Periparturient Period Flashcards
What species most commonly gets a vaginal prolapse?
Cows
What 2 breeds of cow most commonly get a vaginal prolapse?
Herefords
Shorthorns
NOTE: Heritable, you should cull these animals
Why shouldn’t you re-breed a cow that has a vaginal prolapse?
Because it is heritable. Should cull them instead.
How many grades of vaginal prolapse are there?
4
What is a Grade 1 vaginal prolapse?
Floor of vagina protrudes intermittently.
What is a Grade 2 vaginal prolapse?
Floor of vagina protrudes permanently.
What is a Grade 3 vaginal prolapse?
Cervix and most of vaginal floor protrude.
What is a Grade 4 vaginal prolapse?
2nd or 3rd degree that has been exposed long enough to cause necrosis/fibrosis.
What is the treatment of a vaginal prolapse in a cow?
Reduction
NOTE: Oven mitts! Keep your fingers together so you don’t damage the tissues.
How does sugar help when reducing a prolapsed vagina?
Uses osmosis to help reduce edema and make it easier to reduce the prolapse.
What are 4 techniques to help prevent recurrence of a vaginal prolapse?
Buhner technique
Halstead technique/Horizontal mattress
Bootlace
Jorvet prolapse kit
What is the Buhner technique for preventing recurrence of a vaginal prolapse?
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.
What is the Halstead technique for preventing recurrence of vaginal prolapse?
Horizontal mattress across the vagina with umbilical tape and the Buhner needle.
NOTE: Used for grade 1 and2 prolapses.
What grade vaginal prolapse is the Halstead technique used for?
1 or 2
What is the bootlace technique for preventing recurrence of vaginal prolapse?
Create suture loops and criss-cross umbilical tape over the vagina and tie down.
What grade vaginal prolapse is the bootlace technique used for?
Good for a grade 4.
What is the Minchev technique for preventing recurrence of vaginal prolapse?
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.
What is a big downside to the Minchev technique?
Lots of inflammation and aftercare.
What is the Jorvet prolapse kit?
Same idea as the Minchev technique, just a little bit easier to place.
What do you need to make sure you do after using one of the techniques to prevent prolapse of the vagina?
Watch the cow for impending parturition.
What will you do with the cow that prolapsed her vagina and her calf?
Will cull both cow and calf because predisposition is heritable.
What is the relationship between vaginal and uterine prolapse?
No relationship.
When is there an increased incidence of uterine prolapse?
Following a dystocia.
What are 3 other predisposing factors to a uterine prolapse?
Hypocalcemia
Uterine inertia
Straining
What does uterine prolapse begin with?
Begins with involution of one horn.
T/F: A uterine prolapse is a true emergency.
TRUE!!!!!
What is a major concern in a uterine prolapse?
You can risk middle uterine artery rupture if the cow gets trailered. GO TO THE COW.
What is the treatment for a uterine prolapse?
Reduce the prolapse.
What is the ideal position to have a cow in to reduce a uterine prolapse?
Cow laying down in sternal with hind limbs extended caudally.
Why is it so important to try to position a uterine prolapse in sternal with hind limbs extended caudally?
Because it helps tip the pelvis down so that you can work with gravity to get the uterus back in.
How can you reduce the edema of a prolapsed uterus to make reduction a little easier?
Bathe tissue in hyper tonic saline (1st choice) or dextrose (2nd choice) or sugar (3rd choice).
Once the uterine prolapse has been reduced, what 3 therapies would you consider using?
Vulvar retention sutures
Abx
Calcium therapy
If the prolapsed uterus cannot be reduced, what is your last resort treatment?
Amputation of the uterus cranial to the cervix.
What are 5 major sequelae to a uterine prolapse?
Uterine artery rupture Septicemia Hypotheria Strangulation of other abdominal viscera Reperfusion injury
What is the prognosis of a uterine prolapse?
Depends on the initial state of the animal.
Is recurrence likely in a cow with a uterine prolapse?
Nope.
What is the most common cause of a perineal laceration?
Iatrogenic during dystocia.
How many degrees of perineal laceration are there?
3
What is the 1st degree of perineal laceration?
Only mucosa
What is the 2nd degree of perineal laceration?
Entire wall of vulva/vestibule. NOT the anus or rectum.
What is the 3rd degree of perineal laceration?
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.
If you have a caudal uterine or cervical tear, what are 2 ways you can treat it?
Blind stitch
Give oxytocin to let uterus contract down and repair itself.
If you have bleeding from the vagina, what should you look for and what can you do to stop it?
Look for tears or a torn caruncle, then give oxytocin to let uterus contract down and repair itself.
What is a uterine artery rupture usually associated with?
Uterine prolapse.
What is the prognosis of a uterine artery rupture?
Usually fatal.
