A Clinical Approach to the Diagnosis and Treatment of Retained Fetal Membranes with an Emphasis Placed on the Critically Ill Mare

Placental homogeneity: Characterizing transcriptional variation among equine chorioallantoic locations

The proper function of the placenta is essential for the health and growth of the fetus and the mother. The placenta relies on dynamic gene expression for its correct and timely development and function. Although numerous studies have identified genes vital for placental functions, equine placental molecular research has primarily focused on single placental locations, in sharp contrast with the broader approach in human studies. Here, we hypothesized that the molecular differences across different regions of the equine placenta are negligible because of its diffuse placental type with a macroscopic homogenous distribution of villi across the placental surface. We compared the transcriptome and stereological findings of the body, pregnant horn, and non-pregnant horn within the equine chorioallantois. Our transcriptomic analysis indicates that the variation between regions of the placenta within individuals is less than the variation observed between individuals. A low number of differentially expressed genes (DEGs) (n = 8) was identified when comparing pregnant and non-pregnant horns within the same placenta, suggesting a remarkable molecular uniformity. A higher number of DEGs was identified when comparing each horn to the body (193 DEGs comparing pregnant horn with body and 207 DEGs comparing non-pregnant horn with body). Genes with a higher expression in the body were associated with processes such as extracellular matrix synthesis and remodeling, which is relevant for placental maturation and placenta-endometrial separation at term and implies asynchrony of these processes across locations. The stereological analysis showed no differences in microcotyledonary density, and width between the locations. However, we observed a greater chorioallantoic thickness in the body and pregnant horn compared to the non-pregnant horn. Overall, our findings reveal a uniform transcriptomic profile across the placental horns, alongside a more distinct gene expression pattern between the uterine body and horns. These regional differences in gene expression suggest a different pace in the placental maturation and detachment among the placental locations.

Colostrum conductivity, pH and Brix index as predictors of passive immunity transfer in foals

BACKGROUND

Foal immunity relies heavily on the absorption of colostrum immunoglobulins; thus, colostrum evaluation is used to predict the transfer of passive immunity (TPI), and its conductivity is associated with TPI in cattle. Leading up to and at parturition, a reduction in colostrum pH and conductivity is thought to be necessary for TPI; however, this remains to be determined.

OBJECTIVES

To assess conductivity, pH, and Brix refractometer index of colostrum to predict the TPI in foals.

STUDY DESIGN

Field study.

METHODS

The colostrum of 241 mares was assessed for conductivity, pH, and Brix index using handheld devices immediately after parturition. Twenty-hour postpartum foals had complete blood cell count and plasma IgG concentrations assessed. Foals were split in complete versus incomplete TPI (i.e., IgG ≥8 g/L vs. <8 g/L). Mare (breed, duration of pregnancy, parity, and age), foal (sex), and colostrum (conductivity, pH, and Brix index) data were computed to assess factors affecting TPI. Multivariate regression and receiver operating characteristic (ROC) curves were employed for analysis.

RESULTS

Complete TPI was achieved in 89.4% of foals. The ROC TPI values were conductivity ≤5 mS/cm (AUC = 0.68), Brix ≥23.4% (AUC = 0.70), and pH ≤6.4 units (AUC = 0.73). The odds ratio for TPI in 24 h post-partum was 6.1 (2.1-17.1, 95% CI) for conductivity, 3.2 (1.2-9.3, 95% CI) for pH, and 4.5 (1.5-12.7, 95% CI) for Brix index. Sensitivity and specificity of 93% (88-96 95% CI), 56% (44-7, 95% CI), 92% (87-96, 95% CI), 28% (14-47, 95% CI), 94% (88-97, 95% CI) and 18% (14-47, 95% CI) for conductivity, Brix and pH, respectively.

MAIN LIMITATIONS

Low incidence of incomplete TPI.

CONCLUSIONS

Conductivity, pH and Brix are strong predictors of foals that succeed in the transfer of passive immunity; however, all three presented low to moderate specificity. The established cutoff values obtained herein can be used on-field by other foaling programs. All three handheld devices used in the study are inexpensive and ready to use on-farm.

