Therio- Bovine- The postpartum period 2

wilsbach's version from 2015-11-04 18:39


Question Answer
def of Retained fetal Membranes (RFM)?Membranes that are not expelled within 12 hours of completion of stage II
how common is RFM?MOST COMMON post partum complication
5 possible etiologies for RFM?(1) Vit/mineral deficiency eg. Vit E/Selenium (2) Abortion (3) dystocia (4) Partus induction (5) True multifactorial disease
what are normal processes which result in detachment of the placenta?Softening of collagen in placentomes, Intrapartal pressure, Postpartal anaemia of fetal villi, Decreased size of caruncles with uterine contractions
what are the Two basic processes that result in RFM?(1) Uterine inertia (<10% of cases) (2) Failure of loosening process
what are some reasons there would be failure of the loosening process of the placentomes? (6)(1) Immaturity of placentomes (2) Oedema or hyperaemia of chorionic villi (3) Necrotic areas in villi (4) placentitis (5) metritis (6) Leukocyte inactivity
what is the prog for RFM?Uncomplicated RFM not associated with serious consequences and affected animals have normal production & fertility (+/- 50 % of cases)
RFM can lead to what types of complications/ inc the risk of.. (5)metritis, endometritis, pyometra, ketosis, displaced abomasum
how do you go about treatment of RFM?depends on time table... (1) SHORTLY after calving (24hrs) you can give oxytocin (help inc uterine contractions, might help get it out) (2) if not just after birth, LEAVE HER ALONE and monitor her... appetite, habitus, milk production, nature of lochia, and rectal temp. If any of these go downhill, may need to interfere
*Do you want to give abx in the case of a RFM?NO!!! Bacterial action, autolysis and putrefaction will assist in loosening + expulsion, which is why you don’t want to give AB’s
If you need to remove the RFM, what DO you do?After a few days, re-examine and gently cord (twist) RFM, while massaging uterus per rectum
**if you need to remove the RFM what DONT you do?DO NOT attempt to manual “peel” off placentomes – hemorrhage, leave bits of cotyledon behind, impair leukocytes work
what are Ecbolics? examples?they cause contractions-- ex are oxytocin, calcium, PGF.
are ecbolics useful for RFM?(drugs which cause contractions) limited value unless given very early (24 h post partum) when uterus is still sensitised
how useful is Intrauterine administration of theraputics for RFM?not very... Doesn’t penetrate deeper tissues (where problem lies), Persistence is short, Absorbed systemically (NB! Milk withdrawal), Suppression of uterine defences, introduce new infxn, Uneven distribution of drug
which abx would you rather use for RFM- tetracycline, or penacillins?Tetracyclines are drug of choice, they are broad spectrum and active in pus. (Inactivated by penicillinases produced by mixed flora in early post partum period. also inactivated with pus and narrow spectrum.. can use in late post partum tho)
*when do you use uterine antiseptics? examples?DO NOT use unless in very chronic cases of endometritis...usually things like Formaldehyde, iodine, which can burn the entire endometrium.
what is usually more preferable to uterine antiseptics?Would rather you instilled large volumes of tap water to help flush out uterus, without compromising uterine defences excessively.
what are the two kinds of metritis?(1) Acute puerperal metritis (2) Subactute metritis
when does Acute puerperal metritis occur? how does lochia present? how does it feel upon rectal palpation?happens Within 5 days post-partum. Lochia: dark red/black, watery, foul smelling. Rectal palp: large, fluid-filled, flaccid uterus
when does Subactute metritis occur? how does lochia present? how does it feel upon rectal palpation?usu. 2nd wk post partum. Lochia: purulent. Rectal palp: firmer (“doughy”) & thick walled
how do metritis and RFM relate?metritis Often preceded by, or occurs concurrently with retained fetal membranes (RFM)
**etiological factors for metritis?Hygiene at calving, Dystocia (NB! Iatrogenic!), Poor uterine contractions (clean out all the gunk), Concurrent systemic disease, Gram +ve and Gram –ve + anaerobes
If you suspect metritis (cow is systemically ill), you know the metritis involves _________, and these problems are associated with (3 problems)__deeper layers of uterine tissue__. This means can also be associated with Toxaemia &/ septicaemia, peritonitis, and death
what are the clinical signs of metritis? (5)Inappetance, Dehydration, Decreased production, Increased temperature, abnormal Lochia (ACute: dark red/black; watery, foul smelling. SUBacute: purulent)
how does metritis feel upon rectal palp if it is an ACUTE case?Large, flaccid, fluid filled bag
how does metritis feel upon rectal palp if it is an SUBACUTE case?becomes firmer (“doughy”) + thick walled
**what should you know about performing uterine manipulations on a cow with metritis?NB!! Uterus VERY FRIABLE…. Any manipulation may result in perforation unless performed VERY CAREFULLY.
