Making sense of equine uterine infections: the many faces of physical clearance.
Authors: Causey Robert C
Journal: Veterinary journal (London, England : 1997)
Summary
# Editorial Summary Uterine infections represent a substantial economic burden in equine breeding, with persistent inflammation compromising both fertility and embryo survival, particularly in mares with compromised uterine defence mechanisms caused by fluid retention and inflammatory exudate. Causey's review synthesises evidence on the pathophysiology of equine endometritis, distinguishing between opportunistic infections from commensal bacteria in susceptible individuals and true reproductive pathogens affecting immunocompetent mares, whilst detailing diagnostic approaches including clinical history, inflammatory markers, bacterial culture, and the utility of detecting intrauterine fluid during oestrus or within 6–48 hours post-breeding. Multi-modal therapeutic interventions—combining oxytocin, uterine lavage, targeted antibiotics, and prostaglandin analogues—demonstrated additive benefits over single-agent treatment, with emerging evidence supporting intrauterine autologous plasma infusion in improving conception rates despite ongoing uncertainty regarding its antimicrobial mechanisms. For practitioners, this work underscores the importance of identifying susceptible mares early, individualising treatment protocols rather than relying on single interventions, and exercising caution with intrauterine antiseptics given the risk of iatrogenic endometrial damage that could further compromise fertility.
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Practical Takeaways
- •Screen mares during oestrus or early post-breeding for intrauterine fluid to identify those susceptible to infection before breeding problems occur
- •Use combined oxytocin and antibiotic protocols for infected mares rather than single agents; consider intrauterine plasma as an adjunctive therapy when conventional treatments have failed
- •Avoid routine intrauterine antiseptics due to risk of endometrial damage; reserve uterine lavage and prostaglandin analogues for specific clinical scenarios
Key Findings
- •Persistent uterine inflammation leads to conceptus loss in mares susceptible to infection
- •Susceptible mares can be identified by detection of intrauterine fluid during oestrus or 6-48 hours post-breeding
- •Combined oxytocin and antibiotic therapy shows additive benefits over single treatments
- •Autologous intrauterine plasma improves conception rates despite ongoing debate about bactericidal mechanisms