Repro 5 Flashcards
List 4 peripartuient/prepartum problems in female
- Uterine displacement = prepubic tendon rupture
- Vaginal prolapse
- Uterine torsion (horses)
- Hydrops allantois/amnii
List 7 parturient/intrapartum problems in the female
- Foetal dystocias (not covered here)
- Uterine torsion (cattle)
- Incomplete cervical dilation
- Uterine inertia
- Haemorrhage
- Perforations/lacerations
- Eclampsia
List 5 Postparturient/ Postpartum problems in the female
- Uterine prolapse
- Infections
- Endometritis
- Metritis
- Pyometra
- Salpingitis/pysalpinx
- Subinvolution of placental sites (SIPS)
- Retained foetal membranes
- Cystic ovarian disease
Uterine displacement what is it, how occur and what leads to
○ AKA prepubic tendon rupture (doesn’t actually rupture) - actually uterine haemorrhage
○ Ventral herniation -> uterus move through the tearing of the abdominal cavity
§ Separation or tearing of prepubic tendon and musculature - structural defect
§ Rapid progression to entire ventral abdomen
§ Painful ventral swelling
○ Alters uterine conformation and hinders normal foetal expulsion
§ Normally foetus on gently slope, now have to do a sharp turn and lost abdominal musculature to push the baby out
Uterine displacement what most common in, treatment options and prognosis
- More common in older draft mares
○ Not common in athletic breeds (thoroughbreds or standardbreds) - Treatment
○ Abdominal support and reducing activity
○ Induced or assisted or elective C-section - traditionally
○ Conserve approach -> wait and let mare foal may result in better mare and foal prognosis - Prognosis is poor for survival of both dam and foetus
○ Prognosis of foetus depends on when during gestation this occurs -> generally very premature and doesn’t survive
How to tell the different between vaginal and uterine prolapse
Uterus -> have caruncles
Vaginal prolapse what common in, what else may prolapse, what stage of pregnancy, why and does it occur again
○ Older ruminants and pigs -> generally after having a few babies
○ +/- cervix
○ Usually late pregnancy
§ Increased abdominal pressure and relaxed perineal musculature (relaxin)
§ More common in obese animals or with twins
§ Predisposed by increased oestrogens
□ Including phytoestrogens
○ Often recurs at parturition and subsequent parturition
§ If not valuable probably cull the animal
Uterine torsion in horses, what stage of gestation, what predisposed by and results and treatment
○ Horses mid-late gestation (from 8 months)
○ Predisposed by
§ Foetal movement
§ Slipping/falling
§ Trauma
§ Hilly terrain
§ In horses often associated with colic (effect of rolling) -> uterine torsion cause colic or colic cause uterine torsion???
○ >180degree rotation causes uterine and foetal vascular compromise
§ Dystocia (cervical torsion)
§ Infarction/necrosis
§ Foetal death
Treatment
- Horses treated surgically by flank incision and correction of torsion
○ Put on exogenous progesterone for a couple of weeks (or until 320 day of gestation
Uterine torsion in cattle what stage of gestation occur, why occur, predisposed by the two types and what torsion in small animals
- most commonly found at time of parturition
§ Broad ligament attachment unstable in late pregnancy
□ As uterus swells with pregnancy the broad ligament attachment moves around the underside of the uterus
® Predispose to twists of the uterus -> torsion - Can occur clockwise or anti-clockwise
○ Determine by looking at vulva and rectal palpation with confirm direction
Small animals may have segmental torsion
What are the 4 steps in correcting a uterine torsion in cattle and what may be needed
- Cow placed on the side of torsion (right torsion on right side)
- Plank is placed in the flank
- One person of 70-90Kg should stand on the plank while the cow is rolled over her back with help of ropes attached to her feet
- Checked rectally if the torsion has been resolved
- If move to the wrong direction can tear the broad ligament -> need to know which way the torsion is
A C-section is still often necessary if the cervix is not sufficiently dilated to deliver the calf vaginally -> still worth a try
Hydrops allantois what is it, clinnical signs in cattle, how to diagnose via palpation, prognosis and treatment
- Bilateral distention, apple shaped (different from bloat, which is usually just distention of the left side) - distention on both side
○ Fluid accumulation in the allantois -> the placenta isn’t doing its job - Cow is sick (anorexic, down, weak, decreased rumen motility)
- If only tight uterine wall can be palpated and no fetal parts or placentomes, a diagnosis of hydrops allantois is made
- Prognosis is poor for cow’s life and fertility.
