VGO 421 Obstetrics

April 11, 2020 [DRVET.
IN]
VGO 421
Veterinary Obstetrics Credit: 1+1=2
1. Types and functions of placenta in different species

2. Diseases & accidents during gestation – Abortion in domestic animals – diagnosis &
control
3. Dropsy of fetal membranes and fetus
4. Fetal mummification, maceration, pyometra & mucometra
5. Prolonged gestation
6. Teratology
7. Premature birth
8. Uterine torsion
9. Cervico- vaginal prolapse
10. Termination of pregnancy
11. Parturition
12. Puerperium and involution of uterus in domestic animals
13. Care and management of dam and newborn
14. Dystocia – Types of dystocia- maternal & fetal – approach, diagnosis & Treatment
15. Epidural & other anaesthesia in obstetrical practice
16. Obstetrical operations – Mutation, Forced extractions, fetotomy & caesarean section
17. Injuries and diseases in relation to parturition
18. Postpartum diseases and complications, uterine prolapse, retention of fetal
membranes, metritis and postpartum paraplegia
19. Animal birth control – ovariohysterectomy and non-surgical interventions
Terminology:
Theriogenology is a branch of veterinary medicine that focuses on the reproductive system in
animals. Term proposed by D.Bartlett and others to indicate all aspects of veterinary obstetrics,
genital diseases and animal reproduction; “Therio” means animal or beast and “gen” means
coming into being from greek medical terminology.
Veterinary Obstetrics is that branch of veterinary science which deals with the necessary or
advisable aid during the act of parturition in all animals coming under the jurisdiction of the
veterinarian. It is the art of managing cases of animal birth. It is that branch of surgery which
deals with the management of pregnancy and labor.
Gynaecology is the branch of medicine particularly concerned with the health of the female
organs of reproduction and diseases thereof.
Embryology is the study of the physiological development and growth of the antenatal
individual.
Teratology is the division of embryology and pathology dealing with abnormal development
and malformations of the antenatal individual.
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April 11, 2020 [DRVET.IN]
1. Gestation In Domestic Animal

 The gestation period or pregnancy period is the period from fertilization or conception to
parturition or the birth of young one. During this period single cells divide and develop in to
highly organized individuals.
 This antenatal period is the least understood and probably one of the most important periods
of life.
 The mortality rate of the ovum, embryo or fetus during this period is much greater than for
any other period of equal length after birth.
 Because they are usually unrecognized, early death of the fertilized ovum or the small
embryo with resulting resorption or abortion is often considered as sterility or infertility.
PRE-NATAL DEVELOPMENT
The pre-natal development of farm animals may be divided in to three main periods based on
the size of the individual and the development of its tissues and organs.
 Period of ovum or blastula
 Period of embryo and Organogenesis
 Period of fetus and fetal growth
PERIOD OF OVUM OR BLASTULA

 In cow it is about 10-12 days.
 It extends from the time of fertilization that usually occurs within a few hours after
ovulation, to the development of the zygotes primitive fetal membranes in the uterus.
 In domestic animals, the size of the ovum not including the zona pellucida is about 120-
180 µm at the time of fertilization and the shedding of the second polar body.
 During this period, division of the fertilized ovum progresses in the region of the ampullary
isthmic junction of the oviduct to the morula stage characterized by the inner and outer cell
masses totalling about 16-32 cells.
 In sows, on the 3rd day and 4th to 5th day in other domestic animals the morula enters the
uterus.
 By 6-10 days after fertilization the zona pellucida fragments and a blastocyst is formed
composed of the embryoblast or inner cell mass and trophoblast or outer cell mass and fluid.
 By 11 days in the ewe and 12 days in the cow, the blastocyst is about 1 and 1.5 mm in size.
PERIOD OF EMBRYO AND ORGANOGENESIS

 It extends from 12-15 days to about 45 days of gestation in cow, 11-34 days in ewes, 12-55
to 60 days in horse.
 During this period the major tissues, organs and systems of body shape occur so that by the
end of this period the species of the embryo is readily recognizable. This usually coincides
with the development of the eyelids.
 The trophoblast elongates starting at 12 days in the ewe and 14 days in the cow.
 By 18-19 days of gestation in the cow, the trophoblast may extend in to the opposite horn.
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 In horse, dog, and cat the trophoblast does not elongate but remains oval during this period
causing a localized enlargement in the uterus helpful in early pregnancy diagnosis.
 By 22 days - heart is crudely formed and beating
 The allantois is well developed, anterior limb buds are formed, eye and brain development
is well advanced.
 In the cow, as in other animals, attachment of the fetal membranes is a gradual process that
begins with the formation of the first villi about 30 days of gestation and progresses to a
primitive attachment of the chorioallantois to the endometrium in the caruncular areas about
33-36 days of gestation.
 Until the well developed attachment of the chorion to the endometrium, the nourishment of
the ovum and embryo is provided by the secretion of the uterine glands called "Uterine
milk" a yellowish or whitish, thick, opaque secretion grossly resembling and occasionally
mistaken as for a purulent exudate.
 During this period,
o Severe teratological defects or anomalies of development occur.
o Embryo may die and be expelled unnoticed at the next estrum.
o Becomes macerated and absorbed without external signs.
PERIOD OF FETUS AND FETAL GROWTH

 It extends from 34 days in sheep and goat, 45 days in cattle and 55 days in horse to
parturition.
 During this period minor details in the differentiation of organs, tissues and systems occur
along with the growth and maturation of the antenatal individual.
 Changes in the bovine fetus from 70 days to parturition are not radical.
 The increase in the size of bovine and equine fetus takes place very rapidly the last 2-3
months of gestation.
 From 210-270 days the increase in weight of bovine fetus is equal to 3 times the increase
from the time of fertilization to 210 days.
HORMONAL CONTROL OF GESTATION

 Nervous control of the uterus is not essential during gestation in man and other animals.
 Conception, gestation and possibly normal parturition can occur with complete paralysis
and lack of nerves in the lower portion of the body.
 Gestation and the onset of parturition are entirely under hormonal control.
 In the cow, sheep and pig and probably the mare, about 12-16 days after estrum and fertile
coitus, the trophoblast of the embryo grows very rapidly and its presence causes a
persistence of the corpus luteum (CL) and cessation of the estrous cycle. This is
accomplished by the effect of the trophoblast acting on the endometrium:
o To cause a continuing release of pituitary luteotrophin by means of a neuro-humoral
mechanism acting on the hypothalamus and anterior pituitary gland, and
o To prevent the release or formation of uterine luteolysin and thus block the transport
of this substance by the local utero-ovarian pathway to the CL.
 The progesterone from the CL or the fetal placenta during pregnancy is essential for
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o Endometrial gland growth.

o Secretion of uterine milk.
o For endometrial growth.
o Attachment of placenta for the later nourishment of the fetus.
o For inhibiting the uterine motility to aid in placental attachment.
 A certain amount of ovarian or placental estrogen appears to enhance the effect of
progesterone and in later pregnancy to produce udder development, relaxation of pelvic
ligaments, initial uterine tonus and cervical relaxation and to sensitize the uterus to
oxytocin.
 Other hormones essential in maintaining pregnancy are the gonadotropic or luteotrophic
hormones from the anterior pituitary gland necessary for the persistence of the CL and its
active secretion of progesterone.
 In the mare, the gonadotropins can be produced by the endometrial cups and in women by
the chorion of the fetal placenta.
 The endocrine glands of the fetus, thyroid, adrenals, gonads, anterior pituitary gland and
possibly others besides the fetal placenta play important roles in maintaining and
terminating the pregnancy.
 The CL of pregnancy is required throughout gestation to maintain a normal gestation period
and permit a normal parturition. It is reported that the normal CL in cows contains about
270 µg of progesterone. Levels below 100 µg were not conducive to embryo survival.
 In sows, ovaries are essential for the maintenance of gestation (pregnancy) throughout most
of the gestation period.
 The ovaries or CL may be removed in the latter half of the gestation in the ewe, mare, and
woman.
DURATION OF PREGNANCY
 Duration of pregnancy is the period from implantation of the blastocyst in the endometrium
until termination of pregnancy (pregnancy or gestation).
 The length of gestation is calculated as the interval from fertile service to parturition.
Species Duration (in days)

Cow 273 – 296
Horse 327 - 357
Sheep 140 - 155
Swine 111 - 116
Dog 60 - 63
Cat 56 – 65
Goat 148 – 156
Water buffalo 316 – 318
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FACTORS INFLUENCING DURATION OF GESTATION

 The duration of gestation is genetically determined, although it can be modified by
maternal, fetal and environmental factors.
1. Maternal factors
 In different species, the duration of pregnancy is influenced by the dam.
 A two day extension from the normal occurs in the 8 year old ewe.
 Young heifers carry their calves for a slightly shorter period than older heifers.
2. Foetal factors
 In polytoccus species with exception of pig there is an inverse relation between the duration
of gestation and litter size.
 Monotocus species carrying multiple fetuses also have shorter gestation periods.
 Twin calves are carried 3-6 days less than single calves.
 Interaction between fetal and placental sizes may influence gestation in horse.
 The sex also determines the length of gestation; male calves are carried 1-2 days longer than
females.
 Endocrine functions of the fetus may also influence the duration of pregnancy.
3. Genetic factors
 The small variations in duration of pregnancy among breeds may be due to genetic, seasonal
or local effects.
 The extreme expression of genetically prolonged gestation is known among dairy cows that
carry fetus homozygous for an autosomal recessive gene.
 Breed of embryo determines the length of gestation in cattle. This has been established by
transferring the embryos from breeds with shorter gestation length than the donor's and
vice-versa.
 Genetic factors are also responsible for differences in gestation length between mutton and
wool breeds of sheep.
4. Environmental factors
 Season may influence the duration of gestation.
 Foals conceived in late summer and autumn have significantly shorter gestation periods
than those conceived at the start of the breeding season in early spring.
SHORT GESTATION
Abortions and premature births often lead to short gestation. The gestation period is 3-6
days shorter in cattle carrying twins and is 0.6 days shorter in sheep and goats. Adverse disease
condition affecting the endometrium and placenta or the fetus may result in abortion and short
gestation.
 Other adverse influences include:
o Malnutrition.
o Chronic debilitating diseases.
o Deficiency diseases.
o Starvation.
o Severe stress.
o Other conditions favouring abortion.
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PROLONGED GESTATION IN DOMESTIC ANIMALS

 In general, the length of gestation period varies depending upon the breed and certain
hybrid. In domestic animals, the gestation period gets prolonged in a variety of conditions.
PROLONGED GESTATION IN CATTLE

