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Management of postpartum cervico-uterine prolapse in a cow.

Introduction

Prolapse or eversion of uterus is also called 'casting of wethers' or 'casting of calf bed' and is a common complication of third stage of labour in cow, buffalo, doe and ewe (Roberts, 1986; Joseph et al., 2001; Selvaraju et al., 2004; Sharma and Dhami, 2007). It occurs less frequently in sow and is rare in mare and bitch (Arthur et al., 1996). It is considered as one of the major and commonly encountered reproductive problem occurring in postpartum cows and buffaloes causing great economic loss to farmers (Sloss and Dufty, 1980). Stall-feeding, atony of reproductive tract and weakness of genital organs may predispose the condition. Utero-vaginal prolapse occurs in animals exhibiting persistent straining following calving, prolonged difficult birth or retained placenta. The condition usually occurs immediately or within few hours after delivery of fetus. The affected animal not only produces less milk, but may also lose its future reproductive efficiency or even life, if not attended. It has been estimated that 0.3-0.5% of all calvings terminate in prolapse of uterus (Lukuke and Choudhary, 1965). Genital prolapse is one of the most common mishappening during postpartum period which accounts for about 22% of total reproductive disorders in buffaloes (Pandit et al., 1982). The present report puts on record a case of postpartum complete uterine eversion in a Kankrej cow and its successful clinical management on a farm.

History and Clinical Observations

An 8-years old Kankrej cow in her third parity was attended with complete eversion of whole uterus along with cervix due to severe straining before shedding of placenta. There was no history of prolapse during previous two calvings. The cow had delivered an HF [F.sub.1] crossbred healthy male calf weighing 36 kg with forced traction following rupture of water bags.

The animal when attended was very active, straining severely and in lateral recumbency with a portion of invaginated utero-vaginal mass protruding from vulva. It had normal rectal temperature, but elevated respiratory rate, heart rate and pulse rate. Examination of prolapsed uterus revealed complete cervico-uterine eversion without any laceration or bleeding and oedema, but placenta was still adhered at various placentomes (Fig.1).

Treatment

The animal was sedated by injecting 2.5 ml of Siquil intramuscularly. Then epidural anaesthesia was induced with 8 ml of 2% Lignocaine hydrochloride. The exposed cervix and uterus were adequately washed with clean cold water added with potassium permanganate crystals. The palpation of prolapsed mass revealed an engorged and distended urinary bladder inside. This was evacuated by lifting the prolapsed mass and reducing pressure over urinary meatus. There was complete eversion of uterus through cervix and vagina with fetal membranes still adhered. Attempts made to make the animal stand up were futile, hence it was lifted and placed on ramp available within the calving box, with hind portion elevated. The fetal membranes were easily separated out from caruncles. The prolapsed mass was then thoroughly cleaned with ice water and smeared with Cephalexin powder 40 gm and was gradually pushed inside and placed in normal intra-abdominal position with a well-lubricated hand introduced through cervix and invaginated utero-vaginal mass.

Calcium-magnesium borogluconate 450 ml and Dextrose 25% 500 ml were injected intravenously, and Strepto-penicillin 2.5 gm, Meloxicam (a) 20 ml and Oxytocin 50 IU were administered by i/m route. The animal got up on its four feet, but within next 15 min or so, a strong straining bout resulted in recurrence of complete prolapse and animal again assumed lateral recumbency. Further, Xylazine hydrochloride 1.0 ml was injected i/m to sedate the animal and prevent straining. The prolapse was again replaced systematically and two horizontal mattress sutures were placed on the vulvar lips using file lash dipped in Tr. Iodine to retain prolapsed mass. The animal was put under antibiotic and analgesic coverage parenterally with other supportive treatment of calcium and liver tonics for the next three days. The animal made an uneventful recovery.

Discussion

Post partum utero-vaginal prolapse is an emergency, which needs immediate attention, otherwise mutilation may lead to severe lacerations and profuse bleeding or else interference to blood supply to prolapsed tissue may result in oedema and cyanosis which may eventually result in gangrene of uterus (Arthur et al., 1996; Joseph et al., 2001). Excessive stretching of pelvic ligaments and loosening of vaginal muscles in earlier calving may be probable reason to higher incidence of malady in pluriparous animals. Dystocia and retained placenta were the exciting causes for genesis of postpartum prolapse of genitalia, as 35.68% vaginal and 33.33% uterine prolapses were prelude to the same (Holland and Knox, 1967). Mishra et al. (1997) recorded bladder distension with retention of urine in 55.56% of animals showing uterine prolapse, whereas it was only 15.15% in prepartum vaginal prolapse.

