Equine Reproductive Procedures. Группа авторов

Чтение книги онлайн.

       It is important that sufficient fluid is recovered from the uterus to be of diagnostic use.

       Enough fluid should pass through the lavage tubing so that assessment of the uterine environment is performed. Care should be taken to not just pass fluid into and out of the catheter without actually contacting the uterus.

       Note any discharge present on the sterile sleeve when the gloved arm is pulled from the vagina. There should not be any purulent or hemorrhagic discharge, only the lubricant and clear mucous should be present.

       The clarity and presence of debris and mucus should be noted in the effluent fluid recovered from the uterus. Typically, the recovered fluid is graded as clear, cloudy, or cloudy with mucus.

       Microscopic examination is performed at 400× (10× eye piece and 40× objective) magnification or under oil immersion at 1,000× (10× eye piece and 100× objective).

       Evaluate slide quality (e.g., the presence of normal uterine epithelial cells) as well as the presence and relative number of inflammatory cells (neutrophils, macrophages, lymphocytes, etc.) and any bacterial or fungal organisms.

       The amount of background debris and sediment appearing on stained slides from a low volume lavage is often greater than with swab or brush techniques. The amount of debris may be correlated with the degree of inflammation.

       The presence of >5–10 neutrophils per high power field is an indication of inflammation, providing that an adequate cellular sample was obtained.

       The greater the ratio of neutrophils : uterine epithelial cells, the greater the degree of inflammation or endometritis.

       Neutrophils are the primary white blood cells present with acute inflammation. Macrophages, lymphocytes, and plasma cells may be noted with chronic inflammation. Eosinophils may be noted in cases of fungal endometritis, urine pooling, or aspiration of air into the uterus.

       The absence of white blood cells (with normal endometrial cells present) often suggests that there is no inflammation present in the uterine lumen. However, some bacteria such as Escherichia coli and Pseudomonas aeruginosa may not stimulate a large inflammatory response and a “negative cytology” (i.e., the absence of white blood cells) may provide incorrect evidence of a “clean” or non‐infected uterus. Consequently, it is recommended that both culture and cytology samples be collected and evaluated and not just one or the other.

       Please see Chapter 17 for further description of cell types found on cytology.

      1 Ball BA, Shin SJ, Patten VH, Lein DH, Woods GL. 1988. Use of a low‐volume uterine flush for microbiologic and cytologic examination of the mare’s endometrium. Theriogenology 29: 1269–83.

      2 Brook D. 1993. Uterine cytology. In: McKinnon AO, Voss JL (eds). Equine Reproduction. Philadelphia: Lea and Febiger, pp. 246–54.

      3 Couto MS, Hughes JP. 1984. Technique and interpretation of cervical and endometrial cytology in the mare. J Eq Vet Sci 4: 265–73.

      4 Leblanc MM, Magsig J, Stromberg AJ. 2007. Use of low‐volume uterine flush for diagnosing endometritis in chronically infertile mares. Theriogenology 68: 403–12.