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Reproduction > Large Animal - Pregnancy Problems > Flashcards

Large Animal - Pregnancy Problems Flashcards

1
Q

Define dystocia

A

Abnormal parturition

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2
Q

Define eustocia

A

Normal parturition

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3
Q

What do we regard as dystocia when calving?

A

Any calving that requires intervention

Sometimes not veterinary as farmer can handle a lot of them

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4
Q

What are the four stages around parturition?

A

Pre-parturient stage
Parturition
Puerperium
Postpartum period

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5
Q

Describe the pre-parturient (prodomal) period

A

Cow separates off and becomes restless
Udder begins to bag up
Ligament starts slacking off
Important for farmer

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6
Q

When does the farmer notice a problem during the pre-parturient period?

A

When things are occurring then stop suddenly

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7
Q

What are some examples of problems that can occur during the post-partum period?

A

Mastitis

NE balance

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8
Q

What are the three stages of parturition?

A

Stage 1 - foetus positioned for birth, cervix dilated, foetal membranes exposed through vulva, possible rupture of foetal membranes
Stage 2 - Foetus expulsion
Stage 3 - Placenta expulsion

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9
Q

If the cow is making progress what should you not do?

A

Interfere

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10
Q

What varies between species in regards to parturition?

A

Duration of the stages of parturition

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11
Q

How long is each stage of parturition in various animals?

A

Cow - 1 6 hours, 2 0.5 to 4 hours, 3 6 hours
Mare - 1 1 to 4 hours, 2 10 to 30 minutes, 3 1 to 2 hours
Ewe - 1 2 to 6 hours, 2 1 hour, 3 3 hours
Doe - 1 2 to 6 hours, 2 1 hour, 3 3 hours
Sow - 1 2 to 12 hours, 2 4 hours, 3 1 to 4 hours
Bitch - 1 2 to 12 hours, 2 6 hours
Queen - 1 1 to 12 hours, 2 4 hours

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12
Q

What tends to occur in bitches and queens that doesn’t in large animals?

A

Placenta emerges with foetus

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13
Q

Which breeds have a high incidence of dystocia?

A

Brachycephalic breeds

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14
Q

Which cows is dystocia incidence higher in?

A

Beef cattle

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15
Q

What are the three causal categories of dystocia?

A

Maternal
Foetal
Foeto-maternal disproportion

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16
Q

What are some maternal causes of dystocia?

A

Expulsion - primary uterine inertia, secondary uterine inertia, defective straining, inadequate straining
Birth canal - failure of cervix, soft tissues or ligaments to relax, uterine torsion, inadequate pelvic diameter

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17
Q

What are some foetal causes of dystocia?

A

Foetal size - too large, monster

Disposition - abnormal presentation, abnormal position, abnormal posture

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18
Q

What is the main reason for dystocia caused by foetal-maternal disproportion?

A

Foetal skeleton is too large to fit through pelvis of mother

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19
Q

When is dystocia an emergency?

A

When the client thinks it is
Severity of emergency always depends on owner
Treat as an emergency whatever

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20
Q

What sort of questions should included in a dystocia history?

A 
Full term, overdue or early?
First time or had calves before?
Any problems during pregnancy?
Number of foetuses?
When did straining begin?
Hormonal treatments?
Water bag, foetal fluids or foetus?
Foetus alive?
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21
Q

What should be checked on a general examination of a dystotia cow?

A

Status of the dam
Exhaustion - struggling to breath, acidotic, straining for too long
Milk fever

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22
Q

What is needed when examining dystocia cows?

A

Adequte restraint - big animals, ensure she doesn’t pressure you

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23
Q

What is needed for both you and the cow during examination?

A

Floor grip - prevent slipping

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24
Q

What equipment do you need for a dystocia case?

A

Parturition gown - stay clean, ideally sterile
Halter
Head and leg snares - rope, chain, lambing aid
Lots of lube - reduce friction
Soap, disinfectant and cotton wool - clean cow off
Syringes
Local anaesthetic - case dependent
Calcium
Antibiotics

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25
Q

Why do we need to be as sterile as possible during a dystocia case?

