Calving and Dystocia in cattle 1, 2 + 3 Flashcards
Describe stage 1 of labour
- Dilation of the cervix
- May take 3-6hrs
- Thick string of mucus is seen hanging from the vulva
- Abdominal straining gets more frequent
- Uterine contents pushes against the cervix
How does a cows behaviour change in stage 1 of labour?
- Separates herself from the group
- Decreased appetite
- Frequently alternates between lying and standing
Describe stage 2 of labour
- Delivery of the calf
- Begins with the appearance of membranes (water bag) at the vulva
- This stage may last several hours
- Water bag ruptures with a sudden rush of fluid
- Cervix dilates with further pressure from the calf
- Powerful reflex and voluntary contractions of abdominal muscle and diaphragm (“straining”) serve to expel the calf
Describe stage 3 of labour
Expulsion of the placenta
Usually happens relatively quickly, within a few hours
When are membranes classed as retianed?
If not expelled within 12hrs after delivery of the calf
Describe the features of ideal calving facilities
- Optimum is a 12x12ft individual pen
- Needs to be easy to clean out in-between calving’s to provide excellent hygiene
- Well bedded and dry
- Good access to food and water
- Good lighting
- Well ventilated and in a well located quiet area of the farm
- Milking facility
What is the main consequence of intervening too early when a cow is in labour?
Intervention too early when the cow is in 1st stage labour can prevent full dilatation of the cervix
In which situations should you intervene during labour?
- No progress has been made by the cow after 1 hour of the water bag starts showing
- If you thought she was showing signs of 1st stage labour but has not progressed to 2nd stage after 6 hours – possible twisted uterus
- She appears in extreme discomfort
- There is significant bleeding from the vulva
List some causes of dystocia
- Malpresentation
- Foeto-maternal oversize
- Congenital abnormality
- Hydrops allantois
- Schmallenberg Virus
- Primary inertia: hypocalcaemia
What are some causes of foeto-maternal oversize?
Large calf
Fat dam
Young/poorly grown dam
Dead emphysematous calf
How is dystocia diagnosed?
- History
- General impression: cows attitude, BCS, behaviour
- General exam (if indicated, e.g. recumbent and not bright / bloated. Check udder)
- Obstetrical examination: vaginal exam, rectal exam
What needs to be assessed during the vaginal exam of a cow with dystocia?
- Lesions (tears) or haemorrhage
- Position of uterus and calf
- Relaxation and dilatation of vulva, vagina, cervix
- Signs of life from calf
- Possibility of extraction
- Position of umbilical cord (particularly with breech presentations)
How should you initially approach a cow with dystocia?
- Restrain – not recommended to do in a crush in case the cow goes down
- Clean
- Lubricate
- Identify
What are the 3 Rs used in the approach to dystocia?
- Reposition
- Repulsion
- Rotation
What are some tips to remember when dealing with dystocia?
- Position cow “downhill” (or uphill): use gravity
- Best lubricant = J-lube
- Pump warm water & lube into uterus: Fill her up !
- Sink plunger for repulsion
- Epidural anaesthesia
Which drug can be given to help relax the uterus?
Clenbuterol
In which situations would you want to phone a colleague during a dystocia case?
- You find a true breech
- You suspect a twisted uterus
- You can’t make sense of what you feel in the vagina
- You find lots of bleeding
- You don’t make any progress within 20 minutes of trying to calve her/correct a malpresentation
Which factors can increase the likelihood of a difficult calving?
- Twins
- First pregnancy
- Bull calf
- Breed of dam
- Breed of sire
Compare placing rope/chain above vs below the fetlock of the calf
Above = higher risk of leg fracture
Below = higher risk of rope slipping off
Double loop = minimal chance of leg fracture or rope slipping off - one loop above fetlock, 2nd below
What does a calfs legs crossing in the birth canal suggest?
That they are too big so a caesarean is needed
In the standing cow with a calf in an anterior position describe the rules for decision making on wether to delivery vaginally or perform a c-section
- Head can be brought into pelvis
- Head stays in the pelvic canal and doesnt fall back into the uterus
- Hand can be easily slid between the foetal cranium and maternal sacrum
- Each fetlock can be alternately exteriorised
How can you decide on which legs are forelimb and which are hindlimb?
Front leg – 2 joints that go ventrally
Back leg – one joint goes ventrally and one goes dorsally
What do you need to be careful of when twisting a calf into an dorsal anterior position?