○ Treatment can be either induction or C-Section with slow release of fluid (cow should receive fluid replacement therapy)
Hydrops amnii/hydramnios what is it, what due to, characteristics, results, prognosis and treatment
extension of the amnion via amniotic fluid
- due to a defective calf, usually attributed at least partly to a defect in swallowing of amniotic fluid by the calf (calf generally swallows the amniotic fluid to decrease the amount)
- Cow is pear shaped (c.f. apple shape in hydrops allantois).
- Characterized by a gradual accumulation of highly viscous fluid during the last half of gestation
○ The placenta is normal
○ Usually fetus and placentomes can be palpated
○ The cow is usually clinically otherwise unaffected.
○ The pregnancy usually goes to term, and frequently a small, deformed fetus is delivered.
- Postpartum metritis is uncommon (unlike hydrops allantois).
- The prognosis is good for life and fertility.
- No treatment is required -> The cow may be allowed to go to term or induced to calve
Incomplete cervical dilation what species most common in, what called in sheep, pathogensis and what sheep predisposed by
○ Mostly ruminants particularly in sheep (50% dystocias)
§ Called ringwomb in sheep
§ Ruminant cervix highly collagenous, very thick barrier if not relaxed
○ Pathogenesis poorly understood
§ Hormonal imbalance, Hypocalcemia and hypophosphataemia proposed as risk factors
□ Involved with muscular movement and dilation
§ Sheep predisposed by previous vaginal prolapse
□ Scaring and fibrosis around cervix
Uterine contraction what primers the uterus and positive and negative hormones and therefore what could cause uterine inertia
Oestrogen priming of the uterus - Therefore occur with decrease Negative with progesterone - Therefore occur with increase Positive with prostaglandin and oxytocin - Therefore occur with decrease
Uterine inertia what are the 2 types, common in, due to and causes
1) Primary inertia
§ Common in multiparous animals
§ Due to inadequate myometrial contraction
§ Causes
□ Hypocalcaemia/hypomagnesaemia
□ Overdistension/under-distension of the uterus
® perfect stretch for maximum contraction
□ Increased progesterone
□ Decreased oxytocin, prostaglandin or oestrogen
2) Secondary inertia
§ Due to myometrial exhaustion
§ Any cause of dystocia that causes prolonged myometrial contracture
Foaling what is important in terms of ensuring a easy delivery
- Generally come out one leg first then other close behind as the shoulders are broad and cannot fit across together
- Therefore if pulling foal through should pull one leg at a time
Haemorrhage during parturition where does it occur, 3 clinical signs, treatment and prognosis
- Bleeding into broad ligament after uterine artery rupture
○ Can stop the bleeding by the broad ligament blocking the rupture
○ If bleed into the abdomen then problem but generally clot themselves - Clinical signs
○ Colicky post foaling
○ High heart-rate
○ Prolonged CSF - Treatment
○ Keep quiet
○ Tranexamic acid -> reduce enzymatic destruction of fibrin and fibrinogen -> help form the clot
○ Maybe fluid replacement - Prognosis
○ Either self-limiting or not (dying)
○ If survive recommend that don’t breed again (increased risk of occurring again)
Lacerations/perforations during parturition where occur, what can result from and how to fix
- Vulvar and vestibular lacerations are quite common and usually do not require repair if they only involve the mucosa
○ If submucosa involved, immediate suturing is indicated to prevent contamination - Recto-vaginal perforation
○ Foot comes through anus leads to recto-vaginal fistula -> generally not too much of an issue
§ Try to push back through and give epidural (to stop the pushing) IF CANNOT
□ Cut through recto-vaginal shelf itself with a scalpel (preferable to a tear) - Third degree perineal laceration; tear of vulva, perineal body and anal sphincter -> creates cloaca
- Fix via surgery -> want to do surgery after healing and oedema has gone down therefore the season is lost for that mare
Necrotic vaginitis following trauma during dystocia what can lead to and how to avoid this
- If very bad can lead to adhesions in the vagina -> infertile
- Therefore need to stop these adhesions from occurring by giving intramammary antibiotics via rectal sleeve and breaking down the adhesions (needs to be done everyday)
- Also if very bad should give antibiotics systemically
Uterine prolapse what most common in, result from, predisposed by, 3 main consequences and prognosis
○ Older ruminants (dairy cows and ewes)
○ Caused by excessive abdominal straining, uterine inertia and/or contractile dysrhythmia
