Camel Endometritis: Diagnosis and Practical Treatment Considerations

A repeat-breeding camel does not automatically have endometritis. One of the most important diagnostic traps is confusing the uterus’s normal response to mating with persistent uterine disease. 

Because mating is intrauterine in camelids, post-mating uterine inflammation is expected. Healthy polymorphonuclear neutrophils may be present for up to three days after mating^[1]. The clinical challenge is therefore to determine whether the uterus is clearing this response appropriately or whether inflammation is persisting and compromising fertility. 

Start with the breeding history^[1] 

The reproductive history can change the interpretation of an apparently abnormal uterine finding. 

The uterus normally has mechanisms to clear post-breeding inflammation and infection. These mechanisms may fail in association with overbreeding, degenerative uterine changes, systemic illness, or inappropriate intrauterine manipulation. 

Therefore, a female presented for repeat breeding should not be assessed on cytology alone. The timing of examination relative to mating, previous reproductive interventions, and the pattern of reproductive failure all need to be considered. 

Cytology and culture: Use them together 

Endometrial cytology, culture, and biopsy are established approaches for evaluating endometritis in camelids. Endometrial samples can be obtained by low-volume uterine flushing or a cytology brush^[1],[2]. 

For suspected subclinical disease, cytological and bacteriological findings should be interpreted together rather than relying on either result in isolation^[1]. 

Reported bacterial isolates include Streptococcus equi subsp. zooepidemicus, β-hemolytic streptococci, Enterococcus spp., coagulase-negative Staphylococcus spp., Proteus spp., Enterobacter aerogenes, Klebsiella pneumoniae, Pseudomonas aeruginosa and Trueperella pyogenes. Evaluation may also include Ureaplasma spp., Mycoplasma spp., fungi and Campylobacter fetus venerealis, which has been suspected in infertility^[1],[3],[4]. 

When is biopsy valuable? 

In a persistently barren female, cytology and culture may not fully characterise the uterine lesion. Endometrial biopsy is considered the gold standard for diagnosing endometritis and is an important component of evaluating the barren female^[1]. 

Acute disease is characterised histologically by widespread polymorphonuclear neutrophils. Chronic endometritis is predominantly lymphocytic, with occasional plasmacytes, macrophages, eosinophils or mast cells. Granulomatous chronic endometritis has also been described in camels^[1],[3]. 

Treatment should follow the diagnosis 

Controlled treatment trials in camelids are limited, and therapeutic approaches have largely been adapted from other livestock species. Reported approaches include uterine lavage with saline or weak antiseptic solutions followed by systemic or intrauterine antimicrobial treatment. Cephapirin has also been used for intrauterine treatment in camels^[1],[5]. 

Because camelids may be food-producing animals, antimicrobial selection must also consider antibiotic stewardship and appropriate milk and meat withdrawal requirements. 

Preventing unnecessary uterine contamination is equally important. Careful breeding management and avoiding inappropriate intrauterine manipulation may reduce the risk of uterine infection^[1]. 

Clinical takeaway 

In the repeat-breeding camel, neutrophils alone do not establish endometritis. Timing after mating, reproductive history, cytology, bacteriology and, when indicated, endometrial biopsy should be brought together to distinguish normal post-mating inflammation from clinically relevant uterine disease, and to avoid unnecessary antimicrobial treatment.

References:

1. Sghiri A, Ciccarelli M, Waqas MS, Anouassi A, Tibary A. Advances in the diagnosis of reproductive disorders in female camelids. Animals. 2025 Oct 4;15(19):2902. https://www.mdpi.com/2076-2615/15/19/2902
2. Ali A, Derar DR, Almundarij TI. Infertility in female dromedary camels. Journal of Camel Practice and Research. 2021;28(3):267-76. https://www.researchgate.net/profile/Ahmed-Ali-118/publication/357651097
3. Elshazly MO, Abd El-Rahman SS, Hamza DA, Ali ME. Pathological and bacteriological studies on reproductive tract abnormalities of she-camels (Camelus dromedarius), emphasizing on zoonotic importance. Journal of Advanced Veterinary and Animal Research. 2020 Oct 7;7(4):633. https://pmc.ncbi.nlm.nih.gov/articles/PMC7774787/pdf/JAVAR-7-633.pdf
4. Elshazly MO, El-Rahman SS, Hamza DA, Ali ME. Prevalence of non-neoplastic ovarian disorders in non-pregnant she-camels (Camelus dromedaries) and their correlation to bacteriological isolation. http://www.ijvets.com/pdf-files/Volume-8-no-1-2019/20-27.pdf
5. Swelum AA, Alowaimer AN. Comparison of the use of cephapirin and oxytetracycline for the treatment of clinical endometritis in the camel (Camelus dromedarius): a field study. Journal of Animal and Veterinary Advances. 2013 Jan 1;12(4):527-32. https://www.researchgate.net/profile/Ayman-Swelum/publication/257029808