Not causing a uterine torsion
In the standing cow with a calf in a posterior position describe the rules for decision making on wether to delivery vaginally or perform a c-section
- Assess space by sliding hand over tail head
- Two people should be able to exteriorise the limbs to the point at which the hocks are past the vulva. Failure to do so rules out calving per vaginum
- Check position of umbilical cord. Could be round hock. If so then as you pull calf break cord and calf may die/drown before you get it out. Advice farm of risk. Could do caesarean section or calve and take the risk
Are twins more likely to be identical or non-identical in cattle?
Most twins are non-identical – different horns
What is an episiotomy?
Cutting of the vulva to allow more space for calving
Is an episiotomy commonly used in cattle?
Uncommonly used in cattle
Almost totally reserved for heifers
In HF heifers 5-10% may need episiotomy
When is an episiotomy indicated?
Vulva not fully slackened and dilated BUT cervix dilated and calf entering pelvic canal
What should be tried before resorting to an episiotomy?
Manually stretching vulval lips with arms for ~20 minutes
Why are antibiotics required when performing an episiotomy?
Perineum area contamination risk HIGH - antibiotics required to help prevent breakdown
Describe the episiotomy procedure
- Caudal epidural anaesthesia
- Cut at 10-11 o’clock OR 1-2 o’clock position: controlled cut, rather than tear vulva during traction
- Interrupted deep dissolvable sutures
- Interrupted or continuous skin sutures
What are some complications associated with the episiotomy procedure?
- Wound infection and breakdown is common
- Distorted vulva conformation
- Weak point to muscles which may affect ability to calve naturally in the future
- Cut at 12 noon = Rectovaginal fistula
If performing an embryotomy what must be sufficient?
Must have sufficient space within the vagina and pelvic canal for embryotome and arms
What are the indications for an embryotomy?
Full embryotomy:
- Large dead calf
- Foetal monster
Partial embryotomy:
- Hip locked calf
- Head back: unable to correct and dead calf
- Leg back: unable to correct and dead calf
Name the two methods of placing wire during an embryotomy
- Passing
- Cleat
Describe the passing method for placing wire during an embryotomy
- Pass wire by hand around the appendage/area of calf needing removal
- Where appropriate attach a curved snare director or another form of weight
- Thread the wire through each side of the embryotome, tighten, check wire in correct place by palpation before sawing
Describe the cleat method for placing wire during an embryotomy
- Place an obstetric chain on the limb in question
- Thread the wire through the embryotome
- Place the loop of the wire in-between the cleats on the leg aiming to remove
- Advance the embryotome laterally up the limb to just past the top of the scapula/anterior aspect of the greater trochanter
- Unhook the wire from between the cleats, pass the obstetric chain through the loop, to allow the wire to be tightened up the medial aspect of the limb to lie in the auxilla or between the hindlimbs
- Check the position of the wire before sawing
Assuming a normal position how would you remove the head during an embryotomy?
- Cut as far caudal along neck as possible
- Embryotome placed lateral or ventral – space allowance will dictate this
- Avoid cutting cervix or vaginal wall
Why must care be taken when removing a forelimb?
- Ensure entire scapula removed
- Care not to cut through humerus – this will lead to sharp bony edges, and will not have narrowed the calf width at all
Once the foetus has been removed using an embryotomy what must be carried out?
- Check for a twin
- Check for damage to the uterus (as far in as you can feel), cervix and vagina and treat accordingly
- Remove foetal membranes if possible
- Anti-inflammatory and antibiotic therapy are advised
List some complications of an embryotomy
- Uterine tears
- Cervical tears
- Vaginal tears
- RFM
- Metritis
- Adhesions
When do most uterine torsions occur?
At the onset of parturition
List the risk factors for uterine torsion
- Poor rumen fill
- Space in the abdomen
- Hilly land
- Process of standing up/lying down
How will a cow with uterine torsion present?
- Appear to start calving but do not progress
- No straining as Ferguson’s reflex not stimulated
- May just see slightly raised tail
- Dry cow off colour/down/toxic
When examining a cow with a uterine torsion what will be found?