§ Therefore anything that causes this will result in
○ Predisposed by
§ Prolonged dystocia
§ Retained placenta
§ Postparturient hypocalcaemia
○ Consequences
§ Infarction
§ Endometritis/Metritis
§ Urinary/intestinal obstruction
- Poor prognosis for future fertility and guarded for survival
○ Replacement might be possible if hind-end of mare can be elevated and the organ Is not necrotic
§ Chance of recurrence is not great so if properly corrected no serious long term effects
What are the 6 steps in the treatment of uterine prolapse of a cow and what disease need to treat first
- Epidural anaesthesia is helpful to prevent straining
1. Tip of pelvis cranially by placing the cow in “frog leg” position and elevate the uterus
○ Aid in replacing the uterus and may help empty the bladder if it is trapped
2. Generally the placenta is removed only if loose - More trauma is caused to the endometrium by manually removing the placenta than by leaving some attached to the uterus
3. Sugar, glycerol, or other hyperosmolaric substances are sometimes used to reduce the oedema in the uterus and shrink it down
4. Oxytetracycline powered or other broad spectrum antibiotics are sprinkled on the uterus before replacement of uterus
5. Complete replacement is essential to prevent continues straining and reoccurrence
○ Need to ensure the uterine horns are inverted (use old wine bottle)
6. Wait until you get it into place then give oxytocin (after replacement)
○ If give before uterus will contract down and make the job more difficult
Important to treat milk fever first before replacement because that is a life-threatening condition
Endometritis what are the 2 main mechanisms of transmission and what causes in cattle and horses and were the 3 consequences
1) Venereal disease
□ Cattle: Trichomoniasis, brucellosis (EXOTIC), leptospirosis, campylobacteriosis
□ Horses: Taylorella equigenitalis (contagious equine metritis – EXOTIC)
2) Ascending infection -> most important
□ Predisposed post-partum due to retained membranes, uterine trauma/prolapse, immunosuppression
□ Cattle: Trueperella pyogenes, Fusobacterium necrophorum, other anaerobes
□ Horses: Streptococcus zooepidemicus, Pseudomonas aeruginosa, coliforms
Consequences
§ Mild cases resolve spontaneously
§ May persist chronically and cause endometrial damage
§ Foetal loss and/or infertility
Metritis what are the 4 main consequences
§ Infertility § Uterine rupture and peritonitis § Abscessation/adhesions § Sepsis (especially horses) □ Susceptible to laminitis
Pyometra in cattle define, clinical signs results and treatment
○ Accumulation of purulent material in the uterus due to persistent corpus luteum and continued progesterone secretion
○ Cattle (and dogs, but different pathogenesis)
○ Develops after oestrus cycle
○ Often clinically silent
§ Cervix closed so no exudate
§ Uterus doughy on palpation
§ Affected animal infertile
○ Difficult to treat
§ Can try to give an injection of prostaglandin (but problem persists so will have same problem next time)
§ Therefore often culled
Salpingitis/pyosalpinx what is it, how present, what results in and causes
○ Inflammation of the uterine tube
§ Pyosalpinx: segmental pus accumulation due to obstructed drainage
○ Usually bilateral
§ Uterine tube highly susceptible to damage and secondary stenosis/occlusion
§ Infertility common -> very serious
○ Cause
§ Usually extension from metritis/endometritis
§ Some pathogens (Ureaplasma, Mycoplasma) may specifically localize in uterine tube
Subinvolution of placental sites what species and age, what lead to, what result in and 3 treatment options
○ Subinvolution of placental sites
§ Young bitches (<3 years old)
§ Persistent haemorrhagic discharge (lochia) due to failure of uterine involution
□ Discharge >6 weeks post-partum suggestive
§ Trophoblasts fail to regress and invade uterine wall - act as psuedomalignancy
□ Uterine perforation may occur
§ Potentially fatal iron-deficiency anaemia results from persistent discharge
Treatment
1. In light case-> nothing, as it often self-limiting
2. In more severe cases: oxytocin (1-2IU every 2-4 hours) and methergine (2 to 4 drops ever 6-8 hours)
3. In case the dog does not respond or life-threatening haemorrhage occurs, ovariohysterectomy is recommended
Retained foetal membranes what are the main species affected, defined at what duration in cattle and consequences in cattle
○ Mostly an issue in cattle (6-8% of calving), rarely horses and other species
○ Incomplete placental expulsion >12 hours post-partum
Consequences in cattle
○ Typical persist for 6-10 days until autolytic dehiscence occurs
