Bovine Postpartem Reproductive Problems

Question 1

Normal postpartum involution

Answer 1

Process of restoration of reproductive tract to ability to support subsequent pregnancy
-shrinkage and repair of uterus and cervix
-Sloughing of caruncles ( lochia) and re-epithelialization of endometrium
-Clearance of bacterial contamination within 3 weeks
-Ideally: Gross – 21 d Histologic – 40 d

Question 2

what is uterine prolapse associated with

Answer 2

-Associated with hypocalcemia, therefore older cows
-Thought to be due to lack of smooth muscle ‘tone’

Question 3

treatment and prognosis of uterine prolapse in cows

Answer 3

Treatment
-Epidural and manual replacement
-If recumbent = ‘frog leg’ posture (see next slide)

Prognosis: good for survival, less for
pregnancy
-Some die from ruptured uterine artery, often after correction

Question 4

treatment details for uterine prolapse in cows (12)

Answer 4

-Epidural
-If recumbent = ‘frog leg’
-If marked edema = apply dextrose or sugar
-Rinse with clean saline
-Place uterus on a clean sheet
-Elevate
-Circumferentially push back in (easier said…)
-Invert back to normal position (Extend reach with a smooth bottle)
-Stitch vulva for 3-5 d (at lateral hair line)
~~Buhner purse string
~~Prolapse pins
-Calcium supplement SC or bolus
-Systemic antibiotics e.g. penicillin
-Oxytocin 20 IU IM

Question 5

when is a placenta considered retained in cows

Answer 5

-Failure to expel fetal membranes by 24 h post calving
-Common (5 to 10% of calvings) in dairy cows

Question 6

risk factors for retained placenta in cows (6)

Answer 6

-Dystocia
-Twins
-Abortion
-Milk fever
-Caesarian section
-Induced delivery

Question 7

pathogenesis of a retained placenta?

Answer 7

-Key element in pathogenesis is impaired immune function = failure of detachment of placentome

Question 8

what does placental detachment rely on

Answer 8

-Placental detachment depends on
neutrophils to break the collagen links between caruncle and cotyledon

Question 9

is RP a disease of uterine pushing?

Answer 9

-Balance of evidence is against lack of
uterine motility as the cause of RP; Uterine motility is normal to increased in cows with RP

Question 10

neutrophils in cows with RP

Answer 10

-Immune function is greatly reduced in cows with RP
-Neutrophils from cows with RP have = chemotaxis at calving and = killing capacity prepartum
-Reductions in neutrophil function are present 7-14 days prepartum

Question 11

what is RP a risk factor for

Answer 11

RP is a major risk factor for subsequent metritis, PVD, and/or
endometritis; displaced abomasum (?) (secondary to  feed intake?)

Question 12

is a RP directly harmful

Answer 12

no

Question 13

what does the impact of an RP depend on

Answer 13

Impact of RP depends on ability of cow’s immune system to deal with
it

Question 14

how many cows with an RP develop metritis

Answer 14

33 to >50%

Question 15

treatment for metritis

Answer 15

-NOT oxytocin, PGF, or calcium
-No good evidence of benefits of intrauterine (IU) antibiotics
-Systemic antibiotics if/when metritis occurs

Question 16

what lies between physiology and pathology of challenges in cows

Answer 16

-Almost all cows have bacterial contamination of the uterus after calving
-The same immune system mediators appear to be involved in healthy and affected cows
-Difference lies in the magnitude, regulation, duration and effectiveness of the response

Question 17

what are cows typically infected with PP?

Answer 17

-Typically mixed infections but E. coli is a common agent in week 1 and
Trueperella pyogenes in weeks 2‐3

Question 18

risk factors to uterine disease (6)

Answer 18

-Feed intake
-Energy and lipid metabolic health
-Stressors & hormonal changes
-Hypocalcemia
-Species of bacteria; Virulence factors
and Strain
-Level of contamination

Question 19

what are the primary effectors of PP uterine defence

Answer 19

neutrophils

Question 20

what is pyometra and what is present

Answer 20

-Uterus filled with pus (few hundred mL to several litres)
-In the presence of a (persistent) CL

Question 21

diagnosis and treatment of pyometra in cows

Answer 21

-Diagnosed > 3 weeks postpartum; mostly 1 to 3 months pp
-Diagnosed by rectal palpation or ultrasound
-Treatment: PGF injection(s) (Repeated at 10-14 d interval)

Question 22

are pyometras in cows normally open or closed

Answer 22

Almost always ‘closed’ (cervix)

Question 23

what is metritis

Answer 23

-Cow is systemically ill (fever, off feed)
-fetid uterine discharge is watery, red-brown, and foul smelling (anaerobic bacteria)
~~Normal discharge is thick, often red (lochia)

Question 24

what type of problem is metritis?

Answer 24

largely a problem of PP immune function

Question 25

when do you see metritis

Answer 25

< 10 DIM

Question 26

prevalence and treatment of metritis

Answer 26

-affects 5-20% of cows depending on means/intensity of diagnosis
-treatment; systemic antibiotics (ceftiofur, penicillin, etc)

Question 27

is PVD the same as endometritis

Answer 27

no

Question 28

PVD; diagnosis, associated with what, treatment

Answer 28

-Metricheck
-Associated with: Trueperella pyogenes and Endometrial trauma
-Treatment = Cephapirin IU. Partially to fully restores pregnancy at first AI. 2 injections of PGF, 2 weeks apart, may improve reproduction modestly

Question 29

endometritis; diagnosis, associated with what, treatment

Answer 29

-Cytology
-Not associated with concurrent bacterial infection
-Hypothesis: dysregulation of postpartum inflammation
-Treatment = we dont know

Question 30

cystic ovarian condition; what is it, what happens from it

Answer 30

-Follicle that fails to ovulate or regress and grows to abnormal size (>2.5cm diameter)
* The ovum in a cyst will age and be infertile

Question 31

what causes cystic ovarian condition

Answer 31

Problem is lack of LH surge; associated with excessive negative energy balance

Question 32

treatment of cystic ovarian condition

Answer 32

Treatment: Induce LH surge (Ovsynch) with supplemental P4

Question 33

Prevention of postpartum reproductive disease

Answer 33

-Prevention of reproductive tract disease currently relies on non-specific measures
-Implementation of best management practices for transition cows will plausibly improve metabolic health, immune function, and regulation of inflammation