Intas Polivet (2014) Vol. 15 (II): 248-249
Short Communication
Clinical Management of Prepartum Uterine Torsion and Cervico-Vaginal Prolapse in a Cow S. K. Sheetal1, Shiv Prasad2 and H. P. Gupta3 Department of Veterinary Gynaecology and Obstetrics College of Veterinary and Animal Sciences Govind Ballabh Pant University of Agriculture and Technology (GBPUAT) Pantnagar - 263145 (Uttarakhand) Abstract A 6 year old crossbreed cow affected with dystocia due to uterine torsion at full term along with cervico-vaginal prolapse and inability to stand was presented for treatment. The cow was pre-treated, leading to uterine adhesion, so it was decided to perform caesarean section and manage dystocia and save fetal life. A male live foetus was removed after caesarean operation and uterus was detorted. To manage cervico-vaginal prolapse, the prolapsed mass was washed with potassium permanganate and pushed inside. Lignocaine jelly and Soframycin ointment were applied locally for five days. The dam started standing from fifth day of treatment and recovered uneventfully. Keywords: Caesarean section; cow; dystocia; prolapse; uterine torsion
vaginal prolapse are important to save life of foetus as well as dam.
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-
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).
1. Ph.D. Scholar and Corresponding author. E-mail:
[email protected] 2. Professor 3. Professor and Head
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Sheetal et al.
Fig. 1: Protruded Cervico-vaginal prolapsed mass
Fig. 2: Vaginal examination to diagnose torsion
Fig. 3: Incision site on uterus
Fig. 4 : Calved calf
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.
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.
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.
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. 9 th ed., W.B. Saunders Company, Philadelphia. p. 236-237, 830.
The dam recovered uneventfully following administration of isotonic saline followed by seven day treatment with antibiotics, i.e Ceftriaxone (Intacefa 3 gm, I/M), Neurobionb fort injection 8ml. I/M, Novizaca injection 25ml. I/M, anti-inflammatory
Sloss, V. and Dufty J. H. (1980). Dystocia. In Handbook of Bovine Obstetrics, Baltimore; London: Williams & Wilkins, p. 108-11.
a - Brand of Intas Animal Health, Ahmedabad b - Brand of Merck Ltd., Mumbai
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