Three types of prolonged gestations have been observed in a number of cattle breeds.
a) Associated with premature, long haired fetal giants in Holstein and Ayrshires and in other
breeds:
Due to a homozygous recessive autosomal gene, Gestation prolonged by 20-90 days
Characteristic features of premature fetuses
Fetus weight 130-200lbs
Long hooves
Erupted incisors teeth
Dehydration
Hypoplastic adrenals
b) Associated with cretin-like immature fetuses with cranial and CNS anomalies including
hydrocephalous, anencephaly or cyclopia and short, deformed loose jointed legs with aplasia of
anterior pituitary gland and a degree of hairlessness.
Observed in Guernsey, Ayrshires, and Swedish Red cattle
Due to autosomal recessive mode of inheritance
Gestation gets prolonged from 20 to over 230 days over the normal period.
Dystocia may occur, but not a serious problem
c) Associated with cerebral hernia or Catlin mark is an opening of the frontal and parietal bones.
Observed in Holsteins
Results in dystocia
Prolonged gestation: 20-60 days overtime
In the last three conditions no pre-partum or post-partum changes are observed at the time of
parturition and the udder in undeveloped until after the fetus has been removed. Parturition does not
occur unless the fetus dies in-utero.
 Cattle carrying male fetus had one or two day’s longer gestation than female fetus.
 Gestation lengths in heifers and in second pregnancy carry one or two days less than parous
cows.
 High doses and continued injection of progesterone or progestins delayed parturition.
 Most fetuses die the following month of normal parturition.
PROLONGED GESTATION IN SOWS

 Iodine deficiency or the administration of thiouracil to produce hypothyroidism results in
prolonged gestation by 4-10 days longer than normal with poorly viable, goitrous, and
hairless piglets.
 Gestation period gets prolonged by 3-4 weeks in inbred sows.
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PROLONGED GESTATION IN EWES

 Ingestion of veratrum californicum about the 14th day of gestation caused severe deformities
of the face, head with hypoplasia of the hypophysis resulted in prolonged gestation up to
230 days with fetal giantism and even rupture of prepubic tendon.
 Deficiency of Vitamin A resulted in prolonged gestation by 1-4 weeks.
 Decapitation of ovine fetuses resulted in overtime small, weak, edematous lambs with
adrenals one fourth to one fifth the normal size.
 Destruction of pituitary glands of ovine fetuses by electro cautery at 90-142 days results in
prolonged gestation.
PROLONGED GESTATION IN MARES

 Normal gestation in mares is considered to be 330 days, with a range of 320-340 days.
 Pregnancies that extend well past this upper range have been reported.
 In most cases, the mares progress past the expected foaling date with no signs of impending
parturition such as mammary development or pelvic ligament relaxation. Delivery of these
offspring’s has spontaneously occurred from 365-415 days following ovulation or breeding.
 Fetal oversize has not been typically associated with this condition as it has been in cattle.
 Etiology of prolonged gestation is not fully understood, but it is thought to involve a period
of embryonic diapause. This has been suspected when mares have embryonic vesicles that
do not grow normally in the first month of gestation and endometrial cup formation is
delayed. This delay in endometrial cup formation has been reported to extend for up to 1
month in some cases. The idea of embryonic diapause is supported by the lack of fetal
overgrowth with the extended gestation length.
 Ingestion of fescue infected with endophyte has also been associated with prolonged
gestation. The average gestation length of mares consuming infected fescue past 300 days
of gestation is 2 weeks to 20 days longer than mares not ingesting the endophyte. These
mares also do not have mammary development prior to delivery and on occasion do not
even develop the gland following parturition.
 Parturition in these mares is frequently associated with dystocia. This can result from fetal
malformations, edema of placenta and premature placental separation without rupture of the
chorioallantois at parturition, or "Red Bagging".
 Emaciated status of the fetus may be due to the decrease in the availability nutrients from
across the placenta because of vasoconstriction.
 Vasoconstriction may also be partially responsible for the presence of edema in the fetal
membranes at delivery.
 An ergot alkaloid is thought to be responsible for the associated complications of fescue
ingestion because it causes vasoconstriction and decreased prolactin from increased
dopaminergic activity and decreased serotoninergic activity.
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INCIDENCE AND ETIOLOGY

 An uniparous animal when aborts or gives birth to two or more fetuses or young they are
called twins, triplets, quadruplets, quintuplets, or sextuplets.
 In mare, the incidence of twin births is about 0.5 to 1.5 percent.
 In sheep and goats, the incidence of twinning is greatly influenced by the nutritional status
of the animal at the time of ovulation as well as the hereditary background of twins in the
breed. Primiparous ewes bear twins and triplets much less often than do pluriparous ewes.
 In cattle, the frequency of multiple births:
 Twins 1 to 96 single births.
 Triplets 1 to about 7,500 single births.
 Quadruplets 1 to about 700,000 single births.
 Quintuplets 1 to about 60 million single births.
 Twinning is to some extent a breed characteristic, the frequency being 3.3 % in Holsteins,
2.7 % in Brown Swiss and about 1 % for jerseys.
 Many multiple conceptions terminate early in the gestation period in embryonic death and
absorption, and later in abortion or premature birth.
 The incidence of monozygous twins to all cattle births: 0.05 to 0.3 percent.
 Monozygotic twins arise from one fertilized ovum that divides into two zygotes in the
oviduct.
 Dizygotic twins usually arise from the rupture of two follicles, often one in each ovary, or
rarely the rupture of a single follicle containing two ova.
 Monozygotic twins may occur as members of triplet or greater multiple births.
 Monozygotic twins have similar characters in respect to color, color pattern, number of
teats, top line, tail, hair whorls, muzzle pattern, etc. They are always of the same sex and
have the same blood type. Skin or organ grafts survive for an indefinite period when
exchanges are performed between monozygotic twins.
 Dizygotic or fraternal twins bear no greater resemblance to each other than do full siblings.
 Dizygotic twins have different blood types that frequently show blood chimerism due to
early arnastomosis of the placental vessels of the two twins and the exchange of primitive
erythrocytic cells that become established in both embryos.
Etiology of twinning
a) Environmental causes
Season
Age of the dam
Sires
Hormone injections – FSH and PMSG
b) Hereditary causes
Breed differences
Differences between dams, sires and families
Repetition of multiple births in same cow
Cystic ovaries
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2. Development of Fetus
Implantation
 The term in animals often refers to the attachment of the placental membranes to the
endometrium.
 True implantation is a phenomenon observed in rodents and humans.
 The conceptus/blastocyst that penetrates the uterine mucosa by penetrating and
phagocytizing the uterine luminal epithelium and “buries” as they migrate into the uterine
stroma.
 The conceptus temporarily disappears beneath the surface. This invasive process is
accompanied by transformation and proliferation of uterine stromal cells (referred to as
decidualization) in the vicinity of the developing blastocyst.
 In contrast, implantation in domestic animals is superficial and noninvasive and involves
phases of trophoblast-uterine epithelial cell apposition and adhesion and never disappears
from the luminal compartment.
 The pig trophoblast, however does exhibit invasive properties when placed in an ectopic
site, e.g., the kidney capsule. This invasive property appears to result from blastocyst
production of proteolytic enzymes such as plasminogen activator; but, invasive
implantation is prevented by uterine epithelial secretion of protease (plasmin/ trypsin)
inhibitors that coat the blastocyst and protect the uterus from this protease.
 During implantation in domestic animals, an outgrowth of extra-embryonic mesoderm
originates from the embryoblast and migrates between the trophectoderm and endoderm.
PREIMPLANTATION CHANGES
When the embryo undergoes the cleavage and blastocyst formation, the uterus undergoes
changes preparing the way for implantation. The characteristic changes during this phase are
 The muscular activity and tonicity of the uterus is decreased to help to retain the blastocysts
in the uterine lumen.
 Blood supply to the uterine epithelium gets increased. In some species, this is more along
the side of the uterus at which implantation takes place.
At the time of implantation:

 Amino acid and protein content shows marked changes in the uterine fluid.
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 In rabbit, the concentration of most amino acids is much higher in uterine fluid at
implantation than in blood serum.
 Glycine, alanine, taurine and glutamic acid are particularly abundant and their concentration
is progesterone dependent.
 In cow, the concentration of free amino acids in uterine fluid is high and is reported to
undergo cyclic variation.
 Changes occur in the secretory activity of glandular and surface epithelium of the
endometrium.
 High molecular weight compounds (proteins, carbohydrates, mucopolysaccharides) are
broken down, and low molecular weight derivatives, along with glycogen and fats
accumulate. This material along with cellular debris and extra vasated leukocytes in the
uterine lumen forms the histotrophe (Uterine milk). Before the chorio allantoic placenta is
established, during the early period of uterine life, this uterine milk provides nourishment
for the embryo.
 In rabbits, about 80 hr post coitus and from nine days blastocyst stage in sheep histotrophe
play a vital role.
 In farm animals, the placenta is of epitheliochorial or syndesmochorial type and the
association between fetal and maternal blood is not very close. Histotrophic nutrition is
therefore important not only in the early stages of uterine life, but throughout gestation.
 The hormonal basis of implantation varies widely.
 Progesterone plays a major role in determining the preimplantation changes in the uterus.
 The balance between estrogen and progesterone is probably more important than the
absolute levels of either alone.
 In rats, estrogen priming is required for sensitizing the endometrium for implantation.
MATERNAL RECOGNITION OF PREGNANCY (MRP)

Establishment of pregnancy involves interactions between two interdependent systems defined
as:
 Uterus, and conceptus (embryo and extra embryonic membranes)
 At the appropriate time, the conceptus must produce steroid hormones and /or proteins to
signal its presence to the maternal system.
MECHANISM OF MRP
 If the conceptus fails to signal its presence at exactly the correct time, the function of CL is
terminated by the luteolytic action of prostaglandin F2 alpha (PGF2 alpha) from the uterus.
This ensures that the female will return to estrus and mate at frequent intervals until a
successful pregnancy is established.
 Uterine PGF2 alpha is produced by endometrium of cows, ewes, mares and sows and causes
morphologic regression of CL and cessation of progesterone production.
 The effect of conceptus is luteostatic, since progesterone production is maintained at a level
comparable to that of diestrus during pregnancy.
 Basal secretion of LH from the anterior pituitary is also essential for CL maintenance and
function during pregnancy.
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Time of Maternal Recognition of Pregnancy (MRP) in domestic animals

