Transrectal ultrasonographic assessment of the fetal proximal phalanx: A new tool to assess fetal age and bone development in horses.

Fetal age in Quarter Horses can be predicted within 2 weeks from 100- to 200- days of gestation using femur length, biparietal diameter (cranium diameter) and eye approximated volume. However, as pregnancy advances, the femur and cranium become too large to be imaged in their entirety using ultrasound and the corresponding biometric parameters can no longer be measured. In this longitudinal study, the proximal phalanx (P1) was evaluated as a novel biometric parameter for late gestation to predict fetal age and bone maturation. Transrectal ultrasound was performed in ten pregnant mares with known ovulation dates, every two weeks from 240- days of gestation until parturition. P1 was imaged in 69 % of the examinations. Inability to image P1 was due to obstructive positioning such as carpal or fetlock flexion, or posterior presentation of the fetus. Advancing fetal age did not affect visibility of P1. P1 length correlated significantly with days of gestation and a correlation equation was established: y = 0.3837x -69.55 where y is the predicted value of P1 length and x is the day of gestation (with day 0 being the day of ovulation). When P1 length was equal to or larger than the width of the ultrasound image (52.5 mm), 90 % of mares (9/10) were above 300- days of gestation. Ossification of the proximal and distal epiphysis of P1 typically appeared between 277- and 303 -days of gestation (mean: 288 days). The proximal epiphysis did not close before parturition whereas the distal one closed between 306- and 333-days of gestation (mean: 320 days). P1 epiphyseal appearance and closure occurred chronologically reflecting bone maturation. Radiographic findings at birth and prenatal ultrasound findings were in agreement, apart from timing of P1 distal epiphyseal closure. In conclusion, P1 length can be used as a new fetal biometric parameter to assess fetal age and growth after 240- days of gestation. The knowledge of P1 bone maturation process in utero as a marker for fetal bone development, may also be valuable in clinical decision-making when considering inducing parturition in the mare.

In utero ultrasound diagnosis of bilateral cataract and hydrops in a mule pregnancy: Case report.

Once diagnosed pregnant with ultrasound at an early stage of gestation, mares are usually not examined before foaling. The objective of this case report was to highlight the importance of transrectal ultrasound screening examination and to report a unique case of fetal congenital cataracts associated with other feto-placental abnormalities in a mule pregnancy, its in utero ultrasound diagnosis and outcome. A 17-year-old Thoroughbred research mare carrying a mule fetus was examined by transrectal ultrasonography at 186 days of gestation for a routine pregnancy examination. Ultrasonography allowed in utero diagnosis of fetal congenital cataracts, hyperechogenic bowels, intrauterine growth restriction (IUGR), hydramnios and placental abnormalities. The mare was monitored bi-monthly to observe the progress of the pregnancy. At 258 days of gestation, the abnormal chorioallantois detached at the cervical star and at 272 days, fetal asystole was diagnosed. Abortion was induced and the fetus was delivered uneventfully. Post-mortem gross and histologic findings confirmed the prenatal ultrasonographic diagnosis. This case highlights the diagnostic value of a complete fetal ultrasound examination to detect equine fetal abnormalities.

Pregnancy monitoring in mares: Ultrasonographic and endocrine approaches.

Methods to diagnose and monitor equine pregnancy continue to advance with improved instrumentation enabling the development of novel, non-invasive approaches to assess fetal well-being and viability using ultrasound and endocrine testing. From early embryonic loss to placentitis, that is typically encountered later in gestation, fetal viability and development as well as placental function can be evaluated using two fundamentally different, structural and functional, approaches. Ultrasound provides structural information on embryonic and fetal growth using such parameters as combined thickness of the uterus and placenta (CTUP), visual assessment of fetal fluids, activity, heart rate and multiple biometrics involving the fetal head and eyes, limbs and joints among many others, depending on the stage of gestation. Endocrine profiles that include progesterone and 5α-dihydroprogesterone, other metabolites, androgens and estrogens can be evaluated simultaneously using liquid chromatography-tandem mass spectrometry (LC-MS/MS) providing more functional information on fetal and placental competence and development. Endocrine information can be used in making clinical decisions including the need for progestin supplementation or when it can cease, and even estimating gestational stage in mares that cannot be easily palpated or scanned, as with mini-breeds or rancorous animals most notably. When used together, monitoring gestation by ultrasound and hormonal analysis provides unusual insight into feto-placental well-being and the progress of pregnancy, helping to identify problems needing therapeutic intervention.

