I have a 23 yr old Arab mare, that came to me with a uterine infection and is a urine pooler. I was told it would clear up on its own, it did not. January of 2016 she was cultured and tested positive to the infection, she was put on SMZs and then had a uterine flush with saline then the Nexcel, this was done 3 times, it was also noted at this time that she held a lot of fluid in her vaginal vortex… She was totally fine after, the fluid she was passing was of normal urine color. She was fine up to March of this year when I noticed the normal fluid started to become thick and colored and she was running a high fever. She was tested and came back positive again for the infection. She was put on smzs, but a flush was not done. She was on Smzs for 3 weeks and then off for a week and the infection returned with the fever. She was put back on smzs for 3 weeks, again no flush, off a week, the nasty discharge came back and she was placed back on smzs. She was flushed this time, but no visible matter came from the uterus, but most had collected in the vortex right inside the vaginal opening. She had normal passing of fluid after flushes for only 2 days and then the thick infection discharge comes back. Please help has anyone had anything similar?
Poor gal. The bacteria might be resistant to SMZs. Has a culture and sensitivity test been done on the bacteria to identify what type of bacteria it is and which antibiotics it responds to? Is she on a high quality probiotic? Antibiotics kill off the bacterial overgrowth but also disrupt the balance of the healthy flora. Is her anatomy as such that fecal matter could be getting inside her vagina? Has the vet discussed that she might be a candidate for a caslicks to help keep her clean?
This March, she was tested and I was told to put her on the SMZ’s, but I am starting to wonder if it has not become resistant? I do have her on a probiotic and have had for a few moths, but wondering if I need to switch that too? Always open to suggestions for a good probiotic. I have been told that her anatomy is good, she is very straight up and down, but also wonder if that is not an issue.
Switch to a different, possibly more modern, antibiotic and be quicker to flush as soon as symptoms show. Probably never completely got rid of it and it’s going to keep coming back until you do.
Might want to seek additional vet help from one with more experience treating stubborn vaginal infections. No vet can know everything and the average GP doesn’t see a lot of repetitive vaginal infections, you need a specialist. Mares age is not helping her bounce back as a younger mare might, all the more reason to step up your treatment protocols.
More specialized vet can also make the call on a caslicks, might help if there’s fecal matter involved, might not if she’s not voiding urine completely.
That’s what I’m wondering. Antibiotic resistance or that something else is going on here. What is her history? Has she had foals? Some older mares who’ve had foals can get infectious endometriosis. She came to you with the uterine infection. How long had she had it when you got her? Did the previous owner say the infection would clear up on it’s own or a vet? I don’t see how an equine uterine infection would clear up on it’s own any more than a bacterial infection in women does.
Has she had an endometrial swab and culture? If she has infectious endometriosis, a series of daily lavages infusing antibiotics can help clear the infection. A repro vet should be able to diagnose and treat, since they deal with this part of the horse all the time.
Broad spectrum probiotics like, Figuerola’s Probiotic and Enzyme Complex. Equerry’s Large Animal Probiotic. Mare Magic Probio Blend.
Even about a million years ago when I worked briefly at a breeding farm, they didn’t use SMZs, did repeat lavages with solution containing antibiotics and they continued antibiotic injections long after the symptoms cleared to be sure it was actually eradicated.
None of that was particularly expensive, especially if you can give an IM shot, and it still isn’t today compared to most other procedures. Poor mare needs labwork and long term treatment to help her beat this, it will drag them down over time, especially the seniors.
She has had 5 foals.
She did come to me with the owner saying that she had a uterine infection because she was bred by her dirty stud and the vet said it would clear up. I did not at that time see anything to indicate an active infection.
She had a vaginal swab that came back as strep, same as last year. And it is sensitive to Smz’s. Just frustrating 
I am looking for a repro vet, but seems they are few and far between in my area. Called one today to discuss over the phone to see if it would be worth the trip.
Just because you don’t see symptoms mean there isn’t a reduced population of bacteria remaining that will increase their numbers until the symptoms reappear yet again. Have to kill all of them AND correct the conditions that allow them to thrive.
Again, it takes more persistence then cash, even if you involve a specialist.
That was a very informative article. Thank you! The article states “Listed by McCue as antibiotics that have been effective in combating uterine infections are Amikacin, Ampicillin, Gentocin, K Penicillin, and Ticarcillin.”
Can you get the owner to release her vet records if you don’t already have them? Owner said the vet said it would clear, or the vet directly said to you it would clear? Five foals, chronic uterine infection. Owner had the mare for awhile. She let her dirty stud breed the mare. If she does breeding, she might have some understanding of mares getting infections and how hard they can be to clear up in chronic cases. There might just be some veterinary records in the mare’s history addressing this problem.
