Exam 2 - Periparturient Period Flashcards
What is the most common species for vaginal prolapse?
BOVINE!
Heritable
Esp: Herefords, Shorthorns
- usually prepartum
- cull
what are the 4 classifiations of vaginal prolapse
- 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
how is vaginal prolapse in cow tx
Reduction!
- epidural
- clean w/ mild antiseptic
- debride if needed
- Sugar=osmosis. combined w/ squeezing to reduce edema
Manual reduction (OVEN MITTS). PATIENCE.
How to prevent reoccurrence of VP
Buhner technique - best, purse string suture
Halstead technique/horizontal mattress
Bootlace
Jorvet prolapse kit
what is another name for Huhner needle
Hurlock needle
(get it? “Her lock!”)
what is this technique called?
Buhner technique
What is this technique called?
Halstead technique
what is this technique called?
Bootlace
what are precautions need to take after tx VP
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
What is this?
uterine prolapse
When does uterine prolapse occur?
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
What is a Dx of uterine prolapse in a cow mean?
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
What is this and why is cow tied like this?
A uterine prolase
SEE PLACENTOMES!
Tied nose to tail to prevent movement.
What is the tx for UP?
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
Possible sequela to UP
Uterine artery rupture
Septicemia
Hypothermia
Strangulation of other abd viscera w/i prolapse
Reperfusion injury
Px for UP
Guarded at best
recurrence is NO more likely in these animals than animals that have never prolapsed
Long-term: potential for metritis & subfertility
How are perineal lacerations usually caused?
Iatrogenic during dystocia
How are perineal lacerations graded?
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
What degree is this?
3rd degree!
What are some other OB tear injuries that can be seen?
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
What are some other OB injuries
Bleeding from vagina
- ck for tears, may be torn caruncle; admin oxytocin
Uterine a. rupture
- usually associated w/ UP; usually fatal
Name 3 Metabolic & Nutritional Dz that can occur periparturiently
Ketosis
Hypocalcemia
LDA +/-
3 periparturient dz other than metabolic & nutritonal dz
Mastitis
Uterine infections (Metritis, endometritis, pyometra)
Retained placenta
How long does uterine involution take
Usually takes 25-50 days
▪ Lochia is expelled
▪ Blood vessels to caruncles undergo vasoconstriction and slough after necrosis
▪ Endometrial epithelium repairs
