Indications for oestrus suppression
Some mares seem to experience back or colic-like pain
in the peri-ovulatory period. A mare being “in season” (ie
displaying signs of behavioural oestrus) is often perceived
as a problem by owners, who feel that it makes the mare
difficult to manage and/or detracts from her performance.
Equally, mare owners often blame behavioural issues or
poor performance on the mare being “in season”, when
in fact there is another underlying cause (such as lameness or poor rider ability). It is therefore important, before
embarking upon treatment to suppress oestrus, to verify
that episodes of pain, behavioural problems or poor performance do indeed correlate with being in oestrus. This
can be achieved through a combination of ultrasonography
and serum progesterone analysis. Once verified, there are
numerous treatment options available.
Progestin treatment
High plasma progesterone levels in mares suppress oestrus behaviour. Progesterone also has an inhibitory effect
on the secretion of luteinising hormone, via a negative
feedback effect on the hypothalamic-pituitary axis.
The oral synthetic progestin altrenogest (Regumate
Equine, MSD Animal Health) is the only treatment licensed
for the suppression of oestrus in mares in the UK. The
license is for use during the vernal transition period, for 10
days, although oral altrenogest is often used (off-licence)
for prolonged periods in mares who would otherwise be
cycling regularly during the physiological breeding season.
Despite common use, oral altrenogest has significant
disadvantages. It can cause positive drug test results for
in-contact horses via feed contamination. It also poses risks
to pregnant women, women of childbearing age, and those
with certain types of tumour and thromboembolic disease.
It is crucial that horse managers are aware of these risks,
and that the drug is handled according to the data sheet.
The use of altrenogest may exacerbate endometrial infection if a low level of (sometimes undiagnosed) infection was
present when treatment was initiated. Its use is contra-
indicated in mares which have been diagnosed with uterine
infection. Furthermore, the use of oral altrenogest is not
permitted by the governing bodies of some competitive
equine sports, and others require special permissions for
use to be issued. This must be discussed with the horse
owner/manager.
In Australia, an injectable form of altrenogest is available
(Readyserve, CEVA Animal Health). This has reduced risk of
cross-contamination compared to the oral form. The same
concerns otherwise apply. Injectable altrenogest can cause
discolouration of the coat, alopecia and hair thinning at the
site of injection – mare owners should be warned of this.
GnRH vaccination
The injection of the GnRH hormone (or a modified form)
plus an adjuvant induces GnRH antibody formation. The
antibodies bind to endogenous GnRH, and prevent endodogenous GnRH from acting on pituitary receptors. This
removes the normal stimulus for gonadotrophin (LH and
FSH) production, and thus ultimately abolishes behavioural
oestrus by reducing steroid hormone secretion.
There is no GnRH vaccine currently licensed in the UK.
A GnRH vaccine (Equity, Zoetis) is licensed in Australia for
the suppression of oestrus in mares. Injection site reactions
have been reported. There is great individual variation in
response to vaccination. Some mares continue to display
behavioural oestrus, despite ovarian inactivity. Some (particularly older mares) require repeated vaccination for the
treatment to work. Others enter very prolonged suppression of reproductive cyclicity, or fail to regain ovarian activity at all. Owners should be warned of this – the vaccination
is not recommended for use in mares intended for future
breeding.
Repeated oxytocin injections
Repeated injections of oxytocin during dioestrus using various regimes have been shown to suppress oestrus in some
mares (Gee et al., 2012; Vanderwall et al., 2016). Normally, oxytocin mediates the endometrial prostaglandin release,
which induces luteolysis and brings a mare back into oestrus. Repeated injections of oxytocin disrupt this mechanism, probably either by down-regulating oxytocin-receptor
synthesis, or by decreasing receptor sensitivity. The main
disadvantage of this technique is the need for repeated
injections, which may produce injection site reactions and
muscular soreness.
Injection with human chorionic gonadotrophin
Injection with human chorionic gonadotrophin has also
been used as a method of suppressing oestrus in mares.
It has been reported in one study using a small number of
mares, with variable results (Hedberg et al., 2006).
Insertion of an intrauterine device (eg marble)
The introduction of a 30-35mm sterile marble or plastic
ball into the uterus immediately after ovulation has been
reported to suppress oestrus in mares (Nie et al., 2003). The
mechanism of oestrus suppression was believed to be that
the marble blocked the release of PGF2α from the uterus,
either by mimicking an embryo moving through the uterus,
or by mildly damaging the endometrium.
In recent years, it has become apparent that the use of an
intrauterine marble or similar device is not an efficacious
nor reliable method of suppressing oestrus in mares (Argo
and Turnbull, 2010). There have been a number of reports
of adverse side effects including marbles fracturing, and
adverse effects on future fertility by damaging the endometrium. There are ethical issues surrounding failure to
declare the insertion of an intrauterine marble at the time
of sale, or during competition. Removal of marbles when
they are no longer required can be difficult; conversely,
some mares seem to quite literally “lose their marbles”
because the treatment fails, they return to oestrus, and the
marble escapes through a relaxed cervix.
Intrauterine infusion of plant oils
One paper reported that intrauterine infusion with either
fractionated coconut oil or peanut (arachis) oil at day 10
post-ovulation suppressed oestrus in the majority of mares
for up to 30 days post-ovulation (Wilsher and Allen, 2011). It
was postulated that this worked by monounsaturated fatty
acids and polyunsaturated fatty acids found in the plant
oils interfering with prostaglandin synthesis, and thus
blocking luteolysis.
Subsequently, two separate publications (Diel de Amorim
et al., 2016; Campbell et al., 2017) reported that neither
fractionated coconut oil nor peanut oil reliably suppressed
oestrus in mares when infused into the uterus at 10 days
post-ovulation. Both papers also suggested that intra-
uterine infusion of plant oils causes at least a temporary
inflammation in the uterus. Veterinarians considering the use of intrauterine plant oils as a method of oestrus
suppression in mares should make owners aware of these
facts, and alert them that sports governing bodies could
consider intrauterine plant oils to be medication.
Ovariectomy
The permanent surgical removal of the ovaries from a
mare may suppress oestrus behaviour, but does not always
do so. It is therefore advisable to evaluate the mare’s
response to non-surgical methods of inducing ovarian
quiescence (such as GnRH vaccination) before proceeding to surgery – if behavioural oestrus is not significantly
diminished by medical methods, it is unlikely to be by
surgery. While ovariectomy avoids problems of medicine
administration, it carries associated surgical risks, and obviously results in irreversible loss of fertility for the mare.
Some sports governing bodies may require ovariectomy to
be declared.
Conclusion
Before embarking upon suppression of oestrus as a
treatment for behavioural or performance issues in mares,
veterinarians should verify the correlation between the
mare being in oestrus and the occurrence of the episodes
of pain/undesirable behaviour/poor performance. There is
currently only one licensed method of oestrus suppression
for mares in the UK. All the methods described above have
significant disadvantages associated with them.