Treatment of Hydropsical Conditions Using Transcervical Gradual Fetal Fluid Drainage in Mares With or Without Concurrent Abdominal Wall Disease

Hydroallantois in a mare associated with schistosomus and unilateral ovarian agenesis in the fetus

Hydropsical conditions in domestic animals are characterized by abnormal fluid accumulation. While their complete pathophysiology remains unclear, factors such as changes in chorioallantoic membranes, placentitis, or fetal abnormalities may contribute. Hydrops present as a medical emergency that can cause complications for the mare. Early diagnosis and treatment are crucial for the mare's prognosis, as fetal survival is often poor. This report describes a case of hydroallantois in a 9-year-old pregnant Quarter mare at 271 days of gestation, leading to dystocia of a non-viable foal with multiple congenital abnormalities. Given the poor prognosis for fetal survival, transcervical gradual fluid drainage and pregnancy termination were performed. The malformed fetus was subsequently delivered and humanely euthanized. Necropsy findings revealed a schistosomus fetus with palatoschisis, a wry nose, prognathism, and unilateral ovarian agenesia. The case underscores the importance of timely intervention in managing hydroallantois. The report contributes to understanding horses' clinical presentation, diagnosis, and management of hydroallantois.

Birth of a Healthy Monozygotic Twin Foal with Hydrops and a Dead Co-Twin

Transfer of in vitro-produced (IVP) equine embryos is associated with a higher incidence of monozygotic multiple pregnancies, but this remains a rarity. The outcome of monozygotic twin gestation is poor, and good management techniques are lacking. In addition, hydrops conditions are exceptional in horses, with hydroallantois occurring more frequently than hydramnion. Most hydrops conditions will lead to compromise or death of the foal and mare. A 6-year-old multiparous standardbred recipient mare, 332 days pregnant, diagnosed with a monozygotic twin and hydrops with a dead co-twin, gave birth with an assisted vaginal delivery. The dead foal, previously determined at 9 months by ultrasound, turned out to have the dimensions and hair corresponding to an 8-month-old foal. The other foal was born alive and considered healthy and normal-sized for its age. Both mare and foal were discharged from the clinic one week after parturition. This report is the first to describe the birth of a healthy foal born from a monozygotic twin pregnancy in the presence of hydrops, following transfer of a single IVP equine embryo. In addition, it is rare to find a non-macerated, non-mummified dead co-twin after fetal death at 8 months together with a healthy full-term foal.

Placental abnormalities associated with Leptospira interrogans infection in naturally infected mares

The reproductive features of equine leptospirosis are often neglected. Equine genital leptospirosis is characterized as a silent chronic syndrome, and besides abortions, leads to placental abnormalities, stillbirths, and birth of weak foals. This study aimed to study the occurrence of placental abnormalities associated with Leptospira interrogans infection in naturally infected mares under field conditions. The studied herd had a high occurrence of placentitis and abortions. Ten pregnant mares, eight with placental abnormalities on ultrasonography and were selected. Serum and cervicovaginal mucus (CVM) samples were collected for serology and PCR, respectively. Positive samples in lipL32-PCR were submitted to the sequencing of the secY gene. In lipL32-PCR of CVM, five out of 10 (50%) mares were positive and all were characterized as Leptospira interrogans. Our results highlight the presence of placental abnormalities in the reproductive subclinical leptospirosis syndrome. We encourage field veterinarians to include leptospirosis testing in their reproductive management.

FACTORS AFFECTING SURVIVAL AND FUTURE FOALING RATES IN THOROUGHBRED MARES WITH HYDROPS

Prognosis for life and future fertility in broodmares following hydrops is reportedly good, but evidence to support these reports is limited. The objective of this case series was to describe the prognosis for survival and fertility in mares presented to a referral hospital following diagnosis of hydrops. Medical records were reviewed to identify mares diagnosed with hydrops. Data collected included history (gestation, sire of the foal), clinical findings at presentation and throughout hospitalization (complications, treatments, survival to discharge) and future foaling rates. Thirty mares were presented for hydrops between 2009 to 2019. Ninety percent (27/30) of mares survived (94.7% (18/19) hydrallantois, 75% (6/8) hydramnios) and 95% (20/21) of mares successfully had a future foal, of which 75% (15/21) had a foal the following year. There was no reoccurrence of hydrops. Mares managed with transcervical gradual fluid drainage demonstrated higher survival rate compared to those not managed with transcervical drainage (100% with vs 78.6% without). The most frequent complications observed in mares that did not survive included hypovolemic shock (n=7), hemorrhage (n=4) and laminitis (n=3). Complications observed in mares not returning to breeding included hypovolemic shock and hemorrhage. Causes of non-survival included peritonitis secondary to abdominal wall rupture or uterine tear, and tibial fracture. These results suggest that prognosis for survival and future fertility following a diagnosis of hydrops is good, provided the hydrops is diagnosed and treated appropriately with no damage to the reproductive tract or abdominal wall.

Managing Reproduction Emergencies in the Field: Part 1: Injuries in Stallions; Injury of the External Portion of the Reproductive Tract and Gestational Conditions in the Mare

Selected emergency conditions of male and female reproductive tracts in horses are described, including injuries affecting the external genitalia of male horses and emergent conditions arising during gestation in mares. Conditions affecting male horses are discussed in the context of breeding stallions, but kicks or other mechanisms of trauma in the groin can also affect geldings. Priapism, paraphimosis, trauma to the scrotum and testicles, and penile injury are discussed. In mares, traumatic vestibular injury, placentitis, hydropsic conditions, prepubic tendon and abdominal wall compromise, and uterine torsion are included. Clinical recognition of the problem, diagnostic procedures, and treatments are summarized.

