Non Infectious Infertility

Question 1

What is metritis?

Answer 1

Severe inflammation involving all layers of the uterus

• endometiral mucosa and submucosa
• muscularis
• serosa

Question 2

Whet is endometritis ?

Answer 2

Inflammation of the endometrium extending no deeper than the stratum spongiosum

Question 3

Metritis and endometritis usually occurs _______ days post calving

Answer 3

21

Question 4

What is pyometra?

Answer 4

Collection of purulent exudate of variable amount within the endometiral cavity

Persistence of a corpus luteum
Suspension of the estrous cycle

Question 5

Clincial signs of metritis?

Answer 5

Fetid red-brown watery uterine discharge
Within 21days post calving

If systemic 
Pyrexia
Reduced milk yield 
Dullness 
Inappetence or anorexia 
Elevated HR
Dehydration

Question 6

Cow presents with an abnormally large uterus post calving

There is purulent discharge and pyrexia is present

What is your DDX?

Answer 6

Metritis

Question 7

How do you treat Metritis?

Answer 7

Systemic antibiotics
—ceftiofur (longer lasting)
—penicillin
—oxytetracycline (not really used anymore due to resistance)

Anti-inflammatory

+/- uterine lavage

Question 8

T/F: there is usually systemic illness with endometritis?

Answer 8

False

No systemic illness

Question 9

Clinical signs of endometritis?

Answer 9

Purulent discharge in the vagina 21 or more days after calving

Question 10

Risk factors for endometritis?

Answer 10

Retained fetal membranes 
Still birth 
Twins 
Assisted calving 
Primiparity

Question 11

How can you confirm diagnosis of endometritis?

Answer 11

Rectal palpation
Transrectal ultrasound

Examine contents of the vagina
—gloved hand
—speculum
—metricheck device

Question 12

Treatment of endometritis ?

Answer 12

Systemic and intrauterine antibiotics

Penicillin
Withdrawn: milk 96hrs, meat 10days

Ceftiofur sodium

Ceftiofur crystalline free acid (LABELD for metritis - last the longest)
Withdraws: meat 1days

Oxytet — not effective

Hormone therapy

• prostaglanin F2a
• oxytocin -increase uterine tone
• estrogen - increase oxytocin rectors

Supportive care

Question 13

What is the etiology of pyometra?

Answer 13

Occurs when metritis, endometritis, lochia or other contents are present and ovulation occurs resulting in CL formation
—1st post partum ovulation in dairy cow is 18days
—normal gross uterine involution is complete at 30days

Uterine contents inhibit PGF2a release and the CL is maintained

Question 14

Pyometra discovered after NATURAL breeding may be more likely due to __________________

Answer 14

Tritrichomonas

Question 15

Clincial signs of pyometra?

Answer 15

Lack of estrus

Purulent exudate in uterus

Question 16

Diagnosis of a pyometra?

Answer 16

History -lack of estrus

Rectal exam — thin walled, fluid filled uterus
Must be differentiated from pregnancy —lack of cardinal signs

Question 17

Treatment of pyometra?

Answer 17

Removed CL
— PGF2a

Prognosis is fair to good, but do not breed on the first heat after CL removal

Question 18

What is a true anestrus?

Answer 18

Due to insufficient hormonal stimulus

Factors
—nutrition
—eliminate stress
—detect and treat

Question 19

Causes of prepubertal anestrus?

Answer 19

Poor nutrition

To young — breed variations or genetic components

Intersex states
—free martinism
—ovarian aplaisa/hypoplasia

Question 20

What is the pathophysiology of freemartinism?

Answer 20

Shared chorioallantoic membranes

Testicles of male twin develop prior to female —> produced AMH —> circulates into female tract and inhibits female duct system development

Question 21

Clinical appearance of a freemartin cow?

Answer 21

Most are apparently normal
Can have a small vulva, enlarged clitoris, tuft of hair on ventral vulva

Internal structures are abnormal

• vestigial ovaries
• reduced development of paramesonephric ducts
• some development of the male duct system

-most commonly = small genital tract, hypoplasia ovaries, short vagina, and absent cervix

Question 22

How can you diagnose freemartinism?

Answer 22

History of twin birth

Probe vagina — usually 1/3rd the length of the normal vagina

Lab test — Y chromosome with PCR or karyotype

Question 23

Causes of postpartum anestrus?

Answer 23

Normal 3-5wks

Metritis

Poor nutrition

High producing dairy cows

Lactational anestrus

Question 24

What is usually the cause of a post -service anestrus?

Answer 24

Poor nutrition

Other causes are: 
Environmental stress (heat), neoplasia (GCT)

Question 25

Ovarian follicular cysts are AKA?

Answer 25

Cystic ovarian degeneration
Ovarian cysts
Cystic ovaries

Question 26

Clinical signs of ovarian follicular cysts?

Answer 26

Anestrus

Irregular estrus intervals
“Bull like appearance”

Increases calving interval by 50days

Question 27

What is the etiology of ovarian follicular cysts?

Answer 27

GnRH sure center appears to be refractory to estradiol stimulation —> therefore no LH surge for ovulation or luteinization

Question 28

How do ovarian cysts develop?

Answer 28

Similar to follicular waves with recruitment, selection, and dominance

Dominant follicle reaches ovulatory size but fails to ovulate

Growth continues until cystic
Cyst produces Estradiol and inhibin A

Question 29

Diagnosis of ovarian follicular cysts?

Answer 29

> 80% of cows show anestrus

A 2.5cm or greater large fluid filled structures in absence of CL (rectal palpation)

Ultrasound

Question 30

Treatment for ovarian follicular cysts ?

Answer 30

Spontaneous recovery
50% before fist postpartum ovulation
20% after first postpartum ovulation

Manual rupture not recommended

Lutenization/lyse it

• GnRH/PGF2a
• hCG/PGF2a

Aspiration
Progesterone (CIDR) fro 7days then lyse