IV fluids are very very expensive for a large cow-- what other option do you have if cow isnt too compromised?May use oral rehydration
when do you use oxytocin for uterine contractions in a cow with metritis?only effective when responsive, which is like within 24hrs of brith
Metritis--> Once systemic condition has improved, you want to flush the uterus' contents-- what do you do? once flushed, how do you get the rest out?valuable cow: isotonic saline solution. Less valuable: tap water. To get it out, rectal massage to manipulate fluid out of uterus
which is more severe- endometritis or metritis?METRITIS-- potential for systemic illness
what are the drugs/therapies you want to do on a cow with metritis? (5)(1) Aggressive antibiotic treatment--> oxytetracycline/penicillin (2) Anti-inflammatories (Finadyne, Metacam (Remember withdrawal periods) ) (3) Shock therapy if valuable cow (4) Oxytocin To aid uterine contraction + rid the uterus of fluid. (remember, only responsive for a short time) (5) drench with rumex to save rumen if systemically ill
what are the three main Consequences of metritis?protracted recovery phase, Delayed involution, endometritis
what is ENDOmetritis?Inflammation LIMITED TO THE superficial layers of the uterus ie. Endometrium
when does endometritis usually occur?Usu. ≥ 2 wks after calving
what is endometritis usually a result of?Usu. as a result of failure to eliminate infection during involution. May also result from unhygienic AI or specific venereal pathogens (tritrich, campy...)
list of some predisposing factors to ENDOmetritis (read over)Retained fetal membranes, Dystocia, Caesarian section or assisted calving, Induced parturition, Still Birth, Twins, Unhygienic calving environment, Ovarian inactivity, Parity, Concurrent disease and nutrition
what are 2 examples of Concurrent disease and nutrition inc rates of endometritis? (prolly not SUPER important to know..)fatty liver disease and hypocalcaemia
is there any reasons seasons might have an affect on endometritis rates?has to do with unhygenic environments- includes seasonal effect as indoor calving has higher endometritis rates
how is endometritis a cost drain on the farmer?Increased inter-calving interval, Increased services per conception, Increased culling
*main culprit of endometritis?T. pyogenes often in combo with F. necrophorum
which is associated with systemic illness- metritis or endometritis?metritis, NOT ENDO
what are the clinical signs of ENDOmetritis? (2)(1) Purulent vaginal discharge (may not appear at vulva) called "whites" (2) irregular cycles
what is "whites"?Purulent vaginal discharge (may not appear at vulva)
what is a Metricheck?rubber scooper to check for purulent discharge into fornix of vag
how does endometritis present on a rectal exam?Enlarged cervix, Enlarged, asymmetrical uterine horns, Thick walled and doughy consistency of uterus (NB! Stage of cycle?), Preg. Horn still remarkably enlarged. Active ovaries – can be at any stage in cycle
what is the Treatment of Endometritis? (remember, May resolve spontaneously) (3-4 options)(1) Intrauterine antibiotics (Cephalosporins)--> NB! Culture and antibiogram if non-responsive (2) Systemic antibiotics (Penicillin/Tetracyclines) (3) PGF2α (Two doses 11-14 days apart-->Returns cow to estrus with all the resultant beneficial effects) (4) (estrogens-- she has a frowny face here)
how does PGF2alpha help with endometritis?give 2 inj 11-14d apart so she goes into estrus, and then you get the benefits of estrus (high defenses, open cervix, etc)
metritis vs endometritis--> how do the timetables differ?Metritis is usually first 5d post partum. Endo is >2wk PP
metritis vs endometritis--> what microbes usually cause metritis? endo?metritis is Gram +ve, Gram –ve and anaerobes. ENDO is usually T. pyogenes + F. necrophorum
what is pyometra?Accumulation of pus in uterus in the presence of a functional CL (so, progesterone is predom so cervix closed, pus trapped inside. Also Depressed uterine defences+ Glandular secretions)
how do you ID pyometra on rectal exam?uterus is grossly enlarged
what usually causes pyometra (in general, not specific pathogens)Usu. Results from persistence of infection (metritis/endometritis) into the late postpartum period [Active CL perpetuates the condition]. ALSO can occur from Embryonal/fetal death with retention of septic material in a closed uterus – eg. Trichomonosis
*which PATHOGENS usually cause pyometra? T. pyogenes, F. necrophorum, Bacteroides
does pyometra show systemic dz?NO
what kinda discharge do you see with pyometra?trick question- NO DISCHARGE, cervix closed
how do you dx pyometra?Dramatically enlarged uterus that is asymmetrical, fluid-filled, thick walled, atonic, and there is a CL (not necessarily ipsilateral to larger horn)
how do you tx pyometra? what is the prognosis?GOOD PROGNOSIS, give a Single injection of PGF2α (Allow 1 cycle before attempting to breed)