Pyometra in cow

Definition
Epidemiology
Predisposing factors
Etiology
Pathology
Classifications
Symptoms
Diagnosis
Treatment
Prescription writing
Prevention
References

1. Pyometra in cow Prepared by Aynul Ha que Faculty of veterinary Science Bangladesh Agricultural University, Mymensingh

2. Outlines Definition Epidemiology Predisposing factors Etiology Pathology Classifications Symptoms Diagnosis Treatment Prescription writing Prevention References

3. Definition Pyometra is defined as an accumulation of pus in the uterus It is a chronic inflammatory process of endometrium with large amount of purulent and mucopurulent exudates in the uterus

4. Epidemiology Occur in bitches, queens , rabbits, hamsters, ferrets, rats, guinea pigs, cows and mares Rarely in ewes and sows Pyometra is common in cow and bitch More common in old cows than young ones Most often during early post partum period (15 – 60 days post-partum )

5. Predisposing factors Bovine pyometra is usually sequel or after-effect of abnormal parturition like ….. Abortion, pre-mature birth, twin births, dystocia, Retained placenta, septic metritis or postpartum metritis Under such conditions, the chances of invasion and multiplication of large numbers of pathogenic bacteria get increased inside the uterus

6. Etiology Infectious causes Trichomonas foetus Streptococcus sp Stapylococcus sp Corynebacterium sp Fusobacterium necroforum Cmpylobacter sp Bacteroides sp Others Unhygienic condition Retained placenta Dystocia Prolapse of uterus Prolups of vagina

7. Pathogenesis During the puerperal period Mixed populations of bacteria in the uterus. Their numbers remain increased for several days In the intermediate period ( up to the First postpartum ovulation), pathogenic bacteria are eliminated from the uterus of normal cows If conditions are favourable , C. pyogenes , Fusobacterium necrophorum and Bacteroides spp. get established.

8. Cause endometritis or metritis and are usually a signal for pyometra Chronic inflamed endometrium does not form PGF2u. Persistant of CL Secretion of progesterone Cervix remains closed Favours the growth of micro-organisms Stimulate exudation of a large number of leucocytes resulting in pus formation

9. In case of Trichomonas foetus It colonizes in the uterus. This particular protozoan species does not prevent fertilization but causes embryonic death at an early stage of gestation, sometimes embryonic death is followed by development of pyometra and persistence of corpus luteum .

10. Classifications 1. Open pyometra If the cervix is open, the infected material can leave the body. This is called open pyometra . It is more easier and safer to treat 2. Closed pyometra Here the cervix is fully closed, there is no discharge from the vulva.it is called closed pyometra . The uterus may rupture and pus escapes into the abdomen, causing peritonitis and possible rapid death

11. Figure: Open pyometra Figure: Close d pyometra

12. Symptoms There is permanent or intermittent discharge of purulent or mucopurulent exudates Sometimes cervix may closed and no discharge at all In cows , cyclic activity may present in irregular interval and corpus luteum persist for longer time. But in mare cyclicity remain normal On rectal palpation uterus may feel like 2-3 months of pregnancy. The uterine wall feels thick, no fetal membrane Presence of dullness Decre a s e milk production

13. Diagnosis History: It includes Age of the animal Date of insemination Come in heat after 21, 40 days of insemination Abnormal cyclicity Clinical findings: It includes Purulent or mucopurulent discharge from the vagina Large abdomen D ullness, anorexia Decressed milk production

14. Physical examination: On rectal palpation _ The cervix may remain close or open Uterus feel like 2-3 months of pregnan c y Corpus luteum persists Uterine wall feels thicker No uterine caruncles and fremitus present There is not possible to slip alantochorion fetal membrane On pressure on the uterus the pus come out through the vagina

15. Diagnosis can sometimes be difficult, particularly in the closed-cervix form of pyometra where no pus is seen Blood and urine tests may be ordered to help with the diagnosis By Radiographs (X-rays) or ultrasound examination 