A

Dystocia increases chances of endometritis 5 times

Reduce introduction of bugs from us

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26
Q

What four things should you think about during a specific examination of a dystocia case?

A

Hygiene - vet, dam, environment
Lighting
Assistance
Position of dam - sow lying, cow standing, mare standing, ewe standing

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27
Q

What three things should be examined in the vulva, vagina and cervix?

A

Injury - check before to ensure you don’t get blamed for it
Dilation of birth canal - calf could struggle to come out
Lubrication

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28
Q

What should you examine the foetus for in a dystocia case?

A

Three Ps - presentation, posture and position
Number of foetuses
Live or dead - impacts course of action
Size in relation to dam

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29
Q

How can you check whether a calf is alive or dead?

A

Squeeze on foot and see whether it pulls back
Dystocia can depress reflexes
Feel for heartbeat instead or umbilicus
Eye socket can be a good place to look

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30
Q

What three things shuold be thought about when correcting dystocia by manipulation?

A

Lubrication
Repostioning
Traction

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31
Q

What are the three methods of correcting dystocia?

A

Manipulation
Foetotomy - only if calf is dead
Caesarean section - not before trying traction

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32
Q

What are the five types of anaesthesia that can be given to a cow in dystocia to help parturition?

A 
None
Epidural
Paravertebral
Inverted L
Line block
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33
Q

Why should you be careful giving cows sedation?

A

Can go down which will hurt both you and the cow

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34
Q

What three things should be thought of when calving a cow?

A

Foetal-maternal disproportion
Management of expectations - likelihood of success, complications
How much force can be used - use aids carefully, careful of disproportionate forces compared to cow

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35
Q

How many people should be enough to provide traction force?

A

One or two

Any more might be a problem

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36
Q

Describe a traction forced extraction

A

Repostion calf
Ropes or chains on both legs
Manually dilate vagina and vulva
Look for space in pelvis - hand above head, straight legs
Pull downwards
With the carpal joint 10cm outside of the cow - 2 people pulling should fit
Double muscled calf - only one person pulling
Coordinate pulling with straining of the cow - aid calving process
Once head is born rotate 90 degrees and change pulling direction dorsally

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37
Q

How should you rotate a calf to ensure it can fit?

A

Cross front legs

Pull calf down and to one side

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38
Q

What should be done with a calf presenting caudally?

A

Manually dilate vulva and vagina
Check umbilical cord
If it fits pull and deliver
Hock joint 10cm outside cow - 2 people pulling should fit
Deliver as soon as possible - umbilicus can snap, cutsoff oxygen supply
Pull dorsally

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39
Q

What does foetal presentation describe?

A

Relationship between longitudinal axis of foetus and dam

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40
Q

What are the three presentations of the foetus?

A

Longitudinal anterior - normal
Longitudinal posterior
Transverse

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41
Q

What does the foetal position describe?

A

Relationship between dorsal surface of foetus and surface of maternal birth canal

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42
Q

What are the three positions a foetus can be in?

A

Dorsal - normal
Ventral
Lateral

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43
Q

What does foetal posture describe?

A

Disposition of movable appendages of the foetus

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44
Q

What three posture changes can occur?

A

Limb flexions
Neck flexions
Head displacements

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45
Q

What are some reasons for incorrect disposition of a foetus?

A 
Weak uterine contractions
Delayed development of foetal reflexes
Weak foetal movements
Competition uterine space
Oversized calf
Ankylosis of joints
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46
Q

What aftercare should be provided for a dystocia case?

A

Mother - trauma care, antibiotics, oxytocin, NSAIDs

Neonate - dip navel, colostrum supply

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47
Q

What is the average calving rate in the UK?

A

43%

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48
Q

When do most embryonic losses occur?

A

By day 42

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49
Q

When does early embryonic mortality occur?

A

Before maternal recognition of pregnancy
First return to oestrus
Regular returns

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50
Q

When does late embryonic mortality occur?

A

After maternal recognition - irregular return

Before completion of organogenesis/foetus

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51
Q

When does foetal loss occur?

