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Repro II > The Post Partum Period in the Cow > Flashcards

The Post Partum Period in the Cow Flashcards

1
Q

describe the postpartum period

A
  1. period after calving: uterine involution and resumption of cyclicity
  2. lochia normally expelled during 1st few weeks postpartum
  3. lactation starts: increased metabolic rate and calcium mobilization
  4. if uterine involution is delayed, discharge may persist for 30d
    -normal discharges range from dark brown to red to white
    -discharge considered normal unless fluid is fetid or systemic signs present
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2
Q

describe uterine involution

A
  1. decreases in uterine size
  2. increase in uterine tone: feel lines or strips
  3. absence of fluid in the uterus (14 days even in dairy cows)

dairy cows: 30d gross involution/45d histologic involution
beef cows: 21d gross involution, 30d histologic involution

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3
Q

describe resumption of cyclicity (HHO axis)

A
  1. cyclical secretions of GnRH, FSH, LH: 1st ovulation and cyclicity
  2. FSH increases result in emergence of 1st follicular wave within 10-14d pp
  3. dairy cows: 1st ovulation <21d pp
    -beef cows: 1st ovulation 45-60d pp
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4
Q

describe retained fetal membranes

A
  1. most cows expel placenta by 6 hours
    -considered retained if >24hr pp
  2. detrimental effects:
    -repro performance, milk prod, health, culling rate
  3. primary retention: lack of detachment
    -most common
  4. secondary retention: difficulty in expelling already detached fetal membrane
  5. spontaneous expulsion of RFM at 5-7d pp due to cotyledon proteolysis and caruncle necrosis if you don’t treat
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5
Q

describe etiology and cause of retained fetal membranes

A
  1. caruncles and cotyledons normally separate by enzymatic proteolysis
    -RFM: placenta-anchoring mechanisms not enzymatically degraded due to lack of cotyledon proteolysis (collagenolysis)
  2. RFM caused by a deficiency of collagenase due to
    -hypocalcemia (<8mg/dl; collagenases are Ca-dependent enzymes)
    -deficient PMN migration, phagocytosis, imbalance ROS production/neutral (due to stress/immunosuppression)
    -anti-collagenase system
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6
Q

describe risk factors for RFM (5)

A
  1. obstetric: abortion, multiple births, previous retentions, C-section, stillbirth, fetotomy, advanced age, dystocia
  2. physiologic: short gestation plus low calf weight, summer calvings
  3. hormonal:
    -prepartum CL ablation, abnormal P4, E2, induced delivery (PGF2a, dexamethasone)
  4. nutritional:
    -Se/vit E deficiency, feeding hay crop/corn silage, excess iron
  5. infectious: brucellosis-positive status
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7
Q

describe treatment of RFM

A
  1. correct any trace mineral deficiency, low BCS, stress, vx program, dystocia

(manual removal):
-CONTRAINDICATED: predisposes to uterine infections
-prolongs interval calving-first ovulation

  1. hormones:
    -oxytocin: ecbolic of choice in early postpartum cow; short lasting effect of spactic contraction, dose 20-30 U 3-4x daily
  2. antibiotics
    -do not hasten detachment of RFM, may delay release of RFM by inhibiting putrefaction
    -value seems controversial: ceftiofur preferred over oxytetracycline
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8
Q

describe predisposing factors to uterine infections

A
  1. retained fetal membranes
  2. hypocalcemia (8mg) and ketosis
  3. dystocia
  4. delivery of twins
  5. over or underconditioning
  6. large herd size
  7. unsanitary calving conditions
  8. traumatic obstetric procedures
  9. stress
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9
Q

what organisms are commonly associated with uterine infections

A
  1. E. coli, trueperella pyogenes
  2. fusobacterium necrophorum and bacteroides melaninogenicus
  3. other coliforms, pseudomonas aneruginosa
  4. staph, hemolytic strep
  5. clostridia
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10
Q

how do we define uterine infections?

