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Therio > 1.4.1 Conditions Associated with Pregnancy > Flashcards

1.4.1 Conditions Associated with Pregnancy Flashcards

1
Q

what would a mummified fetus feel like upon rectal palpation?

A
  • small uterus for stage, feel “mass” inside, uterus contracted down around it (no or little fluid)
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2
Q

Fetal Mummification etiology/pathophysiology

A
  • Fetal death and
  • Absorption of the fluids
  • Fetal retention
  • Retention of CL
  • Closed (tight) cervix
  • No ascending bacterial invasion
  • STERILE
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3
Q

what is the most common cause of fetal mummification in cows?

A

Sporadic in cows
Most common cause is BVD infection

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4
Q

when are we most likely to see fetal mummification in mares?

A

Rare in mares (Twinning; P4 supplementation)

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5
Q

when are we most likely to see fetal mummification in sows? is it common?

A

Frequently in sows (parvovirus)

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6
Q

Other than twinning, why is fetal mummification so rare in mares?

A

no CL to be retained > if fetus dies, placenta dies, endometrial cups no longer produce eCG to sustain secondary CLs…

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7
Q

pathogenesis of fetal mummification?

A

Abortion Diseases –end of 1st/beginning 2nd trimester
3‐5% rate following PGF2a to induce abortion due to failure of complete luteolysis
Genetic Factors
-Chromosomal abnormalities resulting in fetal
death
-But CL remains
In P4 supplementation – mimics the CL so dead fetus stays in uterus

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8
Q

clinical signs of fetal mummification?

A
  • Not as big as expected for stage
  • Lack of udder development
  • Ultrasound – fetus/bones but absence of fluid – placentomes absent
  • Absence of parturition as expected
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9
Q

why is there absence of parturition as expected in the case of fetal mummification?

A

no fetal stress response
dead fetus > no functional HP axis > no ACTH > no cortisol

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10
Q

how can we treat fetal mummification in cows? what is the prognosis?

A
  • PGF2a to induce luteolysis – cervix will open ‐ expel fetus
  • Two doses often required
  • Incomplete cervical relaxation can occur
    > Topical PGE2 may help
  • Prognosis: Good for cow’s future fertility
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11
Q

what is fetal maceration?

A

Decomposition of soft tissues and placenta in a septic environment leaving bones

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12
Q

what is the process that leads to fetal maceration?

A

fetal death
> relaxation of the cervix
> bacterial invasion
> retained CL
> emphysema in 24-48 hours (air filled uterus/fetus)
> maceration by 4 days (“wasting away”)

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13
Q

clinical signs of emphysematous fetus and fetal maceration

A

Emphysematous fetus:
Distended, swollen and crepitus fetus
Fetid (foul) uterine discharge
Fever, anorexia, decreased milk production
»
Maceration of fetus:
Thick uterine wall
Bones
Bones embedded in wall

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14
Q

treatment of fetal emphysema

A

PGF2α to induce luteolysis
Fetal extraction if the cervix is open
Treat metritis; Systemic antibiotics, anti‐inflammatories, fluid therapy

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15
Q

treatment of fetal maceration

A

Estrogen or topical PGE to dilate cervix
Manual bone extraction
(use lots of lubricant in the uterus)
Surgical removal

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16
Q

prognosis of fetal maceration?

A

Poor prognosis for future fertility ‐ cull

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17
Q

do we often see fetal maceration in mares?

A

no, fetal maceration is rare in mares

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18
Q

difference in clinical signs between mummification and maceration

A

both:
fail to calve; anestrus

maceration only:
+/- sick animal

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19
Q

prognosis for mummification vs maceration

A

mummification: good
maceration: poor

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20
Q

what characterizes Hydropic Conditions (Dropsy; Hydrops)?

A

Excessive accumulation of placental fluids

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21
Q

what is the origin of fluids in hydropic conditions?

