminetetraacetic acid (EDTA, a chelating agent)-tris has been shown to be effective in decreasing the viability of P. aeruginosa from horses.
              • Veterinarians have infused a variety of other solutions to treat infectious endometritis such as iodine, chlorhexidine, hypertonic saline, kerosene, and hydrogen peroxide. Many of these are strong irritants and can damage the endometrium. Therefore, veterinarians should use these treatments with caution.
              • Treatment with immunostimulatory agents has been reported to improve pregnancy rates in mares with persistent endometritis, but the mechanism is not fully understood."


              Has anyone tried Bactivate?
              http://horsetalk.co.nz/2013/03/17/tr...fertile-mares/
              FWIW, Michelle LeBlanc is a good friend and was the vet who recommended a DMSO lavage for my Rubinstein I mare back when I had not been able to get her in foal for several years, despite a good biopsy, no infection, good cycles, no other detectable problems (we even did a scope of her uterus). The dmso lavage worked and she went on to have quite a few foals.

              I would definitely check out anything Michelle has put her name on. She is a brilliant researcher.
              Mary Lou
              http://www.homeagainfarm.com

              https://www.facebook.com/HomeAgainFarmHanoverians

              Member OMGiH I loff my mares clique

              Comment


              • #8
                Originally posted by RunningwaterWBs View Post
                I've been doing lots of reading about biofilm and work done by Michelle LeBlanc (now at Rood and Riddle) on endometritis. Very interesting stuff! (Google is your friend.)

                From this source: http://www.sefarm.com/breeding-info/432-dirty-mares
                "It has been proposed that endometrial biofilms that appear to be nonresponsive to conventional treatment are responsible for chronic endometritis. A bacterial biofilm is a complex aggregation of microorganisms growing on a solid substrate, such as the uterine lining. The biofilms' complex structure greatly increases the resistance to antibiotic therapy. The presence of biofilms has been described in the mouth and in the bladder of people and has recently been suggested to occur in the uterus of the horse. This still needs to be documented, however. Researchers in Denmark have offered an alternative explanation for persistent bacterial endometritis. These veterinarians suggest that bacteria can persist in the endometrial glands and the uterine wall in a dormant state, which would increase their resistance to antibiotic therapy.To overcome some of the obstacles for effective antibiotics therapy in the uterus, supplemental treatments have been suggested:
                • A 30% dimethyl sulfoxide (DMSO) solution and acetylcysteine in a 20% solution have been added to uterine lavage fluids in mares with suspected biofilms in the uterus to break down mucus or clear biofilms.
                • Ethylenediaminetetraacetic acid (EDTA, a chelating agent)-tris has been shown to be effective in decreasing the viability of P. aeruginosa from horses.
                • Veterinarians have infused a variety of other solutions to treat infectious endometritis such as iodine, chlorhexidine, hypertonic saline, kerosene, and hydrogen peroxide. Many of these are strong irritants and can damage the endometrium. Therefore, veterinarians should use these treatments with caution.
                • Treatment with immunostimulatory agents has been reported to improve pregnancy rates in mares with persistent endometritis, but the mechanism is not fully understood."


                Has anyone tried Bactivate?
                http://horsetalk.co.nz/2013/03/17/tr...fertile-mares/
                FWIW, Michelle LeBlanc is a good friend and was the vet who recommended a DMSO lavage for my Rubinstein I mare back when I had not been able to get her in foal for several years, despite a good biopsy, no infection, good cycles, no other detectable problems (we even did a scope of her uterus). The dmso lavage worked and she went on to have quite a few foals.
                Matts, the author of the article linked above, was the UF vet (he was in FL then) who gave Rubi an entire clean slate. My regular vet was in touch with him after we "fixed" Rubi with Michelle's old tie dmso solution. I agree with Hillside that dmso should be used as a last resort and carefully.
                Mary Lou
                http://www.homeagainfarm.com

                https://www.facebook.com/HomeAgainFarmHanoverians

                Member OMGiH I loff my mares clique

                Comment


                • #9
                  It was your post, HAF, on an old thread about DMSO lavage that prompted me to research LeBlanc articles. :-) Just found that Matts article this morning and posted it because it had a succinct blurb about biofilm. Very interesting that you've dealt with both and that Matts was stumped. At least he had the sense to involve LeBlanc.

                  Edited to add: The mare I'm trying this on is Diorella, an SPS overall 8 Donnerhall mare, so I feel she deserves every effort.
                  Last edited by RunningwaterWBs; Mar. 30, 2013, 11:55 AM. Reason: additional info
                  Kendra -- Runningwater Warmbloods
                  Home of EM Raleska (Rascalino/ Warkant) and Donatella M (Furstenball/ Jazz Time)
                  'Like' us on Facebook

                  Comment


                  • #10
                    My vet has said she's had very good luck with infusions of DMSO (as stated above, 5% DMSO in 60cc saline is infused). She said she thinks that the use of oxytocin has helped to outmode DMSO lavage (oxytocin followed infusion by 6-8hrs). I've decided to trust her on this because she has considerable experience with it and has gotten good (live foal) pregnancy rates, but I'm worried that I should be lobbying for a true lavage.

