Veterinary Reproductive Health Quiz

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Questions and Answers

What is a common consequence of low IU absorption when treating endometritis with IU infusions of Oxytetracycline?

Irritation and necrosis of the endometrium (correct)

Increased fertility of the cow

Improved lymphocyte function

Decreased risk of bacterial contamination

Which method is effective for diagnosing pyometra in cows?

Laparoscopy

Blood test analysis

Urinalysis

Transrectal palpation (correct)

What condition necessitates the use of PGF2α treatment in pyometra cases?

Open cervix and immune activation

The persistence of a corpus luteum (correct)

The presence of a pregnancy

Elevated levels of estrogen

What percentage of cows may need additional treatment after PGF2α administration for pyometra?

15-20% Signup and view all the answers

Which factor should be identified to minimize the impact of uterine inflammation in herds?

Critical points in breeding and calving Signup and view all the answers

What is considered normal for the discharge during the postpartum period in cows?

Dark brown to red to white discharge Signup and view all the answers

Which factor is primarily responsible for the retention of fetal membranes beyond 24 hours postpartum?

Deficiency of collagenase Signup and view all the answers

How long after calving does gross uterine involution typically occur in dairy cows?

30 days Signup and view all the answers

What is the management concern when retained fetal membranes occur?

Increased health problems and culling rates Signup and view all the answers

What is a characteristic clinical sign of metritis in cows?

Foul-smelling vaginal discharge Signup and view all the answers

Which of the following best describes secondary retention of fetal membranes?

Difficulty in expelling already detached membranes Signup and view all the answers

What role does hypocalcemia play in retained fetal membranes?

Affects collagenolysis necessary for placental detachment Signup and view all the answers

What does clinical endometritis primarily result in compared to subclinical endometritis?

Pathological effects on reproduction Signup and view all the answers

What is the prevalence rate of subclinical endometritis at 40-60 days postpartum?

26% Signup and view all the answers

Which method is noted for its low predictive value in detecting subclinical endometritis?

Ultrasound Signup and view all the answers

What is the threshold percentage of PMN cells for identifying subclinical endometritis at 21-35 days postpartum?

<blockquote> 18% </blockquote> Signup and view all the answers

What is considered a disadvantage of endometrial biopsy compared to cytology?

Cost and time Signup and view all the answers

Which treatment is recommended alongside antibiotics for endometritis?

Administration of PGF2α Signup and view all the answers

Which is a symptom indicative of clinical endometritis during transrectal palpation?

Lack of symmetry in uterine horns Signup and view all the answers

What is a common effect of subclinical endometritis on reproductive performance?

Prolonged post calving intervals Signup and view all the answers

What signifies the presence of endometritis in endometrial cytology?

PMN response against pathogenic bacteria Signup and view all the answers

What is the primary concern associated with using Oxytetracycline LA for metritis treatment?

It has a high resistance rate in metritis cases. Signup and view all the answers

Which treatment has been shown to have no preventive or curative benefit for metritis?

Oxytocin Signup and view all the answers

What is a defining characteristic of clinical endometritis?

Purulent vaginal discharge after 21 days postpartum Signup and view all the answers

What is the dose range for administering Oxytocin for uterine contractions after delivery?

20-40 U every 3-6 hours Signup and view all the answers

What effect does PGF2α have during the early postpartum period?

It does not affect uterine involution. Signup and view all the answers

What is a significant difference between clinical and subclinical endometritis?

Subclinical endometritis features elevated PMN percentages in uterine cytology. Signup and view all the answers

The use of which systemic antibiotic requires extra-label administration for metritis treatment?

Ampicillin Signup and view all the answers

What is the primary purpose of providing fluid therapy in metritis cases?

To address dehydration Signup and view all the answers

Study Notes

Postpartum Period in the Cow

The postpartum period is the time after calving, involving uterine involution and resumption of the estrous cycle.
Lochia, a discharge, is typically expelled in the first few weeks after calving.
Lactation begins, increasing metabolic rate and calcium mobilization.
Delayed uterine involution can cause discharge to persist for up to 30 days.
Normal postpartum discharges vary in color from dark brown to red to white.
Discharge is considered abnormal if it is fetid or accompanied by systemic signs.

Uterine Involution

Uterine size decreases.
Uterine tone increases (feeling of lines or strips).
Fluid in the uterus is absent after 14 days, even in dairy cows.
Dairy cows typically take 30 days for gross involution, and 45 days for histologic involution.
Beef cows typically take 21 days for gross involution and 30 days for histologic involution.

Retained Fetal Membranes (RFM)

Most cows expel the placenta within 6 hours.
Retained fetal membranes are considered present if the placenta is not expelled within 24 hours postpartum.
RFM causes detrimental effects on reproductive performance, milk production, health, and culling rate.
Primary retention is when the placenta does not detach.
Secondary retention is when the detached placenta is not expelled. Spontaneous expulsion of RFM occurs 5–7 days postpartum, often accompanied by cotyledon proteolysis and caruncle necrosis. Possible reasons for RFM include: a deficiency of collagenase, hypocalcemia (<8mg/dL), deficient polymorphonuclear leukocyte (PMN) migration and phagocytosis, deficiencies in the anti-collagenase system

Risk Factors for RFM and Postpartum Uterine Infections

Obstetric: Abortion, multiple births, previous retained fetal membranes, Cesarean section, dystocia, advanced age.
Physiologic: Short gestation periods and low calf weight, calving during summer.
Hormonal: Prepartum cystic ovarian ablation, abnormal progesterone (P4), estrogen (E2), induced delivery (PGF2α).
Nutritional: Selenium (Se) and vitamin E deficiencies, feeding hay and corn silage, excess iron.
Infectious: Brucellosis-positive status.