A

can be:
-amniotic
-allantoic
-both

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22
Q

what is Hydroallantois? how does it arise?

A

Abnormal fluid accumulation in the allantois due to abnormal placentation or a diseased uterus
Caused by functional or structural changes that lead to excessive fluid production

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23
Q

hydroallantois can be associated with what?

A

Can be associated with decreased numbers of placentomes in cows

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24
Q

clinical signs of hydroallantois. when do we usually see it? what do we find via rectal exam and what are symptoms?

A

Usually in the last 3 months of pregnancy]
Rapid abdominal enlargement
Up to 150‐250 Litres (normal is 15‐25 L)

Rectal exam – very large, distended uterus – fetus and placentomes are NOT palpable
Round shaped abdomen
Clinical signs depend on severity:
Anorexia, weakness, reluctance to move, dyspnea, recumbancy
Potential for rupture of body wall or prepubic tendon

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25
Q

what do the following clinical signs point to:
8 months pregnant
Rapid abdominal enlargement recently
Abdominal wall round and tense
Anorexic, weak
Rumen stasis
Reluctant to move
Dyspneic, tachycardic

A

hydroallantois

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26
Q

what do the following clinical signs point to:
* 8 months gestation
* Slow abdominal enlargement over last weeks
* Abdominal wall is pear shaped

A

hydroamnion

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27
Q

what causes hydroamnion? is it common?

A

Due to abnormal fetus that cannot swallow or process amniotic fluid, so there is GRADUAL increase in amniotic fluid during last trimester
‐Less common

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28
Q

what is hydroamnion associated with?

A

‐Associated with Large Offspring Syndrome
in ART calves (IVF, cloned)

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29
Q

what volume of fluid is associated with hydroamnion?

A

‐Up to 19 ‐ 100 L (normal is 4‐7 L)

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30
Q

what can we feel upon rectal exam in a case of hydroamnion?

A

Rectal exam ‐ Fetus and placentomes ARE palpable

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31
Q

shape of abdomen in hydroamnion case?

A

pear shaped

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32
Q

shape of abdomen in hydroamnion case?

A

pear shaped

33
Q

etiology of Hydroallantois vs Hydroamnion

A

Hydroallantois: placental
Hydroamnion: fetal

34
Q

incidence of Hydroallantois vs Hydroamnion

A

Hydroallantois: 90%
Hydroamnion: 10%
—–sporadic——

35
Q

prognosis of Hydroallantois vs Hydroamnion

A

Hydroallantois: poor
Hydroamnion: good (for cow)

36
Q

fluid character of Hydroallantois vs Hydroamnion

A

Hydroallantois: watery/clear
Hydroamnion: viscous

37
Q

complications of hydroallantois or hydroamnion

A

RFM, metritis

38
Q

Hydrops in Cows ‐ Treatment considerations

A

If not severe – induce parturition to save cow
Euthanasia if severe

Recurrence possible if uterine/placental (hydroallantois)

39
Q

what do these symptoms point to?
9 months pregnant with 9th foal
Rapid abdominal enlargement in the last month Depressed, anorexic

A

hydrops in the mare

40
Q

how common is hydrops in the mare?

A

rare compared to cows

41
Q

is hydrops in the mare serious?

A

yes
A train‐wreck waiting to happen!
 Potential for loss of mare and foal

42
Q

potential causes for hydrops in the mare

A

Causes can be:
 Placentitis
Fetal abnormality
 Leptospirosis
Uterine /placental insufficiency
Twins
Genetic – recently identified RTL1 gene expression variant (paternal in origin) – leads to decreased #s placental capillaries

43
Q

treatment for hydrops in the mare. what should we be careful to avoid?

A

Terminate pregnancy to save mare prior to abdominal wall / PPT rupture
-Slow drainage of hydrops in mares
Beware of potential for Acute Shock in mares due to rapid loss of fluids and circulatory volume

44
Q

how do we proceed with Slow drainage of hydrops in mares

A

Use of a trochar thru cervix – puncture membranes and drain thru tubing Slow Drainage - can take 2-4 hours
Sedate mare
Monitor mare’s heart rate etc. for signs of shock
Extract fetus (malposition is common)

45
Q

why is the outcome of hydrops in the mare usually poor?

