Application of blood parameters for the early diagnosis of natural ascending placentitis in pregnant mares.

Placental infection is an important cause of late-term pregnancy loss and neonatal diseases in horses. Detection of changes in blood parameters especially during early placentitis could improve the diagnostic accuracy, treatment decision, and potential outcomes. The objectives of this 2-part study were to identify differences in circulating immunological, inflammatory, and hormonal parameters between mares with natural ascending placentitis and control mares; evaluate each and combination of parameters as predictors of placentitis; and determine how these parameters indicate severity of placentitis. Reproductive examination and blood sampling were prospectively performed on pregnant mares in a natural setting. Study 1 enrolled mares diagnosed with early stage of ascending placentitis based on ultrasonographic findings (n = 12), and gestationally age-matched mares with healthy pregnancies as controls (n = 12). Blood samples were classified as pre-onset (before) and early onset (at the time of ultrasonographic changes) of placentitis. There were no detected statistically significant differences between groups and timepoints in immunological and inflammatory parameters, including peripheral lymphocyte subpopulations, cytokine, and serum amyloid A concentrations. The placentitis group showed a reduced (P = 0.01) DHP/20α-DHP ratio when compared to the control group at the early onset timepoint. Plasma estradiol-17ß concentration <359 pg/mL predicted ascending placentitis with acceptable accuracy (area under the curve, AUC = 0.71). Combined albumin <3.7 g/dL, estradiol-17ß < 499 ng/mL, and DHP <33 ng/mL predicted 100 % of cases of ascending placentitis. In study 2, samples were classified according to the presence and severity of the abnormal ultrasonographic findings as mild (n = 11) and moderate-severe (n = 23), and gestationally age-matched with samples from control mares (n = 34). Mares with moderate-severe ascending placentitis had increased (P = 0.03) plasma 20α-DHP concentration and reduced (P = 0.03) DHP/20α-DHP ratio when compared to control mares. Our results suggest that the early events of ascending placentitis detected by ultrasonographic findings include hormonal alterations of feto-placental metabolism measurable in the mare's circulation, yet without obvious systemic immunological and inflammatory changes. Additional studies are warranted to further assess how hormonal markers and cutoff values could guide decisions for timely therapeutic intervention.

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 and 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.

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.

Management of postfixation twins in mares.

Methods to manage twins after fixation include natural reduction,dietary reduction, transvaginal ultrasound-guided aspiration,surgical removal, craniocervical dislocation, and transabdominal ultrasound-guided injection. Of these, results have been inconsistent with regard to producing a single healthy foal, except for craniocervical dislocation. This new technique enables the twin to be reduced before complete placenta formation has occurred, allowing the remaining fetus to use the entire endometrial surface and grow to its full potential.