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THERIO L7-8 PostPartum Conditions of the Cow

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drhartz's version from 2017-09-05 22:16

Retained Placenta

Question Answer
what are the 7 postpartum conditions of the cow?1. retained placenta 2. uterine prolapse 3. Metritis 4. Endometritis 5. Pyometra 6. Cystic Ovarian Dz 7. Anestrus
post partum conditions are considered what type of problem?managerial
what is externalized with a calf during birth?1. amnion 2. umbilical cord
what is left in the cow immediately after birth? when is it delivered?chorioallantois.. 2-12 hours - the chorioallantois maintains its close attachment to the maternal caruncles for 2-12 hours
when is the chorioallantois delivered?2-12 hours after birth
when is the amnion delivered?at birth - it is broken and externalized with the calf
what is the BEST TIME for the chorioallantois to be delivered?by 7 hours
identifiable features of the chorioallantois?membrane with rough surfaces over the multiple cotyledons
when is the placenta considered maintained?if it is not passed within 12 hours but some veterinarians say 24 hours
if the chorioallantois placenta is retained entirely (not hanging from vulva) what aids in dx of it being inside?there is an odor
predispositions that cause a retained placenta?1. dystocia 2. hypocalcemia 3. management 4. infectious and toxic abortions
what forms of dystocia /mechanical aspects cause a retained placenta1. twinning 2. c-section 3. fetotomy 4. fetal congenital abnormalities
what in management causes retained placenta?stress, obesity, heredity, induction of parturition
what abortogenic infections/viruses cause retained placenta?1. BRUCELLA 2. INFECTIOUS BOVINE RHINOTRACHEITIS 3. BOVINE VIRAL DIARRHEA 4. LEPTO 5. EPIZOOTIC BOVINE ABORTION
what is the toxic abortion that causes retained placenta?pine needle abortion
is fertility effected from retained placenta?yes
what are direct infertility indices following retained placenta?delayed first service, increased services per conception, decreased pregnancy rates, increased days open
what are the infectious/metabolic pathologies following retained placenta?metritis, endometritis, pyometra, ketosis, mastitis, displaced abomasum, higher bacteria load in the vagina
how are placentomes formed?fetal cotyledons attach to the maternal caruncle forming placentome. villi and microvilli connections are formed at the cotyledon and caruncle interface. collagen creates the strong linkage
cascade of parturition which are factors in caruncle and cotyledon seperation? whats inc. and whats dec.?decrease in progesterone. increase in enzymatic activity at placentome, corticosteroids, estrogen, oxytocin, prostaglandin = luteolysis = release of relaxin. relaxin promotes collagen breakdown
what are reasons for caruncle/cotyledon separation? aka retained placenta (4)1. immaturity of placentomes 2. reduced inflammatory response/ immuno-supppression 3. depressed collagenase activity 4. uterine inertia
what are causes of immaturity in placentomes? (which causes failure of caruncle/cotyledon separation aka retained placenta)abortion, induction of parturition, early c-section
prevention of retained placenta?1. prepartum management & nutrition 2. good calving protocol (when to intervene) 3. injection of collagenase into umbilical cord blood vessels postpartum 4. post or intra - partum administration of prostaglandin, lysozyme dimer, propranolol
what are drugs used to prevent retained plancenta?prostaglandin, lysozyme dimer (enhances immune response), propanolol (beta blocker), collagenase (into umbilical cord)
tx of retained placenta?1. cut exposed placenta off at vulva (so feces will not be drawn into the vagina) 2. monitoring for potential health problems (get temp/day to rule out metritis) 3. observe and wait *current protocol* Antibiotics are not indicated!
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Uterine Prolapse

Question Answer
what is uterine prolapse?uterus is pushed out of vulva with pregnant horn everted, may hang to hocks
when does uterine prolapse occur?within 12 hours of calving
why is uterine prolapse important?its an emergency life-threatening condition
uterine prolapse complications?rupture of blood vessels, shock, endotoxic shock, trauma and necrosis of prolapsed tissue, sudden death
replacement of uterus with reperfusion results in?endotoxins & thromboemboli
steps of uterine replacementreplacement with.. 1. epidural to prevent straining 2. pressure, sugar & hypertonic solutions for edema reduction 3. warming of tissue
tx of uterine prolapse other than replacement1. buhners stitch or prolapse pins 2. tx hypocalcemia
if prolapse cannot be replaced what can be done?amputation of uterus to salvage animal for slaughter/culling
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Metritis

Question Answer
what is metritisinflammation of the uterus - deep infectious damage to the uterine wall with foul smelling watery uterine contents
what is puerperal metritislife threatening condition occurs within the first 10–14 days postpartum. It results from contamination of the reproductive tract at parturition and often, but not invariably, follows complicated parturition
when does puerperal metritis occur?2-3 weeks post partum
puerperal metritis is prevalent in who?high producing dairy cows
risk factors?retained placenta, dystocia
diagnosis of metritis occurs when? 5-10 days post partum
puerperal metritis is characterized by what? when do you see these signs?enlarged uterus, watery red/brown uterine discharge, systemic illness signs, fever > 103 F ...seen within 21 days postpartum
difference between acute metritis & clinical metritis?acute: severe signs during the first 5 days postpartum... clinical: no systemic illness but uterus is enlarged with fetid discharge
is fever always present during metritis?NO not all cases of metritis will have fever
metritis is diagnosed by ?temperature, palpation per rectum of uterus (fragile), evaluation of concurrent metabolic/infectious dz: ketosis, displaced abomasum, pneumonia, mastitis
tx of metritis1. intra-uterine abx NOT favored 2. systemic abx: cephalosporins: ceftiofur hydrochloride, ceftiofur cystalline free acid & oxytetracycline: liquamycin 3. flushing uterus 4. anti-inflammatories 5. self cure 6. oxytocin/prostaglandin?? efficacy??
prognosis of metritis?death, reduced pregnancy rate, delayed pregnancy , reduced milk production (milk discarded if tx with drugs)
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Endometritis

