Diagnosis and Treatment of the Subfertile Mare - Endometritis

Endometritis is a major cause of reproductive wastage in the mare. It may be categorized as acute infectious, chronic infectious or post-mating induced endometritis. Rapid physical clearance of endometrial fluid and debris is the most important defense mechanism. In the absence of rapid clearance, infection and inflammation may become chronic, inducing permanent changes in the endometrium. Successful management of endometritis is based on restoration of efficacious uterine defense mechanisms, treatment of specific infections when indicated, and control of post-breeding inflammation. In contrast to resistant mares, mares susceptible to endometritis retain uterine fluid and endometrial edema due to poor physical clearance. Bacterial overgrowth and accumulation of inflammatory mediators then lead to depressed phagocytosis, mucociliary clearance and lymphatic drainage. Epithelial disruption may occur allowing increased bacterial adherence. The inflammatory response changes from a neutrophilic short term physiological process promoting endometrial clearance, to a lymphocytic and plasmacytic low grade chronic inflammatory response that results in epithelial disruption, loss of normal endometrial gland architecture, and stromal fibrosis. […]