In the present case, complete eversion of uterus and cervix through vagina was suspected to have occurred following delivery of a heavy crossbred [F.sub.1] calf by forced traction leading to irritation and severe straining added with presence of undetached portion of the foetal membrane in vagina. However, Arthur et al. (1996) believed that uterine eversion and prolapse were associated with onset of uterine inertia during third stage of labour, when a portion of detached placenta occupied birth canal and protruded from vulva. Usually the size of utero-vaginal prolapsed mass varies from approximately 10 cm-30 cm in diameter (Sloss and Dufty, 1980), whereas in the present case, it was unusually very large. In general, the prolapsed mass usually involves greatly distended urinary bladder and occasionally rectum or even intestinal mass following uterine rupture (Roberts, 1986). Sharma and Dhami (2007) and Kumar et al. (2011) successfully managed postpartum uterine prolapse in cows. The favourable prognosis in present case could be due to timely management. The result suggested that prompt handling of uterine prolapse could save the animal from unnecessary suffering and fatality. The success in the present case could be the immediate repositioning and timely management made before any damage/mutilation and bleeding or necrosis/gangrene occurred.

References

Arthur, G.H., Noakes, D.E., Peterson, H. and Parkinson, T.J. (1996). Veterinary Reproduction and Obstetrics. 7th edn. W.B. Sounders Company Ltd., London.

Holland, L.A. and Knox, J.H. (1967). Vaginal prolapse in Hereford cows. J. Anim. Sci. 26: 885-88.

Joseph, Cecilia, Kulasekar, K., Balasubramanian, S., Kathiresan, D., Veerapandian, C. and Pattabiraman, S.R. (2001). An unusual complication of postpartum uterine prolapse in a she buffalo--A case report. Indian Vet. J. 78: 57-58.

Kumar Pravesh, Kumar Amit, Barman Purabi, Singh, M. and Ranaut, N. (2011). Postpartum uterine prolapse in a nondescript cow. Indian J. Field Vets. 7: 74-75.

Luktuke, S.N. and Choudhury, G. (1965). Studies on the incidence of physiological and pathological termination of pregnancies in Hariana females. Indian Vet. J. 42: 930-36.

Mishra, U.K., Agrawal, R.G. and Pandit, R.K. (1997). Clinical study on prolapse of genitalia in Murrah buffaloes. Indian J. Anim. Reprod. 18: 124-26.

Pandit, R.K., Gupta, S.K. and Pattabiraman, S.R. (1982). A clinical study of vagina and uterus in buffaloes. Indian Vet. J. 59: 975-80.

Roberts, S.J. (1986). Veterinary Obstetrics and Genital Diseases (Theriogenology). 3rd edn. Ithaca, New York.

Selvaraju, M., Vijayanand, K.T., prathaban, R., Vijay, D. and Jagatheseen, R.P.N. (2004). Postpartum uterine prolapsed in a goat. India J. Anim. Reprod. 25: 74-75.

Sharma, S. and Dhami, A.J. (2007). Management of postpartum uterine prolapse in a cow. Indian J. Field Vets. 3: 14-15.

Sloss, V. and Dufty, J.H. (1980). Hand Book of Bovine Obstetrics. Williams and Wilkins, Baltimore, London.

M.A. Dhami (1), A.J. Dhami (2) and B.C. Parmar (3)

Department of Animal Reproduction Gynaecology and Obstetrics College of Veterinary Science and Animal Husbandry Anand Agricultural University (AAU) Anand--388001 (Gujarat)

(1.) Asstt. Research Scientist, Amul Research and Development Association, Anand

(2.) Professor and Head and Corresponding author. E-mail: ajdhami@aau.in

(3.) Associate Professor, Livestock Research Station, AAU, Anand

(a)--Brand of Intas Animal Health, Ahmedabad
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Title Annotation:Short Communication
Author:Dhami, M.A.; Dhami, A.J.; Parmar, B.C.
Publication:Intas Polivet
Article Type:Report
Geographic Code:9INDI
Date:Jul 1, 2014
Words:1329
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