From the Foaling Barn

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MQFs: Two Down and One to Go

Jewel and Her 2011 Filly, Amber

Yesterday, Brian finished treating Dry Sugar Rose and Ozzie. He had treated both mares for the last three days by infusing them with Naxcel. Finally, with Ozzie he performed a Casslick to keep her from reinfecting herself by aspirating air and debris into her vagina.

However, it's back to the drawing board for Jewel. As I noted when Brian treated her previously, he noted an ugly discharge and mucus on his glove. Then yesterday when he ultrasounded Jewel he detected quite a bit of fluid in her uterus--this after being treated for mucus and infection for two days. So rather than a regular culture or a small volume lavage, using the ultrasound Brian directed a pipette into the uterus and actually drew off the fluid which looked like a pinkish-grey glue. When he saw it, Brian was pretty sure we were dealing with a staph infection rather than a fungal infection. But, before we go any further, he'll send the sample into Marshfield Lab to be cultured. Then we'll decide how best to proceed.

While he was collecting the uterine fluid, Brian detected a fairly sizeable tissue tag attached to Jewel's cervix. He thinks this tag could be wicking infection into the uterus from the vagina. He's debating about removing this tag.

So basically, Jewel has three breeding problems: the uterine infection, conformation problems that cause her to contaminate herself by aspirating air into her vagina, and the tag attached to the cervix.

The culture will be back by the end of the week. I'll keep you posted on what we find out and what we decide to do about it.


MQFs (Mares of Questionable Fertility): Updates and Corrections

My Problem Girl--Jewel (Smart Chic Olena X Gay Freckles Rio)

In my last post I gave you some incorrect information. Only Ozzie was flushed and then treated with Naxcel. The other two mares Dry Sugar Rose and Jewel were treated with acetylecysteine. When we did the small volume lavages (SVL) the flushes on both mares was cloudy with mucus and debris. The recommendation was for acetylecysteine to be infused on these two mares until the uterine lavage is clear. Today, Ozzie was infused again with Naxcel. Dry Sugar Rose was infused with acetylecysteine once more. Both of them looked good.

Before we treated Jewel today, we ultrasounded her to get a better look at her ovaries to see if the observed abnormalities might be dialated fallopian tubes. After a close look Brian thought this was unlikely, and what we are seeing is what it looks like--ovaries with many unusually small follicles. However,when Brian prepared to infuse Jewel he found suspicious material leaking from her vulva. And after he infused her, he found thick mucus on his glove. As it did with Dry Sugar, the acetylecysteine should have taken care of the mucus. He now thinks we should do another SVL on her and test it for a fungal infection. Usually, fungal infections create a nasty looking uterine environment. But a few years ago, one of our mares had a fungal infection that looked a great deal like what we are seeing in Jewel. We treated her for it, and she got infoal on one breeding the following year.

Actually, I'm feeling more confident about all three mares. None of them appear to have unsurmountable problems. I think we should be able to get each of them in foal next year.

I just want to mention one of the suggestions we received from Rood and Riddle ( the clinic in Kentucky that evaluated the biopsies). It was suggested that we give the three mares an Omega-3 fatty acid supplement daily for at least 60 days prior to breeding. Actually, when I contacted the supplier of the specific supplement mentioned by the clinic, they suggested that the supplement needs to be given for three months before it takes full affect. So, when I start bringing the mares in at night to put them under lights in November, I'll also begin administering the supplement then.

I'll keep you updated on these three mares.


MQF #2 and #3: The Verdict and the Treatment

Dr. Brian Dahms setting up to treat out three open mares.

Today, our great vet, Dr. Brian, came out to treat our three open mares. The results of the small volume lavage (svl) and the biopsys came back and one thing we learned is that all three mares had uterine infections and endometritis (inflamation of the uterine walls). In addition each mare had their own distinctive issues. I've already discussed Ozzie's uterine cysts in other posts. The other two mares, Jewel and Dry Sugar Rose, both have problems that are fairly common in aging mares. Now, for the specifics:

Jewel. Jewel's biopsy was the poorest of the three, with a grade in the low IIB range. In contrast, Dry Sugar Rose was a IIA and Ozzie was a low IIA /high IIB. The condition of her uterus suggests that she is aspirating air and contaminating herself. From now on she should have a Casslick once she is confirmed infoal to avoid this source of contamination. Also, Dr. Brian had been concerned about how her ovaries looked. She appeared to have numerous small follicles or cysts bilaterally. When Brian talked to the clinic that processed the biopsy, the vet there suggested that what we are seeing is dialated fallopian tubes, which might suggest a blockage.
Brian is a little dubious about this, but tomorrow when he flushes Jewel, he's also going to ultrasound her and look more closely at the ovaries. At nineteen, Jewel is the oldest of the three mares and is expected to have the most serious issues, which she does.