A
  • Outcome is usually poor as most mares have ruptured the body wall or prepubic tendon as a result of rapid abdominal wall enlargement
  • Often don’t know until the edema/swelling goes down weeks later
  • No future breeding potential (except ET)
46
Q

if mare survives hydrops, what should we consider for the cause and for future breedings?

A

If mare survives, consider RTL1 gene as potential cause – do not rebreed to same stallion

47
Q

what are these symptoms consistent with:
* 18 yr old Draft X TB mare
* 340 days of gestation
* 6th foal
* Severe ventral edema
* Getting worse over last few days
* Painful gait
* Sweating
* Tachycardia
* Blood in milk
* Rectal palpation
– fetus alive

A

Prepubic Tendon Rupture

48
Q

warning sign and common symptoms of prepubic tendon rupture in the mare

A

 Severe ventral edema is a warning sign
 Reluctance to walk
 Painful
 Stretched out stance

 Blood in milk
 Lordosis
 Udder pulled cranially
 Confirm diagnosis by ultrasound

49
Q

predisposing causes for Rupture of Prepubic Tendon and/ or Abdominal Wall

A

Draft mares
Hydrops
Twins
Uterine Torsion
? Genetics
Often no predisposing factor

50
Q

treatment for Suspected Cases of Abdominal Wall Hernia or PPT Rupture

A

If at term and fetus is mature: induce parturition‐ be prepared to assist!

If not:
 Belly wrap
 Pain management
 Restrict exercise
 Monitor Calcium/Na/K/pH of milk
 And induce parturition when fetus is mature

51
Q

Prognosis – PPT Rupture or Hernias

A
  • Poor for future foalings/calvings
  • Surgical repair possible but difficult
    > Mesh repair
    > Complications – infection, failure
  • Embryo Transfer Donor
  • Pasture Pet
  • Euthanasia esp. in cases of PPT Rupture
  • Terminal C Section if fetus mature
52
Q

why are uterine torsions very different in the cow and the mare?

A

‐ Differences in anatomy (attachment of broad ligaments) plus fetal positioning in mid‐ to late gestation

53
Q

broad ligament anatomy of the cow

A

Broad ligaments attached caudally and along lesser curvature
‐greater curvature free
‐cervix is mobile
‐if empty rumen, heavy fetus has space to rotate

54
Q

fetal position in late gestation for the cow

A

squished with feet towards caudal aspect of abdominal cavity, head up and towards vaginal opening

55
Q

broad ligament anatomy in the mare

A

Broad Ligament attaches dorsally
Cervix broadly attached

56
Q

position of the equine fetus at 8 months

A

head towards caudal aspect of abdominal cavity, back towards ground
-ie. fetus is lying on back, hind feet curled upward into ‘limb horn’

57
Q

where anatomically does uterine torsion usually occur in the mare

A

cranial to cervix

58
Q

cow Uterine Torsion ‐ Clinical Signs

A

Late gestation / during parturition
Dystocia
Failure to progress at parturition
Anorexia, rumen stasis
Sometimes –dystocia, fetus upside‐down

59
Q

mare Uterine Torsion ‐ Clinical Signs

A

Mid to late gestation
Colic signs
Intermittent and mild
Severe (>270̊ torsion)

60
Q

uterine torsion diagnosis in cow

A

Clinical sign – failure to progress during parturition
Rectal palpation– rotation of uterus and broad ligament
Vaginal exam – twist in the anterior vagina – cervix is included in torsion in most cases

61
Q

uterine torsion diagnosis in the mare

A

Colic signs but not attributable to GIT
Rectal examination (broad ligaments crossing and taught)
Vaginal examination NOT usually helpful

62
Q

Diagnosis of Uterine Torsion in the Mare - what will we feel in a rectal exam? how do we determine the side of the torsion?