Species Day of MRP Day of definite Attachment
Cow 16-17 18-22
Ewe 12-13 16
Mare 14-16 36-38
Canine
Sow 12 18
The terms embryo, conceptus and fetus are often used interchangeably to describe the
developing organism.
 Embryo is defined as an organism in the early stages of development. In general, an embryo
has not acquired an anatomical form that is readily recognizable in appearance as a member
of the specific species. During early stages of development, it is impossible to distinguish
the pig embryo from the cow embryo, except by skilled embryologists.
 Fetus is defined as a potential offspring that is still within the uterus, but is generally
recognizable as a member of a given species. Fetus is often thought of as a more advanced
form of an embryo.
 Conceptus is defined as the product of conception. It includes:
o The embryo during the early embryonic stage.
o The embryo and extraembryonic membranes during the pre implantation stage and
o The fetus and placenta during the post-attachment phase.
PRE-ATTACHMENT DEVELOPMENT OF EMBRYO

 Following fertilization, embryo must undergo certain developments before it is capable of
attaching to the uterus.
 Fertilization results in the formation of male and female nuclei and cell are called an ootid,
the largest single cell in the body and are characterized by having an enormous cytoplasmic
volume relative to nuclear volume.
 Fusion of the male and female pronuclei occurs and the single-celled embryo is now called
a zygote.
 The zygote undergoes a series of mitotic divisions called cleavage divisions dividing the
embryo into cells each of which are called blastomeres. As a result of the cleavage divisions
an embryo gains cell number but still contains the same total mass of cytoplasm it had when
it was a 1-cell zygote.
 Each blastomere undergoes subsequent divisions yielding 4, 8 and then 16 daughter cells.
 In the early stages of embryogenesis, each blastomere has the potential to develop into
separate healthy offspring, a property called totipotency. Totipotency is a term used to
describe the ability of a single cell (blastomere) to give rise to a complete, fully formed
individual.
 When the resultant embryo is a solid ball of cells where individual blastomeres can no
longer be counted accurately, the early embryo is called a morula.
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 Within the morula, compaction of the outer cells occur causing cells to separate into two
distinct populations, the inner and outer cells.
 Cells in the inner portion of the morula develop gap junctions that allow for intercellular
communication and may enable the inner cells to remain in a defined cluster.
 The outer cells of the morula develop cell-to-cell adhesions known as tight junctions that
are believed to alter the permeability of the outer cells.
 Fluid begins to accumulate inside the embryo. This fluid accumulation is brought about by
an active sodium pump in the outer cells of the morula that pump sodium ions into the
centre portion of the morula. This build-up of ions causes the ionic concentration of the
fluid surrounding the inner cells of the morula to increase. As the ionic strength inside the
morula increases, water diffuses through the zona pellucida into the embryo and begins to
form a fluid filled cavity called a blastocoele. The embryo is now called a blastocyst.
 The embryo becomes partitioned into two distinct cellular populations, the inner cell mass
(ICM) and the trophoblast (TE).
 The inner cell mass will give rise to the body of the embryo.
 The trophoblastic cells will become the fetal component of the placenta.
 As the blastocyst continues to undergo mitosis, fluid continues to fill the blastocoele and the
pressure within the embryo increases.
 Growth and fluid accumulation is accompanied by the production of proteolytic enzymes by
the trophoblastic cells that weaken the zona pellucida so that it ruptures easily as growth of
the blastocyst continues.
 Finally, the blastocyst itself begins to contract and relax. Such behaviour causes intermittent
pressure pulses. These pressure pulses coupled with continued growth and enzymatic
degradation cause the zona pellucida to rupture.
 Zona develops a small crack or fissure through which the cells of the blastocyst squeeze out,
escaping from their confines.
 The blastocyst now becomes a free-floating embryo within the lumen of the uterus and is
totally dependent on the uterine environment for survival.
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DEVELOPMENT OF EXTRAEMBRYONIC MEMBRANES

Following hatching, the conceptus undergoes massive growth.
 In the cow, the blastocyst is about 3 mm in diameter around day 13, which undergoes
maximum growth to 250 mm in length within the next four days and appears as a
filamentous thread. By day 18 of gestation, the blastocyst occupies space in both uterine
horns.
 In the sow, the development of blastocyst is even more dramatic; where it grows from 2mm
spheres on day 10 to about 200 mm in length in the next 24-48 h reaching lengths of 800 to
1000 mm by day 16 (Growth is at a rate of 4 to 8 mm per hour).
 The dramatic growth of the conceptus is due largely to development of a set of membranes
called the extraembryonic membranes.
 The pig, sheep and cow are characterized as having filamentous or threadlike blastocysts
prior to attachment. In the mare, however, blastocysts do not change into a thread like
structure but remain spherical.
 The extraembryonic membranes are a set of four anatomically distinct membranes that
originate from the
Trophoblast
Endoderm
Mesoderm, and
Embryo
 As the hatched blastocyst begins to grow, it develops an additional layer called primitive
endoderm just beneath, but in contact with the inner cell mass which continues to grow
downwards eventually lining the trophoblast.
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 At the same time, it also forms an evagination at the ventral portion of the inner cell mass to
form the yolk sac, a transient extra embryonic membrane that regresses in size as the
conceptus develops.
 As the blastocyst continues to expand, the newly formed double membrane (the trophoblast
and mesoderm) becomes the chorion. Further development of the blastocyst causes the
chorion to push upward in the dorso lateral region of the conceptus and begins to surround
it.
 The chorion begins to send “wing-like” projections above the embryo, the amnion begins to
form. Fusion of the chorion over the dorsal portion of the embryo results in formation of a
complete sac called amnion around the embryo.
 The amnion is filled with fluid and serves
 To hydraulically protect the embryo from mechanical perturbations.
 As an anti-adhesion material to prevent tissues in the rapidly developing embryo from
adhering to each other.
 The amnionic vesicle can be palpated in the cow between days 30 and 45 and feels like a
small, turgid balloon inside the uterus. The embryo, however, is quite fragile during this
early period and amnionic vesicle palpation should be performed with caution.
 During the same time that the amnion is developing, a small evagination from the posterior
region of the primitive gut begins to form. This sac-like evagination is referred to as the
allantoic sac that collects liquid waste from the embryo.
 As the embryo grows, the allantois continues to expand and eventually will make contact
with the chorion.
 When the allantois reaches a certain volume, it presses against the chorion and eventually
fuses with it. When fusion takes place the two membranes are called the allantochorion.
The allanto-chorionic membrane is the fetal contribution to the placenta and will provide the
surface for attachments to the endometrium.
FORMATION AND DIFFERENTIATION OF GERM LAYERS

 During early differentiation, cells at one pole of the blastocyst, the germ disc give rise to
three separate layer of cells.
 The primary sex cells may be derived from either the mesoderm or the ectoderm.
 The body segment or somites, which develop from the outer somatic layer of mesoderm,
differentiate into three regions and forms different parts of the fetus.
 The first region develops in to the vertebrae, which encase the neural tube.
 The second region forms the skeletal muscles, and
 The third region forms the connective tissues of the skin.
Differentiation of the somite region starts on the 19th day after ovulation in cattle, the
number increases rapidly to 25 on 23rd day, 40 on 26th day and 55 on 32nd day.
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3. Development of fetal membrane
INTRODUCTION
The fetal or extra embryonic membranes serve as
 Protection of the embryo.
 A means of getting nutrients (from dam to fetus).
 In caring for fetal waste products.
 Synthesis of enzymes and hormones.
The fetal membranes consists of the
 The primitive yolk sac.
 Amnion.
 Allantois.
 Trophoblast or chorion (combined with allantois forms the chorioallantois.
The first two structures develop early in the life of the embryo of domestic animals.
YOLK SAC
 It is a primitive structure.
 Develops early in the embryonic period from the entoderm.
 In ruminants and swine, it disappears after a short period of time. But persists for 4-6 weeks
in horse before it becomes a remnant in the fetal membranes.
 Prior to formation of the amnion, the blastocyst or blastodermic vesicle and then the yolk or
vitelline sac perform limited functions.
 Under the influence of progesterone from the corpus luteum (CL), the uterine glands
produce a secretion called “uterine milk”. This contains fat globules, proteins, organic and
inorganic solids and possibly other nutrients.
AMNION
 It is an ectodermic vesicle that arises from an out folding of the chorion or from a space in
the inner cell mass of the blastocyst, as a doubled wall sac that completely surrounds the
fetus except at the umbilical ring.
ALLANTOIS
 Arises during the second or third week of gestation in bovine fetuses as an out pocketing of
the hind gut and consists of entoderm covered by vascular layer of splanchnopleuric
mesoderm.
 As the allantois grows and enlarges it extends between the true and false amnion. The outer
layer of the allantois fuses with the trophoblast, false amnion, or serosa to form the
chorioallantois. The inner layer, largely devoid of blood vessels, lies against the amnion and
invests the allantoic portion of the umbilical cord.
CHORIOALLANTOIS
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 It is formed by the fusion of the outer layer of the vascular allantois and the trophoblast,
chorion or serosa.
 This structure is richly supplied with blood vessels communicating with the fetus and in
intimate contact with the endometrium.
 It is designed to carry metabolic interchanges of gases, nutrients and wastes between the
fetal and maternal circulations.
 Allantois chorion is the fetal placenta, solids and most bacteria ordinarily cannot pass unless
disease of the chorion allows their penetration. Certain bacteria, viruses and parasitic larvae
can pass through the intact placental barrier.
 In the cow, pig and sheep, the allantois is attached to the amnion at various points. This
divides the allantois in to a number of compartments.
 The necrotic tips of the chorion, found at the apices of the chorio allantois, are observed in
sheep, cow and pig and are usually about 1–2.5 cm long and about 0.3 cm in diameter.
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4. PLAENTA
WHAT IS PLACENTA?
 It is a unique organ that develops in mammalians for the development of the fetus.
 It is an apposition of fetal membranes to the endometrium to permit physiological exchange
between the fetus and the mother.
The placenta is composed of two parts:
1. The fetal placenta or allantois chorion
2. The maternal placenta or endometrium
INTRODUCTION
 The yolk sac or amniotic chorion acts as primitive placenta for a few weeks in the early
embryonic period.
 Allantois develop as a diverticulum of hind gut and fuses with the chorion (trophoblastic
capsule of the blastocyst) to form the chorioallantoic placenta.
 The blastocyst gets attached to the endometrium and the fetal membranes including the
allantois chorion develop during the first month or more of gestation.
 At this time the villiform projections of the chorion and the maternal crypts in the
endometrium are rudimentary, small and friable and the nutrition is from the uterine
secretions.
 The easy separation of the two structures i.e., (maternal and fetal placentae) is prevented,
not until the end of the first third of gestation because they do not become sufficiently
intimate and complex.
NON-REJECTION OF PLACENTA IN PREGNANT ANIMALS