A
  1. character of uterine discharge
  2. days postpartum
    -1st 2 weeks: metritis
    -beyond that: endometritis
  3. clinical findings
  4. endocrine status
    -if have a CL: pyometra
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11
Q

describe metritis

A
  1. severe inflammation involving all layers of uterus:
    -mucosa, submucosa, muscularis, serosa
  2. generally in the 1st week after calving
  3. associated with dystocia, RFM, calving trauma
  4. ketosis, hypocalcemia, displacement of abomasum may be present
  5. puerperal/septic/toxic metritis: fever, depression, anorexia, toxemia, and reduced milk yield (septic), copious fetid vaginal discharge may be present
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12
Q

describe diagnosis of metritis

A
  1. history of dystocia and/or RFM
  2. decreased milk production
  3. PE: fever, anorexia, and depression
  4. rectal palpation: distended and flaccid uterus, thickened wall, lumen with liquid, lack of longitudinal lines, fibrin and adhesions
  5. fetid vaginal discharge
  6. ultrasound not necessary for diagnosis!
  7. bloodwork:
    -left shift and severe neutropenia
    -hypocalcemia and ketosis
    -increased haptoglobin and substance P
    -these tests are not done routinely
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13
Q

describe treatment of metritis

A
  1. systemic antibiotics!
    -most common: ceftiofur, cephalosporin, broad spectrum

-abx need to concentrate in uterus at levels > required MIC, reach all layers of the uterus, and not leave residues in milk! also needs demonstrated efficacy

-penicillin or ampicillin extra-label use

-oxytetracycline not shown to reach MICs in uterus to eliminate uterine pathogens and has high resistance

DONT put anything in the uterus; uterus too friable, adding fluid can make it absorb more toxins

  1. hormonal therapy:
    -oxytocin: contraction of myometrium first (48-72hr after delivery) but needs too frequent dosing to be practical
    -PGF2a during early postpartum period does not affect uterine involution
    -no benefits of hormonal therapy shown yet
  2. if dehydrated: provide adequate fluid therapy
  3. NSAID: flunixin meglumine for toxemia, fever, inflam and to improve appetite
    -efficacy in healing and performance not proven
  4. supplement with calcium, dextrose, and polyethylene glycol (ketosis)
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14
Q

describe endometritis

A
  1. inflammation of endometrium no deeper than stratum spongiosum
  2. after RFM, metritis, mating, AI, or infusion of irritants
  3. may be purulent exudate on visual inspection of the vulva (>21d pp)
  4. on palpation, uterus may be normal or with secretions in lumen
  5. NO systemic disease!!!
    -but may be accompanied by cervicitis or vaginitis
  6. clinical versus subclinical
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15
Q

describe clinical endometritis

A
  1. presence of purulent vaginal discharge (PVD) >21d pp
    -discharge in cranial vagina or in ventral commissure of vulva
  2. PVD not in all cases!
    -many cows with PVD do not have increased PMNs or pus in endometrium
    -PVD can also indicate cervicitis, vaginitis, endometritis, both, or any combo
  3. affects pregnancy rate and post calving interval
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16
Q

describe subclinical endometritis

A
  1. cytological endometritis: increased PMNs in uterine cytology relative to days pp
  2. immunosuppresion decreases PMN and monocytes in peripheral blood
    -increased prevalence with poor conditions
  3. decreases pregnancy rate, high services per conception, high percentage of repeat breeding cows, prolonged post calving intervals
17
Q

describe diagnosis of endometritis

A
  1. discrepancy in dx criteria: subjective
    -low Se and Sp via TRP, TRUS, vaginoscopy
    TRP:
    -asymmetry of horns
    -increased thickness
    -increased cervical diameter
    -NOT accurate
    -TRUS: thickness and echogenicity of mucosa, vol and texture of uterine fluid, can help ID small amt of fluid, low predictive value

-cytology!!
-PMN response against pathogenic bacteria of pp uterus; increased PMN cells within uterine lumen, PMN count successful in IDing cows with endometritis
-18% PMN at 21-35d pp normal
>10% at 35-45 day = endometritis
>5% PM 45d pp : def endometritis
-cytology associated with fertility in current lactation

-biopsy:
-for highly valuable cows
-gives more info on inflammation than cytology

18
Q

desribe endometritis treatment

A
  1. abx + PGF2a
    -luteolysis and estrus induction: contraction of myometrium, decrease P4 and increase E2, which increases immune response of uterus and increases luekotriene B4

no intrauterine oxytet!!!

19
Q

describe pyometra

A
  1. purulent exudate in uterine lumen
  2. persistence of a CL and suspension of estrous cycle
  3. 1st ovulation pp before cleaning uterine bacterial contamination
20
Q

describe pyometra diagnosis

A
  1. TRP; thicker uterine wall
  2. US confirms purulent fluid with variable echogen
  3. CL in one of the ovaries but absence of pregnancy
21
Q

describe treatment of pyometra

A
  1. 2 doses PGF2a, 14d apart
    -luteolysis and estrus

Repro II (28 decks)

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