Question Answer
what is endometritissuperficial infection and inflammation that is only as deep as the endometrium
difference between endometritis and metritis?metritis is deep infectious damage to the uterine wall while endometritis is a superficial infection only as deep as the endometrium
difference between diagnosis of clinical endometritis and subclinical metritis ?clinical endomet dx: observing a uterine discharge on physical exam.. subclinical endomet dx: evaluation of uterine cytology
endometritis is highly prevalent in who?lactating dairy cows
clinical endometritis is characterized by1. presence of uterine discharge 21 days postpartum/days in milk 2. mucopurulent discharge after 26 days postpartum
how is uterine discharge observed in clinical endometritis?vaginoscopy, collecting discharge in the gloved hand, or metricheck
subclinical endometritis is characterized byabsence of clinical endometritis w ...1. >18% neutrophils 21-33 days in milk or 2. >10% neutrophils 34-47 days in milk, 3. uterine cytology w cytobrush or lavage 4. ultrasound imaging of fluid in uterus
tx of endometritis1. ABX: none approved in the US, cephapirin benzathine in 19 g emulsifier (Metricure®) in other countries 2. prostaglandin PGF2a 3. self cure endometritis is not life threatening
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Bacteria of Postpartum Uterus

Question Answer
bacteria found in healthy cowsstreptococcus spp., staphlocuccus spp., bacillus spp.
bacteria found in metritistrueperella pyogens, escherichia coli, fusobacterium necrophorum, prevotella melaninogenicus
bacteria found in endometritistrueperella pyogenes alone or in combination with Fusobacterium necrophorum and Escherichia coli
pus in the uterus and inflammation of the endometrium may interfere with ?luteal fx, sperm survival, embryo survival
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Pyometra

Question Answer
what is pyometra?pus filled uterus with corpus luteum present
why is the CL persistent in pyometra ?PGF2a failure of release from uterus - luteolysis fails bc the infected endometrium does not synthesize or release prostaglandin PGF2a
how does the cervix play a role in pyometra dx?if the cervix is closed diagnosis can not be made by external observation... if cervix open pus may be dripping out
what is the primary sign of pyometra?anestrus and recognition of cow being nonpregnant with "persistant CL"
dx difference in dairy cows vs beef cows?dairy: palpation & anestrus .. beef: not pregnant on herd check & anestrus
cause of pyometra in dairy cows?1. retained placenta 2. dystocia 3. metritis 4. endometritis ... etc.
cause of pyometra in beef cows?1. tritrichomonas 2. campylobacter 3. assisted calving
dx of pyometra in beef & dairy cows other than anestrus ?Ultrasound
pyometra txadmin of PGF2a or synthetic prostaglandins .... endometrium may be TOO DAMAGED TO RESPOND TO LUTEOLYSIS TX
why is prostaglandin administration the first line of tx for bovine pyometra?PGF2a admin (aside from dec in progesterone/beginning new cycle) will expulse exudate and bacteriologic clearance from uterus
how is mucometra/hydrometra similar and different to pyometra ?similarities of muco/hydrometra & pyometra: can all present on palpation or ultrasound .. difference: muco/hydropyometra have mucus or watery fluid rather than microorganisms and pus
what causes muco/hydrometra?fibrosis adhesions, segmental aplasia of uterus
name the organisms that cause pyometra from venereal transmission?????????
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Cystic Ovarian Dz

Question Answer
what is cystic ovarian dz?follicular cysts that follow from 1. failure of ovulation of a follicle following proestrus and estrus & 2. failure of formation of a normal corpus luteum
what can the follicles that failed to ovulate do to impact effectiveness of dx and tx?partially luteinize
what is the diagnostic rule for classifying cystic ovarian dz ?follicle is > 2.5 cm diameter
why is cystic ovarian dz more common in dairy cows than beef cows??????
characteristics of a cystic ovarian dz follicle1. follicle >2.5cm detected on ovary 2. may be thin walled, fluid filled, fluctuating, wall that is partially luteinized
[partially luteinized cysts] vs [fluid filled "cystic cysts"] ?[partially luteinized cysts] are pathological as a normal CL is not formed ..... [cystic cysts]: fluid filled center that is much like a cyst but is not pathological bc these fluid filled CL’s are funcitonal and associated with ovulation and produce sufficient P4 to support a pregnancy.
dx of >2.5cm follicle?1. palpation per rectum 2. ultrasound
cystic ovarian dz effect on cow/symptoms? 1. anestrus 2. constant estrus (nymphomania) 3. Erratic estrus (irregular pattern) 4. lack of tone in both internal and external genitalia 5. vaginal prolapse 6. mucus discharge 7. relaxation of pelvic ligaments / tail head hump 8. nervous 9. dry hair coat 10. emaciation
when does cystic ovarian dz occur?45-60 days postpartum >in fall/winter
cystic ovarian dz is most commone in 1. what type of cow? and 2. what breed of cow?1. dairy cows associated with high milk production 2. Holstein
cystic ovarian dz tx1. GnRH 2. if cyst is luteinized Prostaglandin 3. Bc timed AI uses GnRH & PGF2a ..admin of GnRH/PGF2a/GnRH sequence may be used as tx 4. usually transient and Self-Cure!!
WHEN do you tx cystic ovarina dz?tx is NOT UNDERTAKEN until > 1 month postpartum bc follicular cysts are usually transient
should you crush a follicular cyst manually?NO
why is AI used as a combined tx of cystic ovarian dz & breeding management approach???
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