Bovine - Postpartum Disease

Question 1

What are the most common issues that can happen postpartum?

Answer 1

uterine prolapse, retained placenta, metritis/endometritis, and pyometra

Question 2

What is uterine prolapse?

Answer 2

expulsion of the uterus

Question 3

When does uterine prolapse typically occur?

Answer 3

within 4 hours post-calving

Question 4

How common is uterine prolapse?

Answer 4

it occurs in less than 1% of all calvings

Question 5

What are the predisposing factors to uterine prolapse?

Answer 5

dystocias with assistance, reduced uterine contractility, obese, breed predilections (Herefords), retained fetal membranes, or paresis

Question 6

What can cause reduced uterine contractility?

Answer 6

hypocalcemia and oxytocin receptor not functioning at its peak

Question 7

What complications are associated with uterine prolapse?

Answer 7

ruptured vessels, tears in the uterus, loss of caruncles, decreased fertility, and 18-20% mortality

Question 8

What vessel are we most worried about rupturing?

Answer 8

the middle uterine artery

Question 9

Are uterine prolapses emergent?

Answer 9

yes - it is a true emergency

Question 10

What is the treatment for uterine prolapse?

Answer 10

put it back in quickly - epidural, clean uterus, and complete inversion of uterine tips

Question 11

If a cow is down, what position should the cow be in to replace the uterus?

Answer 11

sternal recumbency with the legs pulled back

Question 12

When putting the uterus back into the cow, what must you make sure not to use?

Answer 12

do not use your fingertips - the uterus is very friable and if you use your fingertips you may cause a tear in the uterus

Question 13

What stich should you use to keep the uterus in place?

Answer 13

Buhner stich

Question 14

What tool is helpful to get complete eversion of the uterine tip?

Answer 14

a probate

Question 15

How long post partum is retained fetal membranes considered a retained placenta?

Answer 15

greater than 12 hours post partum

Question 16

What is retention of the placenta primarily due to?

Answer 16

failure for cotyledonary villi detaching from maternall crypts of the caruncle

Question 17

What other factors can lead to retained placenta?

Answer 17

endocrine, structural, immunological, vascular, and/or contractile changes

Question 18

What are some prolonged issues that cows that had a retained placenta have?

Answer 18

fertility issues, poor milk production, and an increased risk of metritis

Question 19

What are some ways to treat retained placenta?

Answer 19

manual removal - be careful, antibiotic (none are labeled), antiseptics, collagenase, hypertonic saline - yes, lavaging is important

Question 20

Overall, what is the best treatment for retained placenta?

Answer 20

lavage and systemic antibiotics

Question 21

All retained placenta animals should be re-evaluated _____ days after removal or elimation. Make sure to assess ______.

Answer 21

20-30, involution

Question 22

What is metritis?

Answer 22

inflammation of all layers of uterine tissue

Question 23

What type of discharge is associated with metritis?

Answer 23

fetid, watery-brown discharge with systemic illness

Question 24

What is endometritis?

Answer 24

inflammation of only the endometrium

Question 25

What are the two types of endometritis?

Answer 25

clinical vs. subclinical

Question 26

What type of discharge is associated with endometritis?

Answer 26

purulent discharge

Question 27

When is there a higher incidence of metritis/endometritis?

Answer 27

in cases of dystocia, twins, retained fetal membranes, trauma, and nutritional deficiencies - all it takes is a slight depression of the immune system

Question 28

What pathogens are associated with metritis/endometritis?

Answer 28

F. necrophorum, T. pyogenes, Bacteroides, Clostridials, E. coli, proteobacteria

Question 29

What pathogen typically causes the most severe endometritis?

Answer 29

T. pyogenes - usually 2 weeks post calving

Question 30

When do clinical signs associated with metritis/endometritis typically show up?

Answer 30

within 2 weeks post-calving

Question 31

What clinical signs can be associated with metritis/endometritis?

Answer 31

fever, anorexia, lethargic, fetid discharge, reduced milk yields, etc.

Question 32

How is metritis/endometritis diagnosed?

Answer 32

history and clinical signs, true definitive diagnosis, and on-farm diagnosis

Question 33

How do you get true definitive diagnosis of metritis/endometritis/

Answer 33

biopsy and culture, and cytology +/- vaginoscopy

Question 34

How do you get an on-farm diagnosis of metritis/endometritis?

Answer 34

palpation or discharge categorizing

Question 35

What will the uterus feel like on palpation if it has metritis?

Answer 35

large flaccid uterus without rugae, large amounts of fetid brown discharge when milked out by hand

Question 36

What will the uterus feel like on palpation if it has endometritis?

Answer 36

enlarged horns but have identifiable thickening and fluid

Question 37

What is pyometra?

Answer 37

a collection of purulent exudate within the lumen of the uterus, with a persistent CL, and stoppage of the estrous cycle

Question 38

When does pyometra typically develop?

Answer 38

in females that cycle prior to contamination elimination post-partum

Question 39

How is pyometra diagnosed?

Answer 39

visual discharge, palpation/ultrasound

Question 40

What is the treatment for pyometra?

Answer 40

prostaglandin