 In epitheliochorial placentas, (cow, sheep, mare and sow) where the interdigitation of
microvilli of the chorion or trophoblast and endometrial epithelium are closely apposed, no
extensive degeneration or deposition of fibrinoid is present.
 Therefore, in the former an acellular mechanical barrier and in the latter, the absence of
trophoblastic antigenicity offer reasonable explanations for the retention of the placental
homograft.
 The inability of the immunologically active maternal cells to penetrate in to fetal circulation
may also be important.
 The sire contributes half of the genetic make up of the fetus and placenta and hence there
should be sufficient tissue incompatibility to induce an immune reaction in the dam and
subsequent rejection of the conceptus.
 Wynn postulated that the greater the trophoblastic invasiveness (man and rodents), the
greater the necrosis of both the chorionic and endometrial tissue. As a result there is
development and deposition of a mechanical acellular barrier of acid mucopolysaccharide
in man and rats having haemochorial placenta.
Classification of Placenta
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GENERAL CLASSIFICATION
 Deciduate or conjoined, Seen in man and rodents and in a slightly modified form in the dog
and cat.
 In this type, the decidua composed of portions of the maternal epithelium or endothelium,
submucosa, decidual cells and the fetal placenta are shed at parturition leaving the portion
of the endometrium denuded.
b) Indeciduate or Non-deciduate
 Seen in swine, horses and ruminants.
 In this type, the fetal membranes and placenta are expelled at the time of parturition, leaving
the endometrium intact except in ruminants in which only the surfaces of the carcuncles are
devoid of epithelium after the caruncles sloughs about 6–10 days following parturition.
A. ANATOMICAL CLASSIFICATION
It is divided in to 4 general types based on their shape as:
 Diffuse
 Cotyledonary
 Zonary
 Discoidal
DIFFUSE PLACENTA
 It is found in wide range of species, including pigs, horses, camels, lemurs, whales,
dolphins, kangaroos and possums.
 The villi of the chorion are distributed more or less evenly over the entire surface of the
chorionic sac.
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 The villi interdigitate with corresponding depressions or villi in the uterine epithelium, and
physiological exchange take across these surfaces.
 The most striking feature of the ontogeny of the fetal membranes in the pigs is that the
membranes undergo a rapid and dramatic elongation between days 6 and 12 of gestation,
during which time the 2 mm spherical vesicle grows in to a filament of up to 1 m in length.
 This elongation is due to a proliferation of trophoblastic tissue
 Although it is well recognized that the fetal placenta can produce gonadotrophic hormones
during pregnancy in many species, the horse always appeared to be an exception to the
general rule.
COTYLEDONARY PLACENTA
 The cotyledonary placenta is characteristic of the ruminants; instead of being uniformly
distributed over the entire surface of the chorion, the chorionic villi are clumped together in
to well developed circular regions known as cotyledons.
 These cotyledons develop only in those regions of the chorion that overlie predetermined
aglandular areas of the endometrium known as the caruncles.
 The fetal cotyledon and maternal caruncle unite to form a placentome and these
placentomes are the only sites of maternal-fetal exchange, the inter-cotyledonary chorion
being devoid of villi and unattached to the endometrium.
ZONARY PLACENTA
 It is characteristic of the carnivores, and is the result of an aggregation of chorionic villi to
form a band that encircles the equatorial region of the chorionic sac.
 It may be complete, as in dog and cat, or incomplete, as in bears.
 The yolk sac persists as a vestigial structure floating in the allantoic fluid, whilst the
chorioallantois remains as an oblong, fluid filled sac, with its girdle of placental villi.
 Incomplete zonary placenta may resemble the single or double discoid type, but the zonary
placenta always has a central or marginal effusion of the maternal blood (the haemophagous
organ).
DISCOID PLACENTA
 It is found in a mixed group of mammals, including man and mouse, bats and rats, rabbits,
hares.
 The chorionic disc may be single (man) or double (monkey).
 We should remember, however, that not all primates have interstitial implantation.
B. Classification based on the tissues or structures that intervene

between the maternal and fetal blood
1. Epitheliochorial type: (Horse, Pig, Cow and Sheep)
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In this six structures: the endothelium, connective tissue, epithelium of the endometrium
and the trophoblast or the chorion, mesenchyme and and endothelium of the fetal tissue separate the
maternal and fetal blood.
2. Syndesmochorial: (Ruminants)
All tissues of the previous type are present with the exception of the maternal epithelium.
The loss of uterine epithelium was previously considered to occur in the placentomes in this type
by phagocytosis and cytolysis by the cells of the trophoblast.
3. Endotheliochorial: (Dog and Cat)
This has four structures seperating the maternal and fetal blood. i.e., the endothelium of the
uterine vessels and the chorion, mesenchyme and endothelium of the fetal tissues.
4. Haemochorial: (Man and Rodents)
CLASSIFICATION OF CHORIOALLANTOIC PLACENTAS
Species Classification of Chorioallantoic Placentas

Chorio Villous Pattern Maternal-Fetal Loss of Maternal
Barrier Tissue at Birth
Pig Diffuse Epitheliochorial None (non-deciduate)
Mare Diffuse and Micro- Epitheliochorial None (non-deciduate)
cotyledonary
Sheep, goat, Cotyledonary Epitheliochorial None (non-deciduate
cow, buffalo
Dog, cat Zonary Endotheliochorial Moderate (deciduate)
Man, monkey Discoid Hemochorial Extensive (deciduate
Placental Attachment
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Attachment or fusion of the placenta to the endometrium of the uterus.

Species Day of Gestation
Cow 30 - 35
Ewe 18 - 20
Mare 50 - 60
Sow 12 - 20
Implantation is the invasion of the embryo into the endometrium where the embryo and
placenta continue to develop. This type of placentation is observed in humans, primates and
rodents. Dogs and cats have a semi-invasive placentation.
Placental Anatomy and Function

The primary function of the placenta is to accommodate the fetus throughout gestation and
to allow for nutrient transfer from the maternal circulation to the fetal circulation so the fetus can
grow and develop. It is important to remember that the maternal and fetal circulatory systems never
mix. Additionally, the individual components of the placenta have specific functions.
Yolk Sac Nutrient supply for the early developing embryo. Becomes vestigial as gestation
progresses.
Amnion Protects fetus from injury, provides lubrication for parturition, and serves as a
reservoir for urine and waste.
Allantois Fuses with chorion (chorio-allantoic placenta), carries blood vessels of umbilical
cord, which attaches fetus to allantois, and is a reservoir for nutrients and waste.
Chorion Attaches to uterus, absorbs nutrients from the uterus, and allows maternal/fetal
gas exchange. Produces hormones.
PLACENTAL FUNCTIONS
 The placenta functions as a multi-organ performing many functions and substituting for the
fetal:
o Gastro intestinal tract
o Lung
o Kidney
o Liver, and
o Endocrine glands.
 In addition, the placenta separates the maternal and fetal organism, thus ensuring the
separate development of the fetus.
PLACENTAL EXCHANGE
 The blood of fetus and dam never come in to direct contact. Yet, the two circulations are
close enough at the junction of chorion and endometrium so that oxygen and nutrients can
pass from the maternal blood to the fetal blood, and waste products in the opposite
direction.
 The placental membrane controls the transfer of a wide range of substances by several
processes.
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 Simple diffusion: The movement of molecules from an area of high concentration to an area
of low concentration.
 Most molecules of physiologic importance are transferred by some active transport, thus
they can be “Pumped” against a concentration gradient allowing the embryo to accumulate
higher concentrations of nutrients that exist in the maternal blood.
CLASSIFICATION OF TRANSFER OF SUBSTANCES

Group Physiologic role Substances Exchange mechanism
I Maintenance of biochemical Electrolytes, water and Rapid diffusion
homeostasis or protection against respiratory gases
sudden fetal death
II Fetal nutrition Amino acid, sugars and most Predominantly by active
water soluble vitamins transport system
III Modification of fetal growth or the Hormones Slow diffusion
maintenance of pregnancy
IV Immunologic or toxic importance Drugs, anaesthetics, plasma Rapid diffusion
proteins, antibodies and Pinocytosis or leakage
whole cells through pores in placental
membranes
RESPIRATION (O2 and CO2)

There many similarities between gases exchange across the placenta and the lungs.
 The major difference, however, is that in the placenta it is a fluid to fluid system whereas, in
the lungs it is a gas to fluid system.
 The process of transfer of O2 from maternal to fetal blood involves its dissociation from the
maternal blood, its diffusion through the placental membrane and finally its combination
with fetal hemoglobin.
 The umbilical arteries carry deoxygenated blood from the fetus to the placenta, while the
umbilical veins carry oxygenated blood from the placenta to the fetus.
SYSTEMS OF GAS EXCHANGE

 The gas exchange in the placenta takes place through four basic systems.
o Concurrent
o Counter current
o Multivillous
o Pool
 The efficiency of oxygen exchange varies with the particular system. It is greatest in the
counter current system and least in the concurrent system. The efficiency of the multivillous
system is intermediate between the above mentioned systems. In the pool system, gas
exchange is less than in the multivillous system but is comparable to a concurrent system.
 It is difficult to ascertain which of these systems is primarily involved in a particular species
and probably some species may contain more than one system.
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The oxygenated blood from the dam is carried to the fetus through the tributaries of
umbilical veins whereas the tributaries of umbilical artery carry the deoxygenated blood
from the fetus.
TRANSPORT OF WATER
 Water moves very freely between the dam and fetus.
 Of the total substances absorbed by the fetus 77% is water.
 However, the water moves from the dam to fetus against the osmotic gradient and low
concentration of plasma proteins.
TRANSPORT OF INORGANIC NUTRIENTS

