10.6.9 Reproductive infections
Bacterial infections of the reproductive tract are
relatively common, particularly in broodmares
(Table 10.11). Many infections are associated with
breeding, parturition, uterine motility defects and
conformational defects. Underlying risk factors for
infection must be considered and addressed.
Systemic and local (intrauterine) approaches
may be practical in some cases. Infections confined
to the uterine lumen and superficial endometrium
are best treated by intrauterine therapy. A variety of
antimicrobials may be infused into the uterus, including
sodium/potassium penicillin, gentamicin, amikacin,
ceftiofur, ticarcillin and ampicillin (24–26).
Typically, a volume of 50–250 ml is infused. Irritating
drugs should be avoided in order to reduce the risk
of causing chemical endometritis. Buffering of acidic
drugs such as aminoglycosides with sodium bicarbonate
has been recommended. Systemic therapy, with
or without local therapy, is indicated if deeper tissues
are involved.
Uterine lavage is often an important component of
treatment because excessive uterine fluid can result
in a marked dilutional effect, as well as containing
organic debris that decreases the activity of most
antimicrobials. Another benefit of lavage is to remove
bacteria and bacterial by-products. Other adjunctive
medical therapies, such as oxytocin administration,
may also be important in many cases.
The external reproductive tract is not a sterile
site and care must be taken to prevent contamination
during sampling of the uterus, which should be