Post-partum Conditions Flashcards
Examples of Post-partum conditions
- Haemorrhage
- Trauma/lacerations/contusions
- Prolapse of something
- Placental retention
- Metritis
- Recumbency / nerve damage
Haemorrhage
○ Blood passage after parturition
○ Profuse bleeding can be due to:
Breakage of the umbilicus and blood leaking from the placenta
Uterine or vaginal laceration
□ E.g. vaginal artery haemorrhage in heifer after forced extraction
○ Minor seepage can occur from where placenta attached
Trauma/lacerations/contusions
○ Result of bruising/oedema of the wall of the vestibule or vulva during delivery
○ Perineal laceration:
Most commonly seen in cow and mare
Often at first parturition
Most commonly when there has been forced traction
Degrees of perineal laceration
First degree - superficial
□ Skin and mucosa (usually of dorsal commissure)
Second degree
□ Deeper laceration involving muscle of perineal body
Third degree
□ Torn vagina and rectal wall (creating a cloaca)
Recto-vaginal fistula
□ Penetration from the vaginal cavity into the rectum but not continuous distally
Bladder prolapse
Bladder prolapses through tear in vagina
□ Ewe or cow
□ Serosal surface of bladder visible (external)
Bladder everts through urethra
□ Mare
□ Mucosal surface of bladder visible (luminal)
Vaginal/cervical prolapse
- Most commonly seen in late pregnancy and not post-partum
- Ewes
○ Common pre-partum - Cows
○ Less common - Sows
○ Uncommon
○ Most often seen in gilts during oestrus - Bitches
○ Prolapse of hyperplastic vagina during oestrus
Prolapse of uterus
- Cow and ewe
○ Common post-partum
○ Usually complete eversion of previously pregnant horn - Sow
○ Infrequent
○ Eversion of one horn - Mare
○ Rare
○ Eversion of the whole of the uterus - Bitch and Queen
○ Rare
○ Eversion of one horn
Aetiology of Uterine Prolapse
- In cows more common in multiparous cow
○ Hypocalcaemia=risk factor - Usually seen soon after calving
- Associated with uterine inertia or poor involution of a portion of uterus which predisposes to protrusion when there is protracted abdominal straining
- May be associated with traction of retained placenta (mare)
Treatment of Uterine Prolapse
- Epidural, establish ‘frog-leg’ position in cow
- Push components close to vulval lips first and gradually replace
- Ensure complete inversion
- Post replacement: oxytocin, calcium, parenteral antibiotic, NSAIDs
- Prognosis: good if treated soon after prolapse occurred
Retained foetal membranes
○ Cow
Common
Important in metritis-endometritis-pyometra complex
○ Mare
Less common
Consequences (metritis -> laminitis) can be very severe
○ Ewe
Uncommon
Consequences metritis but often limited treatment required
○ Bitch and Queen
Uncommon
Consequence is metritis
Aetiology of retained foetal membranes in the cow
Failure of normal process of dehiscence and expulsion
○ Associated with:
□ Abortion
□ Dystocia
□ Inertia
□ Hypocalcaemia
□ Caesarean
□ Twins
□ Some mineral/vitamin deficiencies
Aetiology of retained foetal membranes in the mare
○ Associated with:
□ Breed
□ Dystocia
□ Uterine inertia
□ Hypocalcaemia
Treatment of RFM in cows
○ Gentle removal (triple glove!!)
○ Parenteral antibiotics if clinically ill
○ Ecbolic have little (PG) or no (oxytocin) effect
Treatment of RFM in mares
○ Treatment is urgent
○ Can be removed by careful traction
○ Sometimes ecbolic agents used (oxytocin in different regimes)
○ Careful examination of membranes
Any fragments remaining = metritis
Treatment of RFM in bitches and queens
○ The condition is less common than the concern about it
Dams often eat the placentae and this is not noted by the owner
Persistence of green-coloured discharge is suitable confirmation
○ Diagnosis/treatment is often undertaken from day 2
○ Ecbolic agents; oxytocin, prostaglandin, ergometrine
○ Critical other treatments: NSAIDs, parenteral antibiotic, fluid therapy