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BackgroundEndometritis is a common problem in a broodmare practice, often leading to infertility. The diagnosis is based on several methods such as cytology, bacteriology and histopathology; however the outcome of these methods may be inconclusive even when used together. The objectives of this study were: (1) to investigate the usefulness of acute phase proteins as an additional diagnostic tool for diagnosis of subclinical endometritis in mares and (2) to evaluate the association between macroscopic changes in uterine flushes and inflammation of the uterus. Materials were collected from 53 Icelandic mares with subclinical endometritis. Endometrial swabs and uterine lavage for cytological and bacteriological examinations and two endometrial biopsies were taken. Blood samples were collected 12–24 h after ovulation to determine the concentrations of serum amyloid A and haptoglobin in the 53 subfertile mares and, for comparison, from 20 non-pregnant mares that later conceived.ResultsTwenty-five mares were classified as positive for endometritis based on endometrial biopsy, which was used as the ‘gold standard’. We observed a correlation between cloudy efflux in the lavage and (1) polymorphonuclear cell (PMN) infiltration of the endometrium (P = 0.031), (2) positive cytology in samples obtained by cotton swabs (P = 0.019) and uterine lavage (P = 0.011), and (3) positive microbiology from samples obtained by cotton swabs (P = 0.001) and uterine lavage (P = 0.047). The degree of agreement between PMN infiltration and positive cytology from samples taken by cotton swabs and uterine lavage was fair to moderate. We found no association between the concentration of acute phase proteins and infiltration of the endometrium by PMNs, or with positive results of cytological and microbiological examinations.ConclusionsMeasurement of serum amyloid A and haptoglobin was not proven useful for diagnosis of subclinical endometritis in Icelandic mares. Macroscopic changes in the fluid collected by lavage were not consistently indicative of infection, but when present they indicate inflammation in the uterus with a high probability.

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SummaryBuczkowska, J., R. Kozdrowski, M. Sikora, M. Dzięcioł & A. Matusz, 2015. Non-traditional treatments for endometritis in mares. Bulg. J. Vet. Med., 18, No. 4,[285][286][287][288][289][290][291][292][293] Routine treatment for persistent mating-induced endometritis is directed at enhancing the clearance of accumulated fluid from the uterus and includes the use of ecbolic agents (oxytocin, prostaglandin F 2a ) which may be used alone or in combination with large-volume uterine lavage and administering antimicrobials if infection is diagnosed. However, traditional therapies are not always effective in resolving chronic uterine inflammation or infections. Treatment failure may be caused by uterine exudates, inspissated mucus or biofilm produced by some bacteria and yeast. Exudate can interfere with antibiotic penetration, whereas biofilm can confer antibiotic resistance. The endometrium of mares with delayed uterine clearance or chronic endometritis produces more mucus than reproductively healthy mares. Loss of cilia and abnormal mucus blanket provide areas for bacterial attachment. This review describes new strategies of endometritis treatment that may be added to typical therapy and includes intrauterine mucolytics, chelators, immunomodulators, corticosteroids, nonsteroidal antiinflammatory drugs and others.

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Degenerative endometrial changes can predispose to uterine infection and inflammation. Our study shows that mares with endometrial score I are less predisposed to infection than mares with category IIA, IIB and III. Endometrial biopsy is a reliable diagnostic tool.

Significant differences in the biopsy score, and fibronectin and PTGS-2 expression, between two endometrial biopsies obtained from individual mares demonstrated that a single biopsy could be insufficient for diagnosing uterine health status in Icelandic mares.

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