 Sodium is much restricted in the passage through placenta. Iron content is much higher in
fetus, which is stored in liver, spleen and bone marrow.
 The transfer of trace elements like copper is readily affected. This element also accumulates
in the liver.
 Calcium and phosphorus enter the fetal blood against the concentration gradient. Depletion
of calcium and phosphorus reserves from the dam occurs in cases of low plane of nutrition.
 Fetal blood comprises of 70–80% fructose whereas glucose predominates in maternal blood.
Probably glucose is formed in the placenta and stored in the fetal liver which serves as a
reserve energy source.
 Placenta is not permeable to fat but the fatty acids and glycerol pass freely
 Vitamin A, D and E are obstructed by placenta and hence their concentration in fetus is
much lower. Since water soluble vitamins are synthesized in the rumen their concentration
in fetus has not been studied.
Placental Hormones
In addition to its role in transporting molecules between mother and fetus, the placenta is a
major endocrine organ. It turns out that the placenta synthesizes a huge and diverse number of
hormones and cytokines that have major influences on ovarian, uterine, mammary and fetal
physiology, not to mention other endocrine systems of the mother.
This section focuses only on the major steroid and protein hormones produced by the
placenta.
Steroid Hormones
Sex steroids are the best known examples of placental hormones. Two major groups are
produced by all mammals:
Progestins: Progestins are molecules that bind to the progesterone receptor. Progesterone itself is
often called the hormone of pregnancy because of the critical role it plays in supporting the
endometrium and hence on survival of the conceptus.
The placenta of all mammals examined produce progestins, although the quantity varies
significantly. In some species (women, horses, sheep, cats), sufficient progestin is secreted by the
placenta that the ovaries or corpora lutea can be removed after establishment of the placenta and the
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pregnancy will continue. In other animals (cattle, pigs, goats, dogs), luteal progesterone is
necessary throughout gestation because the placenta does not produce sufficient amounts.
Progestins, including progesterone, have two major roles during pregnancy:
 Support of the endometrium to provide an environment conducive to fetal survival.
If the endometrium is deprived of progestins, the pregnancy will inevitably be
terminated.
 Suppression of contractility in uterine smooth muscle, which, if unchecked, would
clearly be a disaster. This is often called the "progesterone block" on the
myometrium. Toward the end of gestation, this myometrial-quieting effect is
antagonized by rising levels of estrogens, thereby facilitating parturition.
Progesterone and other progestins also potently inhibit secretion of the pituitary
gonadotropins luteinizing hormone and follicle stimulating hormone. This effect almost always
prevents ovulation from occurring during pregnancy.
Estrogens: The placenta produces several distinct estrogens. In women, the major estrogen
produced by the placenta is estradiol, and the equine placenta synthesizes a unique group of
estrogens not seen in other animals. Depending on the species, placental estrogens are derived from
either fetal androgens, placental progestins, or other steroid precursors.
With few exceptions, the concentration of estrogens in maternal blood rises to maximal toward the
end of gestation. Two of the principle effects of placental estrogens are:
 Stimulate growth of the myometrium and antagonize the myometrial-suppressing
activity of progesterone. In many species, the high level of estrogen in late gestation
induces myometrial oxytocin receptors, thereby preparing the uterus for parturition.
 Stimulate mammary gland development. Estrogens are one in a battery of hormones
necessary for both ductal and alveolar growth in the mammary gland.
Like progestins, estrogens suppress gonadotropin secretion from the pituitary gland. In
species like humans and horses, where placental estrogens are synthesized from androgens
produced by the fetus, maternal estrogen levels are often a useful indicator of fetal well being.
Protein Hormones: Several protein and peptide hormones are synthesized in placenta of various
species. They have effects on the mother's endocrine system, fetal metabolism and preparation of
the mother for postpartum support of her offspring.
Chorionic gonadotropins: As the name implies, these hormones have the effect of stimulating the
gonads, similar to the pituitary gonadotropins. The only species known to produce a placental
gonadotropin are primates and equines. The human hormone is called human chorionic
gonadotropin or simply hCG. This hormone is produced by fetal trophoblast cells. It binds to the
luteinizing hormone receptor on cells of the corpus luteum, which prevents luteal regression. Thus,
hCG serves as the signal for maternal recognition of pregnancy. The first hormone you produced
was hCG. Equine chorionic gonadotropin is also produced by fetal trophoblast cells. It is actually
the same molecule as equine luteinizing hormone.
Placental lactogen: These hormones are molecular relatives of prolactin and growth hormone.
These hormones have been identified in primates, ruminants and rodents, but not in other species.
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Relaxin: Relaxin is a hormone thought to act synergistically with progesterone to maintain

pregnancy. It also causes relaxation of pelvic ligaments at the end of gestation and may therefore
aid in parturition. In some of the species in which relaxin is known to be produced, it is produced
by the placenta, while in others, the major source is the corpus luteum. In some species, relaxin is
produced by both the corpus luteum and placenta.
5. PARTURITION IN DOMESTIC ANIMALS SYMPTOMS OF

APPROACHING PARTURITION
 Parturition refers to those events which take place at the end of a normal gestation period,
leading to the expulsion of the fetus and the fetal membranes.
From the Veterinarians stand point of view
 One must be familiar with the normal process of parturition in various domestic animals and
be able to immediately recognize any deviation and extend artificial interference in order to
save the life of the dam and fetus.
From the farmers stand point of view
 Parturition is considered to be a specially important juncture, wherein highest death rate
occurs. Furthermore, there may be severe damage or injury to the fetus, and also the dam
thus compromising its future reproductive and productive efficiency.
 Eutokia or a safe, easy, natural, or physiological parturition is completed spontaneously
without any complications that might affect the health, viability and subsequent productivity
of the dam and it’s off spring.
 Dystocia refers to difficulty in birth especially when the first or usually the second stages of
parturition gets prolonged, becomes difficult or impossible for the dam to deliver without
artificial interference.
Terminologies referred to act of parturition in farm and pet
animals
Cow Calving
Mare Foaling
Ewe Lambing
Doe Kidding
Sow Farrowing
Bitch Whelping
Queen (Cat) Kittening
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SIGNS OF APPROACHING PARTURITION

 In domestic animals, signs of approaching parturition are somewhat similar but vary in
certain important aspects.
 Between individual animals and between consecutive parturitions, symptoms are
inconsistent, making it difficult for accurate prediction.
 Veterinarians should refrain from making too positive or definitive statement concerning the
exact time of parturition. Breeding date, if known, would be helpful in predicting the
approximate time of parturition.
 Towards the end of pregnancy, the preparation stage to parturition commences and may last
from a few days to several weeks.
 During this period, the dam undergoes many changes and prepares herself for the delivery
of the young and provide for it subsequent nourishment.
 During most of the gestation period in monotocus species (cow, mare and ewe), the fetus
usually lies on its back with its feet pointing upwards. The first sign of parturition may start
with the “rotation of the fetus to birth position” wherein the fetus lies on its thorax or
abdomen, head resting between the forelimbs and pointing towards the cervix. In this
position, parturition proceeds easily, except in pigs where both anterior and posterior
delivery proceeds with equal ease.
SIGNS FEW DAYS PRIOR TO PARTURITION

 The clinical signs observed within few days prior to parturition are categorized as follows
o Maternal behavior
o Changes in pelvis and genital organs
o Changes in mammary gland
o Changes in body temperature
A. MATERNAL BEHAVIOUR
 In all species, as parturition approaches, the dam seeks seclusion.
 Mostly in herds, the expectant dam leaves the herd and prefers quiet surroundings in
preparation for the process of parturition.
 Mares greatly prefer solitude and calm environment, and are more capable than other
animals to control or suppress parturition until the night hours.
 The nesting behaviors are strong in queens, bitches and sows, but is nearly absent in ewes,
cows and mares.
B. CHANGES IN PELVIS AND GENITAL ORGANS
As parturition approaches sacrosciatic ligaments relaxed - Relaxation of pelvic
tissues and ligaments. May occur up to 10 days prior to calving. Changes are most obvious
in the sacrosciatic ligaments of pluriparous animals. In cows and buffaloes, results in slight
sinking of the gluteal muscles, hollowing of the croup and an elevation of the tail.
 Relaxation of pelvic ligaments and the structures around the perineum is due to the changes
in the collagen fibers of the connective tissue, probably caused by an increase in estrogen.
 In young females, the pubic symphysis undergoes sufficient demineralization or dissolution
of connective tissue to allow some separation at the time of parturition.
 In most cows, presence of very relaxed ligaments indicates that parturition will probably
occur in 24-48 h.
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 In mares, sinking of the sacrosciatic ligaments is not so pronounced due to the heavy croup
muscles.
Vulval lips:-
Vulval opening increase in size between the dorsal and ventral commissure.
 In all species, as the labia enlarge and soften it becomes more mobile and pendulous.
 In mare, the vulval edema is not so pronounced as in cows.
 In the bitch, the vulva becomes flaccid, enlarged and edematous.
C. CHANGES IN MAMMARY GLAND
In all animals, noticed few days prior to parturition.
In cow
 The mammary gland becomes distended and swollen that the overlying skin cannot be
easily picked up between the fingers and thumb.
 In heifers, the changes in the udder may commence during mid-gestation, whereas in older
pluriparous cow they may not become evident unit a few weeks before parturition.
Distended mammary gland
 Just prior to parturition, the udder secretions changes (in cow and in buffalo) from a honey-
like dry secretion to yellow, turbid, opaque cellular secretion called colostrum.
 During this time, the udder and teats are so distended with colostrum, and in “easy milkers”
it may leak out through the teat orifice.
 Occasionally, edema of the subcutaneous tissues surrounding and adjacent to the udder may
also develop.
In mare
 Two days before foaling, the colostrum oozes from the teats, called “waxing” usually
noticed in 95 % of mares 6-48 h before foaling.
In bitch, sow and cat
 The mammary glands become enlarged and edematous and milk may be present in the
udder several days before parturition.
In the sheep and goat
 The development and udder is not so marked.
D. CHANEGS IN BODY TEMPERATURE

 Body temperature changes are a signal of impending parturition.
 In the cow, during the last 7-10 days of pregnancy, a slight decrease in the rectal or vaginal
temperature takes place maximum values being attained 2-4 days before commencement of
labour. However, this sign for predicting the onset of parturition is limited.
SIGNS WITHIN FEW HOURS OF PARTURITION

 In all species, inappetance, distress and anxiety are observed.
 The dam may move about in circles.
In cows
 Anorexia and restlessness
 Kicking the abdomen
 Treading
 Switching of the tail, and
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 Frequent lying down and rising.

