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541 (sex class) > dairy uterine health > Flashcards

dairy uterine health Flashcards

(73 cards)

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1
Q

post partum uterine diseases in the cow are largely a result of _____. these risk factors play a role in this.

A

impaired immune function

  • DMI
  • metabolic health
  • stressors and hormonal changes
  • hypocalcemia
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2
Q

why is there immune suppression at calving?

A
  • cortisol released from fetus to signal parturition
  • NEB (as NEFA and BHBA go up, neutrophil function goes down)
  • E2 increasing
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3
Q

tissue remodelling (mammary gland for lactogenesis, separation of cotyledon and caruncle, lipolysis) causes 4 things. what are they?

A
  • increase oxidative stress
  • decrease immune cell function
  • increase pro-inflammatory cytokines
  • increase acute phase proteins
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4
Q

what are the risk factors for uterine dz?

A
  • species of bacteria (virulence factors, strain)
  • level of contamination
  • DMI
  • E and lipid metabolic health
  • stressors and hormonal changes
  • hypocalcemia

balancing acts between immune response and bacterial contamination

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5
Q

dairy cattle need to eat ____ DM before calving for proper immune function. then it needs to be increased to ____ a day after calving for proper immune function.

A

22lbs, 50 lbs

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6
Q

who is affected by retained fetal membranes?

A

any bovine, but esp dairy cattle

incidence ranges from 5-15% in dairy catle

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7
Q

what is retained fetal membranes?

A

failure to pass fetal membranes within 24 hours after calving

failure of cotyledons to separate from caruncles

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8
Q

why do retained fetal membranes happen?

A
  • neutrophil dysfunction (immune response and regulation)

additionally:
- abortion
- premature birth
- hydrops
- uterine torsion
- twinning
- dystocia
- induction of labor
- vitamin and mineral deficiencies (esp Vit E and selenium)

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9
Q

what is needed to separate cotyledons from caruncles?

A

neutrophils!

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10
Q

true or false: retained fetal membranes is a disease of “lack of squeezing”.

A

false!

it is a disease of neutrophil dysfunction

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11
Q

what are the C/S of retained fetal membranes?

A
  • protrusion of fetal membranes hanging ventrally from vulva
  • tenesmus
  • fetid odour
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12
Q

how do you manage retained fetal membranes in the cow?

A
  • most RFM’s separate and fall away 3-12 days after calving IF UNTREATED
  • cows with RFM that had dystocia, twinning, obesity, or induced parturition should be considered high risk for development of dystocia –> more justified prophylactic therapy
  • tx indicated if cow becomes systemically ill, usually due to metritis
  • treatments are not effective
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13
Q

should you use oxytocin, PGF2alpha, or manual removal of fetal membranes to help retained placenta in cows? why or why not?

A

nope!

oxytocin: disease not due to lack of contractions, so oxytocin won’t help
PGF2alpha: CL needed to respond to this, and they don’t have CL until day 30 postpartum
manual removal: prolapse and hemorrhage can occur

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14
Q

what is metritis?

A

inflammation of ALL layers of the uterus within 21 days of calving

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15
Q

who is most at risk for metritis?

A
  • cows that had a retained placenta and were exposed to all the same risk factors as those without retained placenta
  • primiparous >multiparous
  • 10-20% dairy cattle affected
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16
Q

what is the relationship bt DMI and metritis?

A

insufficient DMI prior to calving –> NEB –> poor immune function –> higher incidence of postpartum metritis

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17
Q

what are the C/S of metritis?

A
  • foul smelling uterine discharge
  • ± systemic illness (fever, dullness, inappetence, tachycardia)
  • C/S typically appear w/i 1 week of calving, and almost always before 2 weeks after calving
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18
Q

tell me about the bac t involved with metritis

A
  • early uterine infection by E. coli
  • gram (-) anaerobes by 3-7 days post-calving (ex. F. necrophorum, Bacteriodes)
  • Truperella pyogenes in more chronic infections
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19
Q

how can you dx metritis?

A
  • rectal exam –> looking for flaccid or atonic uterus w/ fluid distention, physometra, gentle raking of uterus yield brown-tinged, foul-smelling discharge, pain on palpation
  • Metricheck device –> insert into vag, push up to cervix, sweep, do visual check

if cow is systemically ill, no need to Metricheck

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20
Q

how do you assign scores of the Metricheck discharge?

