Periparturient Period Flashcards
T/F: bovine are the most common species to have vaginal prolapse and can be a heritable trait
True
Heritable especially in Herefords and shorthorns
Grade this prolapse..
Floor of the vagina protrudes intermittently
Grade 1
Grade this prolapse. .
Floor of vagina protrudes permanently
Grade 2
Grade this prolapse ..
Cervix and most of vaginal floor protrude
Grade 3
Grade this prolapse ..
Cervix and vagina protruding to a greed that there is necrosis/fibrosis
Grade 4
Can also see bladder and rectal prolapse
Treatment for vaginal prolapse?
Reduction
- epidural
- clean with mild antiseptic
- may need to debride some necrotic tissue
- sugar=osmosis. Combined with squeezing to reduce edema
-manual reduction (use your oven mitts!)
How can you prevent reoccurrence of vaginal prolapse ?
Buhner technique with umbilical tape Halstead technique/horizontal mattress Bootlace Minchev technique Jorvet prolapse kit
You must watch for parturition in these cows— trauma can occur if calves through the Buhner
If there is significant fribosis/edema, a C-section may be required
What are predisposing factors for uterine prolapse ?
Parturient accident
Dystocia
Hypocalcemia
Uterine inertia
Straining
Begins with inversion of one uterine horn
How can you diagnose uterine prolapse and how do you approach a case?
History from owner
This is a true emergency
You must travel to the cow(reduce cows movement and risk of uterine artery rupture)
Minimize stress to animal
Treatment of uterine prolapse?
Epidural
Clean and debride
-standing animal — elevate uterus with tarp, towel, or tray
-position animal in sternal and extend hindlimbs caudally AKA frog leg (tilts pelvis forward)
Reduction
- hold uterus at level of vulva, reduce gently (will be friable and edematous)
- make sure horns are everted
- once reduced give oxytocin
Vulvar retention sutures
Antibiotics
Ca therapy
Last resort — amputation
What are possible complications due to uterine prolapse?
Uterine artery rupture — hypovolemic shock, death
Septicemia — devitalized tissue
Hypothermia — due to exposed tissue
Strangulation of other abdominal viscera within prolapse
Reperfusion injury
What is the prognosis for uterine prolapse ?
Depends upon initial state (Ca status, shock, dehydration, time spent prolapsed)
Metritis and subfertility possible long term effects
T/F: Cows that have had a uterine prolapse are more likely to have recurrence than those animals that have never prolapsed
False
Recurrence is NO more likely in animals with previous prolapse
What is a first degree perineal laceration?
Only involves the mucosa of vulva or vestibule
May involve perivaginal fat-excise
Spontaneously heal
What is a second degree perineal laceration?
Entire wall of vulva/vestibule and portion of perineal body but not the anus or the rectum
What is a third degree perineal laceration?
Entire wall of vagina, perineal body, rectum, and anus —> leaves cow with common opening for vagina/rectum
How long does uterine involution take?
25-50days
What occurs during uterine involution?
Lochia is expelled — blood tinged fluid, tissue, debris
Blood vessels to caruncles undergo vasoconstriction and slough after necrosis
Endometrial epithelium repairs
What factors can alter involution?
Retained fetal membranes
—delays (foul odor/unsightly)
Negative energy balance Local factors Hormone factors —presence of progesterone —oxytocin (sucking response and milking)
Inflammation — presence of leukocytes
What is the treatment for retained fetal membranes?
Clean out= manual removal
Infusions — antibiotics and antiseptics
Hormones — ecbolics (PGF2a and oxytocin)
Antibiotics
Collagenases —most promising therapy
Injected into umbilical artery
