Surgical repair of third-degree perineal lacerations with rectovestibular fistulae in dairy cattle: a series of four cases (2010-2018).

We describe the successful surgical repair of third-degree perineal lacerations with rectovestibular fistulae in four cases using the single-stage modified Aanes method with purse-string suture of the vaginal vestibule and rectum. Fistulae formation and dehiscence of the repair were not observed after surgery. Two cows had five calves and one cow had four calves after surgery. The pregnant cows delivered normally. Additionally, there was no dehiscence of the suture line during the subsequent parturition. The breeding and fertility results obtained after the surgery are presented. According to the results of the present study, the modified Aanes method for the repair of third-degree perineal lacerations with rectovestibular fistulae appears to have a good prognosis for fertility following surgery in cows.

COMPLICATIONS ASSOCIATED WITH PREGNANCY AND PARTURITION IN AFRICAN WHITE-BELLIED PANGOLINS (PHATAGINUS TRICUSPIS).

There are no studies to date on the normal reproductive physiology of African white-bellied pangolins (Phataginus tricuspis). As a reclusive species, little is known about normal gestation, successful parturition, and potential complications during pregnancy. Ten female P. tricuspis were diagnosed as pregnant and monitored under professional care. Five developed complications during pregnancies or during parturition and are detailed in this case series. Dystocia occurred in two dams each, with malposition of a singleton fetus. Both dams were successfully treated with surgical intervention by caesarian section. Of the two individuals, one fetus was nonviable, but the other neonate survived and was reared by the dam to weaning. A third pregnant female died during pregnancy from septicemia resulting in death of the preterm fetus. The two additional dams of the five gave birth to full-term neonates. One fetus was stillborn with evidence of fetal distress, and the other died immediately after birth (perinatal death) with undetermined etiology. Based on this case series, complications associated with pregnancy occur in P. tricuspis, indicating the need for further study and close monitoring during impending parturition.

Hand-assisted laparoscopic repair of a grade IV rectal tear in a postparturient mare.

CASE DESCRIPTION: An 8-year-old multiparous Thoroughbred broodmare was admitted for evaluation of a rectal tear sustained during parturition. CLINICAL FINDINGS: On initial evaluation, the mare had mild signs of abdominal discomfort. A full-thickness rectal tear located 30 cm cranial to the anus and extending approximately 15 cm longitudinally along the surface of the small colon between the 4 and 6 o'clock positions, when viewed from behind, was diagnosed on examination per rectum. TREATMENT AND OUTCOME: Laparoscopic evaluation of the abdomen was performed to assess the tear and extent of peritoneal contamination. A hand-assisted repair via a flank incision was performed. The tear was closed in a single-layer, simple continuous pattern with size-0 polydioxanone with a handheld needle holder. Subsequently, a ventral midline celiotomy was performed, and intestinal contents were evacuated via a pelvic flexure enterotomy and a typhlotomy. Following surgery, the mare was managed with IV fluid therapy, partial parenteral nutrition, antimicrobials, and NSAIDs for 5 to 7 days before being gradually reintroduced to a complete pelleted feed and alfalfa hay. Prior to discharge, examination per rectum revealed no stricture formation associated with repair. The mare was discharged from the hospital and performed successfully as a broodmare, with the delivery of a live foal 1 year after surgery. CLINICAL RELEVANCE: Successful repair with an excellent outcome was achieved in this mare. Hand-assisted laparoscopic repair should be considered as a possible treatment option in horses with grade IV rectal tears.

Perioperative risk factors for mortality and length of hospitalization in mares with dystocia undergoing general anesthesia: a retrospective study.