Conductivity of mammary gland secretions is a sensitive and specific predictor of parturition in mares

BACKGROUND

Accurate prediction of parturition is paramount to ensuring monitoring of delivery and preventing complications. Assessing the pH and electrolytes of the mammary gland secretions (MGS) helps detect impending parturition. As conductivity is related to electrolyte concentrations and pH, it could be a useful alternative for predicting impending parturition; however, this hypothesis warrants a critical assessment.

OBJECTIVES

To assess the ability of conductivity, pH, and Brix in the MGS to predict parturition and to investigate their associations.

STUDY DESIGN

Field study.

METHODS

The MGS of periparturient mares (n = 241) was assessed daily for conductivity, pH, and Brix index from 320d until parturition. Receiving operating curve cut-off values for conductivity (≤4.8 mS/cm), pH (≤6.4), and Brix index (>23.6%) were used to calculate sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for predicting parturition in ≤24 h.

RESULTS

Impending parturition was associated with a reduction in conductivity and pH (p < 0.05), and conductivity was strongly correlated with pH (r = 0.88) and Brix (r = -0.80) (p < 0.05). Sensitivity, specificity, PPV, and NPV for parturition in ≤24 h for conductivity (82%, 91%, 77%, and 92%, respectively), pH (79%, 84%, 81%, and 71%, respectively), and Brix (72%, 79%, 66%, and 83%, respectively) were determined separated and pairwise. Of interest, the sensitivity, specificity, PPV, and NPV, of combining conductivity and pH, were 80%, 95%, 90%, and 88%, respectively. Conductivity (≤4.8 mS/cm) presented the greatest odds ratio for predicting parturition in ≤24 h, and coupling it with pH (≤6.4 pH units) doubled its odds ratio (i.e., 25.4-62.3).

MAIN LIMITATIONS

Field study.

CONCLUSION

The conductivity of MGS is a sensitive and specific method to predict parturition. This is the first large-scale study showing that a combination of conductivity and pH is useful for predicting parturition in mares. The methods employed can likely apply to other settings with similar results.

Evaluation of peritoneal l-lactate concentration in horses in the early post-partum period

BACKGROUND

Peritoneal fluid lactate concentration is an important diagnostic tool in horses with abdominal pain. Information on peritoneal lactate concentrations is lacking following parturition in the mare.

OBJECTIVES

To compare blood and peritoneal lactate concentrations in a population of mares within 36 h post-partum, report a normal reference range and identify any impact of retained foetal membranes (RFMs).

METHODS

This is a retrospective study evaluating healthy mares from which blood and peritoneal samples had been obtained within 36 h of parturition. Exclusion criteria included signs of abdominal pain within this period. Data was interrogated for normality using a Shapiro-Wilk test. Wilcoxon signed-rank test and Bland-Altman analysis were used to compare blood and peritoneal lactate concentrations. Linear regression was used to compare age and breed data with peritoneal lactate concentrations. Significance was defined as p < 0.05.

RESULTS

Forty mares met the inclusion criteria. Mean age was 12.6 ± 4.1 years, and most mares were multiparous (65%). Peritoneal lactate ((1.2 (IQR = 0.9-1.6) mmol/L) was increased compared to blood lactate concentration (0.7 (IQR = 0-1.1)mmol/L; p < 0.001). Plasma total protein (TP) concentrations were 68 (IQR = 64-74) g/L and peritoneal protein concentrations 8 (IQR = 4-9.7) g/L. Six mares developed RFM. The median fold-increase in peritoneal lactate concentration compared to blood lactate concentration was 0.9 (IQR: 0.01-1.7; range: 0-2.5). The reference range for peritoneal fluid lactate concentration was 0-2.5 mmol/L.

CONCLUSION

Peritoneal lactate concentrations in healthy post-partum mares remained within the normal reference range and were not influenced by RFM or parturition. Increased peritoneal lactate in this group warrants further investigation.

