Microbiological, Cytological and Ultrasonographic studies in infertile mares and their therapeutic management
Abstract
Infertility in broodmares due to uterine infection and associated endometritis occurs following breeding and foaling, and cripples annual foal production and accounts for heavy economic loss in the equine industry. Both diagnosis and therapeutic management as early as possible are warranted to maintain optimum fertility. Present study was therefore undertaken with the aim to evaluate the diagnostic utility of uterine cytology, uterine culture and ultrasonography in detection of uterine infection in infertile mares and to recommend a combination of diagnostic techniques to be employed as a routine procedure in the management of equine uterine infections and associated endometritis. The therapeutic efficacy of different treatment regimens in management of uterine infection in infertile mares was also evaluated. Investigation was conducted on 27 broodmares of equine breeding stud (RVC)-Hisar. Mares were divided into four groups (Group I, II and III, with 7 infertile mares in each group; Group IV with 6 fertile mares). All the mares were subjected to pre-treatment assessment of reproductive status by uterine ultrasonography, uterine cytology and uterine culture, followed by therapeutic management of uterine infections and associated endometritis with three different therapeutic regimens for three different groups. Transrectal ultrasound was done using a linear array probe (5MHz and 7 MHz). Sampling for uterine cytology and uterine cultures was done using low-volume uterine flush technique. Group I mares were treated with saline uterine lavage + PGF2α + intrauterine antibiotic infusion, Group II mares received saline uterine lavage + Cloprostenol + intrauterine antibiotic infusion, Group III mares were treated with saline uterine lavage + Oxytocin + intrauterine antibiotic infusion. Group IV mares received no treatment. The antibiotics used were based on the in vitro antibiotic sensitivity test. Further, therapeutic response was evaluated by post-treatment ultrasound conducted between days 7-10 after treatment and post-treatment conception was recorded following 1st, 2nd and 3rd inseminations. The sensitivity, specificity, positive predictive value and negative predictive value of ultrasound, uterine cytology & uterine culture were recorded to be 86.66%, 50.00%, 68.42% & 75.00%; 71.42%, 69.23%,71.4% & 69.23% and 100%,100%, 100% & 100% respectively. The results of all the techniques were highly and significantly correlated. Uterine cultural examination of the flush sample was the most reliable method for detection of uterine infection in infertile mares. Uterine culture and uterine cytology was found to be the best combination for routine use in the diagnosis of infections. However, uterine ultrasonography may be used for evaluation of quantity of uterine fluid as well as assessment of endometrial oedema/uterine wall thickening in prediction of fertility. Therapeutic regimens involving Cloprostenol and Oxytocin in addition to uterine lavage + intrauterine antibiotic infusion were found to be first and second preference treatment protocols, respectively, in management of uterine infections in infertile mares.
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