Calving And Dystocia Flashcards
Describe stage 1 labour.
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
Describe stage 2 labour.
Expulsion of the calf
- first the waterbag appears, then pops
- strong abdominal contractions push the calf out
Describe stage 3 labour.
Expulsion of the placenta
Usually within a couple of hours
Retained if still present after 12 h
What makes the ideal calving pen?
12 x 12ft
Easy to clean out
Cow is alone
Quick release headlock
When should you intervene during labour?
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
What is the most common cause of dystocia?
Fetomaternal disproportion
What can cause dystocia?
Fetomaternal disproportion Malpresentation Insufficient cervical dilation Uterine torsion Uterine inertia Cervical prolapse Pelvic fracture Cervical neoplasia Uterine rupture Foetal abnormalities
What factors predispose a dam to dystocia due to fetomaternal disproportion?
Large calf
Fat dam
Poorly grown dam
Dead emphysematous calf
What should you ask in a dystocia specific history?
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?
What should you assess in a vaginal exam in a case of dystocia?
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
How can you cause uterine relaxation to provide you with more space?
Caudal epidural
Clenbuterol (beta 2 agonist)
What must you consider when using obstetric traction?
Don’t use more than the force of 3 men
Calf pullers cause lots of damage and increase infections
Follow pelvic conformation
What foetal factors can increase the risk of dystocia?
Bull calves
Twins
Continental calves
What factors suggest that a calf in anterior presentation can’t be delivered per vaginum?
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
What factors suggest that a calf in posterior presentation can’t be delivered per vaginum?
No space between the calls tail head and cows pelvic inlet
Can’t exteriorise the hocks outside the vuvla
What should you always check before delivering a calf in posterior presentation?
That the umbilical cord is not wrapped around the hock
When is an episiotomy indicated?
Heifers
Where the cervix is fully dilated but the vulva hasn’t
Following 20min of attempting to manually dilate the vulva
What drugs should you use for an episiotomy?
Caudal epidural - procaine
Antibiotics
When and where should you make an episiotomy incision?
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
What suture material should you use for an episiotomy?
Dissolvable sutures - if she tears again there are not sutures to become infected
What are complications of an episiotomy?
Wound infection and breakdown
Rectovaginal fistula
Weak point - may reduce calving ability
Changed perineal conformation - reduced fertility
What are the indications for a full fetotomy?
Large calf
Abnormal calf - eg schmallenberg
What are the indications for a partial fetotomy?
Hip locked - cut trunk, split pelvis, remove each hindquarter
Head back - cut off head
Leg back - cut off leg
What are the two methods of placing the fetotomy wire?
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
What should you give the cow to provide analgesia and increase space in the uterus for a fetotomy?
Caudal epidural
Clenbuterol
NSAID
Antibiotic
When removing a limb what should you always check?
Removed the scapula
Not swayed through the humerus - sharp, will cut the dam
What must you always do after performing a fetotomy?
Check for a twin
Check for damage
Remove foetal membranes
What are common complications of a fetotomy?
Uterine, vaginal and cervical tears
Retained foetal membranes
Metritis
Adhesions
What are the risk factors for a uterine torsion?
Poor rumen fill Hilly land Space in the abdomen Standing up and lying down a lot Twins Hypermotile calf
How does a uterine torsion usually present?
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
How can you diagnose a uterine torsion?
Vaginal examination - corkscrew felt
- most commonly anti-clockwise torsion
How can you correct a uterine torsion?
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
What complications may be encountered with a uterine torsion?
Dead emphysematous calf - toxic
Occlusion of the blood supply to the uterus
What are the indications for a Caesarian?
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
How should you restrain a cow that is standing for a Caesarian?
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
How should you restrain a cow for a Caesarian performed whilst she is down?
High volume caudal epidural to cause cranial spread
Sedation - xylazine
What anaesthesia is best for a Caesarian?
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
What pre operative medication should you provide for a Caesarian?
Clenbuterol - must give to exteriorise the uterus
NSAID - eg ketoprofen, meloxicam (longer lasting)
Prophylactic antibiotic - pen & strep
Calcium if due to uterine inertia
+/- sedation
What is the landmark for the left flank approach to the caesarean?
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!!
Where should you incise the uterus when the calf is presenting normally?
Greater curvature of the uterus
From the point of the hock to the tip of the toe
Where should you make your incision in the uterus if the calf is presenting in breech?
Incise the greater curvature of the uterus
Carpus to toe
What should you ensure before removing the calf from the uterus?
Umbilicus not torsed - this would cause premature rupture
Incision is large enough - make a controlled extension
What should you always ensure once you have removed the calf?
There is an assistant attending to the calf
CHECK THERE IS NOT A TWIN
Remove the foetal membranes
Clean the uterus before replacing
How should the uterus be closed?
2 layer inverted suture pattern
Lembert or Cushing
Round bodied needle
Absorbable monofilament
What must you always give post caesarean?
Oxytocin
Check calf over and give colostrum
What are common complications of Caesarean section?
Haemorrhage - off colour, pale, tachycardic - reopen and ligate
Peritonitis - off colour cow, Pyrexia - reopen and flush
Localised adhesions
Retained foetal membranes
Metritis
Wound infection
What conditions predispose a cow to a uterine prolapse?
Hypocalcaemia
Too much manual traction on the foetus during dystocia
Prolonged straining
Traction on RFM
What restraint should you use for replacing a uterine prolapse?
Down - caudal epidural with cranial spread
How should you replace the uterus?
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
What drugs should you give before replacing the uterus?
Clenbuterol NSAIDs - meloxicam Antibiotics - pen & strep Calcium Procaine caudal epidural
What conditions predispose a ewe to a vaginal prolapse?
High BCS
Multiple foetuses
Old age
Lameness
How can you treat a vaginal prolapse?
Prolapse harness
Manual replacement and purse string suture
Spoons - cause vaginitis and traumatic
How can you judge foetal oversize?
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
What anaesthesia should you provide to a cow for a Caesarian?
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
What is the spectrum of pen & strep?
Penicillin - gram +ves eg staphs and streps
Streptomycin - gram -ves eg e.coli
