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Metritis

Condition Overview:

Contagious equine metritis (CEM) is a highly contagious venereal disease of horses that causes an acute purulent metritis and a copious mucopurulent vaginal discharge 10 to 14 days postbreeding to an infected stallion. The first exposure to the disease usually results in temporary infertility in the mare. Mares may become chroni cally infected and remain carriers of the causal organism for several months or longer. Stallions carry the contagious equine metritis organism (CEMO) on their external genitalia, and the primary site of localization is the urethral fossa. The stallions may carry the CEMO on their external genitalia for years. Newborn foals may become infected at birth and remain infected until they are mature.

The disease is naturally transmitted by coitus. Also, the CEMO can be transmitted indirectly to mares and stallions with contaminated instruments and equipment (3). Undetected carrier mares and stallions are the source of infection for acute outbreaks of the disease. During the breeding season, an infected stallion may infect several mares before the disease is suspected and diagnosed. Also, the CEMO may be transmitted through the use of artificial insemination. Two of the most common genital infections in mares are caused by Klebsiella andPseudomonas spp. bacteria. Differentiating these infections from CEM cannot be reliably done except by laboratory isolation of T. equigenitalis.

Swabs for bacteriologic cultures from mares are taken from the cervix or endometrium of the uterus during estrus, clitoral fossa, and clitoral sinuses. Swabs from stallions should be taken from the penile sheath, fossa glandis, and urethral sinus. Bacterial samples must be delivered in Aimes transport medium (with charcoal) under refrigeration (4 to 6 °C) to an approved laboratory within 48 hours.In mares, various serologic blood tests may be used to detect antibodies to the CEM bacteria. In stallions, detectable antibodies do not develop.

The mare cannot be successfully treated until the CEM bacteria clear from the uterus, a process that may take several months. The external genitalia of the mare and stallion can be treated with disinfectants and antibiotics. Once daily for 5 consecutive days, the external genitalia should be gently scrubbed with 2-percent chlorhexidine in a mild detergent solution and rinsed with warm saline. The external genitalia should then be coated with an antibiotic ointment, such as nitrofurazone. Due to the effectiveness of this treatment, surgical removal of the clitoral sinuses is rarely required.

You are advised to consult the Industry Common Code of Practice for the Prevention and Control of CEM.

The main ways of preventing infection are:

• check stallions, teasers and mares for infection before they are mated: this is done through swabbing
• if a horse proves to be infected, do not use it for mating until the infection has been successfully treated
• always exercise strict hygiene measures when handling mares, stallions and teasers
  
  The main ways of stopping the spread of infection if it does occur are to:
• stop mating by the infected horse(s)
• treat the infection and re-swab to check that the infection has cleared up before resuming mating
• exercise strict hygiene measures when handling the horses involved

NB: For non-Thoroughbreds, Artificial Insemination (AI) is a useful disease control measure. However, mare owners should only use semen collected from stallions proven free of infection at the time of semen collection.