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Clinical management of prepartum uterine torsion and cervico-vaginal prolapse in a cow.

Introduction

Uterine torsion is defined as rotation or twisting of uterus on its long axis. It is commonly observed in buffaloes, dairy cows and occasionally in beef cows. Torsions are more commonly seen amongst cows than heifers. Cows are thought to be more prone to develop uterine torsion than other domestic animals due to uterine instability resulting from broad ligament attachments (Sloss and Dufty, 1980). The broad ligament supports uterus dorso-laterally, but attaches to ventral lesser curvature. As pregnancy advances, broad ligaments do not extend proportionately with the gravid horn, leading to instability (Frazer et al., 1996; Drost, 2007). During last few months of gestation, 90-1800 torsion occurs and becomes evident at time of parturition while more than 1800 uterine torsion is a severe condition often associated with obstruction of blood supply to uterus leading to fetal death (Noakes et al., 2009). Genital prolapse is a major but not very common reproductive disorder in cattle (Ahmed et al., 2005). It is regarded as an emergency condition and should be managed before excessive edema, mucosal trauma, conta-mination and fatal hemorrhage that lead to a grave prognosis (Miesner and Anderson, 2008). Therefore, timely management of uterine torsion and cervico vaginal prolapse are important to save life of foetus as well as dam.

History and Observations

A six year old crossbred dairy cow in its third parity carrying full term foetus reported for treatment. The dam had a history of abdominal pain, restlessness, anorexia, lack of rumination, inability to stand since 10 days. The cow had also pre-partum cervico-vaginal prolapse (Fig. 1) since one week. Clinical examination revealed rectal temperature and respiration rates were slightly elevated. The cow was dull, depressed and slightly dehydrated. Per-vaginal examination confirmed right side pre-cervical uterine torsion (Fig. 2). The vulva was oedematous and vaginal mucus membrane was congested. Previous treatment was attempted by Veterinarian but unable to resolve the problem.

Treatment and Discussion

The case was pre-treated, but condition lead to adhesion of uterus, so it was decided to perform caesarean section (Fig. 3) to manage dystocia and save life of foetus. Local infiltration (inverted L field block) of anaesthetic (2% Lignocaine hydrochloride) in left flank region was used. An 18 cm. long oblique incision was given in left flank region. First of all, rumen was exteriorized and pushed with pressure. Then uterus was explored and incision was given at gravid horn over greater curvature saving caruncles. A live male foetus was removed by applying traction (Fig. 4).

After removal of foetus uterus was flushed thoroughly with Normal saline and Metronidazole solutions. A double row of Lembert's suture was applied using chromic catgut No. 2 to suture uterine incision. After uterine suturing, uterus was detorted and muscles and peritoneum were sutured by simple continuous suture with help of silk thread. Skin incision was closed by horizontal mattress suture by using silk thread. Regular dressing of skin incision was made by applying Povidone iodine ointment locally and spraying of fly repellent.

To manage cervico-vaginal prolapse the prolapsed mass was washed with dilute potassium permanganate solution and pushed inside. Lignocaine gelly and Soframycin ointment were mixed in proper ratio and applied locally for five days.

The dam recovered uneventfully following administration of isotonic saline followed by seven day treatment with antibiotics, i.e Ceftriaxone (Intacef (a) 3 gm, I/M), Neurobion (b) fort injection 8ml. I/M, Novizac (a) injection 25ml. I/M, anti-inflammatory and analgesic (Melonexa plus 15ml., I/M daily) and anti-histaminic (Anistamina inj. 10ml., I/M daily). The dam started standing from fifth day of treatment following caesarean section.

References

Ahmad, S., Ahmad, I, Lodhi, L. A., Ahmad, N. And Samad H. A. (2005). Clinical, haematological and serum macro mineral contents in buffaloes with genital prolapse. Pakistan Vet. J. 25: 167-70.

Drost, M. (2007). Complications during gestation in the cow. Theriogenology 68:487-91.

Frazer, G.S., Perkins, N.R. and Constable, P.D. (1996). Bovine uterine torsion: 164 hospital referral cases. Theriogenology 46: 739-58.

Miesner, M. D. and Anderson D. E. (2008). Management of uterine and vaginal prolapse in the bovine. Vet. Clin. Food Anim. 24: 409-19.

Noakes, D.E. et al. (2009). Veterinary Reproduction and Obstetrics. 9th ed., W.B. Saunders Company, Philadelphia. p. 236-237, 830.

Sloss, V. and Dufty J. H. (1980). Dystocia. In Handbook of Bovine Obstetrics, Baltimore; London: Williams & Wilkins, p. 108-11.

S. K. Sheetal (1), Shiv Prasad (2) and H. P. Gupta (3)

Department of Veterinary Gynaecology and Obstetrics College of Veterinary and Animal Sciences Govind Ballabh Pant University of Agriculture and Technology (GBPUAT) Pantnagar--263145 (Uttarakhand)

(1.) Ph.D. Scholar and Corresponding author. E-mail: sksheetalmuz@gmail.com

(2.) Professor

(3.) Professor and Head

(a)--Brand of Intas Animal Health, Ahmedabad

(b)--Brand of Merck Ltd., Mumbai
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Title Annotation:Short Communication
Author:Sheetal, S.K.; Prasad, Shiv; Gupta, H.P.
Publication:Intas Polivet
Article Type:Report
Geographic Code:9INDI
Date:Jul 1, 2014
Words:785
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