A

0: clear or transcluent mucus
1: mucus containing flecks of white/off-white pus
2: discharge containing ≤50% white/off-white mucopurulent discharge
3: discharge containing ≥50% purulent material, usually white or sanguineous

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21
Q

how do you perform odour scoring of vag discharge?

A

0: no smell
3: rotten/putrid smell

either 0 or 3, no in-between ?!

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22
Q

how do you treat metritis?

A
  • cows w/ metritis & toxemia: ABs, fluids, NSAIDs
  • cows w/ metritis score >2 (visual + odour) + temp >39.5: systemic ABs

no clear evidence that intrauterine therapies are effective

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23
Q

Which ABs do you use to treat metritis?

A

Ceftiofur, ampicillin, penicillin

common to see penicillin G

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24
Q

what are the expected outcomes of metritis tx?

A
  • absence of fever in 80-100% of cows 2-6 days after tx
  • absence of fetid discharge after tx
  • no difference in pregnancy rate b/t ceftiofur and ampicillin
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25
true or false: cows are systemically ill with inflammation of the endometrium, with purulent vaginal discharge, and with cervicitis
false! not systemically ill with any of these diseases
26
what is the definition of purulent vaginal discharge (PVD)?
purulent or mucopurulent vaginal discharge lmao
27
where is the likely origin of Purulent Vaginal Discharge?
cervix (cervicitis)
28
how can you diagnose purulent vaginal discharge?
- clinical (can be seen with discharge or Metricheck) - cervical diameter >7.5 cm
29
who gets purulent vaginal discharge the most?
15-30% of dairy cows
30
what is endometritis and what are some other names for it?
Subclinical endometritis or cytological endometritis = endometrial inflammation subclinical = only cytology or ancillary lab testing can accurately diagnose it
31
how do you diagnose cytological endometritis and who gets it?
- cytology brush or low vol uterine lavage = determine # of neutrophils on cytology - up to 50% of dairy cows
32
PVD (purulent vag discharge) is associated with _____, especially ____ and _____
bacterial infection, esp T. pyogenes and A. pyogenes
33
true or false: many cows with endometritis do not have concurrent bacterial infection
true
34
what is a risk factor for endometritis?
cervical infection with trueperella or strep at week 3 post partum
35
only about ___ of cows with PVD have concurrent endometritis
half
36
uterine inflammation post partum should be gone by week ____ in a healthy cow
3
37
tell me the difference between endometritis with excessive inflammation and endometritis with inadequate response
excessive: more inflammation than there should be post partum, and that doesn't disappear after 3 weeks inadequate: not as much inflammation as there normally is post partum, and it doesn't go away after 3 weeks
38
what effect does cytological endometritis have on median days to pregnancy?
increases median days to pregnancy (additional 1-2 heat cycles for cow to get preggers) = more $ for farmer and increase risk of culling
39
how does uterine disease affect fertility
uterine disease perturbs the endometrium and the ovum = bad for fertility
40
how can you dx PVD in the field?
- metricheck (~4 weeks post partum) - US (fluid in uterus) cytobrushing is not done in the field (impractical, costly)
41
how do you tx PVD and endometritis?
- PGF2 alpha (doesn't really work) - ABs
42
what is the rationale behind using PGF2alpha to tx PVD and endometritis?
induce luteolysis of CL, eliminate progesterone and it's immunosuppressive effect, plus increase in E2 levels stimulates uterine contractions and clearance of its contents, supports combat against inflammation and infection by triggering influx of neutrophils and immunoglobulins into the uterine mucosa and mucus not related to better pregnancy rates, but still commonly prescribed - they don't really work
43
what AB protocol should you use with PVD and endometritis?
Intrauterine admin w/ Cephapirin Benzathine 0 mild withhold, 2 day meat withhold
44
true or false: you should use systemic ABs to tx PVD and endometritis
false
45
what is the definition of pyometra?
accumulation of purulent material within the lumen of the uterus in the presence of a persistent CL and a closed cervix
46
true or false: cows with pyometra are systemically healthy
true
47