Dry Sugar Rose. She had the most optimistic outlook. Like the others, she had signs of inflamation and infection. We bred her twice, got her infoal twice, and then she slipped both embryoes by 30 days. She would have had a great deal of inflamation as a result of the debris left from the embryos, so the condition of her uterus was not a surprise. However, she has had a history of slipping embryos in past years. When she is nursing a foal, she has gotten pregnant and then lost the pregnancy every year. Dr. Brian and the clinic vet wondered about DNA problems, or as Dr Brian says, old eggs. But the vet clinic also says that the hostile environment of her uterus also could account for the early embryonic deaths.

The Treatment: Dr. Brian will be treating all three mares, three days in a row. Today, he intended to inject a broad range antibiotic (Naxcel) into each mare's uterus. The next two days, he will flush each mare. Actually, today he ultrasounded Ozzie first to check to see if she had any fluid or debris from the surgical removal of her cysts. The uterus looked good, but there was a little fluid, so before treating her with the Naxcel, he flushed her and gave her Oxytocin to help her evacuate her uterus.

Dr. Brian will be back tomorrow and the day after to complete the treatments. I'll update if there are any changes. In my next post, I'll write about the pre and post breeding protocol the clinic vet has suggested that we use on each mare to maximize our chances to achieve a pregnancy. Some of the suggestions we do routinely, but there were some interesting practices we have not used in the past.

Ozzie Goes Under the Knife (Actually a Laser)

The University of Minnesota Equine Clinic

Once we determined that Ozzie's three uterine cysts had become so large that they were interfering with her ability to establish and/or sustain a pregnancy, and after discussion with our vet Dr. Brian Dahms, we decided we had no other choice but have the cysts removed. The traditional treatment for uterine cysts is to go into the uterus and cut them out. But often after surgical removal, the cysts will grow back. Recently, vets have begun to remove cysts by inserting a small camera into the uterus and then using a laserto remove them. I googled the subject, read up on it, and decided that, though it was a bit more expensive, the laser surgery was the way to go. Dr. Brian's clinic does not have this technology, so he recommended that we take Ozzie to the University of Minnesota's Equine Center.

We took Ozzie to the clinic on Thursday. Dr. Tatarniuk, a resident at the Equine Center, did the surgery on Friday afternoon. Prior to surgery Ozzie was given antibiotics to forestall any chance of infection. Then she was placed in stocks, and sedated, and the cysts were removed. Following the surgery, her uterus was lavaged to remove any debris. Finally, a rectal ultrasound was used to determine that the surgery had been successful. For the next few days, I am supposed to monitor Ozzie to make sure she shows no signs of infection. Also, about five days after the surgery, Dr. Brian will lavage her one more time.

When we picked Ozzie up, Dr. Tatarniuk confirmed what Dr. Brian believed--that the cysts had grown so large that they were probably interfering with the embryo's movement around the uterus which meant that maternal recognition was not achieved and Ozzie was rejecting the embryo. Also, even if there was maternal recognition the cysts may have interfered with the embryo's implantation in the uterus.

So, we hope with this surgery, we have solved the mystery of Ozzie's sudden infertility. I am so thankful that I have such a good vet and that we live so close to such a wonderful facilty as the U of Minnesota's Equine Center.

Ozzie Leaving the Equine Center


MQF #1: The Verdict

Since Ozzie has been open for two years now, we have started riding her again.  She may not be in great breeding shape, but she sure is in great riding shape

 

The results on Ozzie's fertility assessment came back this week, and there's good news and some not-so-good news, but nothing to make me feel hopeless about her future as a broodmare.
(See my post MQF # 1 to review Ozzie's breeding history.)

First the good news. Ozzie's biopsy results came back a Grade II-B, which while not great is also not inconsistent for a mare of Ozzie's age and breeding history. Also, the biopsy suggested that the glands in her uterus are healthy and in numbers enough to sustain a pregnancy. The other good news, and this won't sound like good news to most people, but Ozzie does have a uterine infection which has been identified as strep. I say this is good news because of all the problems Ozzie has, this is the most fixable and in itself could account for her inability to get pregnant. Dr. Brian thinks that Ozzie has been aspirating air and will need a Caslick to forestall future infections. For those of you unfamiliar with the Caslick, let me explain.  Many mares as as they age undergo changes in their breeding conformation that cause them to contaminate themselves through the aspiration of air into their uteruses which pulls feces and other sources of disease into their reproductory track. To avoid this problem, once a pregnancy is confirmed, the vet will sew up the vulva leaving an opening for urination. This procedure is called a Caslick named for the  the person who first developed it. About two to three weeks before foaling the vet will open the Caslick. Last year two of my mares had Caslicks.