In mares
 No vaginal mucus discharge prior to foaling
 Sweating in the flank region and frequently behind the elbows.
 Anorexia 1-2 h before foaling
 Restless
 Slight colicky symptoms
 Switching of the tail, and
 Frequently lying down and getting up.
 The nature of the mucus and volume of mucus produced by the cervical glands increase and
they may become so copious that strings are found to be hanging from the vulva, soiling the
tail and hocks.
In bitches, during the 6-25 h before birth of the first pup, behavior changes
 Seeking of seclusion
 Digging and scratching at the floor
 Chewing
 Panting
 Anorexia
 Vomiting, and
 Shivering.
 Copious greenish mucoid vaginal discharge before, during and after parturition.
THEORIES ON THE INITIATION OF PARTURITION

 Parturition is triggered by the fetus and is completed by a complex interaction of endocrine,
neural and mechanical factors, but their precise roles and interrelationships are not fully
understood.
Theory Possible Mechanism
Fall in progesterone Blocks myometrial contractions during pregnancy, near term

concentration the blocking action of progesterone decreases.
Rise in estrogen Overcomes the progesterone block of myometrial contractility

concentration and/or increases spontaneous myometrial contractility.
Increase in uterine volume Overcomes the effects of progesterone block of myometrial

contractility.
Release of oxytocin Leads to contractions in an estrogen sensitized myometrium
Release of prostaglandins Stimulates myometrial contractions; induces luteolysis leading

to a fall in progesterone concentrations (corpus luteum-
dependent species).
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Activation of fetal Fetal corticosteroids cause a fall in progesterone, a rise in

hypothalamic-pituitary- estrogen, and a release of PGF2 alpha. These events lead to
adrenal axis myometrial contractility.
MECHANISM OF INITIATION
 Both fetal and maternal mechanisms play roles in initiating parturition. The fetal endocrine
system dominates in ruminants (eg. sheep, goat and cattle) whereas; it plays a minor role in
other species (eg. horse and human).
 The mechanisms that follow the release of cortisol differ among species depending on the
source of progesterone maintaining the pregnancy.
o In sheep, fetal cortisol induces the placental 17 alpha enzyme to catalyze the
conversion of progesterone or pregnenolone to estrogen. The elevated levels of
estrogen stimulate secretion of prostaglandin and development of oxytocin
receptors.
o In CL dependent species, cortisol in addition to the synthesis of estrogen causes a
release of prostaglandin from the endometrium, which in turn causes regression of
the corpora lutea.
 Possible mechanisms of initiation of parturition in farm animals

Species Mechanism
Pig PGF2 alpha is the luteolysin that induces CL regression. The increase in
estrogen reflects increase pituitary-adrenal axis; estrogens increase
oxytocin and PG release.
Sheep Fetal cortisol acts on the placenta to induce the enzyme 17 alpha and in
goat, hydroxylase to decrease plasma P4, while increasing estrogen levels.
The increase in E:P ratio enhances the sensitivity of PGF2 alpha and
oxytocin.
Cattle PGF2 alpha induced luteolysis initiates parturition. Fetal cortisol

stimulates the release of PGF2 alpha, probably from the uterus. Other
endocrine changes are similar to those of sheep and goat.
Horse Oxytocin rises progressively towards the end of pregnancy, and then a
massive release triggered by a mechanical stimulus stimulates the
synthesis of PGF2 alpha. The combined actions of these two hormones
result in expulsion of fetus.
MECHANICS OF PARTURITION
 Successful parturition depends on two mechanical processes
o The ability of the uterus to contract and
o The capacity of the cervix to dilate sufficiently to enable the passage of the fetus.
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 The activity of the uterine muscle (myometrium) is under the influence of progesterone,
which ensures an environment conducive to the developing fetus.
 Myometrial contractions of low amplitude and frequency occur during the major part of the
gestation.
 At term the uterus switches from progesterone dominated to an estrogen dominated state.
 As a result two parallel molecular/biochemical pathways are mobilized within uterine
tissues.
o The first pathway is similar to those in smooth muscle and transforms the uterus
from its "relaxed" state during pregnancy to an "activated" state.
o The second pathway that results from an increase of the E/P ratio increases the
synthesis or release of uterotonins (eg. PGF and Oxytocin).
 These two pathways acting jointly initiate the intense, synchronous myometrial contractions
needed to dilate the cervix and effect delivery of the fetus(s).
SCHEMATIC REPRESENTATION - ROLE OF UTERUS AND CERVIX
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ENDOCRINE CHANGES
Endocrine changes that occur before and during parturition in sow, ewe and cow
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INITIATION OF PARTURITION
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INITIATION PROCESS
 Fetal stress causes stimulation of hypothalamus to release adrenocorticotrophin releasing
hormone (ACTRH) which in turn stimulates the anterior pituitary to release
adrenocorticotrophin hormone (ACTH). ACTH acts on the adrenal cortex causing release of
cortisol. Cortisol acts on the placenta stimulating the enzymes 17 alpha hydroxylase and
converts progesterone to 17 alpha hydroxy progesterone which is converted to
androstenedione which in turn is converted to estrogen by the enzyme aromatase.
 Estrogen acts on the cotyledonary caruncular complex to release PGF2 alpha. PGF2 alpha in
turn cause regression of CL, lower the progesterone level and release of relaxin. Relaxin
causes stretching of pelvic ligaments. Increased estrogen causes stimulation of myometrial
contractions which causes the fetus to engage in the cervix thereby stimulating oxytocin
which potentiates myometrial contractions. Estrogen also increases the secretions of the
cervix lubricating the birth passage.
 The initiation of parturition process is represented in the form of flow chart for the
following domestic animals:
o In cow and goat
o In sheep
o In mare
o In swine
o In bitch
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INITIATION OF PARTURITION IN COW AND GOAT

(CL dependent Species)
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INITIATION OF PARTURITION IN SHEEP
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INITIATION OF PARTURITION IN MARE
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INITIATION OF PARTURITION IN SWINE
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INITIATION OF PARTURITION IN BITCH
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Possible factors responsible for initiation of parturition

Probable factors Effect
Physical factors 1. Increase in fetal size Increase in uterine irritability
2. Uterine distension Reversal of progesterone block

Reflex to reduce size by fetal
expulsion
3. Fatty degeneration of placenta & Leads to interference in fetal
presence of infarcts nutrition & separation process of
fetus from uterus
Biochemical 1. Increase in CO2 tension in maternal Increase uterine contractility
factors blood due to increased fetal activity
2. Release of fetal antigens serotonin Release of collagenase and
stoppage of blood supply to
cotyledons
Neuro-endocrine FETAL
factors 1. Increase in cortisol in adrenals Convert P4 to E2 & release of PG
2. Increase in ACTH by pituitary Stimulate cortisol release
3. Increase in corticotrophin releasing Stimulate ACTH
hormone (CRH) in hypothalamus
4. Increase in endogenous opiods
MATERNAL Stimulate ACTH secretion
1. Reversal of progesterone block
2. Release of Relaxin
3. Placental estrogens rise Myometrial contractility
4. cytokines Dilation of birth canal

Release of PG In contractility
Dilation of pubic symphysis and
5. Release of PG sacro-sciatic ligaments
Softening of cervix, Stimulate
smooth muscle contractility
6. Release of oxytocin Myometrial contractions
Hormonal Changes that Control Parturition
Steps
o Fetal ACTH causes -

o Fetal Corticosteroids causes -
o Progesterone levels
( placental production or CL regression) -
o Production of Estrogens by placenta -
o PGF production by uterus –
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Significance of initial hormonal changes

 Progesterone - removes block on uterine contractions.
 Estrogen - makes uterus more responsive to induction of contractions i.e., more
irritable and smooth muscle tissue stimulation.
Events just Prior to Parturition:

1. Pelvic ligaments soften - Tail head sinks due to estrogens and relaxin.
2. Cervix softens and begins secreting stringy mucus - estrogens and relaxin.
3. Swelling of vulva.
4. Udder swells - fills with first milk and due to edema.
5. Fetus moves into proper position - resting on thorax, front feet and head facing the cervix.
Stages of Parturition in farm animals

1. Dilation of Cervix.
2. Expulsion of Fetus
3. Expulsion of the Placenta
1. Dilation of Cervix-
o Uterine contractions become coordinated and regular - (estrogen & PGF2 alpha
induced).
o Fetus pushed against cervix - amnion dilates cervix.
o Allanto-chorion may break.
o Pressure of fetus in cervix stimulates oxytocin release and reflex contractions of
abdominal muscles.
2. Expulsion of Fetus
o Strong uterine contractions due to synergistic actions of high estrogen,
PGF2alpha and oxytocin.
o Strong abdominal muscle contractions.
o Amnion ruptures - mucin lubricates vagina - vestibule
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o Fetus passes through vagina - vestibule.

o Fetus expelled out during this stage
3. Expulsion of the Placenta
o Uterine contractions continue.
o Blood forced from cotyledon villi - shrinkage separates cotyledon and caruncle.
o Contractions push placenta out.
o Separation and expulsion of the foetal membranes. In polytoccus species second and
third stages are often inter-mixed.
 The following table summarizes the normal time taken to progress through the stages of
parturition in different species.
Species Mare Cow Ewe Sow Bitch

Stage 1: Contractions and 1-4 2-12
2-6 hours 2-6 hours 6-12 hours
Cervical Dilation hours hours
30 6 hours (up to 24
12-30 30-120 150-180
Stage 2: Foetal Expulsion minutes - hours with large
minutes minutes minutes
4 hours litters)
6-12 Placenta Exits

Stage 3: Placental Expulsion 1 hour 5-8 hours 1-4 hours
hours with Foetus
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6. TERMINATION OF PREGNANCY
IN CATTLE
INDICATIONS
 Therapeutic abortion may be indicated during normal or abnormal pregnancy.
During normal gestation
 Misidentification of a breeding female
 Accidental breeding of a very young heifer, and
 Unwanted pregnancy in feedlot heifers.
During abnormal gestation
 Fetal maceration,
 Fetal mummification
 Hydramnios and hydrallantois.
PHYSIOLOGY OF PREGNANCY MAINTENANCE

 Gestation period extends from 270 to 292 days after breeding.
 Once conception has occurred, progesterone is essential for pregnancy maintenance.
 Both luteal and extra-ovarian sources of progesterone must be eliminated for successful
induction of abortion.
 Although the maternal endocrine events of the first 15 days of cycle and of pregnancy are
similar, the conceptus secretes a range of products, including steroids, prostaglandins, and
proteins, beginning at 12 to 13 days of gestation.
 At least one of these products, interferon results in maternal recognition of pregnancy by
inhibition of luteolysis and prolonged luteal lifespan.
 These effects are mediated by attenuation of endogenous prostaglandin F 2 alpha (PGF2α)
secretion.
 The functional life of the corpus luteum (CL) is controlled by a balance of luteotrophic
factors, including luteinizing hormone, and luteolytic factors, including PGF2α.
 PGF2α is the naturally occurring luteolysin, acting both directly and indirectly on the CL.
 PGF2α may cause local vasoconstriction of luteal blood flow; however, PGF2α, receptors
are present on luteal cells, and PGF2α has a direct effect on luteal progesterone secretion.
 Endogenous luteolysis occurs in response to a cascade of hormonal events that result in
pulsatile PGF2α secretion. It has been proposed that as a part of this cascade, estradiol
induces oxytocin receptors on endometrial cells.
 Oxytocin activates those receptors, resulting in the synthesis and secretion of PGF2α.
Role of Progesterone
 Throughout gestation: Fluctuate between 6 and 15 ng/ml
 Two to four weeks preceding parturition: A gradual decline.
 The adrenal gland may contribute 1- 4 ng/ml of progesterone.
 Progesterone is luteal in origin for the first 150 days of gestation.
 Between 150 and 250 days, the placenta acts as additional source of progesterone.
 In the final month of gestation, placental progesterone declines and pregnancy is again
dependent on luteal progesterone.
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 Successful treatment to induce abortion must lower circulating progesterone below 1 ng/ml,
which is the threshold necessary to maintain pregnancy, and must be directed specifically at
the source of progesterone appropriate for the stage of gestation at the time of treatment.
Mechanism of Action of Therapeutic Agents