Causes of equine perinatal mortality

The peripartum period is critical in equine medicine for maintaining healthy mares, and ensuring the delivery of healthy neonatal foals. The field of perinatal mortality in horses is continuously evolving, with several advances being recently made in causes of perinatal fetal and foal loss. This review details the main causes of perinatal loss in horses, through late pregnancy, parturition and the neonatal period. Recent advances in identification of infectious organisms and indicators of survival in neonatal foals will be discussed. Continued advances in reproductive and neonatal medicine will aid improved survival of foals through fewer pregnancy losses, and improved management of high-risk pregnancies and critically ill neonatal foals.

Equine hydrallantois is associated with impaired angiogenesis in the placenta

INTRODUCTION

Hydrallantois is the excessive accumulation of fluid in the allantoic cavities during the last trimester of pregnancy, leading to abdominal wall hernias, cardiovascular shock, abortion, and dystocia. It has been postulated that hydrallantois is associated with structural and/or functional changes in the chorioallantoic membrane. In the present study, we hypothesized that angiogenesis is impaired in the hydrallantoic placenta.

METHOD

Capillary density in the hydrallantoic placenta was evaluated in the chorioallantois via immunohistochemistry for Von Willebrand Factor. Moreover, the expression of angiogenic genes was compared between equine hydrallantois and age-matched, normal placentas.

RESULTS

In the hydrallantoic samples, edema was the main pathological finding. The capillary density was significantly lower in the hydrallantoic samples than in normal placentas. The reduction in the number of vessels was associated with abnormal expression of a subset of angiogenic and hypoxia-associated genes including VEGF, VEGFR1, VEGFR2, ANGPT1, eNOS and HIF1A. We believe that the capillary density and the abnormal expression of angiogenic genes leads to tissue hypoxia (high expression of HIF1A) and edema. Finally, we identified a lower expression of genes associated with steroidogenic enzyme (CYP19A1) and estrogen receptor signaling (ESR2) in the hydrallantoic placenta.

DISCUSSION

Based on the presented data, we believe that formation of edema is due to disrupted vascular development (low number of capillaries) and hypoxia in the hydrallantoic placenta. The edema leads to further hypoxia and consequently, causes an increase in vessel permeability which leads to a gradual increase in interstitial fluid accumulation, resulting in an insufficient transplacental exchange rate and accumulation of fluid in the allantoic cavity.

Prenatal Diagnosis of Megacystitis and Hydronephrosis in an Equine Fetus: How Transabdominal Ultrasonography Can Help to Diagnose Fetal Abnormalities

Premature udder development constitutes an alarm signal in pregnant mares. The objective of this clinical case report is to highlight the importance of transabdominal ultrasound examination of the fetus in these cases and to report a unique case of prenatal diagnosis of obstructive uropathy based on the observation of severe fetal hydronephrosis and megacystitis in utero. A 4-year-old French chaser primiparous mare was referred for evaluation of premature udder development during the ninth month of pregnancy. The mare had clinical signs within normal limits, a developed and sensitive udder with secretions, and no vulvar discharge. Transrectal examination revealed the presence of an immobile fetus. Combined uteroplacental thickness was within normal limits. Transabdominal ultrasound revealed a single live fetus in posterior presentation with several abdominal abnormalities. Unilateral hydronephrosis and megacystitis lead to a hypothetical diagnosis of fetal multiple urinary tract malformation with outflow obstruction. Treatment was discontinued and the mare was monitored. Abortion occurred spontaneously a week later. Postmortem examination revealed a ruptured bladder of abnormally large dimensions and a severely distended left kidney without parenchyma (filled with free urine) and lack of permeability in the left ureter and urethra. Postmortem diagnosis was consistent with our prenatal ultrasonographic diagnosis. Even though described during human pregnancy with various etiologies and severity, prenatal diagnosis of fetal hydronephrosis and megacystitis has not been reported in equine veterinary medicine before. These malformations need to be characterized more precisely in the future. This case highlights the importance of transabdominal ultrasonography to detect equine fetal abnormalities.

Leptospirosis: An important infectious disease in North American horses

North American horses are commonly exposed to Leptospira organisms. Leptospira Bratislava is the most common infecting serovar but this serovar has not been confirmed to cause clinical disease in North American horses. Leptospira Pomona type kennewicki is responsible for most of the clinical diseases (leptospirosis) in North American horses. Leptospirosis is most commonly associated with diseases of the placenta and fetus, the kidneys and the eyes in horses. In-utero infections in pregnant mares may result in abortion, neonatal illness or birth of an antibody positive healthy foal. Acute renal failure in younger horses and recurrent uveitis in adult horses are other well documented clinical syndromes of leptospirosis. Abortions, neonatal disease and acute renal failure are caused by a subacute infection, while horses with Leptospira associated recurrent uveitis develop ocular disease months or years after the initial Leptospira infection. Diagnosis of Leptospirosis is made by a combination of antigen or antibody testing methods. Mares that abort following Leptospira infection have no additional clinical signs at the time of abortion but may shed the offending Leptospira spp. in the urine for several weeks. Antibiotic treatments are sometimes used in hopes of decreasing Leptospira shedding in infected horses or prophylactically in exposed pregnant mares but documentation of efficacy is lacking. Horses with Leptospira - associated acute renal failure can be successfully treated with antibiotics and supportive care. Recurrent uveitis is commonly associated with leptospirosis in North American horses and although horses may have chronic intraocular infection triggering an immune disease, systemic antimicrobial therapy has not been effective in eliminating the organism from the eye. An equine approved Leptospira Pomona type kennewicki vaccine is now available in North America.