Therapeutic management of hydrallantois--a report of 22 buffaloes.
Abnormal abdominal distention during last trimester is a serious concern in bovines. This may be a consequence of twin pregnancy, edema, ascites, hernia, hypoproteinemia and dropsy of fetal membranes (Govaere et al., 2012). Dropsy of fetal membranes is an uncommon accident during gestation and is life threatening for dam requiring immediate attention. Excessive accumulation of fluid either amniotic or allantoic sac referred as hydramnios or hydrallantois, respectively (Noakes, 2009). Hydrallantois is more common (85-90%) than hydramnios which accounts 5-10 percent of dropsical condition in bovines (Peek, 1997; Roberts, 2004). Hydrallantois usually develops rapidly within 520 days and is characterized as distended uterus with enlarged abdomen. The volume of allantoic fluid varies upto 273 litres and such large amounts impose serious strain and greatly hamper respiration and reduce appetite in animals (Roberts, 2004; Noakes, 2009). Genetic or hereditary conditions resulting in defective formation of fetus often linked with hydramnios (Noakes, 2009) however, cause of hydrallantois is not certain. Structural or functional changes in allantois chorion including its vessels with transudation and collection of fluid may lead to hydrallantoic condition in bovines (Roberts, 2004). The condition can be diagnosed by physical examination (vaginal and/or rectal) and ultrasonogrphy in bovines. Termination of pregnancy is one of the effective treatments for this condition (Govaere et al., 2012). Several protocols have been studied for induction of parturition in bovines with variable results (Shukla et al., 2008). Extensive studies have been conducted in cattle, however literatures for buffaloes are lacking. Therefore, present study was designed with the objectives: (i) to evaluate the effectiveness of two treatment protocols for termination of pregnancy (ii) to evaluate therapeutic management and consequences following calving of dam suffering with hydrallantoic condition.
Materials and Methods
In the present study, 22 pregnant (7-9 months) buffaloes between first and fifth parity with history of excessive enlargement of abdomen within 20 days, inappetance, stiff gait and discomfort were used for therapeutic evaluation. Per-vaginal examination revealed dome shaped uterus due to pressure of excessive fluid within uterus. Moreover, cervix was closed and stretched at one side from its normal position. On rectal examination, uterus felt enlarged with thrilling of fluid, however no fetal parts were palpable. The fremitus was good indicating live fetus. As per history and clinical examination, buffaloes were diagnosed as suffering from dropsy of fetal membranes i.e. hydrallantois. Therefore, it was decided to terminate pregnancy and further, buffaloes were assigned to one of these two following treatment groups.
1. Group D (n = 11): Dexamethasone sodium phosphate, 40mg, i.v.
2. Group DC (n = 11): Dexamethasone sodium phosphate, 40mg, i.v.+ Cloprostenol, 500pg, i.m.
Both treatment protocols for termination of pregnancy were administered only once at time of confirmation of hydrallantois. Until fetal expulsion, all buffaloes daily received hypertonic saline solution (HSS; 3%, Nacl) 4 litres and Dextrose normal saline solution (DNS, 25%) 2 litres intravenously. The animal was provided ad libitum drinking water and jaggery.
Duration between treatments administered and calving was recorded to judge effectiveness of protocol for termination of pregnancy. After buffaloes responded to treatment: dystocia, sex of calf born, livability of calf, and frequency of retained fetal membranes, status of dam (live or dead), post-partum consequences such as metritis were recorded. Student's t-test employed to compare cervical dilatation upto 3 fingers and time taken after treatment to calving between both treatment groups. A correlation coefficient was employed to diagnose relationship between volume of allantoic fluid and initiation of calving. Differences at P-value less than 5% (P < 0.05) were considered to be statistically significant. All statistical analysis were performed using SPSS (16.0) system for windows.
Results and Discussion
Results of clinical trial are depicted on Table 1. In present study, history and clinical symptoms observed in buffalo for diagnosis of hydrallantois are similar with cattle (Drost, 2007).
It is a well established fact that fetal hypothalamus-pituitary-adrenal (HPA) axis is responsible for normal parturition in cattle (Noakes, 2009). By understanding this fact several protocols have been developed to induce parturition in cattle. Either steroids like Dexamethasone (Konigsson et al., 2001) or PGF2[alpha] (McCracken et al., 1999) alone and/or their combination therapy (Kask et al., 2001; Shukla et al., 2008) have been tried to induce parturition in cattle and buffalo. In the present study, the initiation of calving measured in form of cervical dilatation (3 fingers) started between 12 and 29 hrs after commencement of treatments. The buffaloes in treatment group DC had lesser (P < 0.05) time to dilate cervix 3 fingers as compared to D group (Table 1). The overall time duration between treatments administered to calving was 44.32 [+ or -] 1.71 hrs, moreover, group D had more time (P < 0.05) for calving than group DC buffalo (Table 1). Studies have shown that either dexamethasone or PGF2[alpha] and its synthetic analogues alone or a combination of these two drugs would result in termination of pregnancy at any stage of gestation. Combination of these two drugs may be more effective for termination of pregnancy as compared to use of either drug alone (Shukla et al., 2008). By synergistic action of these drugs at two different sites simultaneously, might have taken less time duration between commencement of treatment and calving in DC group as compared to D group. The results are in accordance with previous studies in cattle (Momont, 2005) and buffalo (Shukla et al., 2008). In contrast, Napolean et al. (2012) failed to terminate pregnancy by use of Dexamethasone and PGF2[alpha] combination and could deliver by caesarean section only. Duration between treatment administered and initiation of calving was positively correlated (r = 0.85, P< 0.05) to volume of allantoic fluid in buffalo. The membranes were manually ruptured to drain out allantoic fluid slowly and released about 70-120 litres with an average of 86.23 [+ or -] 3.52 litres (Table 1). In cows, normal volume of allantoic fluid varies between 8 and 15 litres at term however, it may increase 10 times during hydrallantois condition (Drost, 2007). It is suggested that a placental dysfunction is prime cause of hydrallantois, however, few studies described inflammatory changes on placenta (Govaere et al., 2012). Overstretching of uterine musculature leads to uterine inertia following dilatation of cervix in bovines, which results in dystocia (Zaborski et al., 2009). In the present study, assisted delivery was observed in 54.54 percent buffaloes during calving. Manual assistance was applied to 72.72 and 36.36 percent buffaloes on group D and DC, respectively. It was noticed that dystocia was mostly related to delivery of dead (63.63%) and male (63.63%) fetuses (Table 1).