This study investigated associations between perioperative factors and probability of death and length of hospitalization of mares with dystocia that survived following general anesthesia. Demographics and perioperative characteristics from 65 mares were reviewed retrospectively and used in a risk factor analysis. Mortality rate was 21.5% during the first 24 h post-anesthesia. The mean ± standard deviation number of days of hospitalization of surviving mares was 6.3 ± 5.4 d. Several factors were found in the univariable analysis to be significantly associated (P < 0.1) with increased probability of perianesthetic death, including: low preoperative total protein, high temperature and severe dehydration on presentation, prolonged dystocia, intraoperative hypotension, and drugs used during recovery. Type of delivery and day of the week the surgery was performed were significantly associated with length of hospitalization in the multivariable mixed effects model. The study identified some risk factors that may allow clinicians to better estimate the probability of mortality and morbidity in these mares.

Peripartal hormonal changes in Alpine goats: a comparison between physiological and pathological parturition.

In this study, 31 pregnant Alpine does were used to investigate the peripartal plasma profiles of progesterone, estradiol-17ß, 15-ketodihydro-PGF(2α) and cortisol, assessing differences between goats with physiological and pathological parturition. The goats were observed around the time of parturition; all peripartum abnormalities were recorded, and veterinary assistance was provided if necessary. Blood samples were collected every 12 h from 7 days before to 7 days after delivery, and plasma used for hormonal analysis by radioimmunoassay. Two animals died during the study, and their data were excluded from the study. Of the remaining 29 animals, 23 goats had a spontaneous and physiological delivery, while six goats showed pathological parturition, including dystocia and retained placenta. The 65 alive kids were viable at birth and at 7 days of age. The results concerning the hormonal concentrations in the normal parturition confirm and define more precisely the patterns already described in the goat, while the comparison between physiological and pathological parturition has never been previously reported in this species. Highest peripartum levels of cortisol were found in the pathological group at delivery (30.6 vs 15.9 ng/ml) (p<0.01) and 12 h later (26.2 vs 11.1 ng/ml) (p<0.05); the greater cortisol concentrations found in goats with dystocia and retained placenta could suggest a higher level of stress. No significant differences between the two groups were found with respect to the circulating values of the other hormones, but the individual variability and the small number of goats enrolled in the pathological delivery group could have masked possible differences.

Calving difficulty in dairy cows has a longer effect on saleable milk yield than on estimated milk production.

A difficult calving affects the welfare of the cow and has economic implications for the farm. The degree of calving difficulty can vary from no assistance needed through a slight pull required to surgery being needed. With respect to milk production, it is not clear at which degree of calving difficulty adverse effects occur or for how long they last. Studies usually only consider the milk produced by animals who completed full lactations but the saleable milk production of the whole herd, regardless of each cow having achieved a full lactation, might be a better indicator of the productivity of the cows and the underlying stresses they experience, as well as being more representative of the real losses that producers incur. The objective of this study was to investigate how various degrees of calving difficulty would alter both the cow's milk production and their production of saleable milk over different stages of their subsequent lactation. The calving difficulty scores and the subsequent milk production were retrieved from an experimental dairy farm (in the United Kingdom) for 2 herds that contained 2,430 and 1,413 lactations. To account for milk saleable by the farmer, individual cumulative saleable milk yields, referred to as saleable milk yields (SMY), were calculated at 30, 60, 90, and 300 d in milk unconditional on the animal having achieved the lactation stage of interest. Lactation SMY were obtained based on the real lactation length achieved by the animal. Mean daily milk yields were also calculated for the same lactation stages as an estimate of the cow's milk production (CMP). Calving difficulty impaired milk production of dairy cows in terms of CMP and SMY in both herds, highlighting impaired income for dairy producers as well as detrimental effects to the productivity of the cows and potentially impaired health and survival. The management of the herd affected the presence of an effect of each degree of difficulty on SMY and CMP as well as its magnitude and duration. The analysis of SMY, independently of each animal having achieved a full lactation, could be a more sensitive indicator of the subsequent long-lasting biological stresses than CMP alone.

Vaginal rupture and evisceration in a dog.

