Page 526 - Equine Clinical Medicine, Surgery and Reproduction, 2nd Edition

Reproductive system: 2.1 The female reproductive tr act 501

VetBooks.ir Prognosis as previously described. If these organisms are cul-
tured, they should be typed if possible and antibiotic
Chronic infectious endometritis carries a guarded
prognosis, with common recurrence of infections
larly with P. aeruginosa infection, can be prolonged
and with increasing difficulty in treating them suc- sensitivity testing carried out. Treatment, particu-
cessfully. Fungal and yeast infections can be very and difficult. It is therefore recommended that all
hard to treat. With increasing age and chronicity of breeding mares (natural and AI breeding) should
infection, degenerative changes in the endometrium have pre-breeding swabs (clitoral swab and cervi-
worsen the prognosis further. cal/endometrial swab) and blood tests. Should an
infection be identified, then the treatment approach
SEXUALLY TRANSMITTED should be guided by (a) the Governmental depart-
ENDOMETRITIS ment, and (b) the breed society where appropriate.
Treatment protocols vary for the site and bacterial
Definition/overview involved. K. pneumoniae infection can be treated
Diseases transmitted through breeding horses with 2 g gentamicin in 50 ml sterile water buffered
(venereally transmitted) can be caused by a vari- with an equal amount of 7.5% sodium bicarbonate.
ety of organisms, some of which are notifiable to P. aeruginosa can be treated with 3.2 g ticarcillin in
government authorities in some countries. The sterile water. Clitoral infections can be successfully
main diseases transmitted venereally include EVA treated using topical silver sulphathiazine cream
(p. 454), coital exanthema (p. 493), dourine (p. 494) daily following cleaning with 2% chlorhexidine.
and CEM (p. 415). In addition to CEM, endome- The surrounding perineal area is generally treated
tritis can be caused by Pseudomonas aeruginosa and as well. Should the infection persist, clitorectomy
Klebsiella pneumoniae capsule types 1, 2 and 5 and should be considered (Figs. 2.110, 2.111) and the
transmitted venereally, either directly from the site treated as previously described.
stallion’s penis or from infected semen. These two Following treatment repeated swabbing of the area
organisms can be involved in PMIE and chronic is necessary to show the mare to be free from infection
infectious endometritis, and clinical signs will be (e.g. three sets of swabs taken at 7 day intervals).

2.110 2.111

Fig. 2.110
A clitoris following
injection with
local anaesthetic
in advance of
clitorectomy.

Fig. 2.111 Removal
of the clitoris as part
of the treatment
of a P. aeruginosa
infection of the
caudal reproductive
tract of a mare.