A

Most caudal ligament felt on rectal exam is usually the side of the torsion
 Ligament on opposite side is pulled forward in front of the uterus
 If you feel the left ligament first, with the right crossing in front of it, then it is a “Left” or “Counterclockwise” torsion

63
Q

Uterine Torsion ‐ Treatment Options‐ Cow.

A

-Detorsion of the fetus per vagina
-Roll the cow
-C‐section (flank laparotomy)

64
Q

when and how should we detorsion a fetus in a cow per vagina

A

Use in Cows only (typically at term, cervix partially dilated) – good if only 90 degree
Per vaginum using detorsion bar and calving chains to “roll” fetus over to de‐torse the uterus
Risk that cervix will not dilate and fetus dies
Risk of limb fracture to calf

65
Q

how does “Plank in the Flank” Rolling to Detorse work in the cow? what do we do if we have a right torsion

A

Right torsion — lay cow on right side —- roll to right

You are rolling the cow around the stabilized uterus

66
Q

Uterine Torsion ‐ Treatment ‐ Mare. options and risks

A

Surgery:
Standing flank laparotomy to detorse the uterus
(cut on same side toward which the torsion occurs)

Rolling the mare:
Requires general
anesthetic
Risk of uterine rupture

67
Q

when during gestatoin do we expect a torsion in a mare vs cow?

A

cow: late pregnancy
mare: mid-gestation

68
Q

Placentitis in the Mare etiology and predisposing factors

A

Most often ascending bacterial infection via cervix
– E. Coli, Strep. zooepidemicus
Simple cervix
Longitudinal folds
Poor perineal conformation
Previous history of placentitis

69
Q

what bacterial causes hematogenous placentitis in the mare?

A

Hematogenous ‐ Leptospirosis

70
Q

clinical signs of placentitis in the mare

A

Usually late gestation (>240 days)
 Vaginal Discharge +/‐
Premature lactation
NO fever or other systemic signs

71
Q

significance of premature lactation in the mare

A

Fetus is stressed!
Indicates impending abortion (from any cause)

72
Q

how to diagnose ascending placentitis?

A

Clinical signs

Transrectal ultrasound exam
>Measure: Combined Thickness of the Uterus and Placenta (CTUP)

Inflammatory markers

72
Q

how to diagnose ascending placentitis?

A

Clinical signs

Transrectal ultrasound exam
>Measure: Combined Thickness of the Uterus and Placenta (CTUP)

Inflammatory markers

73
Q

Nocardioform Placentitis (in Kentucky) caused by what?

A
  • Bacterial organism Crossiela equi or Amycolatopsis
    -gram + bacteria in soil
74
Q

Placentitis ‐ Treatment

A

-Broad Spectrum Combination of Antibiotics that cross placenta well
- Anti‐inflammatories
- Pentoxifylline
-Progesterone Supplementation ??

75
Q

prognosis of placentitis?

A

Prognosis – Guarded to Poor
Foals born alive are often septic
Likely to recur in subsequent pregnancies

76
Q

etiology of vaginal prolapse in the ruminant

A

Cause is high estrogen of late pregnancy

Inherited in Bos indicus cattle (conformational factors)
Pluriparous and fat cows
Edema of vagina
Prolapse of swollen tissues of vaginal floor
Increased abdominal pressure during recumbency – leads to external prolapse

77
Q

what is the cycle of trauma for a vaginal prolapse?

A

drying — necrosis — more straining —- more prolapsing–
Beware!! Frostbite, predators

78
Q

Vaginal Prolapse – Clinical Signs
mild vs severe

A

Vaginal Prolapse – Clinical Signs
Mild – slightly prolapsed during recumbency, replacing when cow stands
Severe – extensive vagino‐cervical prolapse including bladder

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