Prediction of gestational age based on foetal ultrasonographic biometric measurements in light breed horses.

A table was generated, based on foetal ultrasonographic measurements in light breed mares, for each day of gestation beginning with day 100, to provide the predicted value of four biometric parameters: biparietal diameter (BPD), eye approximated volume (EyV), foetal aortic diameter (AortD) and femur length (FL). Using this table, day of gestation was successfully predicted in 23 Quarter Horses (QH) with known mating or ovulation dates. BPD, EyV and FL were the best foetal age predictors between 100- and 200-days gestation predicting within 2 weeks of the actual day of gestation, while BPD and EyV were best between 200 and 300 days (within 3 weeks), and EyV was best after 300 days (within 3 weeks).

Equine granulosa cell tumours among other ovarian conditions: Diagnostic challenges.

BACKGROUND: Granulosa cell tumours (GCT) are the most common ovarian tumours in mares. While the classical presentation may not represent diagnostic challenges, diagnosis is not easy in the early stages. OBJECTIVES: Illustrate the variability in the presentation and serum biomarkers associated with ovarian abnormalities in the mare. STUDY DESIGN: Retrospective case series. METHODS: Nonclassical cases of GCTs and other ovarian conditions were identified and behaviour, GCT endocrine results, palpation and ultrasonographic findings are described and the diagnostic value of each is discussed. RESULTS: Mares in this case series with GCTs had been presenting clinical signs ranging from no behavioural changes to behaviours including aggression, stallion-like and inability to work under saddle. Hormonal profiles of endocrinologically functional GCTs can be erratic and unpredictable. The clinical form and ultrasonographic appearance may also vary with time from an initially enlarged/anovulatory follicular structure that later develops a multicystic 'honeycomb' appearance. Mares with GCTs can also present with persistent anovulatory follicles or apparent luteal tissue that are unresponsive to treatment. If both ovaries are of relatively normal size and symmetry, but hormonal biomarkers are markedly increased (AMH >10 ng/mL, inhibin B and/or testosterone >100 pg/mL; 0.37 nmol/L), it is likely that a functional GCT is present. Still, it can be a challenge to decide which ovary to remove. Post-surgical endocrine testing can be helpful, especially if histopathology is not performed or a GCT is not found. MAIN LIMITATIONS: Cases limited to 14. CONCLUSIONS: Granulosa cell tumours present with a wide variety of clinical signs that do not fit what is commonly described as 'classic'. Only if AMH, testosterone and inhibin B concentrations are markedly increased, and there is an abnormally enlarged ovary, the diagnosis of a GCT is more confident. In the presence of normal size ovaries, normal hormonal biomarkers and abnormal behaviour, it is more likely that the ovaries are not involved.

Fungal Placentitis Caused by Aspergillus terreus in a Mare: Case Report.

Placentitis has been reported as the most important cause of equine abortions, stillbirths, and perinatal deaths in horses. Most cases are caused by bacteria and less commonly by fungal elements. The aim of this report is to describe the clinical presentation of a fungal placentitis caused by Aspergillus terrerus. A 5-year-old thoroughbred maiden mare at the 217th day of gestation presented with some classic signs of placentitis (premature udder development and milk dripping). All ultrasonographic findings were consistent with a live fetus and a severe placentitis. On vaginal examination, purulent discharge was found coming from the external cervical os. Samples sent for culture yielded very small numbers of mixed growth including Enterococcus faecalis (by matrix-assisted laser desorption/ionization time-of-flight mass spectrometer), Streptococcus viridans, and Aspergillus terreus, and polymerase chain reaction was positive for Aspergillus terreus and Pseudomonas. The mare was placed on broad-spectrum antimicrobials, nonsteroidal anti-inflammatories, and hormonal and antifungal treatment. The fetus kept on developing and growing despite the placentitis for 14 days until the demise of the fetus in utero occurred. Aspergillus terreus was isolated from the chorionic surface but not from the fetus. Fungal placentitis is not very commonly found in mares. The extent of the placental lesions and the severity of the placentitis contributed to the death of the fetus. This is one of the few case reports available describing fungal placentitis. Aspergillus terreus has not been previously reported as a cause of placentitis.