Exam 2 - Periparturient Period

Question 1

What is the most common species for vaginal prolapse?

Answer 1

BOVINE!

Heritable

Esp: Herefords, Shorthorns

• usually prepartum
• cull

Question 2

what are the 4 classifiations of vaginal prolapse

Answer 2

• Grade 1: floor of vagina protrudes intermittently
  
  • usually when lying down; goes back in once standing
• Grade 2: floor of vagina protrudes permanently
• Grade 3: cervix & most vaginal floor protrude
• Grade 4: 2nd or 3rd grade that has been exposed long enough to cause necrosis/fibrosis

Question 3

how is vaginal prolapse in cow tx

Answer 3

Reduction!

1. epidural
2. clean w/ mild antiseptic
3. debride if needed
4. Sugar=osmosis. combined w/ squeezing to reduce edema

Manual reduction (OVEN MITTS). PATIENCE.

Question 4

How to prevent reoccurrence of VP

Answer 4

Buhner technique - best, purse string suture

Halstead technique/horizontal mattress

Bootlace

Jorvet prolapse kit

Question 5

what is another name for Huhner needle

Answer 5

Hurlock needle

(get it? “Her lock!”)

Question 6

what is this technique called?

Answer 6

Buhner technique

Question 7

What is this technique called?

Answer 7

Halstead technique

Question 8

what is this technique called?

Answer 8

Bootlace

Question 9

what are precautions need to take after tx VP

Answer 9

Watch her for impending parturition!

Trauma if calves through Buhner

if prolapse was severe may be fibrosis/edema that may require C-section at parturition

predispostion heritable: cull cow & calf

Question 10

What is this?

Answer 10

uterine prolapse

Question 11

When does uterine prolapse occur?

Answer 11

perturient accident in all species

No relationship between vaginal & uterine prolapse

Other predisposing factors:

Hypocalcemia

Uterine inertia

Straining

Begins w/ inversion of one uterine horn

Question 12

What is a Dx of uterine prolapse in a cow mean?

Answer 12

This is a TRUE food animal EMERGENCY!

Your convo w/ the owner is utmost importance

Concerns:

Travel to farm = Risk of middle uterine a. rupture if trailer cow

Minimize stress to animal

Question 13

What is this and why is cow tied like this?

Answer 13

A uterine prolase

SEE PLACENTOMES!

Tied nose to tail to prevent movement.

Question 14

What is the tx for UP?

Answer 14

NOTE: This is an athletic event!

▪Epidural
▪Clean and debride.
▪Standing animal:
▪Elevate uterus with tarp, towel, tray –gravity is your friend
▪Recumbent animal:
▪Position animal in sternal and extend hindlimbs caudally–
▪AKA Frog leg
▪This tilts the pelvis forward

▪Reduction

Hold uterus at level of vulva if possible

Reduce gently. Endometrium becomes friable and edematous.
Need to make sure that horns are everted completely
Can use wine bottle, baseball bat, etc.

• Once reduced give oxytocin to prevent recurrence
• Vulvar retention sutures +/-
• Antibiotics
• Calcium therapy
• Last resort: amputation uterus cranial to cervix

Question 15

Possible sequela to UP

Answer 15

Uterine artery rupture

Septicemia

Hypothermia

Strangulation of other abd viscera w/i prolapse

Reperfusion injury

Question 16

Px for UP

Answer 16

Guarded at best

recurrence is NO more likely in these animals than animals that have never prolapsed

Long-term: potential for metritis & subfertility

Question 17

How are perineal lacerations usually caused?

Answer 17

Iatrogenic during dystocia

Question 18

How are perineal lacerations graded?

Answer 18

First degree:
Only mucosa of vulva or vestibule
May involve perivaginal fat- excise
Spontaneously heal
Second degree:
Entire wall of vulva/vestibule and portion of perineal body but not the anus or rectum
Tissues contaminated→ wait 6-8 wks before sx
Third degree
Entire wall of vagina, perineal body, rectum and anus→leaves cow with common opening for vagina/rectum
Wait 6-8 wks before sx⇒uncommon for return to fertility

Question 19

What degree is this?

Answer 19

3rd degree!

Question 20

What are some other OB tear injuries that can be seen?

Answer 20

Vulva or vestibule tears

• see RV tears for tx

Caudal uterus or cervix

• blind stitch

rent in uterine horn

• repair may be attempted via laparotomy or;
• prolapsing uterus after 10ml epi IV slug/push, repair, replace

Question 21

What are some other OB injuries

Answer 21

Bleeding from vagina

• ck for tears, may be torn caruncle; admin oxytocin

Uterine a. rupture

• usually associated w/ UP; usually fatal

Question 22

Name 3 Metabolic & Nutritional Dz that can occur periparturiently

Answer 22

Ketosis

Hypocalcemia

LDA +/-

Question 23

3 periparturient dz other than metabolic & nutritonal dz

Answer 23

Mastitis

Uterine infections (Metritis, endometritis, pyometra)

Retained placenta

Question 24

How long does uterine involution take

Answer 24

Usually takes 25-50 days
▪ Lochia is expelled
▪ Blood vessels to caruncles undergo vasoconstriction and slough after necrosis
▪ Endometrial epithelium repairs