1. PROSTAGLANDIN F2 ALPHA
 The corpus luteum (CL) is sensitive to PGF2α beginning 5 to 7 days after ovulation.
 In both normal and abnormal pregnancy, administration of PGF2α after that time results in
luteolysis at any stage of pregnancy; however, PGF2α treatment alone induces abortion only
up to 5 months of gestation.
 Rarely, luteolysis is incomplete, in which case luteal progesterone remains above the
threshold, and partial cervical dilation and abdominal straining may occur before the cow
resumes normal gestation.
2. GLUCOCORTICOIDS
 Reduce placental progesterone secretion from 150 days of gestation. Luteal progesterone is
unaffected, however, and abortion does not result from glucocorticoid treatment until the
last month of gestation.
 During the final month of gestation, glucocorticoids act at the feto-placental unit to increase
the production of estradiol and PGF2α, resulting in induced parturition.
 A combination of PG and glucocorticoids will induce abortion from 150 days of gestation.
3. ESTROGENS
 During the first 2 to 3 days after ovulation, administration of estrogens alters oviductal
transport of the bovine embryo and terminates pregnancy.
 After corpus luteum formation, estrogens cause luteolysis by inducing the endogenous
PGF2α luteolytic cascade from the endometrium.
 The endometrium must be intact for estrogens to induce abortion.
 Estrogen is an exogenous luteolysin with unknown effects on the feto-placental unit;
therefore, abortion can be induced reliably at up to 150 days of gestation.
 Administration of 30mg estradiol valerate, alone or in combination with dexamethasone in
cows between 200 and 220 days of gestation has not been shown to decrease serum
progesterone or result in abortion.
 Treatment with estradiol or its synthetic derivatives results in prolonged estrus behavior,
vulvar swelling, mucopurulent discharge, and relaxation of parts of the posterior
reproductive tract.
 The function of the utero-tubal junction as a sphincter may be impaired, possibly allowing
ascending infection and salpingitis.
 Time to return to fertile estrus after estrogen treatment may be longer than after
prostaglandin treatment.
4. OXYTOCIN
 Treatment of cows with oxytocin from days 2 to 7 after estrus with 100 to 200 IU of
oxytocin prevents pregnancy, probably by preventing normal luteal development.
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Treatment Strategies
 TERMINATION OF NORMAL PREGNANCY
 All pregnant feedlot heifers are routinely treated with the combination of PGF2α and
dexamethasone (Preferred combination to all other treatments), regardless of their stage of
gestation.
o Inj.PGF2α : 25 mg IM
o Inj. Dexamethasone: 25 mg IM
 Abortion will occur reliably, with a mean time to abortion of 5 days.
IN HYDRALLANTOIS AND HYDRAMNIOS

 Pregnancy can be terminated within 48 h in cows with simultaneous administration of
PGF2α and dexamethasone, using doses recommended for normal pregnancy.
 Supportive treatment is necessary to compensate fluid loss.
 Parturition usually is abnormal.
 C-section may be an alternative to induced parturition.
IN FETAL MUMMIFICATION
PGF2α or an analogue
 Therapeutic agent of choice.
 Excellent prognosis for return to fertility within 1-3 months.
 Expulsion of the fetus usually occurs within 24-72 h.
 Retreatment of cows with mummified fetuses still present at reexamination occasionally is
necessary.
Estrogens
 Luteolytic doses of estrogen also results in expulsion of mummified fetuses.
 Repeated treatments may be necessary at 48 h intervals.
 After treatment, the mummified fetus may become lodged in the vagina, requiring
lubrication and manual removal.
IN FETAL MACERATION
 Response to treatment with PGF2α or estrogen is unrewarding.
 Macerated bones may be removed at surgery or through a partially dilated cervix, before or
after administration of PGF2α or estradiol however, endometrial damage carries a poor
prognosis for return to fertility.
 In treating fetal maceration and mummification, glucocorticoids are ineffective because an
intact feto-placental unit is necessary for their mode of action.
IN GOAT
 Elective induction of abortion or parturition is easily accomplished in goats.
 In does, throughout gestation a functional corpus luteum (CL), the source of progesterone,
is essential for maintenance of pregnancy.
 The placenta produces little or no progesterone.
 Anything that interferes with proper function of the CL during gestation will result in
termination of pregnancy.
PHYSIOLOGY OF PREGNANCY MAINTENANCE
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 Events that lead to normal parturition require functional maturation of the fetal adrenal
cortex.
 Parturition is triggered by activation of the fetal pituitary-adrenal axis. Adrenocorticotropic
hormone (ACTH) is released by the fetal pituitary, which stimulates release of
corticosteroids by the fetal adrenal glands.
 An increase in fetal corticosteroids stimulates placental estrogen biosynthesis, which in turn
stimulates the synthesis and release of PGF2alpha from the placenta and endometrium.
 The cascade continues and PGF2alpha causes luteolysis, which results in a decrease in
progesterone.
 An increase in estrogen and decrease in progesterone stimulates myometrial activity, which
is further enhanced by the effects of PGF2alpha, causing a direct effect on the myometrium
and stimulating oxytocin release.
 By mimicking some of these events, abortion or parturition can be artificially induced.
INDICATIONS
 Mismated does that may be too young or small for breeding, may be held in reserve for
breeding at some future date, or scheduled to be bred by AI or to a different buck.
 Injury or disease that may compromise the life of the doe or the completion of pregnancy.
TREATMENT APPROACHES
 Most commonly used agent to achieve termination of pregnancy in goats is PGF2 alpha or
its analogs, but corticosteroids and estrogens have also been employed.
 In cases of mismating, the doe should not be treated until 5-7 days after breeding, at the
earliest, to allow the CL to mature and become receptive to the effects of PGF2 alpha. If the
gestational age is 30 days or greater, PGF2 alpha will terminate pregnancy but the
subsequent estrus may be anovulatory, followed by a shortened inter-estrus interval.
IN EQUINE
GENERAL CONSIDERATIONS
 In elective termination of pregnancy in mares, many methods may be employed. However,
care should be exercised to select a procedure that is safe and effective and that minimizes
damage to the mare’s reproductive tract and future breeding health.
 When terminating pregnancy, consider the following factors
o Stage of gestation
o Presence of endometrial cups
o Expected time of return to estrus
o Presence of twin fetuses, and
o Physical condition of the mare.
INDICATIONS
 Elective termination of pregnancy is performed for several reasons
o Mismating
o Change in ownership
o Age or health of dam
o Abnormal gestation, and
o Twin pregnancy.
Treatment Options
 No method has been shown to reliably terminate pregnancy before day 5 after ovulation.
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 Days 5-6 after ovulation, elective abortion is easily accomplished by luteolysis of fully
functional corpus luteum (CL).
 Prostaglandin F2α (PGF2α) or a PGF2α analogue can be administered as an intramuscular
injection.
 Dinoprost and Cloprostenol commonly are used.
 Both have similar efficacy.
 Common side effects of sweating and mild colic are avoided with the administration of
Cloprostenol.
 Trans-abdominal ultrasound-guided fetal cardiac puncture, followed by injection of
potassium chloride, has been successful in reducing twin pregnancies in mid-gestation and
could be used for single pregnancy termination.
IN CANINE
MEDICAL TERMINATION OF PREGNANCY DURING PRE-OSSIFICATION PERIOD
IN CANINE
DURING PRE-OSSIFICATION PERIOD IN CANINE
( Days 20-22 through 40 -42 after LH peak )
Drugs Dose Route Frequency
PGF2 alpha 0.1-0.25 mg/kg SC BID for 4-6 days
Cloprostenol 1.0-2.5 µg/kg SC Once a day for 5 days
Cabergoline Plus 5 µg/kg Oral Once a day for 5 days

Cloprostenol 1 µg/kg SC Once in 48 h
Bromocriptine Plus 30 µg/kg Oral TID

Cloprostenol 1 µg/kg SC On days 28 and 32 after LH peak
Bromocriptine PlusPGF2 alpha 10 µg/kg Oral TID

100 µg/kg SC TID
Aglepristone 10 mg/kg SC Once a day for 2 days
MEDICAL TERMINATION OF PREGNANCY DURING PREATTACHMENT PERIOD

IN CANINE
DURING PRE-ATTACHMENT PERIOD IN CANINE
(Fertilization to days 20-22 after LH peak)
Drugs Dose Route Frequency
Aglepristone 10 mg/kg SC Once a day for 2 days
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Oestradiol 10 µg/kg SC Divided in to 2-3 injections / once in 48 h. Begin 2-4 days

Benzoate (max 1 after mating
µg)
Cloprostenol 1.0-2.5 SC BID to QID for 5 days beginning of day 5 of diestrus

µg/kg
Natural 10-250 SC BID to QID, days 5-11 of diestrus

PGF2 alpha µg/kg
7. TERATOLOGY
Teratology
 It is the division of embryology and pathology dealing with the abnormal development and
malformations of the antenatal individual.
Karyotype or Idiogram
 Systematized arrangement of chromosomes in pairs and groups.
Mosaicism
 The occurrence in an individual of two or more cell populations or tissues each with a different
chromosome complement derived from a single zygote.
Chimerism
 The occurrence in an individual of two or more cell populations or tissues each with a different
chromosome complement derived from different zygotes, as in twins with placental anastomoses.
Cytogenetics
 It is the branch of genetics devoted to the study of the cellular constituents, chromosomes and genes,
which are concerned in heredity.
Pleiotropism
 It refers to certain harmful traits spread widely if they are associated with desirable traits.
Anomaly
 It refers to the malformation involving only an organ or part of the body.
Monster
 It refers to an animal with extensive deformity.