Clinical Aspects of Bacterial Distribution and Antibiotic Resistance in the Reproductive System of Equids

Antibiotic administration is a standard therapeutic practice for the treatment of reproductive disorders of equids. This might lead to undesirable microbial imbalance and could favour the acquisition of antibiotic resistance. Therefore, it is imperative for clinicians to understand patterns of antibiotic resistance when considering and developing treatment regimes. Continued engagement of clinicians with novel alternative approaches to treat reproductive infections would be essential in order to address this rising threat within the One Health perspective. The objectives of the present review were to present the bacterial infections in the reproductive system of equids (horses, donkeys), to upraise the literature related to the issue of antibiotic resistance of bacteria causing these infections and to discuss the topic from a clinical perspective. Initially, the review summarised the various infections of the reproductive system of equids (genital system of females, genital system of males, mammary glands) and the causal bacteria, providing relevant information about horses and donkeys. Subsequently, the clinical therapeutics of these infections were presented, taking into account the significance of antibiotic resistance of bacteria as a limiting factor in treating the infections. Finally, approaches to circumvent antibiotic resistance in clinical settings were summarized. It was concluded that awareness regarding antibiotic resistance in equine reproductive medicine would increase, as we would recognise the multifaceted problem of resistance. Actions and initiatives within the One Health approach, minimizing the potential dissemination of resistant strains to humans and to the environment, with specific applications in medicine of equids should be appropriately instituted internationally.

Dystocia in the Standardbred Mare: A Retrospective Study from 2004 to 2020

Dystocia as a prolonged stage II parturition (>30 min) was associated with a higher risk of complications. The hypothesis of the study was that any type of dystocia could affect the foal’s health, even when the stage II was <30 min. Clinical reports on 222 Standardbred mares and their foals hospitalized at the Veterinary Teaching Hospital of the University of Bologna from 2004 to 2020 were reviewed. Mares were divided into the Eutocia Group (165, eutocic delivery) and the Dystocia Group (57, dystocic delivery). The incidence of dystocia was 4.9%. Stage II was longer in the Dystocia Group (median 20 min) than in the Eutocia Group (median 12 min). All occurrences of dystocia were retrospectively classified into three categories of severity: mild, moderate and severe dystocia. The occurrence of postpartum complications in mares and neonatal diseases and failure of passive transfer of immunity in foals was higher in the Dystocia Group. Foal venous lactatemia and serum creatine kinase were significantly higher in the Dystocia Group (median 3.9 mmol/L; 262 UI/L respectively) than in the Eutocia Group (median 3.1 mmol/L; 187 UI/L respectively). The APGAR score was lower in the Dystocia Group (median 8) than in the Eutocia Group (median 10) and significantly lower in severe dystocia (median 3). The duration of stage II should not be considered the only parameter of dystocia in mares: even a rapid resolution of dystocia could pose health risks to the foal and the mare.

Managing Reproduction Emergencies in the Field: Part 2: Parturient and Periparturient Conditions

Selected conditions affecting broodmares are discussed, including arterial rupture, dystocia, foal support with ex utero intrapartum treatment, uterine prolapse, postpartum colic, the metritis/sepsis/systemic inflammatory response syndrome complex, and retained fetal membranes. Postpartum colic beyond third-stage labor contractions should prompt comprehensive evaluation for direct injuries to the reproductive tract or indirect injury of the intestinal tract. Mares with perforation or rupture of the uterus are typically recognized 1 to 3 days after foaling, with depression, fever, and leukopenia; laminitis and progression to founder can be fulminant. The same concerns are relevant in mares with retention of fetal membranes.

Electrolytes and pH of Mammary Gland Secretions Assessments to Detect Impending Parturition and Associations With Placental and Neonate Features in Donkeys

