HISTOPATHOLOGY OF DONKEYS WITH ENDOMETRITIS (a) (b)
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(c)
(d)
FIGURE 5 Endometrial cytology of the jenny A (a), B (b), C (c), and D (d). Neutrophils (black arrow) and uterine epithelial cells (white arrow) were observed in all 4 jennies while there was a small amount of red blood cells (circle) in jenny A and C. Diff- Quick ' s stain, original magnification ×400.
Kenney- Doig scheme (Abd- Elnaeim, 2008 ; Radar- Chafirovitch et al., 2021 ). The degree of PMN infiltration for inflammation as- sessment may have different criteria in jennies compared to mares, and slight increase in PMNs may be a normal finding in healthy jennies. The endometrium of some donkeys may be classified as grade IIA instead of grade I due to the presence of a larger amount of inflammatory cells. Therefore, further study with a larger num- ber of jennies with and without endometritis will be helpful to establish the normal range of PMNs and adjust the Kenney- Doig classification scheme for donkey endometritis (Radar- Chafirovitch et al., 2021 ). The more significant presence of neutrophils in en- dometrial tissue of jennies in this study might indicate acute en- dometrial inflammation (Van Camp, 1988 ) even though we did not discriminate different stages of endometritis. Besides, a positive cytological result is assumed to be a reliable indication of acute endometritis (Reiswig et al., 1993 ). It has been reported that eosin- ophil infiltration can be evoked by infection with certain bacteria, virus, fungi, and parasites, as well as by allergic reactions in mares, but evidence shows that eosinophils infiltration in jenny ' s endome- trium might be a physiological phenomenon (Grimm et al., 2017 ; Morris et al., 2020 ; Vilés et al., 2013 ). A more recent study sug- gests that eosinophil infiltration in jennies’ endometrium may be associated with IL33, which is related to pro- fibrosis stimuli (Miró
et al., 2020 ). In our findings, eosinophil infiltration was associated with bacterial infection based on the cultural results. Therefore, further investigation into the roles of eosinophils in donkey en- dometritis is warranted. The elevated number of lymphocytes and macrophages in some jennies’ endometrial stromal tissue was con- sidered as an indication of a chronic inflammatory process, which highlights the importance of endometrial biopsy in chronic endo- metritis diagnosis (Snider et al., 2011 ). Although a grade I endometrial biopsy score might overlook per-
acute or subclinical endometritis cases such as Jenny A in this study, endometrial biopsy is still the most reliable confirmatory method in diagnosing chronic endometritis, in which inflammatory cells may infiltrate the stratum compactum, the deeper layers of the endo- metrium (de Amorim et al., 2016 ). In addition, endometrial biopsy is the only diagnostic method that can assess the degree of glandular fibrosis to provide a reference for prognostic evaluation (de Amorim et al., 2016 ). Therefore, endometrial biopsy is recommended to be performed, especially when severe inflammation (e.g. in persistent mating- induced endometritis), chronic or fibrotic endometritis
is
suspected in jennies. This retrospective study described characteristic categories of
endometritis biopsy in jennies based on the Kenny- Doig grading sys- tem along with endometrial cytology. The results provided a more
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