FAC45-47: The Postpartum Cow Flashcards
What is the cause of vaginal/uterine tears?
Dystocia and excessive traction
How do you treat vaginal/uterine tears?
Urgent!
Clamp vessel if possible or apply pressure
Suturing is not normally possible
May result in recto-vaginal fistula
Use episiotomy technique in future
What is the cause of a uterine prolapse?
Associated with prolonged parturition due to oversize calf
Cows may have hypocalcaemia
What is the prognosis of a cow with uterine prolapse?
Good in most casts - occasionally cow will go into shock and die with internal haemorrhage
What nerves are most at risk of damage due ot large calf/dystocia?
Damage to nerves arising from lumbo-sacral plexus - obturator and gluteal nerves most at risk
Describe the normal events in the post-partum cow.
- Uterine involution
- Regeneration of endometrium
- Elimination of bacterial contamination from uterus
- Return of cyclic ovarian activity
When is the uterus completely involuted?
4-6 weeks
What factors affect the rate of involution?
- Parity
- Retained foetal membranes
- Metritis
- Twins
- Hypocalcaemia/selenaemia
- Dystocia/trauma
How is uterine infection eliminated after post-partum?
Infection eliminated by local immune response within weeks (lochia)
Early resumption of cyclicity aids elimination of infection from uterus
Define metritis
Animal that have an abnormally enlarged uterus and a purulent uterine discharge detectable in the vagina within 21 days after parturition
What are the grades of metritis?
Grade 1: enlarged uterus and a purulent uterine discharge but no pyrexia/illness
Grade 2: puerperal metritis - overt systemic illness (decreased milk yield, fever > 39.5C, reduced appetite)
Grade 3: toxaemic metritis - signs of toxaemia (cold extremities, dullness)
When does acute puerperal metritis appear?
Normally within 7 days of calving
How do you treat puerperal metritis?
Systemic antibiotic 3-5 days
NSAID
IV 3L hypertonic saline
Removal of RFM
Define endometritis.
The presence of a purulent uterine discharge detectable in the vagina 21 days or more post partum, or mucopurulent discharge detectable in the vagina after 26 days post partum
How do you diagnose endometritis?
Reach and pull out pus
What are the risk factors for clinical endometritis?
- Dystocia, RFM
- Dirty calving boxes
- Delay in cyclicity
- Fatty liver syndrome
- Immune deficiency
How do you treat endometritis?
- Prostaglandin injection
- Intrauterine antibiotics
- Antiseptic wash out
How do you prevent clinical endometritis?
- General calving hygiene
- Minimise dystocia
- Avoid overfat cows
- Ensure adequate trace element supplementation
Define pyometra.
Accumulation of purulent material within the uterine lumen in the presence of a corpse luteum and a closed cervix
What is pyometra a continuation of?
May develop following endometritis when CL maintained and cervix closes
How do you treat pyometra?
PG injection
Define Foetal Membranes
Partial or complete retention of >12 hours post partum
Failure of normal 3rd stage labour
What is the cause of RFM?
Failure of normal separation of foetal cotyledonary villi from maternal caruncles and/or primary uterine inertia
What are the predisposing factors for RFM?
- Premature parturition
- immature placentomes not ready for separation
- Twin calvings
- Late abortions
- Induced birth
- Oedema of chorionic villi from trauma
- Dystocia
- Caesarian
- Uterine torsion
- Pathological inflammation
- Placentitis caused by abortion agent
- Uterine inertia
- Hypocalcaemia
- Low selenium
- Hydrops
- Twins
Are there any sequelae to RFM?
Spontaneous expulsion in 5-10 days
No long term effect on fertility unless endometritis develops
How do you treat RFM?
- Manual removal (contraindicated unless comes away easily)
- Ecbolic drugs (oxytocin, PGF2a)
- Intrauterine antibiotic pessaries
- Systemic antibiotics
- PGF2a injection after 3-4 weeks
What is the consequence of cystic ovarian disease?
Delay in normal cyclicity cases extension of calving-conception interval (20-60 dd)
Define cystic ovarian disease.
Fluid-filled structure >2.5 cm in diameter present for >10 days on one or both ovaries in absence of CL
What are the different types of cysts?
- Follicular Cyst
- Luteal Cyst
Compare follicular cyst and luteal cysts.
Follicular: thin-walled, no progesterone produced, plasma P<1ng/ml
Luteal: thicker walled, progesterone producing, plasma P>1ng/ml
What is the aetiology of cystic ovarian disease?
Failure of LH surgery around time of ovulation or failure of follicle to respond to LH
How do you diagnose cystic ovarian disease?
Rectal palpation
Palpation plus milk or blood progesterone analysis
Ultrasound scan for accurate determination of cyst type
How do you treat follicular cysts?
- GnRH to induce LH surge causing cyst to luteinise or regress
- Human chorionic gonadotrophin (LH agonist)
- Progesterone
- Prostaglandin Injection
- Manual rupture
How long does it take cows to return to cyclicity post partum?
90% Dairy cows by day 50
70% beef cows by day 50
What stimulates the onset of cyclity?
Following calving, progesterone levels fall and FSH stimulates waves of follicles
What hormone causes a follicle to ovulate?
Sufficient LH Pulse
What controls LH secretion post partum?
- Progesterone in the cyclic cow
- Declining negative energy balance
- Health status
- Suckling
- Maternal bond/calf presence
What are the factors affecting the post partum anoestrus period?
- Season - follicular activity resumes faster in autumn calvers compared to spring calvers
- Nutrition - severe negative energy balance in late pregnancy/early post partum period will suppress LH output via metabolic hormone pathways
- Disease - delayed uterine involution, cystic ovarian disease, persistent corpus luteum
- Suckling - being suckled causes endorphin release which suppresses LH
- GnRH, FSH, LH
How do you diagnose anoestrus?
Two low progesterone levels in milk.blood 10 days apart
If cycling normal, 17/21 days should have high progesterone
How do you overcome anoestrus?
Correct the underlying management factors
- Decrease duration and extent of negative energy balance
- Decrease incidence of metabolic diseases
- Beed cows: calf removal, restricted suckling
Hormonal treatment if appropriate
How do you treat anoestrus?
Progesterone (PRID, CIDR)
GnRH injection
What causes luteolysis?
Pulsatile release of PGF2a from the endometrium towards the end of the luteal phase
What hormone establishes pregnancy?
Relies on the production of an embryo derived antiluteolysin (IFNt)
What is the purpose of giving GnRH at day 11-12 post service?
Works by preventing premature luteolysis in some cows
What is Intercept/Ovsynch regime?
Combination of GnRH and PG used to synchronise dairy cows for AI
Define a repeat breeder cow.
Fails to conceive following 3 or more consecutive serves at normal inter-oestrus intervals
What are the causes of repeat breeding?
Chance
genetics
Undiagnosed pathology
Oocyte-embryo quality
Herd mangement
