Periparturient and postpartum disorders I & II

Question 1

what are the predisposing factors for uterine prolapse

Answer 1

decrease in uterine tone
Hypocalcaemia - milk fever
dystocia - twins, large foetus

Question 2

what is the aetiology of a uterine prolapse

Answer 2

usually occurs within 24h of calving
regarded as an emergency
restricts movement of the cow while waiting for vet to prevent trauma to uterus and potential rupture of uterine arteries

Question 3

How do you treat a uterine prolapse

Answer 3

correct hypocalcaemias if it exist - will improve cardiovasuclar function and improve their ability to get up after there procedure
restrict cow movements
if animal is recumbent place in sternal recumbency with hind legs extended caudally
epidural if needed
Evaluate presence of bladder -evacuate if needed

Question 4

Explain how the uetrous is put back it

Answer 4

replace uterus starting closet to the vulva - gently pushing - helpful is uterus is elevated
when replacing, fully invert uterine horns. consider whether or not to insert a burhners stich to ensure retention for a few days then remove the suture
admin oxytocin to induce uterine contraction

Question 5

Urinary bladder prolapse

Answer 5

Differentiate from bladder inversion, prolapse of cervix or vagina
Prolapse of the bladder usually takes place through a rupture or tear in the floor of the vagina

Question 6

what are some of the prediposing factors to a postpartum uterine infection

Answer 6

damage/disruption to natural barriers; vulva, vestibular sphincter, cervix
impaired neutrophil function
poor calving at calving

Question 7

what are the risk factors for post partum infection

Answer 7

• retained foetal membranes
  Factors that predispose to RFM
  associated with reduced feed intake before a clinical episode

Question 8

what are the Cs of metritis

Answer 8

first week post calving
large, atonic, fluid filled uterus
Fever, depression, anorexia, recumbency, decreased milk yield, red-brown, watery foul smelling vaginal discharge

Question 9

How do you treat metritis

Answer 9

Treat cows that have at least two symptoms of metritis
- RFM
- Rectal temp
- fullness or inappetence
- foul smelling uterine discharge, atonic uterus
Treat for 3-5 days of systemic ceftifor or penicilin
Intrauterine treatment
supportive treatment

Question 10

Endometritis

Answer 10

inflammation of the endometrium extending no deeper than stratum spongiosum
incidence; variable but not uncomon
reduces subsequent reproductive performance
usually no systemic signs
muco-purulent or purulent uterine discharge associated with chronic bacterial infection of the uterous, occuring later than 3 weeks postpartum
chronic cases have reduced reproductive performance

Question 11

what are some risk factors for endometritis

Answer 11

hypocalcaemia with recumbency 
RFM 
Dystocia 
Twins
Metritis 
Ketosis 
LDA

Question 12

How do you diagnose endometritis

Answer 12

external inspection - evidence of pussy discharge
palpation of cervix
detection of material in the vagina of cows more than 21-28 days post partum

Question 13

How do you treat endometritis

Answer 13

intrauterine AB - after 28 days post partum intrauterine admin of cephapirin

Question 14

Pyometra

Answer 14

accumulation of purulent exudate within the uterus in the presence of a functional CL
Usually no signs of systemic illness
cows are typically anoestrous
occurs in cows that ovulate in the presence of uterine infections
high concentrations of progesterone post ovulation suppress uterine defence mechanism
Failure of release of PGF2alpha from uetrous is presence of uterine inflammation, persistent of CL

Question 15

How do you diagnose pyometra

Answer 15

Rectal palpation - fluid filled uterous variable size, horns can be equal in size, lack membrane slip, placentomes or foetus
Presence of CL

Question 16

How do you treat pyometra

Answer 16

PGf2alpha - to induce luteolysis and promote uterine drainage
recurrence of pyometra after a single treatment occurs in 9-13% of cases so follow up examination is warranted

Question 17

How to prevent uterine inflammatory disease

Answer 17

Optimise transition diets to dry matter intake prepartum
adequate concentrations of Se and vit E in prepartum diet
good hygiene at calving and when intervening in cases of dystocia
prevention hypocalcaemia

Question 18

what are risk factors for retained placenta

Answer 18

obsterical intervention/dystocia 
twinning 
Abortion 
short gestation 
summer 
hormonal imbalance 
induction of calving 
nutritional imbalance 
older cows are at greater risk

Question 19

What is the txm for retained placenta

Answer 19

Aim - early detachement to decreased occurence of metritis, decreased milk yield and reduced negative impact

• physical removal
• hormonal therapy
• non if animal is not pyrexic or inappetant
• intrauterine treatment or manual removal of the placement is not usually recommended as no benefits have been shown
• if animal is not pyrexic systemic AB treatment has been shown to be beneficial but the economics of this must be considered in individual circumstances