Post Parturient Problems

Question 1

What are the most common injuries associated with excessive traction on the offspring?

Answer 1

• Joint/ foot/ back lesions
• Fractured ribs, jaws and cervical dislocations
• Diaphragmatic hernia
• Asphyxia in posterior presentation

Question 2

What are the most common injuries associated with excessive traction on the dam?

Answer 2

• Uterine prolapse
• Haemorrhage
• Uterine rupture
• Perineal/ vaginal lacerations
• Retained fetal membranes
• Adductor paralysis

Question 3

What species is a prolapsed uterus most commonly seen in?

Answer 3

Most common in Cows and sheep: due to the way the uterus is attached by its ligaments
Less common in sow and goat: usually fatal in the sow due to rupture of the uterine vessels –> shock
Rare in the mare

Question 4

How do you treat a uterine prolapse in a ruminant?

Answer 4

• Wrap the prolapsed uterus in a damp towel or sheet
• Epidural anesthetic
• Wash uterus and remove fetal membranes where possible
• Before attempted replacement, check for lacterations and contents
• If the animal is standing the uterus should be supported above the level of the vulva and replaced starting with the portions nearest the vulva
• Once the uterus is replaced, the cervix should lie unoccupied at the level of the pelvic brim
• To ensure complete replacement, stretch each horn with a bottle of 9-14 litres of warm water (and remove by siphonage)
• Oxytocin injection to restore uterine tone
• Suture vulva lips (Buhner)
• Epidural

Question 5

How do you treat a uterine prolapse in a mare?

Answer 5

• Caudal epidural and restraint
• Remove fetal membranes IF readily separated: don’t pull too hard as you can make it worse
• Uterus is replaced as in the cow
• Ensure organ is completely inverted
• Systemic antibiotics, NSAIDs and anti-tetanus
• Oxytocin drip

Question 6

How do you treat a uterine prolapse in a sow?

Answer 6

Very difficult due to length of uterine horns

• General anesthesia/ heavy sedation
• Raise the sows rear up
• Uterus is manually eased back into the evagina (can be aided with water infusion)
• Flank laparotomy may be used to replace
• Amputation: sometimes successful

Question 7

Is post partum haemorrhage common in domestic animals?

Answer 7

• Bleeding from the maternal side of the placenta is uncommon in large animals due to their placenta type
• Really only seen when excessive force is used in early removal of the placenta

Question 8

What are the major areas/ vessels where haemorrhage can occur?

Answer 8

• Umbilical vessels: gush of blood right after delivery is normal
• Vagina: Lateral vaginal artery or posterior gluteal artery- this needs immediate attention by clamping and ligating. if ligation is not possible, put hemostats on for at least 24 hours
• Uterus: difficult to see and can be severe
• Broad ligament: caused by compression and laceration of uterine arteries against the pelvis during parturition

Question 9

A dam presents with anorexia, shivering, pallor and tachycardia a few hours after birthing with blood coming from the vagina, what is most likely to be hemorrhaging and how can you Tx it?

Answer 9

• With signs like this, likely to be the uterus that is hemorrhaging

Tx: pressure pack/ oxytocin, and do not remove any clots for 24 hours
Supportive care such as a blood transfusion or bolus of IV fluids may be needed

Question 10

A mare (or cow) presents with colic, collapse (shock) , hyperpnea, pallor, swelling in the perineal region and difficulty passing urine a few hours after birthing
What is most likely to be hemorrhaging and how can it be Tx?

Answer 10

• With signs like this, likely to be the broad ligament, bleeding into the broad ligament or into abdomen

Tx: stabilize the animal with supportive care

Question 11

What causes a hematoma to form on the vulva?

Answer 11

• Contusion of the submucosal tissue during delivery

Question 12

What species is a vulvular hematoma more commonly seen?

Answer 12

Mares and Sows

Question 13

How is a vulvular hematoma treated?

