bovis - Articles
Uterine prolapse
Synonym(s): uterus hypocalcemia hypocalcaemia eversion milk fever
Introduction
- Cause: sporadic but relatively common condition usually seen immediately after calving; concurrent hypocalcemia.
- Signs: uterine tissues protruding from the vulva, usually in a recumbent cow.
- Diagnosis: visual diagnosis by presence of prolapsed uterus.
- Treatment: replacement of the prolapse is possible in most instances.
- Prognosis: studies suggest approximately 80% survival rate after replacement, with good prognosis for return to fertility.
Geographic incidence
- Worldwide.
Breed/Species predisposition
- Dairy cattle over-represented.
Cost considerations
- Replacement is inexpensive and prognosis is favorable, making treatment cost-effective in most instances.
Special risks
Uterine prolapse should be treated as an emergency.- Some cows with uterine prolapse may have ruptured a uterine artery and may exsanguinate internally following replacement of the uterus.
Pathogenesis
Etiology
- Invagination of the tip of a uterine horn from trauma Dystocia, decreased myometrial tone Milk fever, manual extraction of the fetus Calving aids: correct use or a combination of these factors.
- Gravity and/or abdominal straining, combined with myometrial atony, leads to progressive eversion of uterine tissue until the entire uterus is fully everted.
Predisposing factors
General
- Hypocalcemia Milk fever.
- Dystocia Dystocia.
- Manual removal of the calf Calving aids: correct use.
- Trauma during calving.
- Selenium deficiency. Selenium and vitamin E: overview
- Retained fetal membranes. RFM
- Some studies suggest a genetic predisposition.
Pathophysiology
- Hypocalcemia Hypocalcemia or myometrial trauma leads to a decrease in myometrial tone in the peri-parturient period.
- Dystocia, manual extraction of the calf or retained fetal membranes may initiate invagination of a uterine horn.
- Reduced uterine tone combined with invagination of a uterine horn leads to rapidly progressive uterine eversion and prolapse
Timecourse
- Occurs most commonly within 24 h of calving, often as an immediate sequela.
Epidemiology
- Sporadic, but given the link with hypocalcemia may be over-represented in herds with a high incidence of hypocalcemia.
- Reported incidence ranges from 0.002-0.6% of all calvings.
Diagnosis
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Treatment
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Prevention
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Outcomes
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Further Reading
Publications
Refereed Papers
- Recent references from PubMed and VetMedResource.
- Rees G M (2016) Postpartum emergencies in cows. In Pract 38, 23-31 VetMedResource.
- Miesner M D & Anderson D E (2008) Management of uterine and vaginal prolapse in the bovine. Vet Clin Food Anim Pract 24 (2), 409-419 PubMed.
- Murphy A M & Dobson H (2002) Predisposition, subsequent fertility, and mortality of cows with uterine prolapse. Vet Rec 151 (24), 733-735 PubMed.
- Correa M T, Erb H N & Scarlett J M (1992) A nested case-control study of uterine prolapse. Theriogenology 37 (4), 939-945 PubMed.
- Gardner I A, Reynolds J P, Risco C A & Hird D W (1990) Patterns of uterine prolapse in dairy cows and prognosis after treatment. JAVMA 197 (8), 1021-1024 PubMed.
- Jubb T F, Malmo J, Brightling P & Davies G M (1990) Survival and fertility after uterine prolapse in dairy cows. Aust Vet J 67 (1), 22-24 PubMed.
- Plenderleith B (1986) Prolapse of the uterus in the cow. In Pract 8 (1), 14-15 PubMed.
- Risco C A, Reynolds J P & Hird D (1984) Uterine prolapse and hypocalcaemia in dairy cows. JAVMA 185 (12), 1517-1519 PubMed.
- Roine K & Saloniemi H (1978) Incidence of some diseases in connection with parturition in dairy cows. Acta Vet Scand 19 (3), 341-353 PubMed.
- Oedegaard S A (1977) Uterine prolapse in dairy cows. A clinical study with special reference to incidence, recovery and subsequent fertility. Acta Vet Scand Suppl 63, 1-124 PubMed.