Parturition & post partum disease in farm animals Flashcards
Dairy farmer’s wife gives reception a ring: ‘We got a cow for the vet to look at, she’s not doing well’
Questions?
More detail (to assess urgency): painful / uncomfortable / sudden?
At term?
Where is she?
Advice?
- Has she calved recently?
- Could you elaborate
- Is she calving or not?
- Is she painful/ uncomfortable/ sudden?
- At term?
- Where is she?
- On the phone, we want to assess how ill she is, we don’t need to be asking questions about milk yield etc. over the phone
- Check where we are supposed to go
- Don’t have much data to say – just need to say how long its going to take to get there!
Dairy farmer’s wife gives reception a ring: ‘We got a cow for the vet to look at, she’s not doing well’
Clinical exam:
- •Hypovolaemic
- Decreased rumen motility
- Increased respiratory effort
- Seemingly painful / uncomfortable
- Tail switching / treading / straining / abdominal pain
- At term, seemed to be calving but no waterbag observed
- 3rd calver
What next?
- Restrain
- Vagina exam
- Analgesia?? Maybe not, if its something that needs emergency slaughter – don’t want to put drugs into her
On vaginal exam you see this and this is the report:
- Constriction of birth canal
- Folds of the dorsal vagina spiral downwards and forwards to the left
- Fetus palpable, viable
- Cervix moderately dilated
- Fetus normal size
- Vagina/vulva not dilated
1. Differential Diagnosis?
Uterine torsion
With a uterine torsion, what ligaments is there torsion on?
How can you help diagnose it?
Uterine torsion – tension on broad ligaments, this is very painful. So with twister uterus and 50kg calf in there – going to hurt! Rectal exam – sometimes helps as can feel stretch on these broad ligaments.
What is the etiology of uterine torsion?
- Largely unknown
- Anatomy (gravid horn moves away from attached ligaments)
- Slipping
- Butt in the flank
- Movement of fetus
- Lack of fetal fluids
- Reduced rumen volume
What it the treatment for uterine torsion?
Would you give an epidural?
- Manual detorsion: Need to be able to reach fetus
- Rolling the cow
- Detorsion rod
- Laparotomy
Epidural?
Epidural – would be trying to do without, as if live calf inside, want cow to help deliver calf later on – if we give epidural, wont be able to give any abdominal help to get calf out
How can you roll a cow to help with a uterine torsion?
- Soft bedded pen
- 1-2 helpers
- Roll in same direction as twisted uterus
- Rolling – if torsion is clockwise, role cow clockwise (looking from behind her). Use plank to hold calf in place. Or put hand in, hold calf in place whilst someone else roles calf around you that can work
What is a detorsion rod?
It is a meter long rod with a bar handle for applying torque. At the other end is a double prong with an eyelet at the end of each prong. Each of the two presenting limbs is fixed to one of the prongs by rope or chain and the fetus can then be rotated along its long axis by rotating the handle.
With a uterine torsion, after correction - what further management is needed?
- Cervix not well dilated
- Rarely dilates if calf is dead
- Pull calf’s head into the cervix
- Dependent on status cow / calf:
Wait 2 hours
Dilate birth canal slowly
- Oxytocin (post calving)
- Give oxytocin post-calving if not sure if the calf will suckle the cow, if it will suckle – don’t need oxytocin as there will be lots of it! However, if dead calf or weak calf or cow cannot come into parlour as she may be weak – then might give oxytocin
- NSAIDs
- Antibiotics?
What is the prognosis of a uterine torsion?
What are some complications?
- Good if treated early
- Worse with time and degree of torsion
- Fetal survival rate: 24%
- Dam survival rate: 78%
Complications:
- RFM
- Metritis
- Reduced conception
Farmer’s wife gives reception a ring: ‘We need the vet out; calf bed’s out in one of our beef heifers that just calved’
Questions?
Advice?
- When did she calve?
- Calf bed – uterine prolapse
- Have you tried to put it back in?
- Want to try to keep the cow as quiet as possible – keep her in same place, not to walk around at all if possible!
- Don’t want haemorrhage of the uterine artery – with everted uterus, already a lot of pressure on it – if it bleeds, can be dead within 3 minutes!
- Want to know if MM pink – is she haemorrhaging already?
Questions?
- Status of animal
- When did it happen
- Where is she
Advice?
- Restrain or restrict the cow’s movement
- Keep the cow calm and comfortable
- Protect the uterus by wrapping it in a moist towel or sheet
Farmer’s wife gives reception a ring: ‘We need the vet out; calf bed’s out in one of our beef heifers that just calved’
Differential diagnosis?
RFM
Rectal/vaginal/cervix prolapse
Treatment options for a uterine prolapse?
- Replacement
- Euthanasia
- Amputation
How do you perform a replacement of a uterine prolapse?
- Epidural (duration extended with xylazine)
- Sedative?
- Sedative if very difficult, but often related to hypocalcaemia and often post-calving so they will be tired
- Froglike position (2 helpers)
- Support organ with clean sheet (prolapse tray)
- Tie tail out of the way
- Relieve tympany?