- Vaginal exam causes arm to ‘corkscrew’ (normally anticlockwise)
- May just feel a ‘lip’ in front of cervix
- May not be able to feel cervix or calf (depending on degree of torsion)
- Exam per rectum - palpation of the torsion
List the 4 methods to correct a uterine torsion
- Swinging the calf
- Twisting legs of the calf to twist the uterus
- Roll the cow
- C-section
Describe the method of ‘swinging’ the calf to correct a uterine torsion
‘Swing’ calf with coordinated ballotment of abdomen to flip the calf and uterine horn back into the correct position
- MUST be able to reach and firmly grasp calf by hand or with a rope
Describe the method of rolling the cow to correct a uterine torsion
- Majority of cases require cow to be rolled from left lateral recumbency, onto her back, and into right lateral recumbency
- If calf can be reached, grasp a leg firmly or place a calving rope and be held firmly whilst the cow is rolled over
- If the calf cannot be reached, a plank can be placed across the abdomen and weighed down to apply pressure to the abdomen whilst the cow is rolled
What are the complications of a uterine torsion
- If high degree torsion, the blood supply can be occluded leading to very friable tissue at the site of the torsion
- If not noticed early can lead to a dead emphysematous calf and a toxic cow
- During Caesarean uterus can be difficult as untwists away from you when suturing
List the 3 major indications for a forced c-section
- Foetal oversize/foeto-maternal disproportion
- Irreducible uterine torsion
- Insufficient cervical dilatation
List the minor indications for a forced c-section
- Foetal malpresentation: last resort if cannot reposition
- Abnormal calf: embryotomy not feasible
- Dead/emphysematous calf: embryotomy not feasible
- Constricted vagina/vestibule
When is an elective c-section indicated?
Double muscled breeds
Embryo transfer calves
How are cows restrained for a c-section?
- Halter tied to gate
- Stocks
- Head yoke/full access crush (MUST be able to safely remove animal from restraint system should the cow go down)
- Sedation (AVOID unless unsafe to perform surgery without)
- Secure the tail to the leg to avoid wound contamination
Describe anaesthesia used in a c-section
Caudal epidural - Block Ferguson’s reflex
Paravertebral nerve block
What medication may be given to a cow pre-caesarean section?
Tocolytic (Clenbuterol)
NSAID
Antibiotic?
Sedation?
Calcium
What are some additional factors to consider when performing a c-section?
- Adequate lighting
- Standing/down in right lateral recumbency: if standing MUST stay up, if down MUST stay down
Describe how to perform a c-section in a cow
- Left flank approach
- Clip and sterile prep the site
- 1 hand behind the last rib
- Incision length = from the tip of your finger to your elbow
- Locate uterine horn containing calf and exteriorise
- Incise uterus
- Remove calf
- Locate umbilical cord & ensure not torsed, prevent early rupture and rupture too close to the body wall on extraction
- Check for other calves
- Remove foetal membranes
- Close uterus and abdomen
Describe how and what you would use to close the incision post c-section
- Absorbable - ideally monofilament
- Round bodied needle
- Inverting pattern
- 2 layers for uterus, then muscle, peritoneum and skin
- Tack layers together to eliminate dead space
- Bury knots
- Ensure no leakage
What can be done to reduce the risk of wound infection during a c-section?
Application of antibiotics to the muscle layers when closing
Which medications are given to a cow post-c-section?
Oxytocin
Calcium
How should you perform a c-section when you have an emphysematous calf?
- Paramedian incision
- Very low flank incision
- Exteriorise horn
- Sedation/drop
- Large epidural – 50 ml
What are the complications of a c-section?
- Haemorrhage
- Peritonitis
- Localised adhesions
- Retained foetal membranes
- Metritis
- Wound infection/seroma/breakdown
- Poor fertility
How may a cow suffering with haemorrhage post c-section present? How is this managed?
- Post-op check next day may reveal off colour cow, tachycardia/murmur, palor
- Re-open, locate site of bleeding and ligate
How may a cow suffering with peritonitis post c-section present? How is this managed?
- Post-op check next day may reveal off colour cow, pyrexia
- Re-open, identify any site of leakage, flush abdomen with sterile fluid
- At 7 days post-op become palpable on rectal examination: Poor prognosis
Why are c-sections linked to poor fertility in the future?
- Delayed uterine involution
- RFM
- Endometritis
- Salpingitis
- Adhesions
- Abortion
Describe the replacement technique for a uterine prolapse
- Caudal epidural anaesthesia +/- clenbuterol
- Put protective cover under uterus
- Remove foetal membranes and clean off contamination
- Apply liquid lubricant and gradually feed uterus back in: don’t use fingertips as may rupture uterus
- Once replaced ensure horn tips fully everted by using a bottle to extend the reach of your arm, or fill the uterus with water
Which medications should be given to a cow with a uterine prolapse?
oxytocin, NSAIDs, antibiotics, calcium
What provides the best outcome for a c-section?
Early decision to perform one
How can the risk of peritonitis post c-section be reduced?
Exteriorisation of the uterus before incising to minimise abdominal contamination
