Periparturient Period

Question 1

What species most commonly gets a vaginal prolapse?

Answer 1

Cows

Question 2

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

Answer 2

Herefords
Shorthorns

NOTE: Heritable, you should cull these animals

Question 3

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

Answer 3

Because it is heritable. Should cull them instead.

Question 4

How many grades of vaginal prolapse are there?

Answer 4

4

Question 5

What is a Grade 1 vaginal prolapse?

Answer 5

Floor of vagina protrudes intermittently.

Question 6

What is a Grade 2 vaginal prolapse?

Answer 6

Floor of vagina protrudes permanently.

Question 7

What is a Grade 3 vaginal prolapse?

Answer 7

Cervix and most of vaginal floor protrude.

Question 8

What is a Grade 4 vaginal prolapse?

Answer 8

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

Question 9

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

Answer 9

Reduction

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

Question 10

How does sugar help when reducing a prolapsed vagina?

Answer 10

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

Question 11

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

Answer 11

Buhner technique
Halstead technique/Horizontal mattress
Bootlace
Jorvet prolapse kit

Question 12

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

Answer 12

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.

Question 13

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

Answer 13

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

NOTE: Used for grade 1 and2 prolapses.

Question 14

What grade vaginal prolapse is the Halstead technique used for?

Answer 14

1 or 2

Question 15

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

Answer 15

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

Question 16

What grade vaginal prolapse is the bootlace technique used for?

Answer 16

Good for a grade 4.

Question 17

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

Answer 17

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.

Question 18

What is a big downside to the Minchev technique?

Answer 18

Lots of inflammation and aftercare.

Question 19

What is the Jorvet prolapse kit?

Answer 19

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

Question 20

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

Answer 20

Watch the cow for impending parturition.

Question 21

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

Answer 21

Will cull both cow and calf because predisposition is heritable.

Question 22

What is the relationship between vaginal and uterine prolapse?

Answer 22

No relationship.

Question 23

When is there an increased incidence of uterine prolapse?

Answer 23

Following a dystocia.

Question 24

What are 3 other predisposing factors to a uterine prolapse?

Answer 24

Hypocalcemia
Uterine inertia
Straining

Question 25

What does uterine prolapse begin with?

Answer 25

Begins with involution of one horn.

Question 26

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

Answer 26

TRUE!!!!!

Question 27

What is a major concern in a uterine prolapse?

Answer 27

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

Question 28

What is the treatment for a uterine prolapse?

Answer 28

Reduce the prolapse.

Question 29

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

Answer 29

Cow laying down in sternal with hind limbs extended caudally.

Question 30

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

Answer 30

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

Question 31

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

Answer 31

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

Question 32

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

Answer 32

Vulvar retention sutures Abx Calcium therapy

Question 33

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

Answer 33

Amputation of the uterus cranial to the cervix.

Question 34

What are 5 major sequelae to a uterine prolapse?

Answer 34

``` Uterine artery rupture Septicemia Hypotheria Strangulation of other abdominal viscera Reperfusion injury ```

Question 35

What is the prognosis of a uterine prolapse?

Answer 35

Depends on the initial state of the animal.

Question 36

Is recurrence likely in a cow with a uterine prolapse?

Answer 36

Nope.

Question 37

What is the most common cause of a perineal laceration?

Answer 37

Iatrogenic during dystocia.

Question 38

How many degrees of perineal laceration are there?

Answer 38

3

Question 39

What is the 1st degree of perineal laceration?

Answer 39

Only mucosa

Question 40

What is the 2nd degree of perineal laceration?

Answer 40

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

Question 41

What is the 3rd degree of perineal laceration?

Answer 41

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.

Question 42

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

Answer 42

Blind stitch | Give oxytocin to let uterus contract down and repair itself.

Question 43

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

Answer 43

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

Question 44

What is a uterine artery rupture usually associated with?

Answer 44

Uterine prolapse.

Question 45

What is the prognosis of a uterine artery rupture?

Answer 45

Usually fatal.