Post Parturient Problems Flashcards
(29 cards)
What are the most common injuries associated with excessive traction on the offspring?
- Joint/ foot/ back lesions
- Fractured ribs, jaws and cervical dislocations
- Diaphragmatic hernia
- Asphyxia in posterior presentation
What are the most common injuries associated with excessive traction on the dam?
- Uterine prolapse
- Haemorrhage
- Uterine rupture
- Perineal/ vaginal lacerations
- Retained fetal membranes
- Adductor paralysis
What species is a prolapsed uterus most commonly seen in?
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
How do you treat a uterine prolapse in a ruminant?
- 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
How do you treat a uterine prolapse in a mare?
- 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
How do you treat a uterine prolapse in a sow?
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
Is post partum haemorrhage common in domestic animals?
- 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
What are the major areas/ vessels where haemorrhage can occur?
- 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
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?
- 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
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?
- 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
What causes a hematoma to form on the vulva?
- Contusion of the submucosal tissue during delivery
What species is a vulvular hematoma more commonly seen?
Mares and Sows
How is a vulvular hematoma treated?
- Leave for 7 - 8 days and remove the clot
- Prophylactic Antibiotic treatment as a pyogenic infection is likely to occur
Perineal lacerations can be classified into 1st, 2nd and 3rd degree. What are these?
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
Retained fetal membranes is considered a serious emergency in _____
Horses (mares)
note: cattle can become sick from RFM, but isn’t considered an emergency usually
What are the steps of separation of fetal membranes in the cow?
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
What are the most common causes of RFM in the cow?
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
What is the incidence of RFM in cattle (dairy and beef)?
Dairy: 4 - 8%
Beef: less than 6%
What are the predisposing risk factors that increase the incidence of RFM in cattle?
- Dystocia
- Premature birth
- Twins
- Uterine inertia
- Placentitis
- Prolonged pregnancy
- Any sub-clinical disease or illness
How long can it take for fetal membranes to be dropped in the cow?
30 mins to 8 hours
Longer than this is considered a RFM
How long can it take for fetal membranes to be dropped in the mare?
30 mins to 3 hours
Longer than this is considered a RFM
How long can it take for fetal membranes to be dropped in the ewe?
2 - 3 hours
Longer than this is considered a RFM
What is the treatment of retained fetal membranes in cattle?
- 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
What is the treatment of retained fetal membranes in horses?
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