A 1.5-year-old German Shepherd mixed breed dog was admitted with mild haemorrhage from the vulva and a perineal mass of 24-hour duration, which had been first observed immediately after parturition. Parturition had occurred at low ambient temperature, and only one puppy survived out of the seven oversized fetuses. The dog was in poor body condition, dehydrated, hypothermic, depressed, non-ambulatory and in a state of shock. Intestinal loops, the urinary bladder and the uterine horns and body were protruding from the vulva. A true vaginal prolapse was also observed. The abdominal viscera were flushed with warm sterile saline solution, protected and maintained wet. The laboratory findings included moderate anaemia, leukocytosis, hypoalbuminaemia, azotaemia and elevated liver enzyme activities. Stabilisation of the dog's general condition was attempted before surgery. Antimicrobial and analgesic drugs were also administered. After exploratory laparotomy the protruding organs, which were in good condition, were reduced. A recent rupture in the vaginal wall, approximately 6 cm long, was observed. Ovariohysterectomy and partial vaginectomy were performed. The preoperative course of therapy was continued, but the bitch died 12 hours later. The probable cause of vaginal rupture and evisceration in this bitch was tenesmus and/or trauma due to the oversized fetuses.

Use of Luprostiol and Cloprostenol for induction of parturition in pregnant goats.

Pregnant goats were induced to parturition on day 145 of pregnancy, with three different protocols: group Cl (n = 19) was injected intramuscularly (IM) with 75 microg of the prostaglandin analogue R-Cloprostenol; group L (n = 20) was treated IM with 7.5 mg of the prostaglandin analogue Luprostiol; group L(50) (n = 18) was injected IM with 3.75 mg of Luprostiol (IM); in addition, Group S (Control, n = 15) was injected IM with 1 ml of saline solution. Thereafter, goats were continuously observed to record the following parameters: parturition, dystocia incidence, placental delivery and kid and maternal survival. Moreover, blood sampling was performed around kidding and plasma progesterone concentrations were analyzed. The interval from injection to parturition (mean +/- SEM) was not significantly different among the experimental groups: 35.1 +/- 1.5 h, 33.3 +/- 0.9 h and 34.1 +/- 1.8 h (groups Cl, L and L(50), respectively). In the control group, time to parturition was 99.4 +/- 12.1 h (range: 34-166 h). All the goats expelled the foetal membranes within the first 2 h after the induction. The incidence of dystocia due to foetal posture was not significantly different between induced and control goats (21.1%, 20.0%, 22.0% and 20%, for groups Cl, L, L(50) and S, respectively). The percentage of live kids was practically similar between induced goats (93.9%, 94.9% and 92.1%, for groups Cl, L and L(50), respectively); in addition, there was a case of maternal mortality in control group (6.7%; 1/15), whereas there was no mortality in induced goats (0%; 0/57). Plasma concentrations of progesterone showed an intense drop (<2 ng/ml) at 24 h after induction. This study confirms the effectiveness of the luprostiol to induce the parturition in goats, within a narrow range (30-40 h) in most of the induced females (80.0%, 7.5 mg; 77.8%, 3.75 mg).

Large hydatidiform mole: an unusual finding in a calving cow.

CASE HISTORY: A 4-year-old Friesian cow was reported to be having difficulty calving. Palpation by farm staff identified a large mass in the uterus, but no calf. CLINICAL FINDINGS: Veterinary examination per vaginam identified a small calf and a large immobile mass. The calf was delivered by Caesarean section, but the mass could not be extracted during surgery. Biopsying the mass resulted in the loss of a large amount of fluid from it, but it remained immovable; overnight, the mass was expelled per vaginam. Gross and histological examination of the mass showed it to comprise multiple oedematous chorionic villi, prominent stratified trophoblast, undifferentiated sub-trophoblastic mesenchymal tissue that contained adipose tissue, blood vessels and bizarre striated muscle fibres, as well as irregular cisterns in the centre. No recognisable embryonic or fetal tissue was found. DIAGNOSIS: Based on the gross and histological appearance it was concluded the mass was a complete hydatidiform mole. CLINICAL RELEVANCE: This is a rare, poorly understood condition of cattle. This is believed to be the first report in a cow in New Zealand.

