Uterine Disease Flashcards
Give 3 facts on uterine infections in cattle…
Median calving to conception?
How many culled for failure to conceive?
When is the relative risk?
· Median calving to conception 30 days longer
· 3% more culled for failure to conceive
· Relative risk of pregnancy at day 150 decreased by 31%, rate of pregnancy reduced by 16%
How can you identify uterine infections? (6)
observation of odor/discharge, fever, palpation of the cervix and uterus, vaginoscopy, bacteriological culture, biopsy, cytology as well as the interval postpartum when diagnosis is made.
Define clinical metritis
Uterine disease within 21 days of parturition, most common in first 10 days. Enlarged uterus, watery red brown fluid to viscous off white purulent uterine discharge, with fetid odor. Grade 1-3 dependent on signs of health. Clinical metritis can be present without a fever or other signs of severe illness
Define clinical endometritis
No systemic signs. Clinical disease beyond 3 weeks postpartum. (Muco)purulent discharge detectable in vagina defines the ‘clinical’. Grading system based on character of vaginal mucus. Cervical diameter >7.5cm
Define Puerperal metritis
Severe clinical metritis with acute systemic illness <21DIM, pyrexia, dullness, reduced yield, inappetance, tachycardia, dehydration, mostly within 48h after calving
Define Retained placenta
Failure to pass the placenta within 24h postpartum =
Define Pyometra
(Muco)purulent material in the uterus, distension of the uterus, presence of active CL. Often complete closure of the cervix, sometimes incomplete. Mixed echodensity on ultrasound
Define Subclinical endometritis
Chronic inflammation of the endometrium without clinical signs of uterine disease but resulting in significant reduction in reproductive performance. Determined by cytology, PMN’s exceeding 5-18% in samples from flush or cytobrush.
What is a cytobrush used for?
A cytobrush (image below) can be used to swab the uterus and count PMN’s. PMN% is better predictor of reproductive performance than intrauterine bacteriology or gross vaginal inflammation score. Cows in highest PMN% quartile at D28 and D42 had lower pregnancy rates and lower milk yield
The most common presentation vets in practice deal with on routine visits are: cows more than 21 days in milk, not clinically ill but with a vaginal discharge.
What clinical definition would be appropriate?
Clinical endometritis
Draw a graph of the uterine diseases post partum?
What are the principles of uterine infection treatment? (3)
· reduce bacterial load
· enhance uterine defence and repair mechanisms
· halt and reverse inflammatory changes that impair fertility
How can you treat clinical endometritis? (Not ill>21DIM)
PGF2a: Causes luteolysis and subsequent increased oestrogen leads to myometrial contractions. There is some evidence for direct short term contractile effect on uterus. However, PGF2a is not always successful as 20% of cows anovular until 60DIM.
cephapirin
How can we treat puerperal and clinical metritis (animal that are (severely) ill often soon after calving):? (4)
Systematic antibiotics, procain penicillin or amoxycillin, for 3-5 days. There appears to be no benefit of ‘intrauterine & systemic’ over systemic only (provided systemic treatment is applied correctly with regards to dosage and frequency)
NSAIDs; although research demonstrates that one dose of flunixin did not improve outcome (Drillich et al., 2007), animal welfare and the severity of disease warrant anti inflammatory treatment.
Supportive treatment: fluids (oral, IV), warm soft bedding, good quality feed and water. Lavaging the uterus has not been demonstrated to be beneficial
How can we treat pyometra and how does it work?
Give prostaglandin - This should lyse the persistent CL, although not always successful in practice. Sometimes multiple doses are given, however, there is little evidence to support the success of this. There is no difference in effectiveness between the different PGF2a analogues.
What are the repro conseqeunce of a uterine infection?
go beyond the local effect on the uterus, it also effects ovarian cycles, leading to anovulatory anoestrus and a prolonged luteal phase postpartum. Study this graph and read the legend it explains the effect of E.coli on the uterine environment and the ovary; you can read it via the link if image quality is poor (Sheldon et al., 2009).