16. Pyometra Pregnancy On rectal palpation uterine wall feels thicker than pregnancy On rectal palpation uterine wall feels thinner Uterus is more doughy Uterus feels like a thick rubber ballon It is not possible to slip allantochorion membrane It is possible to slip allantochorion fetal membrane Fremitus absent Fremitus present Uterine caruncle absent Uterine caruncles present Differential diagnosis between pyometra and pregnancy

17. Figure: Pyometra in cow Fig.: Ultrasonograph of pyometra

18. Treatment 1. Hormonal therapy (a) Oestrogen and Oxytocin therapy: Oestradiol valerate 3-10 mg. intramuscularly followed by Oxytocin 20 IU - 40 IU 24 hours later to sensitize the myometrium and dilate the cervix Within 24 to 72 hours, most or all of the pus is usually expelled

19. (b) Oestrogen and glucocorticoid therapy: The use of oestradiol valerate (10 mg or 1 ml. I/M) followed by dexamethasone (5 ml. I/M) have good result where oestrogen alone has failed (c) PGF 2a analogues: The best treatment is the use of PGF 2a analogues like Dinoprost trometamol @ 20-25mg [ Lutalyse (5 ml I/M), Dinoprost (2 ml I/M)], Cloprostenol sodium @ 500µg [ Ovuprost ]. These cause regression of the corpus luteum , dilatation of the cervix and expulsion of pus within 5-7 days

20. 2. Antimicrobial therapy Parenteral antibiotics should be administered during the hormonal treatment because it prevents spread of infection to the oviducts due to contraction of uterus If an antibacterial drug is to be infused into the uterine lumen after expulsion of pus, penicillin(10-40 lakh IU) for 3-5 days C. pyogenes and Gram-negative anaerobes remain in the uterus of most of the cows with metritis or pyometra . These bacteria are usually sensitive to intrauterine infusion of penicillin

21. Other antibacterials such as tetracyclines or ampicillin are also useful Prognosis: The cases that have existed only for 60 to 120 days, recover and conceive m ore likely than the cases that have existed for 120 days or longer. In long standing cases the endometrium gets destroyed, the uterine wall undergoes fibrotic changes resulting in permanent sterility

22. 3. Surgical treatment Spaying ( ovariohysterectomy ) completely and promptly removes the infection, prevents uterine rupture and peritonitis, and of course prevents recurrence Spayed animals do very rarely develop pyometra O variohysterectomy is currently considered the most effective and safest treatment

23. Figure: Uterus during surgery Figure: Surgical removed uterus

24. Post operative care Antibiotic therapy Encourage eating and drinking Check incision for signs of infection Administered intravanous fluid if necessary

25. Doctor’s name : Dr. Aynul Hoque Date - 21.03.2017 Address : Sesh mor , Mymensingh Owner’s name : Mintu ; Address : Sesh mor , Mymensingh Patient’s identity- Species : Bovine Sex : Female Age: 3 years Weight: 200k g Symptoms- Mucopurulent discharge from the vagina The uterine wall feels thick, no fetal membrane R x Inj. Prostinol -2ml vial x 1 Sig. Inject 2 ml IM at a time Wash the uterus with nolmal saline Inj.Combipen vet-40 lac vial x 10 Sig: Infuse 20 ml IU daily for five days after washing aynulhoque 21.03.2017 Advice: Come again after 6 days . Prescription writing

26. Prevention Good sanitation and controlled breeding program Virgin heifers should be mated only to young bulls which have not previously been exposed to trichomoniasis Through physical examination before breeding Infected bulls should be removed from the herd AI by trained technician and should be free from contamination

27. References Applied Veterinary Gynaecoloy and Obstetrics by Dr. Pradeep Kumar, M.V.Sc ., Ph.D. (pursuing) Arthur's veterinary reproduction and obstetrics www.merckvetmanual.com/ https://en.wikipedia.org/wiki/ veterinarymedicine.dvm360.com Veterinary Obstetrics and Genital diseasses ( Theriogenology )1986 by S.J. Roberts