○ Uncomplicated RFMs do not cause significant systemic effects
§ Milk decrease in milk production
○ Provide niche for development of metritis - only time will see as sick
§ Wicking ascending infection
Retained foetal membranes in horses when an issue, consequences and treatment
- LIFE-THREATENING EMERGENCY
○ Normally released within 1 hour, retained if not released within 4-6 hours
§ Antibiotics required after 6 to 8 hours
○ Attend if FM not passed 4 hours post foaling - Life-threatening consequences
○ Laminitis, septicaemia, toxic shock and death
○ Septic/toxic metritis happens fast
Treatment
How to remove membranes
○ Should never be removed just by traction
§ Risk of trauma, haemorrhage and severe uterine damage
○ Can get a hold of the RFM and wrap them into a cord and the apply VERY LIGHT traction while feeling rectally where they are attached
§ That area can then be massaged rectally and often the membranes will be released
○ After the membranes are released, uterus is flushed with copious amounts of fluid (saline or ringer’s solution) for days until fluid is clear
○ Oxytocin is continued for another 24-48 hours in order to aid uterine involution
What are 6 predisposing factors to retained foetal membrane
- Dystocia
§ Causes uterine inertia
§ Villous edema impairs separation of interdigitation - Abortion/premature birth/induced labor
§ Imparied hormonal signalling and decreased collagenase secretion - High progesterone/low oestrogen
§ Imparis prostaglandin secretion, decreased post-partum contractility - Placentitis
§ Villous edema and thickening impairs separation of interdigitation - Hypocalcaemia
§ Uterine inertia - Vitamin E/selenium deficiency
§ Possibly impaired uterine contraction???
Eclampsia what species observed in, clinical signs, treatment and prevention
- Observed mainly in toy breeds with large litter <38 days post-partum
- Clinical signs
○ Tremors, nervousness, salivation; late stage: opisthortonus - Treatment
○ Calcium IV to effect, oral calcium supplementation, wean puppies if >4 weeks - Prevention
○ Adequate Ca:P ratio per partum
Cystic ovarian disease what species present in, what develops from, result in and causes
○ Cattle (esp dairy) and pigs
§ NOT HORSES
○ Anovulatory ovarian follicles that become cystic
○ Follicular cysts may be incidental finding or cause disease
○ Cause
§ Impaired ovulatory hormonal signalling
□ Proposed mechanism include
® Decreased pituitary sensitivity to oestrogen stimulus
® Decreased follicular hormonal receptors
□ Predisposed by periparturient stresses
® Dystocia
® Retained foetal membranes
® Ketosis
What are the two forms of ovarian cyst, what need to distinguish between, how
1) Follciular cysts ○ Need to distinguish between follicular cyst from preovulatory follicle § Distinguished based on □ Size (>17-25mm in cows, >20mm in sows) □ Persistence 2) Luteinized cyst ○ Need to distinguish luteinized ovarian cysts from cystic corpora lutea § Cystic corpora lutea have: □ Has undergone ovulation but has fluid retention □ Thicker wall □ Focal protrusion on one side - Site of ovulation
what are the 2 main effects of Cystic ovarian disease
1) Anovulatory infertility - main problem
2) Persistent hormonal secretion
□ Oestrogen
® Persistent oestrus/nymphomania
® Oedema and enlargement of uterus, cervix and vulva
® Hydrometra/mucometra
® Bone marrow suppression - oestrogen is myelotoxic
□ Androgens
® Masculinization
□ Progesterone (Luteinized cysts)
® Predisposed to uterine infection and pyometra
What are the 3 stimulus for the stretching reflex
- Stretching of the vagina
- Stretching of the cervix
- Suckling of the puppies already born
Rabbit gestation length and what are they called when born
- Gestation length of 30 days
- Altricious
○ Their skin is without pigment or hair at birth
Acepromazine and Morphine what important with dystocia
Acepromazine
- Not an analgesic
- Likely to cause hypotension, with an associated reflex tachycardia
Morphine
- Does cross the placenta
○ Results in depressed post-natal respiratory drive
What are 3 sings of hypocalcaemia and 2 hormoens involved with mobilizing stored calcium
Signs of hypocalcaemia
- Generalised skeletal muscle twitching
- Absence of straining when vagina distended with a speculum
- Failure to deliver a pup after two or more hours
Hormones involved with mobilising stored calcium
- Parathyroid hormone
- Cholecalciferol
Define Puerperium and what occurs in this time
puerperium - The time between birth until reproductive function is restored ○ What occurs during this time § Lactation § Uterine Involution § Return of ovarian cyclicity