The frequency of dystocia in present investigation was in agreement with studies in cattle (Yildiz, 2009). A study on buffalo has shown that induced parturition > 2 weeks pre-maturely suffered with dystocia, may be due to incomplete uterine maturation coupled with fetal disposition (Shukla et al., 2008). As expected after induced premature calving, fetal membranes were retained in all buffaloes of both treatment groups (Table 1).
Earlier studies have also shown higher incidence of retained fetal membranes in induced parturition with PGF2[alpha] and/or corticosteroids (Konigsson et al., 2001; Shukla et al., 2008) than normal limits (4-18%; Han and Kim, 2005).
Administration of large volumes of intravenous fluids is not an easy task in buffalo as it is expensive and time taking. However, in present investigation, way out to decrease quantity of intravenous fluid administration was possible by providing hypertonic saline solution (HSS; 3%, NaCl) and Dextrose normal saline (DNS, 25%) followed by oral administration of jaggery and plenty of fresh water to increase energy level, restore intravascular volume to maintain an adequate blood pressure and cardiac output so that possibility of hypovolemic shock and dehydration may be decreased in buffalo. Administration of fresh water through oral route and HSS and Dextrose-40 through intravenous route is a quicker, practical, easy and effective method for resuscitating the dystocia affected buffaloes suffering from variable degree of toxaemia and hypovolemia (Kumar et al., 2009).
Of the 22 buffaloes, following delivery of fetus, 10 (45.45%) animals were unable to survive and allantoic fluid was 81.67 [+ or -] 3.1 and 91.70 [+ or -] 6.6 litres (P > 0.05) for animals those were survive and unable to survive, respectively. Hydrallantois treatment always recommends administration of fluid intravenously and termination of pregnancy (Noakes, 2009). If a large volume of allantoic fluid escapes rapidly from uterus may develop circulatory hypovolemic shock (Peiro eta/., 2007), as observed in present study and lead to death of 10 buffaloes. Remaining twelve buffaloes did not suffer with metritis and it was become possible due to administration of broad spectrum antibiotic and supportive therapy following delivery of fetus.
In conclusion, irrespective of cause for dropsy of fetal membranes needs termination of pregnancy as a therapy, so consequences of this condition i.e. prepubic tendon rupture, dyspnoea, rupture of uterus and death of dam etc. may be minimized. The termination of pregnancy can be achieved successfully with use of either alone dexamethasone and/or combination therapy of prostaglandins and Dexamethasone. If, hydrallantois is diagnosed in early stage, enables Veterinarians possible to save the life of dam. To prevent the hypovolemic shock, hypertonic saline solution may be used and post-partum metritis can be avoided by administering broad spectrum antibiotic therapy in buffaloes.
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A.K. Pandey (1), Gayan Singh, Sandeep Kumar, Kailash Kumar and R.A. Luthra
Teaching Veterinary Clinical Complex College of Veterinary Science Lala Lajpat Rai University of Veterinary and Animal Sciences (LUVAS) Hisar--125004 (Haryana)
(1.) Assistant Professor and Corresponding author. E-mail: email@example.com
Table 1: Clinical findings (Mean [+ or -] SE) following different treatment in buffaloes suffered with hydrallantoic condition Sr. No. Parameters Groups D (n=11) 1 Duration between treatment and 21.27 [+ or -] 1.10 * opening of cervix 3 fingers (hrs) (18-29) 2 Duration between treatment and 50.18 [+ or -] 1.50 * calving (hrs) (42.5-59) 3 Occurrence of dystocia (%) 72.72 4 Approximate volume of allantoic 95.18 [+ or -] 4.80 * fluid (litres) (75-120) 5 Live fetus delivered (%) 36.36 6 Sex of fetus born (male/female) 7/4 7 Frequency of Retention of 100 fetal membranes (%) 8 Per cent of dam those were 72.72 live following calving Sr. No. Groups Cumulative result (n=22) DC (n= 11) 1 17.36 [+ or -] 1.00 19.32 [+ or -] 0.83 (12-22) (12-29) 2 38.45 [+ or -] 6.00 44.32 [+ or -] 1.71 (29-48) (29-59) 3 36.36 54.54 4 77.27 [+ or -] 3.64 86.23 [+ or -] 3.52 (70-110) (70-120) 5 36.36 36.36 6 7/4 14/8 7 100 100 8 36.36 54.54 *(P < 0.05) between groups of a parameter
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|Title Annotation:||Clinical Article|
|Author:||Pandey, A.K.; Singh, Gayan; Kumar, Sandeep; Kumar, Kailash; Luthra, R.A.|
|Date:||Jul 1, 2014|
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