A

After day 42 in the cow

52
Q

Whyshouldyou scan again 2 or 3 weeks after first scan?

A

Ensure that no foetal loss is taking place

53
Q

What are the two broad categories of factors affecting pregnancy rates?

A

Physiological

Pathological - genetic, environmental

54
Q

What percent of embryos tend to be genetically abnormal?

A

10%

55
Q

How does BCS affect pregnancy rate?

A

Loss of BCS reduces pregnancy rate

56
Q

How does dietary protein affect pregnancy rate?

A

Less protein means more services per conception

57
Q

What are some infectious agents that can cause loss of pregnancy?

A 
Leptospira hardjo
Ureaplasma diversum
Campylobacter fetus
Bovine herpes virus 1
Bovine virus diarrhoea virus
Neospora caninum
58
Q

How likely is it that an infection caused pregnancy loss?

A

Not likely

Keep in back of mind though

59
Q

What is the most likely cause of pus emerging from the vagina?

A

Endometritis - not good for foetal development

60
Q

What can cause stress that can affect pregnancy?

A

Overcrowding
Incorrect housing
Incorrect flooring

61
Q

How can rectal palpation affect pregnancy?

A

The more we feel for the higher the chance of foetal loss

62
Q

What iatrogenic things can affect pregnancy?

A

Corticosteroids - induce pregnancy
Prostaglandins
Oestrogens - impact on fertility
Oxytocin

63
Q

What are the four descriptions of foetal loss?

A

Maceration
Mummification - CL persists, calf doesn’t trigger breakdown
Abortion - one or more calves between 152 and 270 days
Still birth - born dead or survived less than 24 hours

64
Q

What complications can cause foetal loss?

A

Hydrops
Uterine torsion
Vaginal prolapse
Uterine prolapse

65
Q

What is hydrops?

A

Oedema of placenta

66
Q

Describe hydrops

A

Placental oedema
Typicallyin last 3 months of pregnancy
Variable amounts of fluuid

67
Q

What options are there for a cow with hydrops?

A

Cull
Induce parturition - corticosteroids, prostaglandins (more effective)
2 stage caesarean - rid of fluids, get calf out

68
Q

What should always be checked before inducing parturition?

A

Not carrying twins

69
Q

Describe hydrops of the foetus

A

Canhave hydrocephalus, ascites or anasarca

70
Q

What are the treatment options for foetal hydrops?

A

Partial foetotomy

Caesarean section

71
Q

When does uterine torsion tend to occur?

A

End ofterm in cattle

Around 9 months in the mare - present as colic

72
Q

Which cows is uterine torsion more common in?

A

Heifers

73
Q

What should be done to detect uterine torsion?

A

Vaginal exam

Rectal exam

74
Q

What shouldbe done with a uterine torsion?

A

Reposition using internal or external forces

Remember which way to turn

75
Q

What animals is cervical vaginal prolapse more common in?

A

Sheep

Cattle

76
Q

What are the predisposing factors to vaginal prolapse?

A 
High BCS or low BCS
High roughage diets/high rumen fill
Twins
Increased oestrogens
Lack of exercise
Urinary retention
Breed
Age
77
Q

What are the consequences of vaginal prolapse?

A 
Infection - caudal genital tract, cranial genital tract
Debility/inappetance
Urinary retention
Rupture of dorsal or lateral wall
Visceral eventration
78
Q

Describe treatment of vaginal prolapse

A

Necessary - painful, loss of mucus plug ofcervix, infection risk
Caudal epidural - local anaesthetic, xylazine
Various methods - harness, surgery

79
Q

What should be done with uterine prolapse?

A 
Treat immediately - can be hypocalcaemic
Emergency!
Support prolapse when cow is standing
Remove foetal membranes
Epidural block
Frog position
Kepp pushing on back
Use sugar
Bottle to push further
80
Q

What is the puerperium period?

A

Period after parturition when reproductive tract returns to non-pregnant condition

81
Q

What four normal processes occur during pruerperium?

