Calving And Dystocia Flashcards

1
Q

Describe stage 1 labour.

A

Dilation of the cervix (3-6h)

  • separates herself, appetite drops, restless
  • thick string of mucous hanging down from vulva
  • towards the end this abdominal straining every 2-3 minutes
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2
Q

Describe stage 2 labour.

A

Expulsion of the calf

  • first the waterbag appears, then pops
  • strong abdominal contractions push the calf out
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3
Q

Describe stage 3 labour.

A

Expulsion of the placenta
Usually within a couple of hours
Retained if still present after 12 h

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4
Q

What makes the ideal calving pen?

A

12 x 12ft
Easy to clean out
Cow is alone
Quick release headlock

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5
Q

When should you intervene during labour?

A

No progress made after the water bag has been present for 1h
No progress to 2nd stage labour after 6h - twisted uterus
Bleeding for the vulva
Extreme discomfort

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6
Q

What is the most common cause of dystocia?

A

Fetomaternal disproportion

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7
Q

What can cause dystocia?

A
Fetomaternal disproportion
Malpresentation
Insufficient cervical dilation
Uterine torsion
Uterine inertia
Cervical prolapse
Pelvic fracture
Cervical neoplasia
Uterine rupture 
Foetal abnormalities
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8
Q

What factors predispose a dam to dystocia due to fetomaternal disproportion?

A

Large calf
Fat dam
Poorly grown dam
Dead emphysematous calf

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9
Q

What should you ask in a dystocia specific history?

A

Age, parity, breed of dam, breed of sire, previous problems
Has the water bag broken, when?
How long has she been straining?
Has the farmer attempted to relieve her?

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10
Q

What should you assess in a vaginal exam in a case of dystocia?

A
Tears
Position of the calf
Relation and dilation of the cervix
Signs of life from the calf 
Possibility of extraction
Position of the umbilical cord
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11
Q

How can you cause uterine relaxation to provide you with more space?

A

Caudal epidural

Clenbuterol (beta 2 agonist)

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12
Q

What must you consider when using obstetric traction?

A

Don’t use more than the force of 3 men
Calf pullers cause lots of damage and increase infections
Follow pelvic conformation

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13
Q

What foetal factors can increase the risk of dystocia?

A

Bull calves
Twins
Continental calves

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14
Q

What factors suggest that a calf in anterior presentation can’t be delivered per vaginum?

A

Forelimbs crossing over - insufficient space

Can’t bring the fetlocks more than a hands width outside vulva - can’t get shoulders in the pelvic canal

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15
Q

What factors suggest that a calf in posterior presentation can’t be delivered per vaginum?

A

No space between the calls tail head and cows pelvic inlet

Can’t exteriorise the hocks outside the vuvla

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16
Q

What should you always check before delivering a calf in posterior presentation?

A

That the umbilical cord is not wrapped around the hock

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17
Q

When is an episiotomy indicated?

A

Heifers
Where the cervix is fully dilated but the vulva hasn’t
Following 20min of attempting to manually dilate the vulva

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18
Q

What drugs should you use for an episiotomy?

A

Caudal epidural - procaine

Antibiotics

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19
Q

When and where should you make an episiotomy incision?

A

10-11 o’clock or 1-2 o’clock - never midline - risk of vaginorectal fistula
Make the incision when the calfs head is passing through the vagina

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20
Q

What suture material should you use for an episiotomy?

A

Dissolvable sutures - if she tears again there are not sutures to become infected

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21
Q

What are complications of an episiotomy?

A

Wound infection and breakdown
Rectovaginal fistula
Weak point - may reduce calving ability
Changed perineal conformation - reduced fertility

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22
Q

What are the indications for a full fetotomy?

A

Large calf

Abnormal calf - eg schmallenberg

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23
Q

What are the indications for a partial fetotomy?

A

Hip locked - cut trunk, split pelvis, remove each hindquarter
Head back - cut off head
Leg back - cut off leg

24
Q

What are the two methods of placing the fetotomy wire?

A

Passing technique - literally putting it around the limb
Eg: leg back / head back

Cleat technique - using a cleat to place the wire eg: around the scapula

25
Q

What should you give the cow to provide analgesia and increase space in the uterus for a fetotomy?

A

Caudal epidural
Clenbuterol

NSAID
Antibiotic

26
Q

When removing a limb what should you always check?

A

Removed the scapula

Not swayed through the humerus - sharp, will cut the dam

27
Q

What must you always do after performing a fetotomy?

A

Check for a twin
Check for damage
Remove foetal membranes

28
Q

What are common complications of a fetotomy?

A

Uterine, vaginal and cervical tears
Retained foetal membranes
Metritis
Adhesions

29
Q

What are the risk factors for a uterine torsion?

A
Poor rumen fill
Hilly land 
Space in the abdomen
Standing up and lying down a lot 
Twins
Hypermotile calf
30
Q

How does a uterine torsion usually present?

A

At the onset of labour

Cow starts to labour but does not progress
No abdominal straining as the ferguson’s reflex is not stimulated
Occasionally a toxic cow
Raised tail head

31
Q

How can you diagnose a uterine torsion?