The objectives of this study were to determine (i) the usefulness of serial assessment of mammary gland electrolytes concentrations and correspondent pH to detect impending parturition in jennies; and (ii2) the associations between mammary gland secretions, and gestation length, foal sex, maternal, placental, and foal birth weights. Multiparous jennies (n = 37) were monitored daily from 350 to 355 days of gestation until parturition. The pH of mammary gland secretions was assessed daily with a hand-held device. Aliquots of mammary secretions were frozen daily and then retrospectively assessed for electrolyte concentrations (Ca²⁺, Mg²⁺, K⁺, and Na⁺) with an automated analyzer from five days until the last sampling pre-partum. Mammary gland electrolytes and pH were analyzed with mix-models. The gestational length, newborn, maternal, and fetal membranes weights were analyzed with t-test grouped by foal's sex. Associations across all variables were assessed with Pearson's coefficient of correlation. Sensitivity, specificity, and negative predictive value (NPV) and positive predictive values (PPV) were evaluated for pH (≤ 6.4), Ca²⁺ (>10 mmol/L), and a combination of both. Each jenny had pH profiles assessed visually and classified as fast pH drop (1), slow pH drop (2), and alkaline pH (3) as previously described for horses. The overall gestation length was 374 ± 8.7 days, ranging from 357 to 390 days. There were no differences for gestation lengths for jennies delivering colts (374 ± 2.1 range 357-385 days), versus the ones delivering fillies (373 ± 2.3 range 358-390 days) (P > .05). Of all the foals, there were 61.8% colts and 38.2% fillies. The ratio of foal birthweight with the dam's bodyweight was 9.7%, and the ratio with fetal membranes was 11%. The majority of parturitions happened during the night (91.9%). There was a significant reduction in Na⁺ and an increase in Ca²⁺, Mg²⁺, and K⁺ concentrations leading to foaling. The pH showed a 90% sensitivity for foaling within 24 hours, whereas the specificity was 70%, and the PPV and NPV values were 40% and 97%. Of interest, Ca²⁺ (>10 mmol/l) displayed a sensitivity and specificity of 71% and 85%, whereas the PPV and NPV were 72% and 84%. In the present study, jennies exhibited profiles 1 to 3 as previously described for mares. Herein, 65% of the jennies displayed profile 2 and foaled with a mean acidic pH of 6.4 ± 0.02. Conversely, 32% of the jennies showed a fast reduction in the pH of mammary secretion (profile 1) from day -1 (7.3 ± 0.2) to the day of foaling with an average pH of 6.6 ± 0.08. One jenny foaled with high and alkaline pH (i.e., 7.5). There were weak and negative correlations between pH and Ca²⁺, Mg²⁺, and K⁺ (P < .05). In addition, Ca²⁺ displayed a weak but significant correlation with Mg²⁺, Na⁺, and K⁺. In conclusion, daily pH measurements of the mammary gland secretions can predict foaling in jennies, whereas Ca²⁺ was not as useful. Contrary to horses that most mares present a fast pH profile, most jennies showed a slow pH profile. The sex of foal did not affect the gestational length and fetal/maternal and fetal membrane proportions in donkeys.

Transcriptome Profiling of the Retained Fetal Membranes-An Insight in the Possible Pathogenesis of the Disease

Simple Summary

Retained fetal membranes (RFM) in mares is a disease of a multifactorial etiology with not fully understood pathogenesis. Profound analysis of genes expressed in the placenta may reveal pathways and processes which might be comprised in mares with this disease and hence help to explain the pathogenesis of RFM. This work employed RNA sequencing to identify and compare genes differentially expressed (DEGs) in the placenta of mares that retained fetal membranes and those that released them physiologically. Results showed that within DEGs genes important for apoptosis, inflammatory-related processes, and metabolism of extracellular matrix were identified.

Abstract

Retained fetal membranes (RFM) is one of the most common post-partum diseases of a complex etiology. Moreover, its pathogenesis is still not elucidated. Detailed transcriptomic analysis of physiological and retained placenta may bring profound insight in the pathogenesis of the disease. The aim of the study was to compare the transcriptome of the retained and physiologically released placenta as well as biological pathways and processes in order to determine the possible pathogenesis of the disease. Samples of the endometrium and the allantochorion were taken within 2 h after parturition from control mares (n = 3) and mares with RFM (n = 3). RNA sequencing was performed with the use of all samples and mRNA expression of chosen genes was validated with Real Time PCR. Analysis of RNA-seq identified 487 differentially expressed genes in the allantochorion and 261 in the endometrium of control and RFM mares (p < 0.0001). Within genes that may be important in the release of fetal membranes and were differentially expressed, our report pinpointed BGN, TIMP1, DRB, CD3E, C3, FCN3, CASP3, BCL2L1. Gene ontology analysis showed possible processes which were altered in RFM that are apoptosis, inflammatory-related processes, and extracellular matrix metabolism and might be involved in the pathogenesis of RFM. This is the first report on the transcriptome of RFM and physiologically released placenta in mares.