                    Can anyone comment on this?
                    Kendra -- Runningwater Warmbloods
                    Home of EM Raleska (Rascalino/ Warkant) and Donatella M (Furstenball/ Jazz Time)
                    'Like' us on Facebook

                    Comment


                    • #11
                      Matts was the senior repro vet at UF veterinary school then. He said that he felt she had a perfect chance of conceiving with fresh semen. Two doses of Fabuleux later, my own personal vet Randy Emmons consulted Michelle. She told him about the research she had been doing that showed that some mares seemed to have a mucus-like coating in the uterus that was preventing pregnancy. She had been playing with dmso as a way to clear the coating. Later, when we had a pregnancy, my vet reported what we had done to Michelle and to Dr. Troedssen. It takes a village.
                      Mary Lou
                      http://www.homeagainfarm.com

                      https://www.facebook.com/HomeAgainFarmHanoverians

                      Member OMGiH I loff my mares clique

                      Comment


                      • #12
                        Kendra, we had used oxytocin religiously with Rubi, even though she did not seem to need it. The dmso made the difference.
                        Mary Lou
                        http://www.homeagainfarm.com

                        https://www.facebook.com/HomeAgainFarmHanoverians

                        Member OMGiH I loff my mares clique

                        Comment


                        • #13
                          Originally posted by Home Again Farm View Post
                          Kendra, we had used oxytocin religiously with Rubi, even though she did not seem to need it. The dmso made the difference.
                          Mary Lou, Kendra was referring to the use of oxytocin to encourage clearance from a dmso infusion, vs. a dmso lavage.

                          My vet uses two lavages of dmso, followed by a dmso infusion and oxytocin.

                          Kendra's vet is using the infusion method only, with oxytocin - no lavage.
                          "No matter how cynical I get its just not enough to keep up." Lily Tomlin

                          Comment


                          • #14
                            Ah, now I see. We did oxy and I wouldn't use the dmso without it.


                            Originally posted by ahf View Post
                            Mary Lou, Kendra was referring to the use of oxytocin to encourage clearance from a dmso infusion, vs. a dmso lavage.

                            My vet uses two lavages of dmso, followed by a dmso infusion and oxytocin.

                            Kendra's vet is using the infusion method only, with oxytocin - no lavage.
                            Mary Lou
                            http://www.homeagainfarm.com

                            https://www.facebook.com/HomeAgainFarmHanoverians

                            Member OMGiH I loff my mares clique

                            Comment


                            • #15
                              ^ Yes, exactly as ahf said, and I'm struggling with whether this is the right course of action.

                              Kyla, I hope you don't feel your thread has been hijacked! I would go for it with your mare, especially since she's only 11 and if you were to discover she's a great producer you'd have time for a few more foals.
                              Kendra -- Runningwater Warmbloods
                              Home of EM Raleska (Rascalino/ Warkant) and Donatella M (Furstenball/ Jazz Time)
                              'Like' us on Facebook

                              Comment

                              • Original Poster

                                #16
                                Thanks guys for all the input, greatly appreciated!! So it sounds like most that have done the DMSO lavage have had very good success with it? I almost feel ready to move to "the last resort" because she has lost three foals in a row and has that biopsy score. If the DMSO lavage is done by a competent therio, the risks should be minimal right??

                                I suppose there is that chance that the caslix could make all the difference as that was never done previously but she looks decent conformationally??

                                Re frozen...am I really increasing my risk of post breeding inflammation via breeding with say, one straw of frozen? Is that still more irritating than a dose of fresh cooled?

                                Kendra, no worries, it is all very interesting and I of course appreciate hearing everyone else's experiences/issues regarding this topic.
                                www.svhanoverians.com

                                "Simple: Breeding,Training, Riding". Wolfram Wittig.

                                Comment


                                • #17
                                  Have you thought of doing an embryo transplant? She seems like the perfect candidate.
                                  -Arthur
                                  www.logresfarmpintowarmbloods.com
                                  www.facebook.com/Logres.farm

                                  Comment


                                  • #18
                                    Originally posted by AFOBGYN View Post
                                    Have you thought of doing an embryo transplant? She seems like the perfect candidate.
                                    That is what I think. A few years ago I had a St. Premium Hanoverian mare who was older and had had a few foals. I took her when her last foal was a yearling. She got in foal easily, and lost the pregnancy every time, once as far along as seven months. Unfortunately I don't know what her biopsy score was, but to me, my mare and the OP's are great candidates for ET.
                                    Mystic Owl Sporthorses
                                    www.mysticowlsporthorses.com

                                    Comment

                                    • Original Poster

                                      #19
                                      Yes, I have strongly considered an ET but after reading this thread I am really leaning towards the DMSO lavage (if my repro vet will do it) and then breeding and caslixing ect and crossing fingers like crazy. If it doesn't work this year then I would probably say she is unable to carry a foal and would go to an ET. I guess I just feel I should give it one more try, just in case a few small management changes end up doing the trick?
                                      www.svhanoverians.com

                                      "Simple: Breeding,Training, Riding". Wolfram Wittig.

                                      Comment


                                      • #20
                                        I just want to point out that there are two totally different things being talked about on this thread. Several people have mentioned success with a DMSO lavage for mares that have been difficult to get pregnant, and have referenced a possible biofilm problem. It is documented that a biofilm does result in some mares not being able to conceive, and DMSO is one of many treatments for that condition. However, this does not sound like the case for the OPs mare. This mare is conceiving and then losing the pregnancy, which means that a biofilm issue is not in play here. This is a classic case of probable pregnancy loss due to fibrosis in the uterus which is supported by the biopsy results in this case. A DMSO lavage may still be helpful, but for reducing fibrosis the DMSO concentration MAY need to be greater than that reported to be successful for the treatment of a biofilm. I say MAY because we are talking about an area where there is very little research and the treatment protocols are all over the map. Just want to make sure that we are comparing apples to apples here.
                                        Already excited about our 2016 foals! Expecting babies by Indoctro, Diamant de Semilly, Zirocco Blue and Calido!
                                        https://www.facebook.com/pages/Hills...h/112931293227

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