A

Vaginal examination - corkscrew felt

- most commonly anti-clockwise torsion

32
Q

How can you correct a uterine torsion?

A

Swing the calf with coordinated ballotment
Twist the legs of the calf and the uterus may twist too
Cast and roll the cow
- use a plank to apply pressure the abdomen
- roll in the opposite direction to the torsion
Caesarian - if unable to untwist uterus or over 360 degrees

33
Q

What complications may be encountered with a uterine torsion?

A

Dead emphysematous calf - toxic

Occlusion of the blood supply to the uterus

34
Q

What are the indications for a Caesarian?

A

Forced Caesarian

  • Fetomaternal disproportion
  • Complicated uterine torsion
  • Insufficient cervical dilation

Minor indications

  • foetal malpresentation that can’t be corrected after 20mins
  • abnormal calf where fetotomy not an option
  • dead emphysematous calf where fetotomy not an option
  • constricted vagina / vestibule

Elective caesareans may also be performed in double muscled breeds and embryo transfer calves

35
Q

How should you restrain a cow that is standing for a Caesarian?

A

Head collar tied to a gate
Yolk
Full access Crush - must be able to safely remove if she goes down

Tie a rope to the right hindlimb and pull on it if she goes down - ensures she falls away from the incision

Xylazine - only if it is unsafe to do this without, decreases foetal viability

36
Q

How should you restrain a cow for a Caesarian performed whilst she is down?

A

High volume caudal epidural to cause cranial spread

Sedation - xylazine

37
Q

What anaesthesia is best for a Caesarian?

A

Paravertebral nerve block - anaesthetises multiple myotomes

I would still give this with an epidural as you can’t guarantee how far the epidural has spread cranially

38
Q

What pre operative medication should you provide for a Caesarian?

A

Clenbuterol - must give to exteriorise the uterus
NSAID - eg ketoprofen, meloxicam (longer lasting)
Prophylactic antibiotic - pen & strep
Calcium if due to uterine inertia
+/- sedation

39
Q

What is the landmark for the left flank approach to the caesarean?

A

On the left hand side
One hands width below the transverse processes
One hands width behind the last rib

Incision length from the tip of your middle finger to the point of your elbow
- 40-50cm for an emphysematous calf!!

40
Q

Where should you incise the uterus when the calf is presenting normally?

A

Greater curvature of the uterus

From the point of the hock to the tip of the toe

41
Q

Where should you make your incision in the uterus if the calf is presenting in breech?

A

Incise the greater curvature of the uterus

Carpus to toe

42
Q

What should you ensure before removing the calf from the uterus?

A

Umbilicus not torsed - this would cause premature rupture

Incision is large enough - make a controlled extension

43
Q

What should you always ensure once you have removed the calf?

A

There is an assistant attending to the calf
CHECK THERE IS NOT A TWIN
Remove the foetal membranes
Clean the uterus before replacing

44
Q

How should the uterus be closed?

A

2 layer inverted suture pattern
Lembert or Cushing

Round bodied needle
Absorbable monofilament

45
Q

What must you always give post caesarean?

A

Oxytocin

Check calf over and give colostrum

46
Q

What are common complications of Caesarean section?

A

Haemorrhage - off colour, pale, tachycardic - reopen and ligate
Peritonitis - off colour cow, Pyrexia - reopen and flush
Localised adhesions
Retained foetal membranes
Metritis
Wound infection

47
Q

What conditions predispose a cow to a uterine prolapse?

A

Hypocalcaemia
Too much manual traction on the foetus during dystocia
Prolonged straining
Traction on RFM

48
Q

What restraint should you use for replacing a uterine prolapse?

A

Down - caudal epidural with cranial spread

49
Q

How should you replace the uterus?

A

Clenbuterol
Clean off uterus with dilute hibiscrub and remove foetal membranes
Evert the uterus whilst you replace it - fill with water or use a bottle
Use lots of lubricant
Place a buhner suture

ALWAYS GIVE OXYTOCIN AFTERWARDS

50
Q

What drugs should you give before replacing the uterus?

A
Clenbuterol 
NSAIDs - meloxicam 
Antibiotics - pen & strep 
Calcium 
Procaine caudal epidural
51
Q

What conditions predispose a ewe to a vaginal prolapse?

A

High BCS
Multiple foetuses
Old age
Lameness

52
Q

How can you treat a vaginal prolapse?

A

Prolapse harness
Manual replacement and purse string suture
Spoons - cause vaginitis and traumatic

53
Q

How can you judge foetal oversize?

A
Can't fit hand over the top of the calf 
Estimated breeding values
Can't keep the foetus in the pelvis 
Hips stuck in the pelvis 
Crossed over legs
Can't make a fist all the way around the calves shoulders
54
Q

What anaesthesia should you provide to a cow for a Caesarian?

A

Caudal epidural - reduces straining
2 inch pink 18g needle

Paravertebral block - blocks T13-L3 +/- L4

  • use an 18g, 10cm spinal needle
  • put 10ml in each deep layer, 5ml in each superficial layer
55
Q

What is the spectrum of pen & strep?

A

Penicillin - gram +ves eg staphs and streps

Streptomycin - gram -ves eg e.coli