Effect of calcium-energy supplements on calving-related disorders, fertility and milk yield during the transition period in cows fed anionic diets.

The objective of this study was to determine the effect of a calcium-energy supplement at calving on the incidence of calving-related disorders (CRD), fertility, BCS and milk yield in cows fed anionic diets and to establish any associations among outcome variables. In Florida, from October to December 1997, 479 cows were assigned to three groups and treated at calving as follows: Group 1: 160 nontreated cows; Group 2: 158 cows, treated orally with 60g Ca as CaCl2; Group 3: 161 cows, treated orally with 110g Ca as calcium propionate (510g) plus propylene glycol (400g). No treatment effect was detected for any of the outcome variables. An association was found between dystocia and age and retained fetal membranes (RFM). Age and RFM were associated with metritis. RFM and displacement of the abomasum were associated with ketosis. Ketosis and age were related to displacement of the abomasum. Parity, BCS, ovarian cysts, RFM and metritis were associated with fertility.

Repair of urinary bladder rupture through a urethrotomy and urethral sphincterotomy in four postpartum mares.

OBJECTIVE: To report the clinical findings, surgical technique, and outcome after repair of urinary bladder rupture through a urethral incision in postpartum mares. STUDY DESIGN: Retrospective study. ANIMALS: Four Thoroughbred broodmares. METHODS: Medical records were reviewed for clinical signs, surgical technique, medical therapy, and outcome. The bladder was everted into the vagina through a urethral incision that included a sphincterotomy. The bladder defect was repaired with absorbable suture material in a single-layer, full thickness, simple, continuous pattern. The urethral incision was closed similarly. RESULTS: Depression, inappetence, signs of shock, dehydration, azotemia, and serum electrolyte abnormalities were consistent findings that increased temporally after bladder rupture. Each bladder defect was repaired successfully, and metabolic derangements were corrected with supportive medical therapy. All mares survived, conceived, and had more foals without further complications CONCLUSION AND CLINICAL RELEVANCE: Bladder rupture associated with parturition in mares can be repaired in a standing position by eversion of the bladder through a urethrotomy and urethral sphincterotomy.

Immunohistochemical assessment of progesterone, oestrogen and glucocorticoid receptors in bovine placentomes during pregnancy, induced parturition, and after birth with or without retention of fetal membranes.

Steroid hormones play an important role in placental development. However, the exact cellular site of hormone action has not been evaluated in bovine placentomes. Thus, the present immunohistochemical study was designed to assess the distribution of progesterone receptors, oestrogen receptors and glucocorticoid receptors in bovine placentomes. Tissue specimens were obtained from cows at slaughter and from cattle during pre-term Caesarean section 27 h after prostaglandin administration, immediately after spontaneous parturition and from cattle that had retained the fetal membranes. Specific antibodies were used for receptor demonstration in tissue sections. Progesterone receptors were only detected in maternal connective tissue cells, whereas oestrogen receptors were also present in maternal crypt epithelium. At specific sites, both receptor immunoreactivities remained constant or changed significantly during pregnancy, were generally higher during Caesarean section and decreased post partum, but were less pronounced in cattle that released the fetal membranes than in those that retained the fetal membranes. Glucocorticoid receptors were evident in fetal connective tissue cells as well as in fetal and maternal blood vessels. Maternal crypt epithelial cells showed increasing immunoreactivities for glucocorticoid receptors during pregnancy. Receptor immunoreactivities tended to be lower after spontaneous parturition than during Caesarean section; these results were significant for progesterone and oestrogen receptors in animals that released the fetal membranes but not for those that retained the fetal membranes. The results indicate that in bovine placentome steroid hormone receptors are distributed in patterns that are specific to the type of cell, the stage of pregnancy and the tissue location, implying highly specific modulation of placental metabolism. Retention of the fetal membranes is reflected by altered placental receptor states at parturition.

Caesarean section and other methods for assisted delivery: comparison of effects on mare mortality and complications.