A

Involution
Endometrium regeneration
Elimination of contaminants of the reproductive tract
Resumption of cyclical activity

82
Q

What are four disorders that affect the normal puerperium?

A

Dystocia
Uterine prolapse
Retention of foetal membranes
Uterine disease

83
Q

What is involution?

A

Reduction of uterus and cervix after calving

84
Q

When does the greatest decrease in uterine size occur?

A

First few days after calving

85
Q

When should the whole of the uterus be palpable rectally?

A

8-10 days post partum

86
Q

How long does it take for complete involution to occur?

A

Within 26-50 days

87
Q

How big should the cervix be 96 hours post partum?

A

Only 2 fingers should be able to fit in

88
Q

What shift occurs in involution?

A

From hypertrophy to atrophy

89
Q

What may control involution?

A

Prostaglandins - exogenous use can accelerate involution

90
Q

Describe endometrial regeneration postpartum

A

Uterine caruncles undergo degenerative changes - vasoconstriction and ischaemia, results in necrosis and sloughing of tissue
Necrotic material constitutes post partum lochial discharge - occurs 2-9 days post partum, yellowish or reddish brown, volume variable, not a fetid odour
Systemic response observed
Caruncular and inter-caruncular surfaces - covered with endometrial epithelium

91
Q

What bacterial species can contaminate from the uterine lumen?

A 
Arcanobacterium pyogenes
E. coli
Streptococci
Staphylococci
Fusobacterium necrophorum
92
Q

What is the main mechanism for bacterial elimination?

A

Phagocytosis by migrating leucocytes

Physical expulsion by uterine contractions and secretion

93
Q

How does the normal ovarian cyclical activity resume after birthing?

A

Increase in plasma FSH 7-10 days post partum
Ovulation occurs if follicle produces enough oestradiol to stimulate adequate LH secretion
Luteal phase may be normal or shortened

94
Q

Why does dystocia affect normal puerperium?

A

Breaks host defence mechanisms

95
Q

What three things does dystocia cause that affects normal puerperium?

A

Physical deformity of the vulva and cervix
Tissue damage so more prone to contamination
Uterine inertia

96
Q

What does dystocia predispose an animal to?

A

Retained foetal membranes

Uterine disease

97
Q

Which cows is uterine prolapse more common in?

A

Pluriparous cows
Ones that are grossly protracted
Had assisted parturitions

98
Q

When does uterine prolapse usually occur?

A

24 hours post calving

99
Q

What are the risk factors associated with uterine prolapse?

A 
Prolonged dystocia
Foetal traction
Foetal oversize
Extreme laxity of the perineum and vulva
Hypocalcaemia
Paresis
Retained foetal membranes
100
Q

Describe treatment of uterine prolapse

A 
Protect and support the prolapse
Calcium borogluconate
Relieve ruminal tympany
Restrain the cow
Epidural
Clean the uterus
"Frog-leg" position
Gentle replacement
Insure total inversion
Stitch the vulva
Antibiotics and NSAIDs
Oxytocin
101
Q

What is the incidence rate of retained foetal membranes?

A

6-8%

25-40% with dystocia

102
Q

Describe separation and expulsion of the placenta

A

Placenta matures
Changes in progesterone and oestrogen concentrations
Changes in collagenase and proteases/glucosaminidases
Number ofbinucleated cells in the trophectoderm is reduced
Foetal side of the placenta is exsanguinated
Trophectodermal villi collapse
Placentome distortion
Lack of antioxidants, stress, oxidative injury and role of PGF and PGE synthesis
IL8, leukocyte migration and collagenases
Leads to separation and expulsion of placenta

103
Q

What are the reasons for retained foetal membranes?

A

Failure of placental maturation
Failure of detachment of foetal and maternal villi of the placentome
Inadequate uterine contractions due to hypocalcaemia or dystocia

104
Q

What are the predisposing factors for retained foetal membranes?

A 
Abortion
Stillbirth
Multiple birth
Dystocia/premature calving
Infectious placentitis
Hypocalcaemia
Hydrallantois
Increasing age of the dam
Prolonged gestation
Micronutrient deficiencies
105
Q

What are the clinical features of retained foetal membranes?