Answer 13

• Leave for 7 - 8 days and remove the clot

- Prophylactic Antibiotic treatment as a pyogenic infection is likely to occur

Question 14

Perineal lacerations can be classified into 1st, 2nd and 3rd degree. What are these?

Answer 14

1st Degree: simple perineal laceration

2nd Degree: constrictor vulvae muscle is also disrupted

3rd Degree: rectovaginal, or rectovestibular laceration. this allows fecal contamination, bacterial infections of the vagina, cervix and uterus

Question 15

Retained fetal membranes is considered a serious emergency in _____

Answer 15

Horses (mares)

note: cattle can become sick from RFM, but isn’t considered an emergency usually

Question 16

What are the steps of separation of fetal membranes in the cow?

Answer 16

Uterine contractions during 3rd stage cause:

• change in the shape of the caruncles
• squeezing of blood from the placenta with shrinking of the fetal villi
• opening up of the endometrail crypts
• the apex of the allantochorionic sac becomes inverted
• Fetal villi are drawn out of the crypts
• The membranes become detached

Question 17

What are the most common causes of RFM in the cow?

Answer 17

1) Insufficient expulsive efforts by the myometrium
2) Failure of the placenta to separate from the endometrium due to:
- Inflammatory changes- placentitis
- Placental immaturity
- Hormone imbalances; estrodiol/ progesterone ratio
- Lack of leukocyte migration
- Immune deficiencies- failure of release of inflammatory mediators
3) Mechanical Obstruction

Question 18

What is the incidence of RFM in cattle (dairy and beef)?

Answer 18

Dairy: 4 - 8%
Beef: less than 6%

Question 19

What are the predisposing risk factors that increase the incidence of RFM in cattle?

Answer 19

• Dystocia
• Premature birth
• Twins
• Uterine inertia
• Placentitis
• Prolonged pregnancy
• Any sub-clinical disease or illness

Question 20

How long can it take for fetal membranes to be dropped in the cow?

Answer 20

30 mins to 8 hours

Longer than this is considered a RFM

Question 21

How long can it take for fetal membranes to be dropped in the mare?

Answer 21

30 mins to 3 hours

Longer than this is considered a RFM

Question 22

How long can it take for fetal membranes to be dropped in the ewe?

Answer 22

2 - 3 hours

Longer than this is considered a RFM

Question 23

What is the treatment of retained fetal membranes in cattle?

Answer 23

• Cut off membranes at the vulva lips
• Supportive treatment with fluids +/- antibiotics if infection is suspected

note: cant adminster oxytocin as the receptors disappear after 24 hours

Question 24

What is the treatment of retained fetal membranes in horses?

Answer 24

This is considered an emergency!
Not passed within 6 hours:
- 20 - 40 IU oxytocin in 1 litre of saline
- Antibiotic and Anti-tetanus should be given

Not passed within 12 hours:
- Manual removal and a further injection of oxytocin is indicated

Question 25

What nerves are affected with Obturator Paralysis?

Answer 25

Obturator and Sciatic nerves

Question 26

Why does Obturator Paralysis occur in cattle?

Answer 26

Prolonged calving or hiplock, leading to pressure, irritation, and bruising of the obturator and sciatic nerves

Question 27

How is Obturator Paralysis treated?

Answer 27

• Tie hind limbs together (1m apart) to prevent legs from slipping: can rupture muscles, tendons or vessels if continuously falling/ slipping
• Secure ground, e.g. hay
• Anti-inflammatories

Careful management and time will be needed

Question 28

What is Peroneal nerve paralysis?

Answer 28

Peroneal nerve paralysis results in flexion of the hock and the dorsal surface of the hoof may contact the ground, and is typically seen in cows after a period of recumbency following calving

Question 29

What is the treatment for Peroneal nerve paralysis?

Answer 29

• With TLC, usually goes away in 1-2 weeks

- Anti-inflammatories