Data from 116 mares that had caesarean section or vaginal delivery at 2 university hospitals were analysed in 5 groups, as follows: dystocia corrected by caesarean section, Group DCS (n = 48); elective caesarean section, Group ECS (n = 10); caesarean section concurrently with colic surgery, Group CCS (n = 8); assisted vaginal delivery, Group AVD (n = 22); and controlled vaginal delivery under general anaesthesia, Group CVD (n = 28). Survival rate in all mares that had caesarean section, excluding Group CCS, was 88% (51/58). All mares in Group ECS survived and Group CCS had the lowest survival rate (38%). In 98 mares with dystocia, Groups DCS (15%) and AVD (14%) had significantly lower (P<0.05) mortality rates than Group CVD (29%). There were no differences between groups for duration of dystocia. The placenta was retained in 75 (65%) of 116 mares, and for a longer period following elective caesarean section than following assisted vaginal delivery. Multiple complications (> or = 3) were recorded in 6 mares in Group CVD but not in the other groups. Of the 102 foals delivered from 98 mares with dystocia, 11 (11%) were alive at delivery and 5 (5%) survived to discharge. Survival rate for foals was 38% in Group CCS, and 90% in Group ECS. Under conditions similar to those in this study, it is calculated that caesarean section is preferable to CVD if dystocia is protracted and great difficulty and trauma is involved, even if CVD allows delivery of the foal.

Standing surgical repair of cystorrhexis in two mares.

Two surgical techniques were used to evert the bladder into the vagina for observation and repair of bladder tears that were associated with parturition. One technique involved an incision through the vaginal floor into the peritoneal cavity just caudal to the cervix, and prolapse of the bladder into the vagina. The second technique involved a 3-cm incision through the urethra, 5 cm cranial to the urethral orifice, and digital exploration of the tear and finger traction to evert the bladder through the urethral incision. In both mares, the bladder defects were repaired in two layers, with use of 2-0 polyglycolic acid in a simple continuous pattern. After repositioning, the vaginal and urethral incisions were closed in single layers using absorbable suture material. A standing vaginal approach eliminates the need for general anesthesia and allows excellent observation and repair of bladder tears in adult mares.

Diseases and surgery of the small colon.

Diseases of the small colon are numerous and they can affect horses of any age. Diseases can be simple obstructions, nonstrangulating obstructions, strangulating obstructions, and congenital defects. American Miniature Horses appear prone to luminal obstruction with impacted intestinal contents, and some ischemic diseases are more common in postpartum mares. Enterotomy and enterectomy have a high success rate in the small colon, provided the affected portion can be exteriorized. The beginning and terminal portions of the small colon can be involved in many diseases and are not readily accessible from standard abdominal approaches. The prognosis is generally more favorable than has been proposed.

Treatment of bovine retained placenta and its effects.

The literature on the treatment of retained placenta and its effects is reviewed. Manual removal, the oldest and commonest method of treatment, benefits parlour hygiene but may adversely affect the cow. The use of collagenase may allow manual removal without such side effects. Ecbolic drugs are often ineffective, both as prophylaxis and treatment for the condition. They are most effective within one hour of parturition, particularly after a caesarean section in which tocolytic drugs have been used. Endometritis is a very common sequel to retained placenta. Antibiotics and oestrogens have been used to treat, control or prevent the condition, but they are not routinely effective and may have deleterious side effects. Gonadotrophin releasing hormone and/or prostaglandins have been used to reduce the deleterious effect of retained placenta on fertility, but the results obtained have been inconsistent.

Effect of hormonal treatment on fertility in dairy cows with dystocia or retained fetal membranes at parturition.

