Periparturient Period Flashcards

1
Q

What species most commonly gets a vaginal prolapse?

A

Cows

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2
Q

What 2 breeds of cow most commonly get a vaginal prolapse?

A

Herefords
Shorthorns

NOTE: Heritable, you should cull these animals

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3
Q

Why shouldn’t you re-breed a cow that has a vaginal prolapse?

A

Because it is heritable. Should cull them instead.

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4
Q

How many grades of vaginal prolapse are there?

A

4

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5
Q

What is a Grade 1 vaginal prolapse?

A

Floor of vagina protrudes intermittently.

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6
Q

What is a Grade 2 vaginal prolapse?

A

Floor of vagina protrudes permanently.

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7
Q

What is a Grade 3 vaginal prolapse?

A

Cervix and most of vaginal floor protrude.

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8
Q

What is a Grade 4 vaginal prolapse?

A

2nd or 3rd degree that has been exposed long enough to cause necrosis/fibrosis.

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9
Q

What is the treatment of a vaginal prolapse in a cow?

A

Reduction

NOTE: Oven mitts! Keep your fingers together so you don’t damage the tissues.

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10
Q

How does sugar help when reducing a prolapsed vagina?

A

Uses osmosis to help reduce edema and make it easier to reduce the prolapse.

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11
Q

What are 4 techniques to help prevent recurrence of a vaginal prolapse?

A

Buhner technique
Halstead technique/Horizontal mattress
Bootlace
Jorvet prolapse kit

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12
Q

What is the Buhner technique for preventing recurrence of a vaginal prolapse?

A

Using the Buhner needle you pass umbilical tape, up the sides and around the top of the vagina, then tie it shut.

NOTE: Remember you need to untie before calving or you can have bigger problems.

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13
Q

What is the Halstead technique for preventing recurrence of vaginal prolapse?

A

Horizontal mattress across the vagina with umbilical tape and the Buhner needle.

NOTE: Used for grade 1 and2 prolapses.

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14
Q

What grade vaginal prolapse is the Halstead technique used for?

A

1 or 2

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15
Q

What is the bootlace technique for preventing recurrence of vaginal prolapse?

A

Create suture loops and criss-cross umbilical tape over the vagina and tie down.

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16
Q

What grade vaginal prolapse is the bootlace technique used for?

A

Good for a grade 4.

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17
Q

What is the Minchev technique for preventing recurrence of vaginal prolapse?

A

Replace the prolapse, and then use stents and suture through the body wall to hold the uterine vault in place.

NOTE: Can calve through this.

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18
Q

What is a big downside to the Minchev technique?

A

Lots of inflammation and aftercare.

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19
Q

What is the Jorvet prolapse kit?

A

Same idea as the Minchev technique, just a little bit easier to place.

20
Q

What do you need to make sure you do after using one of the techniques to prevent prolapse of the vagina?

A

Watch the cow for impending parturition.

21
Q

What will you do with the cow that prolapsed her vagina and her calf?

A

Will cull both cow and calf because predisposition is heritable.

22
Q

What is the relationship between vaginal and uterine prolapse?

A

No relationship.

23
Q

When is there an increased incidence of uterine prolapse?

A

Following a dystocia.

24
Q

What are 3 other predisposing factors to a uterine prolapse?

A

Hypocalcemia
Uterine inertia
Straining

25
Q

What does uterine prolapse begin with?

A

Begins with involution of one horn.

26
Q

T/F: A uterine prolapse is a true emergency.

A

TRUE!!!!!

27
Q

What is a major concern in a uterine prolapse?

A

You can risk middle uterine artery rupture if the cow gets trailered. GO TO THE COW.

28
Q

What is the treatment for a uterine prolapse?

A

Reduce the prolapse.

29
Q

What is the ideal position to have a cow in to reduce a uterine prolapse?

A

Cow laying down in sternal with hind limbs extended caudally.

30
Q

Why is it so important to try to position a uterine prolapse in sternal with hind limbs extended caudally?

A

Because it helps tip the pelvis down so that you can work with gravity to get the uterus back in.

31
Q

How can you reduce the edema of a prolapsed uterus to make reduction a little easier?

A

Bathe tissue in hyper tonic saline (1st choice) or dextrose (2nd choice) or sugar (3rd choice).

32
Q

Once the uterine prolapse has been reduced, what 3 therapies would you consider using?

A

Vulvar retention sutures
Abx
Calcium therapy

33
Q

If the prolapsed uterus cannot be reduced, what is your last resort treatment?

A

Amputation of the uterus cranial to the cervix.

34
Q

What are 5 major sequelae to a uterine prolapse?

A
Uterine artery rupture
Septicemia
Hypotheria
Strangulation of other abdominal viscera
Reperfusion injury
35
Q

What is the prognosis of a uterine prolapse?

A

Depends on the initial state of the animal.

36
Q

Is recurrence likely in a cow with a uterine prolapse?

A

Nope.

37
Q

What is the most common cause of a perineal laceration?

A

Iatrogenic during dystocia.

38
Q

How many degrees of perineal laceration are there?

A

3

39
Q

What is the 1st degree of perineal laceration?

A

Only mucosa

40
Q

What is the 2nd degree of perineal laceration?

A

Entire wall of vulva/vestibule. NOT the anus or rectum.

41
Q

What is the 3rd degree of perineal laceration?

A

Entire wall of vagina, perineal body, rectum and anus.

NOTE: This leaves cow with a common opening for vagina/rectum.

NOTE: Very difficult to get an animal back to a fertile point from here.

42
Q

If you have a caudal uterine or cervical tear, what are 2 ways you can treat it?

A

Blind stitch

Give oxytocin to let uterus contract down and repair itself.

43
Q

If you have bleeding from the vagina, what should you look for and what can you do to stop it?

A

Look for tears or a torn caruncle, then give oxytocin to let uterus contract down and repair itself.

44
Q

What is a uterine artery rupture usually associated with?

A

Uterine prolapse.

45
Q

What is the prognosis of a uterine artery rupture?

A

Usually fatal.