Treatment of RFM

Manual removal is generally contraindicated due to the risk of predisposing uterine infections and prolonging the interval until the next ovulation.
Hormonal therapy: Oxytocin is the preferred ecbolic hormone in the early postpartum period. 20-30 IU 3-4 times daily may be used.
Antibiotics: Ceftiofur is a preferred antibiotic treatment used to delay the release of RFM by inhibiting putrefaction.

Uterine Infections—Predisposing Factors

Retained fetal membranes.
Hypocalcemia and ketosis.
Dystocia.
Delivery of twins.
Overconditioning and underconditioning.
Large herd size
Unsanitary calving conditions.
Traumatic obstetric procedures
Stress.

Organisms Commonly Associated with Uterine Infection

E. coli
Trueperella pyogenes
Fusobacterium necrophorum and Bacteroides melaninogenicus
Other coliforms
Pseudomonas aeruginosa
Staphylococci, hemolytic streptococci,
Clostridium spp

Defining Uterine Infections

Character of uterine discharge.
Days postpartum.
Clinical findings.
Endocrine status.

Metritis

Severe inflammation involving all layers of the uterus (mucosa, submucosa, muscularis, serosa).
Primarily occurs during the first week after calving.
Associated factors include dystocia (difficult birth), RFM, calving trauma, ketosis, and hypocalcemia.

Metritis—Diagnosis

History of dystocia and/or RFM.
Decreased milk production.
Physical exam: Fever, anorexia, and depression.
Rectal palpation: Distended and flaccid uterus, thickened wall, liquid in lumen, lack of longitudinal lines, fibrin and adhesions.
Fetid vaginal discharge.
Blood work: Left shift, severe neutropenia, hypocalcemia, ketosis, increased haptoglobin and substance P.
Ultrasound is unnecessary.

Metritis—Treatment

Systemic Antibiotics: Ceftiofur (3G cephalosporin, broad-spectrum).
Fluid Therapy: Address dehydration.
NSAIDs (Nonsteroidal anti-inflammatory drugs): Flunixin meglumine (to address inflammation, fever, toxemia; may improve appetite)
Nutritional Supplement: Supplement with Ca, dextrose, and polyethylene glycol for ketosis.

Endometritis

Inflammation of the endometrium, not deeper than the stratum spongiosum.
Occurs after RFM, metritis, mating, artificial insemination, or infusion.

Endometritis—Diagnosis

Presence of purulent vaginal discharge (PVD) >21 days postpartum.
Discharge in cranial vagina or ventral commissure.
Associated with PVD but pus or PMNs may not always be present.
Affects pregnancy rate and calving intervals.
May be accompanied by cervicitis and vaginitis.

Endometritis —Clinical/Subclinical

Clinical: Purulent vaginal discharge.
Subclinical: (Cytological): Inflammation as evidenced by specific percentage of PMNs in uterine cytology relative to days postpartum. Immunosuppression (low percentage of PMNs and monocytes in peripheral blood).

Endometritis—Diagnosis (cont.)

Clinical Diagnosis Criteria Discrepancy: Subjective with low sensitivity and specificity.. (e.g., transrectal palpation (TRP), transrectal ultrasound (TRUS), vaginoscopy)
Transrectal Palpation: Asymmetry of uterine horns, increased uterine wall thickness, or presence of fluid, cervix >7.5cm in diameter.
Ultrasound: Usefulness inconsistent, particularly for subclinical cases. Limited to detecting small fluid amounts in the uterine horns. Detecting uterine thickness and echogenicity.
Endometrial Cytology: PMN cell response against pathogenic bacteria. Increases in PMNs in uterine lumen. Can be used to identify cows with endometritis. Useful in identifying subclinical endometritis (given specific criteria).
Endometrial Biopsy: Increased detail of inflammation (epithelial damage, edema, infiltrates of PMNs and lymphocytes, fibrosis) but costly and less practical.

Endometritis—Treatment

Antibiotics and PGF2α administration (two doses, 14 days apart).
P4 and Luteolysis.
Intravenous infections with oxytetracycline not recommended due to low absorption, and risk of residues in meat and milk.

Pyometra

Suppurative discharge (pus) in the uterine lumen, associated with prolonged corpus luteum activity and closed cervix.
Persistent exudate,
Possibly caused by persistence of corpus luteum, and immune suppression.
First ovulation after cleaning the uterine bacterial contamination.

Pyometra—Diagnosis

Transrectal palpation: Thicker uterus wall.
Ultrasound: Confirms purulent fluid. Suggests variable echogenicity (consistency) of fluid, identifies corpus luteum in an ovary, and rules out pregnancy.

Pyometra—Treatment

Two doses of PGF2α 14 days apart for inducing luteolysis.
High success rate of pregnancy after initial treatment.
15-20% of cows may require additional treatment.

Minimizing Uterine Inflammation in Cattle

Identifying herd-specific risk factors (breeding and calving)
Management strategies include sanitation, nutrition, population density, and stress reduction.

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Description

Test your knowledge on key aspects of reproductive health in cows, including conditions like endometritis and pyometra. This quiz covers diagnosis, treatment, and management strategies related to uterine health during and after calving.