what is the difference between PVD and pyometra
pyometra: cervix is closed, presence of persistent CL PVD: cervix is patent, may or may not be a CL
48
how do you manage pyometra?
- PGF2alpha (>1 injection 2 weeks apart) - estradiol (controversial) - to enhance squeeze of PGF2 alpha - therapeutic intrauterine flush for non-responders (time consuming, $$)
49
why do we use PGF2 alpha in the treatment of pyometra?
cause luteolysis of CL and bring cow into estrus (open cervix, uterine tone, expel pus)
50
how do we differentiate b/t a pyometra vs a pregnancy?
- palpation - US need to find a positive sign of pregnancy
51
fetal mummification is most common at ______ gestation
4-6 months
52
what is the pathogenesis of fetal mummification?
fetus dies --> uterus contracts __> progestin concentrations persist and fluid resorbs --> fetus becomes dry and firm
53
list 3 broad etiologists of fetal mummification
- genetic (rare) = holsteins, jerseys - torsion of umbilical cord - infectious
54
list some infectious diseases that may cause fetal mummification
- campylobacter fetus - neospora caninum - leptospira - BVD
55
true or false: cows are generally clinical ill with fetal mummification
false! they are generally NOT clinically ill
56
true or false: there has to be bacterial growth in the uterus for a mummy to form
false. there has to be NO bacterial growth in uterus!
57
how do you dx fetal mummy?
- rectal palp = thickened small uterus contracted around fetus, no palpable cotyledons, no membrane slip - US = loss of fetal fluids, hyper echoic fetal mass
58
how do you treat fetal mummification?
- attempt exogenous hormone injections (1-2 PGF2alpha to lyse CL and hopefully expel fetus) - C-section if high value cow - cull if no treatment (sterile uterine condition, cow not systemically ill)
59
what is the prognosis if a fetal mummy is removed?
reasonable prognosis
60
what is fetal maceration and when does it happen during gestation?
fetal death with partial cervica dilation = uterine contamination and bacterial growth any stage of gestation
61
what are the C/S of fetal maceration?
**cow is acutely ill!** abdominal straining, fetid vulvar discharge, fever, anorexia
62
how do you diagnose fetal maceration?
- distended, swollen uterus - *gas crepitation in uterus*
63
how do you treat fetal maceration?
- attempt to remove fetus manually - hysterotomy - antimicrobials and supportive care
64
which is more common, hydrops of the chorioallantois or hydrops of the amnion?
chorioallantois
65
what is hydroallantois?
abnormal transudative allantoid fluid the fetus is normal, it's a defect of the placenta (uterine/placental dz, decreased number of caruncles, hypertrophies caruncles)
66
there is an increased risk of hydroallantois in what?
multiple fetus pregnancies and IVF pregnancies (implanted embryos - recognize as non-self)
67
what are the C/S of hydroallantois?
- vary with the vol of fluid at presentation - fluid accumulates over a 5-20 day period in the 3rd trimester = progressive abdominal distention during the last 4-6 weeks of pregnancy - severe cases can accumulate 150-250L of fluid - progressive maternal tachycardia, anxiety, discomfort, reduced appetite, dehydration
68
what is hydroamnios?
accumulation of thick syrup-like amniotic fluid fetus is abnormal (brachygnathis and hydrocephalic calves) - amniotic fluid normally swallowed and absorbed into circulation
69
when does hydroamnios and hydroallantois occur during gestation?
3rd trimester
70
what are the C/S of hydroamnios?
**cow is clinically normal with normal placenta!!!** slow enlargement, pear-shaped abdomen
71
what are the tx for dropsical conditions?
- induce abortion/parturition (prostaglandin, abort 36 hours later - supportive care - c-section (terminal or not)
72
tell me when and why you'd do a c-section (terminal and not terminal) for dropsical conditions
normal c-section: hydroallantois ---> if you try a c section, there is likely maternal compromise. will need help and it may go badly. so more often than not, esp if high value calf or low value cow, do terminal c section terminal c-section: hydroallantois --> tend to be high value embryo in a cow with lower value. then terminal c section --> terminal bolt injection to cow, you have 3 mins to get the calf out
73
how do you manage a rupture of the prepubic tendon?
- need muscles to get baby out = elective c section - cull after calf weaned - pretty much impossible to fix

541 (sex class) (22 decks)

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