The Effect of Uterine Lavage on Soluble CD14, Chemokine Ligand 2, and Interleukin 10 Levels in Mares With Postpartum Metritis

Postpartum metritis in mares is a life-threatening condition associated with severe clinical signs due to endotoxemia, and it is often followed by complications such as laminitis. Repeated large-volume uterine lavages are commonly recommended as a part of the treatment protocol to remove endotoxin-laden contents from the uterus. It has, however, also been suggested that lavages may increase the uptake of endotoxin into the circulation, leading to a deterioration of clinical signs. Endotoxemia is associated with the release of a multitude of inflammatory mediators regulating the immune response. The aim of this study was to evaluate if uterine lavage influences serum levels of the inflammation markers soluble CD14 (sCD14), chemokine (C-C motif) ligand 2 (CCL2), and interleukin (IL)-10 in mares with postpartum metritis. Serum samples were collected from eight mares treated for metritis at a university teaching hospital. Mares with fever, tachycardia, and/or leukopenia and hemosanguineous or purulent intrauterine fluid within 1 week of foaling were included in the study. Serum samples were taken before uterine lavage and 15 and 30 minutes after starting the lavage. The concentrations of sCD14, CCL2, and IL-10 were determined with a fluorescent bead-based immunoassay. There were no significant differences between sCD14, CCL2, or IL-10 levels at different sampling times. Heart rate was significantly lower after uterine lavage than before. The differences in body temperature and leukocyte count before and after lavage were not significant. In conclusion, uterine lavage had no immediate effect on the serum concentration of sCD14, CCL2, or IL-10, nor did it affect clinical parameters negatively.

Expression profile of proinflammatory mediators in the placenta of mares during physiological detachment and retention of fetal membranes

Physiological parturition is characterized by sterile, inflammatory-like processes. During parturition, the placenta expresses various proinflammatory mediators, such as chemokines and IL-17. Nevertheless, inflammatory processes present in the parturient mare are poorly characterized. The aim of this study was to investigate the expression of selected chemokines and IL-17 in the allantochorion and the endometrium of mares that retained fetal membranes (RFM) and expelled them physiologically. We hypothesized that the expression of these mediators may be altered in the placenta of mares with RFM and result in RFM occurrence. Differences in mRNA expression in the placenta of investigated groups of mares were detected for CCL2, CCL3, CCL4, CCL8, CXCL1, CXCL8, CXCL10, CX3CL1 and IL-17. There were no differences in mRNA expression of CCL5 and CXCL6. Gene ontology network analysis showed enrichment in genes related to leukocyte migration, cell chemotaxis and response to chemokine in tissues of RFM mares. Analysis of association network suggested denotations between CXCL6, CXCL8, CXCL1, CCL5, CCL4, CX3CL1 and CXCL10. Moreover, possible inhibition of CXCL10 by IL-17A and prostaglandin peroxide synthase 2 (PTGS2) by CXCL1 was detected. Our results suggest that, based on differences in chemokines and IL-17 expression, recruited subsets of leukocytes might differ between the analyzed groups of mares, which in turn may impair the separation of fetal membranes in the group of RFM mares. In addition, the results of the expression analysis suggest that macrophages might be one of the most abundant cells infiltrating the equine placenta during the expulsion of fetal membranes. Furthermore, we suspect that the synthesis of PTGS2 might be inhibited in mares with RFM.