- Wash uterus and perineal area with warm disinfectant solution
- Palpate uterus for entrapped organs, lacerations
- Remove fetal membranes
- In this case, you can peel any RFM off!! As will increase chances of trying to put whole uterus back in
- Just got to keep going, start from vulvar, gentle pressure, don’t use fingers as can perforate, clenched fist, every uterus completely
- Apply lubricant
- Start from vulva, gentle pressure, clenched fist, full arm length, bottle
- Make sure eversion is complete
- Lacerations
- Lacerations – fully perforating, sets you up for disaster – manage expectations, poorer prognosis.
What is the best way to position for a uterine replacement?
Froglike is the best
Others?
- Hiplifters
- Never lateral
- Hind quarters up?
Name some lubricants/hygroscopic solutions for the replacement of uterine prolapse
With a uterine prolapse, what are some further treatments after potential replacement?
- Epidural: 76% always, 3% never
- Sedative: 67% sometimes (‘fractious cow’), 22% never
- Intra-uterine medication: 21% never, 62% antibiotics, 16% antiseptics, 1% oxytocin
- Uterus spasmolyticum: 73% never, 5% always
- Oxytocin: 74% almost always (83% after replacement, 17% before replacement)
- Parenteral antibiotics: 72% always, 8% never
- NSAIDs: 42% almost always, 15% never
- Ca++ (heifer/cow!)
- Lavage & siphonage
How often are vaginal sutures used when replacing a uterine prolapse?
What methods can be used?
59% Always
22% Sometimes
19% Never
Method:
- Bühner
- Horizontal mattress
What is the prognosis for a uterine prolapse?
Varied from very good to very poor depending on:
- Duration
- Sustained injury
- Internal haemorrhage
What is the after care for a uterine prolapse?
- TLC (dry soft bedding, easy access to feed/water/lying space)
- 3-5 days antibiotics
- Monitor 48 hours (straining, anorexia, dehydration, discharge)
- Follow up visit in complicated cases
How can we prevent and what is the etiology of a uterine prolapse?
- Mainly dairy cattle, sometimes beef/sheep
- Pluriparae > primiparae
- 90% within 24 hours after calving
- Immediately after calf in delivery with heavy traction
- Abdominal straining, gravity, hypocalcemia (uterine inertia), dystocia
What are the 3 main treatment options for uterine prolapse?
Replacement
Euthanasia
Amputation
“We got another down cow for the vet to look at”
Parity? 5th
Calving date? Two days ago
Assisted calving? Yes
Calf available? Dead/stillborn
How long recumbent? Calved Sa-morning, in for milking in afternoon, down Sunday morning
Animal been up since calving? Yes, came in for milking once
Moved/changed position? No
Tx? Who? Ca++, farm hand
Any specific clinical signs observed? Shivering
Other down cows? Yes
Eating/drinking? No
Differential Diagnoses?
Toxic: Mastitis, metritis, peritonitis
Metabolic: Hypocalcemia, -phosphatemia, -magnesemia, Fatty liver
Weakness: Emaciation, exhaustion, haemorrhage
Musculoskeletal: Fracture, dislocation, rupture adductor muscle
Nervous: BSE, Spinal cord lesion, calving paralysis
Abdominal: Acidosis, Bloat
Iatrogenic: Epidural, sedation
“We got another down cow for the vet to look at”
Condition/demeanour: bright
Position body / legs, evidence of movement: normal
TPR, auscultate heart/lung: 39.0 degrees C, 70 bpm, 18rpm, normal heart/lung sounds
Mucous membrane: pink, dry nose
Vaginal & rectal exam (palpate pelvis): dry faeces, smelly puerperal fluids, large poorly-involuted uterus, RFM
Check mastitis: normal
Both hind legs: extend, abduct, rotate; compare both legs, listen for crepitus: WNL
Encourage to stand up: not even trying
Minimal rumen motility
Diagnosis and treatment?
Multifactorial:
Hypocalcemia
Metritis
Treatment
Calcium (IV!)
Antibiotics (Amoxycillin)
NSAIDs (Ketoprofen)
TLC (propylene glycol, feed/water, lifting / physiotherapy)
If no response to Tx / to confirm your diagnosis :
Pre-treatment: bloods
Ca, Mg, P
“We got another down cow for the vet to look at”
Condition/demeanour: bright
Position body / legs, evidence of movement: normal
TPR, auscultate heart/lung: 39.0 degrees C, 70 bpm, 18rpm, normal heart/lung sounds
Mucous membrane: pink, dry nose
Vaginal & rectal exam (palpate pelvis): dry faeces, smelly puerperal fluids, large poorly-involuted uterus, RFM
Check mastitis: normal
Both hind legs: extend, abduct, rotate; compare both legs, listen for crepitus: WNL
Encourage to stand up: not even trying
Minimal rumen motility
Prognosis and prevention? (for milk fever and metritis)
Prevention
Milk fever:
Nutrition, transition cow management
Metritis:
Improve immunity cow
Frequent observation
Calving hygiene
