52. Bacterial complications of involution in cattle (cause, symptoms, diagnostics, treatment) Flashcards
Before and after day 21?
Before day 21:
o puerperal metritis
• After day 21:
o clinical endometritis
o subclinical endometritis
o pyometra
Puerperal Metritis?
Puerperal metritis
- Acute, putrid inflammation of all uterine layers
- Most often around day 4 to 10 after calving, but can occur until day 21
Puerperal metritis Pathogens?
Pathogens:
- Escherichia coli
- Fusobacterium necrophorum and other Gram-negative anaerobs
- Trueperella pyogenes
Risk factors of puerperal metritis?
Risk factors:
- dystocia
- assisted calving
- twins
- RFM
- NEB
- hypocalcaemia
- BUT! a number of cases happen without any of the above present!
Pathogenesis puerperal mastitis?
Pathogenesis:
- infection through the open cervix
- bacteria multiply quickly in the lochia and colonise the uterine wall – proteolysis – putrid metritis
- endotoxins from dead Gram-negative bacteria are absorbed from the uterine wall due to it not being
covered by epithelium, and enter the blood stream– endotoxaemia
• If the disease is characterised by endotoxaemia, it is called toxic puerperal metritis.
Clinical signs of puerperal mastitis?
Clinical signs:
• Local findings:
o copious, reddish-brown, watery, smelly discharge that contains tissue debris
o rectal examination: uterus is large, the uterine wall atonic, sometimes thin, large amount of fluid in
the lumen
• General clinical signs (endotoxaemia):
o decreased milk yield!!!
o fever, tachycadia, decreased ruminal movements, anorexia, depression, dehydration, recumbency
o prognosis of toxic puerperal metritis is poor
Diagnosis pueperal mastitis?
Diagnosis:
• large-scale dairy farm
o automatic detection of decreased milk yield/planned involution check – veterinary examination
• small farms
o decreased milk yield + anorexia + sometimes foul smell– noticed by owner/worker – veterinary
examination
Examination of Puerperal mastitis?
Examination:
- anamnesis
- body temperature incr, heart rate incr, ruminal contractions decr
- rectal or vaginal examination (by hand or vaginoscope) – discharge is pathognomonic Puerperal metritis
Treatment of Puerperal mastitis?
Treatment:
• endotoxaemia:
o fluid therapy - large volume – flushing the kidneys
o NSAID: (flunixin meglumine), ketoprofen, carprofen, meloxicam
• putrid metritis:
o AB: systemic cephalosporins (ceftiofur – Naxcel inj.), or local oxytetracyclin (Tetra-bol 2000 uterine
tablets) in case of a still sufficiently open cervix
o uterine contractions: oxytocin (until day 4 or 5), then PGF2α
o non-AB uterine treatments – ozone, iodofoam
o NO UTERINE FLUSHING Puerperal metritis
Prevention of puerperal mastitis?
Prevention:
- general hygiene
- calving hygiene
- hygiene of post partum uterine treatments
- nutrition during the dry peroid – avoid NEB and hypocalcaemia
Clinical endometritis?
Clinical endometritis
- inflammation of the endometrium – other layers not affected
- after day 21
Pathogen:
• Trueperella pyogenes
Risk factors:
- NEB
- puerperal metritis
- CL – P4 - immunosuppression
Pathogenesis of clinical endometritis?
Pathogenesis:
- local immunosuppression due to NEB or high P4 (after the first ovulation)
- uterine clearance decr - pyogenic bacteria incr
- but! regeneration of the endometrial epithel is – barrier – remains localised
Clinical signs of clinical endometritis?
Clinical signs:
• only local findings in the majority of cases: yellowish-white discharge with pus, uterus is bigger than normal,
filled with thick, echodense fluid Clinical endometritis
Diagnosis of clinical endometritis?
Diagnosis:
• routine involution check:
o rectal palpation/US
o vaginoscopy
o sample collection with a gloved hand
o Metricheck
• Discharge score:
o 0: clear, translucent ,
o 1: some pus flakes ,
o 2: with pus but less than 50% ,
o 3: pus over 50% Metricheck
Treatment and prevention?
Treatment:
- AB: uterine infusion (e.g. Metricure – cefapirin)
- iodofoam/ozone
- PGF2α
Prevention:
- Hygiene
- Nutrition
Nsaid of bacterial involutions?