A

Morbidity - lackof appetite, reduced milk yield
Mortality - 1-4% mainly related to metritis/toxaemia
Fertility - no effect on its own if mating 60 days post-calving, with metirits increases days open, services per conception, calving to first oestrus/service interval

106
Q

What does the duration of retention of foetal membranes depend on?

A

Myometrial contractions

107
Q

Describe the treatment for retained foetal membranes

A

Treat for metritis - pyrexic, decreased appetite, decreased milk yield
Parenteral or intrauterine antibiotics
Prostaglandins/oxytocin
Collagenase infusion into umbilical artery stumps

108
Q

What are the three types of uterine disease?

A

Endometritis
Metritis
Pyometra

109
Q

Describe endometritis

A

Disease of endometrium and stratum spongiosum of submucosa
No systemic illness
Leukocytes but no pus in uterine discharge

110
Q

Describe metritis

A

Disease of deeper layers of uterus

Systemic illness - mild to very severe

111
Q

Describe pyometra

A

Chronic
Purulent exudates
Corpus luteum
No systemic signs

112
Q

What does uterine disease usually impair?

A

Fertility

113
Q

What two ways does infection develop in the uterus?

A

Breaking physical barriers of vulva and cervix - dystocia/RFM increases load of pathogens, causes tissue damage and deformity, uterine inertia
Comprimising immune defence system

114
Q

What two things does bacterial load depend upon?

A

Level of contamination

Species of bacteria

115
Q

What are the clinical signs of endometritis?

A

Mucopurulent discharge in clinical cases
No systemic illness
Neutrophils in uterine luminal fluid

116
Q

How is endometritis diagnosed?

A

Rectal palpation - poorly involuted uterus
Presence of discharge around cervicalos
Metricheck to collect discharge

117
Q

Describe endometritis treatment

A

Stimulation of oestrus in both cyclic (PGF2alpha) and acyclic (E2, GnRH) cows
Intrauterine cephapirin - metricure, intervet

118
Q

What are the clinical signs of metritis?

A

Systemic illness
Purulent fetid fluid in uterine lumen
Distended, fluid-filled atonic uterus
Elevated rectal temperature (40-41 degrees C)
Dullness, depression, milk drop,inappetance
Severe dystocia, uterine inertia or RFM
Sore, swollen and inflamed vagina and vulva
Systemic toxaemia
Pyaemia

119
Q

What is the treatment for metritis?

A 
Case dependent
Supportive therapy
Parenteral antibiotics
Oestrogens increase absorption of endotoxins
Uterine lavage followed by antibiotics
120
Q

What arethe clinical signs for pyometra?

A 
Accumulation of purulent material in the uterus
Presence of active persistent CL
Large distended uterine horns
Closed cervix
Follows chronic endometritis
No signs of ill health
Cyclicity absent
121
Q

What is the treatment for pyometra?

A

PGF2alpha

Intrauterine cephapirin

122
Q

What are the signs of impeding parturition in cows, sheep and does?

A 
Slackening of pelvic ligaments
Change in mammary secretion to colostrums
Fall in temperature
Signs of abdominal pain
Occasional straining
Irregular rumination
Belly kicking
May stand with back arched and tail raised
Go down and rise again frequently
123
Q

What are the signs of impeding parturition in pigs?

A 
Swelling of vulva 4 days prior
Mammary growth 1-2 days prior
Milk expressed 24 hours prior
Mostly asleep in lateral recumbency
Marked restlessness and nest-making
Intensely active period followed by recumbency and rest
Intermittent clawing and champing of bedding
Periods of alternate activity and rest
124
Q

What are the signs of the second stage of parturition in cows, sheep and does

A

More frequent straining
Initially remains standing
Lays down during passage of head through vulva
Remains recumbent until baby is born

125
Q

What are the signs of the second stage of parturition in pigs?

A

Cannot distinguish second and third stage
Usually remain recumbent
Intermittent straning with leg paddling
Foetal fluid will be passed with tail twitching before each birth
Most effort made to expel first piglet

Reproduction (14 decks)

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