Is similarity in Major Histocompatibility Complex (MHC) associated with the incidence of retained fetal membranes in draft mares? A cross-sectional study

The failure of the maternal immune system to recognize fetal antigens and vice versa due to MHC similarity between the foal and its dam might result in the lack of placental separation during parturition in mares. The aim of the study was to investigate the influence of MHC similarity between a mare and a foal on the incidence of retained fetal membranes (RFM) in post-partum mares. DNA was sampled from 43 draft mares and their foals. Mares which failed to expel fetal membranes within three hours after foal expulsion were considered the RFM group (n = 14) and mares that expelled fetal membranes during the above period were the control group (n = 29). Nine MHC microsatellites of MHC I and MHC II were amplified for all mares and foals. MHC compatibility and MHC genetic similarity between mares and their foals was determined based on MHC microsatellites. The inbreeding coefficient was also calculated for all horses. The incidence of RFM in the studied population was 33%. Compatibility in MHC I and MHC II did not increase the risk of RFM in the studied population of draft mares (P>0.05). Differences in MHC similarity at the genetic level were not observed between mare-foal pairs in RFM and control group (P>0.05). We suspect that RFM in draft mares may not be associated with MHC similarity between a foal and its dam. Despite the above, draft horses could be genetically predisposed to the disease.

Inter- and intrabreed diversity of the major histocompatibility complex (MHC) in primitive and draft horse breeds

Background

Polymorphism of major histocompatibility complex (MHC) genes ensures effective immune responses against a wide array of pathogens. However, artificial selection, as performed in the case of domestic animals, may influence MHC diversity. Here, we investigate and compare the MHC diversity of three populations of horses, for which different breeding policies were applied, to evaluate the impact of artificial selection and the environment on MHC polymorphism.

Methods

Samples of DNA were taken from 100 Polish draft horses, 38 stabled Konik Polski horses and 32 semiferal Konik Polski horses. MHC alleles and haplotype diversity within and between these populations of horses was estimated from 11 MHC microsatellite loci.

Results

MHC diversity measured based on allelic richness, observed heterozygosity, expected heterozygosity and polymorphism content was similar across the MHC microsatellite loci in all three populations. The highest expected heterozygosity was detected in semiferal primitive horses (He = 0.74), while the lowest was calculated for draft horses (He = 0.65). In total, 203 haplotypes were determined (111 in Polish draft horses, 43 in semiferal Konik Polski horses and 49 in stabled Konik Polski horses), and four haplotypes were shared between the two populations of Koniks. None of these haplotypes were present in any of the previously investigated horse breeds. Intra-MHC recombination events were detected in all three populations. However, the population of semiferal Konik horses showed the highest recombination frequency among the three horse populations. In addition, three recombination events were detected.

Conclusions

These results showed that despite the different breeding policies, the MHC allele and haplotype diversity was similarly high in all three horse populations. Nevertheless, the proportion of new haplotypes in the offspring was the highest in semiferal Konik Polski horses, which indicates the influence of the environment on MHC diversity in horses. Thus, we speculate that the genetic makeup of the domestic horse MHC might be more strongly influenced by the environment than by artificial selection. Moreover, intra-MHC conversion, insertion, and deletion and intra-MHC recombination may be proposed as mechanisms underlying the generation of new MHC haplotypes in horses.

Key Aspects of Donkey and Mule Reproduction

Donkeys are nonseasonal, polyestrous, territorial, and nonharem breeders. Although there are many similarities between horses and donkeys, there are also reproductive features that differ, from the longer cervix in the jenny to spermatogenic efficiency in the jack. Mules display reproductive cyclic activity but are rarely fertile. Frozen donkey semen has high pregnancy rates in mares, but lower rates in jennies. This article reviews key aspects of donkey and mule reproductive physiology, reproductive medicine, and assisted reproductive techniques that are useful for practitioners offering assisted reproductive techniques, and also for practitioners with the occasional client with a basic reproductive question.

Fetal Membrane Removal in the Mare: Proactive Versus Reactive Approaches

Retained fetal membranes are the most common postpartum condition in mares. Although the incidence of retained fetal membranes is low, the consequences for the health of the mare can be severe (metritis, endotoxemia, laminitis, death). Oxytocin administration is often the first line of therapy for management of retained fetal membranes. Removal of fetal membranes using umbilical vessel infusion and manual membrane removal are effective tools for reducing risks associated with abnormally heavy membranes, retained membranes, or for mares that are geographically limited for veterinary care.

