Post-partum disease

Question 1

what is metritis?

Answer 1

abnormally enlarged uterus and purulent vaginal discharge detectable in vagina within 21 days of parturition

Question 2

what is a grade 1 metritis?

Answer 2

enlarged uterus with discharge but no systemic involvement

Question 3

what is grade 2 metritis?

Answer 3

enlarged uterus with discharge and systemic illness (milk drop, pyrexia, decreased appetite)

Question 4

what is grade 3 metritis?

Answer 4

enlarged uterus and discharge but also has signs of toxaemia (dull, cold extremities)

Question 5

what is a pyometra?

Answer 5

accumulation of purulent material within the uterine lumen in the presence of a corpus luteum and closed cervix

Question 6

what is needed to diagnose a pyometra?

Answer 6

enlarged uterus (pus)
corpus luteum
closed cervix

Question 7

how is pyomtra treated?

Answer 7

prostaglandin F2 alpha

Question 8

what is endometritis?

Answer 8

presence of purulent uterine discharge detectable in vagina 21 days or more post-partum

Question 9

how is endometritis graded?

Answer 9

0 to 3

Question 10

what is grade 0 endometritis?

Answer 10

clear fluid

Question 11

what is grade 1 endometritis?

Answer 11

flecks of white or off-white pus

Question 12

what is grade 2 endometritis?

Answer 12

<50% white or off-white pus

Question 13

what is grade 3 endometritis?

Answer 13

purulent material that is usually white/yellow but can be bloody

Question 14

what grade of endometritis should be treated?

Answer 14

2 and 3 (not 0 or 1)

Question 15

what is sub-clinical endometritis?

Answer 15

no clinical signs of endometritis but immune cells can be flushed from the uterus (neutrophils)

Question 16

what are the risk factors for sub-clinical endometritis?

Answer 16

negative energy balance/ketosis
metritis

Question 17

what are the two types of ovarian cysts?

Answer 17

follicular and luteal

Question 18

what is a follicular cyst?

Answer 18

a follicle that didn’t ovulate but continues to grow

Question 19

what is a luteal cyst?

Answer 19

a follicular cyst that has lutenised

Question 20

what are the clinical signs of luteal cysts?

Answer 20

anoestrus (cyst produces constant progesterone so cow doesn’t cycle)

Question 21

what are the clinical signs of follicular cysts?

Answer 21

nymphomania (lots of oestrodiol being produced)

Question 22

when would you not treat a follicular cyst?

Answer 22

if the cow is less than 30 days in milk

Question 23

what are some factors associated with cystic ovarian disease?

Answer 23

high milk production
NED/ketosis (raised NEFA)
higher parity
twins and peri-parturient problems
high BCS at drying off

Question 24

when would a follicular cyst on an ovary be considered hormonally inactive?

Answer 24

if there is a CL present that is >2cm (treatment directed at CL)

Question 25

how do follicular cysts appear of scans?

Answer 25

thin wall (<3mm)
fluid filled
internal diameter >25mm
duration (>10 days)

Question 26

how long do follicular cysts produce estradiol for?

Answer 26

first half of their lifespan

Question 27

why are follicular cysts an issue?

Answer 27

the prolonged estradiol release inhibits LH surges so no other follicles can develop ovulate

Question 28

what are the characteristics of a luteal cyst?

Answer 28

> 25mm external diameter
thick wall (>3mm)
fluid filled lacuna
present for >10 days

Question 29

what are the treatment options for follicular cysts?

Answer 29

burst
GnRH
progesterone (PRID/CIDR)
aspirate
leave alone (if less than 30 days in milk)

Question 30

how can luteal cysts be treated?

Answer 30

prostaglandin

Question 31

if you are unsure whether a cyst is follicular or luteal, how could it be treated?

Answer 31

progesterone device