Diagnostic and Treatment Practices of Equine Endometritis-A Questionnaire.
Authors: Köhne Martin, Kuhlmann Meike, Tönißen Anna, Martinsson Gunilla, Sieme Harald
Journal: Frontiers in veterinary science
Summary
# Endometritis Management in Equine Practice: Diagnostic and Treatment Variability Across Germany Endometritis represents a significant reproductive challenge in mares, yet diagnostic and therapeutic protocols are inconsistently applied across practitioners. A survey of 117 German veterinarians revealed considerable variation in clinical approach, with manual swab sampling predominating over speculum-guided collection, systemic trimethoprim-sulfadiazine favoured over intrauterine antibiotic delivery, and approximately half of respondents routinely performing uterine lavages predominantly with saline rather than irritant solutions. Notably, antibiotic resistance in uterine pathogens was reported at less than 5% by nearly all respondents, though the study identified that practice size substantially influenced management decisions—particularly regarding intrauterine irritant treatments and oxytocin use for persistent breeding-induced endometritis—whilst geographical location had minimal bearing on diagnostic selection. Despite most practitioners adhering to culture-dependent antibiotic protocols rather than utilising cytology, low-volume lavage, or endometrial biopsy, the wide spectrum of non-evidence-based interventions documented suggests scope for standardising diagnostic rigour and therapeutic consistency across equine reproductive medicine. For practitioners managing fertility cases, these findings underscore the value of culture-guided treatment decisions and highlight the need to critically evaluate whether current local practices reflect current best-evidence recommendations for optimising mare reproductive outcomes.
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Practical Takeaways
- •Current field practice shows high variability in endometritis management; consider adopting evidence-based diagnostic methods such as cytology, low-volume lavage, or biopsy if not currently used in your practice
- •Systemic antibiotic treatment remains the dominant approach with good outcomes reported, but intrauterine therapy may warrant consideration for resistant or chronic cases
- •Antibiotic resistance in equine uterine pathogens appears uncommon (<5%), so culture-guided rather than empirical treatment protocols remain appropriate
Key Findings
- •Manual swab sampling was the predominant diagnostic method for endometritis, with speculum technique rarely used by surveyed practitioners
- •Systemic antibiotic therapy with trimethoprim-sulfadiazine was the most common treatment, while intrauterine antibiotic therapy was used only occasionally
- •Uterine lavages with 0.9% saline were performed routinely by nearly half of respondents; irritant solutions were used infrequently
- •Treatment strategies varied considerably and included non-evidence-based methods, though most German practitioners applied recommended suitable treatments