Holstein cows (n = 445) that had experienced dystocia, retained fetal membrane, or both at parturition were used to determine the effects of GnRH, PGF2 alpha, or both on various reproductive measurements. Cows affected with these conditions were assigned randomly to each of four treatment groups. One group of cows was untreated, and three groups received GnRH once at 12 d postpartum, or GnRH at 12 plus PGF2 alpha at 26 d postpartum, or PGF2 alpha given at 12 and 26 d postpartum. Another group of 191 cows that calved normally were untreated. Conception rate after first AI was higher for cows treated with PGF2 alpha at 12 and 26 d postpartum. Cows affected with dystocia, retained fetal membranes, or both and treated early postparum with GnRH alone or followed 14 d later with PGF2 alpha did not have improved reproductive performance. Cows calving during the summer months of June through September experienced a reduction in the reproductive traits examined.

Control of in vitro prostaglandin F2 alpha and E2 synthesis by caruncular and allantochorionic tissues from cows that calved normally and those with retained fetal membranes.

High concentrations of PGF2 alpha and PGE2 are produced by the uterus during the early postpartum period in cows and may play an important role in both placental separation and uterine involution. In the present study, we have examined the hormonal and intracellular control mechanisms involved in PGF2 alpha and PGE2 secretion by caruncular and allantochorionic tissue in vitro. Tissue explants, obtained about 6 hr postpartum from cows that delivered normally (NFM, n = 10) or cows with retained fetal membranes (RFM, n = 4), were incubated for 6 hr and PGF2 alpha and PGE2 concentrations in the medium were determined by radioimmunoassay. Addition of oxytocin (100 microU/ml), platelet activating factor (PAF, 100 ng/ml) and epidermal growth factor (EGF, 100 ng/ml) had no effect on secretion of PGF2 alpha from the caruncle, but oxytocin and PAF did stimulate PGE2. There was no difference between groups of cows. All three substances stimulated PGF2 alpha from the allantochorion of NFM, but not RFM, cows and stimulated PGE2 secretion from the allantochorion of both groups of cows. Incubation of the tissues with cholera toxin (100 ng/ml), dibutyryl cyclic adenosine 3',5'-monophosphate (dibutyryl cAMP, 1 mM), calcium ionophore A23187 (5 microM) or phorbol ester 12-myristate-13 acetate (PMA, 100 nM) showed that PGF2 alpha secretion is essentially via the calcium-protein kinase C effector pathway. However, calcium-protein kinase C and cAMP second messenger systems appear to be involved in the secretion of PGE2. Prostaglandin secretion was sensitive to cycloheximide in both caruncular and allantochorionic tissues, suggesting that protein synthesis may be involved. In conclusion, these data show that in vitro PGF2 alpha secretion can be modulated by the agonists used only in allantochorion and is essentially via the calcium-protein kinase C effector pathway. PGE2 secretion can be modified in both caruncular and allantochorion tissues and involves both inositol triphosphate-diacylglycerol and cAMP second messenger systems.

Use of an on-farm progesterone test in the clinical management of parturient disorders in three cows.

Measurement of blood progesterone concentrations with a rapid, on-farm test was used to guide the clinical management of 3 cows with parturient disorders. An 8-year-old cow in the third trimester of pregnancy had chronic vaginocervical prolapse with partially dilated (4 cm) necrotic cervix. Blood progesterone concentration estimated with the test kit was low (< 2 ng/ml), and the cervical dilatation was attributed to stage-1 parturition. Vaginal delivery of the calf occurred 7 hours later. A 2-year-old cow examined for dystocia had a uterine torsion. Eighteen hours after apparent correction of the torsion, the cervix had failed to dilate. Blood progesterone concentration was 2 to 5 ng/ml, suggesting parturition had not yet been initiated. Parturition was induced with dexamethasone and prostaglandin, and calving occurred 32 hours later. A pregnant, 16-month-old heifer was believed to be about to calve and was admitted because of potential need cesarean section. Examination revealed the cervix to be closed. Blood progesterone concentration was low, and calving was predicted to occur within 24 hours. The heifer was monitored, and stage-2 labor was observed 8 hours later. The calf was delivered with minor assistance. In each case, the test provided diagnostic information that was useful in making therapeutic management decisions.