Now for the not-so-good stuff. As I mentioned in the previous article, Ozzie has at least three sizable uterine cysts, one of which has grown significantly since the end ot the breeding season. The cysts make it  difficult to determine if Ozzie is pregnant at 14 days, and may interfere with the embryo's movement in the uterus. So Dr. Brian thinks we need to have the cysts removed before we do anything else. The best way to treat cysts so that they don't return is to have them lazered off. That means a trip to the University of Minnesota. Once the cysts are removed, we will treat Ozzie for the infection, and hopefully we'll achieve a pregnancy this year.




Case Study: MQF # 1

Today Dr. Brian was out to do fertility evaluations on our three open mares. In this post I want to focus on one of the mares whose breeding problems appear to be the most problematic.

Ozzie (Whizard of Oswald by Topsail Whiz) is a seventeen year-old mare, sound and in good health. She has been a fairly easy breeder until two years ago. After a normal pregnancy and delivery, when Dr. Brian ultrasounded her in preparation for rebreeding, he found signifcant changes in her uterus. She had developed numerous uterine cysts, at least two of them approximately the size of a fourteen day embryo. Brian was not overly concerned about the cysts. He said he has seen mares get pregnant with many more cysts. However, the shape, location and size of the cysts, made it difficult to determine pregnancy until there was a heartbeat. Unfortunately, during the last two years Ozzie never became pregnant, or, if she did, she lost the pregnancy before day 25. When Dr. Brian checked Ozzie today, he found that one of the cysts had grown substantially since he last checked her in June.

While cysts are fairly common in aging mares and often cause no breeding problems, if the cysts are large they can interfere with the embryo when it enters the uterus. The embryo needs to move around in the uterus in order to establish maternal recognition, so that the embryo is not rejected by the mare. Also, cysts may indicate problems in the lining of the uterus that would interfere with the attachment and nourishment of the embryo. To determine the health of  Ozzie's uterus, Dr. Brian took a small biopsy of the uterine lining which will be evaluated for infection or degenerative processes. Biopsys are graded I, II, and III. A Grade I indicates a healthy uterus with pregnancy odds of 75% or better; a Grade III uterus would have only a 10% chance of achieving a pregnancy.

Besides ultrasound, the two most important tests Dr. Brian uses in his feritlity evaluation are a biopsy of the lining of the uterus and a small volume lavage (SVL). The SVL is usually done to determine infectious pathogens in the uterus. A small amount of fluid is injected into the uterus and then drawn out and cultured. The SVL gives a better picture of the health of the uterus than a swab which only tests one small part of the uterus. Often the culture from SVL will show infection when a swab culture will be clean. When Dr. Brian did a SVL on Ozzie, he was only able to retrieve a very small amount of the injected fluid, which may mean that the large cyst is, indeed, interfering with normal uterine activity.

If Ozzie's biopsy comes back a Grade I or II, we could choose to have the three large cysts removed to vastly improve chances of pregnancy. However, with a Grade III Ozzie's breeding career would be over.

I'll keep you updated on the results.

Ozzie and Her Last Foal


Breeding Problems: MQFs (Mares of Questionable Fertility)

 

Next Thursday our excellent vet, Dr. Brian Dahms, is coming out early in the morning to perform a fertility assessment on my three open mares, Dry Sugar Rose, Smart Little Jewel, and Whizard of Ozwald.  Each one of these mares was bred multiple times last spring with differing but always disappointing results.  When Dr. Brian comes out next week, his basic work-up on each mare will include palpation, ultrasound of the uterus and ovaries, speculum examination of the cervix, uterine biopsy, and uterine culture by use of small volume lavage.  The biopsy will be sent out for evaluation and grading; the small volume lavage will be cultured for infectious agents.  After we get the results back, we'll decide how to proceed with each mare. 

During the next week, I'm going to write up a case history of each mare.  Then after the exams, I'll follow up and let you know what if anything we'll be doing differently to each mare before and during breeding season.

These three mares, at ages 19 and two at 17, are among my oldest mares.  Most mares' fertility begins to decline, sometimes precipitously, beginning around aged 17, so it isn't unusual to be facing breeding issues.  I'm willing to spend a little time and effort to try to get a few more foals out of each of these mares because they are three of my best mares.  They all have impeccable pedigrees, outstanding show careers, and/or have a strong  produce records.


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