Evidence for Increased Content of PGF2α, PGE2, and 6-keto-PGF1α in Endometrial Tissue Cultures From Heavy Draft Mares in Anestrus With Endometritis

Endometritis is one of the most important causes of infertility in mares. Mares may suffer from endometritis outside the breeding season; however, pathological condition is often undiagnosed in anestrus. The aim of this study was to examine whether the secretion profiles of prostaglandin F_2α (PGF_2α), prostaglandin E₂ (PGE₂), and a metabolite of prostacyclin I₂ (6-keto-PGF_1α) differ in endometrial tissue cultures of heavy draft mares in anestrus with endometritis compared to those without endometritis. The endometrial biopsies were collected from 51 heavy draft mares. Inclusion criteria for the control group were absence of endometritis confirmed by histology and no ovarian activity. Inclusion criteria for the experimental group were presence of endometritis showing polymorphonuclear cells and/or lymphocytes infiltration in endometrium and no ovarian activity. Retrospectively, 22 mares were enrolled in this study. The content of PGF_2α (P < .05) and PGE₂ (P < .001) in the culture medium was distinctly elevated in mares suffering from endometritis, compared to control mares. The relative mRNA abundance responsible for prostaglandins synthesis, that is, PGF_2α synthase (PGFS; P < .01), PGE₂ synthase (PGES; P < .01), and prostaglandin-endoperoxide synthase (PTGS2; P < .01), were also increased in endometrial tissue of mares with endometritis compared to control mares. The content of 6-keto-PGF_1α (P < .0001) in endometrial tissue cultures from mares with endometritis was strikingly elevated compared to those without endometritis; however, plasma concentration of 6-keto-PGF_1α was not significantly different between experimental and control groups. This leads to the conclusion that augmented endometrial secretion of PGF_2α, PGE₂, and 6-keto-PGF_1α is associated with endometritis even in mares in anestrus.

Expression of proinflammatory cytokines IL-1β, IL-6 and TNFα in the retained placenta of mares

Retained fetal membranes (RFM) is a prevalent postpartum disease in mares. During parturition, various proinflammatory cytokines are released in the placenta, which further facilitates uterine contractions, expulsion of the fetus and fetal membranes. We hypothesized that an altered inflammatory response in mares results in retained fetal membranes. Samples of the endometrium and the allantochorion were collected from 15 mares with RFM and from 29 control mares within 2 h of foal delivery. Next, the mRNA expression of IL-1β, IL-6 and TNFα proteins was analyzed by Real Time PCR and Western blot. These cytokines were also localized by immunocytochemistry. In mares with RFM, the mRNA expression of IL-1β in the endometrium (p < 0.05) and IL-6 in the allantochorion (p < 0.0001) was higher than in mares that expelled fetal membranes physiologically. Higher expression of IL-6 in the allantochorion was confirmed by Western blot. In contrast, no changes in TNFα mRNA and protein expression were observed between the 2 groups of mares. Moreover, TNFα mRNA was barely detectable. The presence of all studied cytokine proteins in the allantochorion was confirmed by immunocytochemistry. The results suggest that the outbreak of inflammation is involved in the mechanism of placenta release in mares. Increased expression of IL-6 in the allantochorion and IL-1β in the endometrium could reflect a local immune response which leads to the detachment of fetal membranes. The low expression of TNFα mRNA might suggest that this cytokine is not involved in the expulsion of fetal membranes. Further work is needed to determine the exact role and timing of inflammatory activation in fetal membranes during equine parturition.

Treatment of Retained Fetal Membranes in the Mare-A Practitioner Survey

Retained fetal membranes (RFM) is a common post-partum problem in mares for which the treatment is highly variable. The aim of this study was (i) to investigate the different treatments used by equine practitioners for RFM and (ii) to determine if there is a difference between treatments used by reproductive specialists and general equine practitioners. Information regarding treatment of RFM was sought from veterinary practitioners via a survey and this was compared to recommendations in the current literature. The survey was sent out to equine veterinarians and mixed practitioners with a high equine case load. Most treatments of RFM were in line with current recommendations, while some obsolete practices are still routinely performed by a small number of practitioners. Treatment recommendations for RFM have changed over the last few decades, but there are no universally accepted guidelines. The vast variety of treatments reported by practitioners in the present survey reflect this lack of guidance. More extensive research is needed in this area to establish evidence-based, uniformly agreed upon protocols.