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Phenocopies
 It refers to non-genetic anomalies that are similar to genetic anomalies.
Teratogens
 Variety of environmental factors or agents causing non-genetic anomalies or monsters.
INTRODUCTION
 The death or malformations of the antenatal individual arises due to teratologic, abnormal
development arrests in development of the ovum, embryo or fetus. An ovum and a spermatozoa
combine to form a single cell, a new mammalian zygote comprising of all of the genetic information
packaged in to two ten-trillionths of an ounce of DNA in the nucleus required to form a new
enormously complex animal.
 Chromosomes consist of a pair of chromatids held together by a centromere the location of which
together with the size of the chromosome aids in the identification of the chromosomes.
TERATOGENIC AGENTS
 In domestic animals, there are innumerable types and degrees of non-genetic anomalies, or
monsters.
 Anomaly refers to malformation of only an organ or part of the body.
 Monster refers to an extensive deformity is extensive.
 Suspect genetic role, if a similar defect appears quite frequently in related individuals or those
tracing back to a common ancestor. It would be impossible to differentiate some of these defects
appearing in families or related animals in a herd due to environmental causes without a carefully
controlled experiment.
Susceptibility
 The period of early differentiation in the embryo or about the time germ layers and organs are
rapidly developing - Highly susceptible.
 The zygote is not as susceptible to teratogens during the period of the ovum or blastula or the period
of the fetus as it is during the period of the embryo and organogenesis, especially the first half of
that period.
TERATOGENIC AGENTS OR FACTORS
Nutritional deficiencies in the dam

 Vitamin A and E, riboflavin, folic acid, pantothenic acid, niacin and other vitamin deficiencies,
minerals such as iodine and possibly manganese, and amino acids such as tryptophane may cause
congenital defects. Hypervitaminoses A and D will also cause anomalies.
Endocrine disturbances of the dam
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 Diabetes, thyroid malfunction, and large exogenous doses of glucocorticoids, ACTH, insulin,
androgens, progestagens, estrogens, thyroxine and thiouracil will cause defects of the embryo. Large
doses of glucocorticoids in pregnant animals at the proper stage of gestation may cause cheilo or
palatoschisis. Progestagens given during pregnancy may cause masculinization of the genitalia of
female fetuses.
Physical factors
 Reduced atmospheric pressures, hypothermia, hyperthermia and, anoxia cause anomalies.
Radiation
 X-ray or radioactive substances induces congenital defects.
Drugs or chemicals
 Thalidomide, quinine, sulphonamides, tetracycline, streptomycin, salvarsan, lead, mercury, nicotine,
malathion, carbon tetrachloride, apholate, selenium, fluorine, cytotoxic agents including aminopterin
in sheep, nitrogen mustard, actinomycin D, 6 mercaptopurine, azoserine, azo dye, trypan blue and
other dyes, salicylates, histamines, ergot, “Diamox,” reserpine, phenylmercuric acid, galactose,
E.D.T.A. and certain plant compounds as in Veratrum californicum and locoweeds possibly
containing lathyrogens, all produce fetal anomalies in animals under certain conditions.
Infections
 Blue tongue in sheep, hog cholera in swine, feline panleucopenia in cats, bovine virus diarrhea—
mucosal disease virus, and toxoplasma can cause anomalies in the embryo.
Ageing of ova
 By delaying ovulation 24-48 h was characterized by a three-fold increase in chromosomal anomalies
with a higher incidence of embryonic death in rats. Similarly ageing of rabbit spermatozoa before
permitting them to fertilize eggs resulted in normal fertilization but greater embryonic death losses.
Thus age affects the genes and chromosomes as does other agents.
INHERITED LETHAL AND SEMILETHAL CHARACTERS
 Achondroplasia, or dwarf, “comprest” or “bull dog calves”

 Epitheliogenesis imperfect - It is a condition where skin fails to form.
 Atresia coli
 Hemophilia
 Fredericksborg lethal, related to sterility in inbred white horses.
 Epitheliogenesis imperfecta, affects lower limbs.
 Hydrocephalus
 Dwarfism or achondroplasia
 Cleft palate
INHERITED AND GENERALLY NON LETHAL DEFECTS
 Polydactylism in Holsteins and Herefords is possibly an autosomal dominant character with

incomplete penetrance.
 Syndactylism or “mule-foot” affecting one or both front feet or all four feet has been reported in
Jerseys, Harianale and Holsteins and has a single autosomal recessive mode of inheritance.
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 Muscular hypertrophy or “double” muscling is characterized by reduced fat deposits, light bone,
thin skin, and large muscles. It is seen in many breeds of cattle including Herfords, Holstein,
Angus, Charolais. When fetuses are affected dystocia often occurs.
 Umbilical hernia was described as being a probable sex-limited dominant character in
male Holsteins but the mode of inheritance in females was uncertain. Umbilical hernia in Holsteins
was caused by one or more pairs of autosomal recessive genes of low frequency. The condition was
seen more often in females but was probably not sex-linked.
 Osteoarthritis and hip dysplasia in Holsteins, Jerseys and Herefords. In dairy breeds the lesions
were noted in the stifle joint at 5 to 13 years of age and were possibly due to a single autosomal
recessive gene
 Epilepsy has been reported in Swedish Red cattle and Brown Swiss cattle characterized by a sudden
loss of consciousness preceded by a convulsion. It may be due to a recessive or dominant factor.
 Congenital cataract and blindness (Jerseys and Holsteins).
 Strabismus and exophthalmos “cross-eyed” or “pop-eyed” (Shorthorn, Guernsey and Jersey) are
inherited as recessive characters.
 Congenital porphyria, or pink tooth, in Holsteins, Shorthorns and Jamaican Red cattle, due to a
simple autosomal recessive condition resulting in photosensitivity arid dermatitis of white or even
pigmented skin, pink to brown teeth and bones that fluoresce with ultraviolet light.
 Polycythemia in one- to two-month-old Jersey calves characterized by congested mucous
membranes, lethargy, dyspnea and reduced growth rate was due to a single autosomal recessive
gene.
 Curly coat (Ayrshires and Swedish cattie).
 Deformed limbs or flexed pasterns (Jerseys).
 Taillessness (Holsteins and other breeds) possibly inherited.
 Multiple lipomatosis (Hoisteins), a dominant trait with incomplete penetrance.
 Fused teats (Guernseys, Herefords).
 Supernumerary teats (all breeds).
 Agnathia or absence of a lower jaw (Jerseys and other breeds)
Opacity of the cornea is probably a recessive character in Holsteins.
 Lumpy jaw or actinomycosis and actinobacillosis is characterized by a lack of genetic resistance
in Guernseys to this disease. Multiple eye defects (Jerseys, Holsteins).
 Prognathism (Herefords and others).
 Congenital blindness
 Cryptorchidism
 Atresia ani
 Testicular hypoplasia
 Hermaphroditism
MALFORMATIONS DUE TO ALTERATIONS IN TISSUE DIFFERENTIATION

THAT ARISE FROM A SINGLE AREA IN THE EMBRYONIC DISC
Most of these are due to the local arrest in the normal process of tissue development and produce
 Defects due to excessive division: polydactylia, polythelia, polydontia.

 Defects due to failure of structures to fuse normally: palatoschisis, cheiloschisis, cranioschisis, spina
bifida, and schistosomus.
 Defects due to arrest in division: cyclopia, ren arcuatus or horseshoe kidney; and syndactyly.
drvet Page 52
 Defects due to complete local failure of tissue growth: amelia or lack of limbs; ectrodactyly or
absence of phalanges; vertebral or costal abnormalities; epitheliogenesis imperfecta; acrania;
agnathia; and anophthalmia.
 Defects due to arrest in assumption of final form or position: ectopia cordis, hypognathia, and
dextro-position of the aorta.
 Defects in the persistence and disappearance of contiguous structures that normally follow a certain
pattern: the aortic arches, foramen ovale, urachus, ductus arteriosus and persistence of the median
wall of the paramesonephric or Mullerian duct.
 Defects due to overdevelopment of’ local tissues: polycystic kidneys; tumors such as sarcomas,
hemagiomas and teratomas.
 Defects due to displacement of tissue: teratomas and dermoid cysts
 Defects due to fusion of sexual characters: true hermaphrodites, false hermaphrodites, and
freemartins.
 Defects due to miscellaneous causes: ichthyosis, chondrodystrophies, osteogenesis imperfecta, and
porphyrinuria.
8. DROPSY AND HERNIA
DROPSY OF FETAL MEMBRANES
 A pathological condition of the pregnant animal characterized by excessive accumulation

of fluid within the amniotic or allantoic cavity is referred to as
o Hydramnios (Hydrops amnii) or
o Hydrallantois (Hydrops allantois), respectively.
 Earlier this condition was termed as hydrops amnii but observations have established that
the excess of fluid is usually in the allantoic sac and hence should be referred to as
hydrallantois (Arthur, 1989).
 Dropsy of the fetal sacs usually occurs in bovine, but also seen in mares of 10-20 years, few
cases recorded in sheep, and also observed in canines.
 In cattle, it is mostly seen in the last three months of gestation.
ETIOLOGY
 Cause unknown; but Arthur has postulated a placental dysfunction consequent upon
incompatibility of mother and fetus.
 Cow bearing twins is more likely to develop hydrallantois.
 Normally, in cattle, there is markedly accelerated production of allantoic fluid at 6-7 months
of gestation and it is suggested that, where placental dysfunction exists, this increase may
become uncontrolled and lead to massive accumulation.
CLINICAL SIGNS:
 All cases of hydrallantois are progressive but they vary in time of clinical onset (within the
last 3 months of pregnancy) and in their rate of progression.
 Distended abdomen (In goat).
 Allantoic fluid volume varies up to 273 liters and such large amounts cause a serious strain
on the cow and greatly interfere with respiration and appetite.
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 Gradual loss of condition and at an unspecified later time leads to recumbency and death.
 Occasionally the animal becomes relieved by aborting.
 Less severely affected animals reach term in poor condition and because of uterine inertia
frequently require help at parturition.
 Dislocation of the hips or backward extension of the rear limbs may occur and the cow lies
on her sternum looking like a "Bloated bull frog appearance" (In cow).
SPECIFIC FEATURES
 Abnormally low number of functionary cotyledons.

 Non gravid horn usually does not take part in placental formation.
 In the gravid horn, a compensatory accessory caruncular development occurs.
 Histological features
o A non-infectious degeneration, and
o Necrosis of the endometrium.
 Fetus may be small sized.
DIFFERENTIATION OF HYDRALLANTOIS AND HYDRAMNIOS

ITEM HYDRALLANTOIS HYDRAMNIOS
Incidence 85 - 95 % 5 - 15 %
Rate of development Rapid, within 1 month Slow, over several months
Shape of abdomen Round and tense Piriform, not tense
R/E of placentomes and fetus Cannot be palpated Can be palpated
Gross characteristics of liquid Watery, clear, amber colored, Viscid, may contain
transudate meconium
Fetus Small seldom malformed Malformations present
Placenta and placentomes Allantois chorion diseased and Placenta, allantois chorion
abnormal with placentomes and placentomes normal
hypertrophied and reduced number
Refilling of cavity after Rapid Does not occur

removal of excess fluid
Occurrence of complications Common Uncommon
Outcome Abortion or maternal death Parturition at approximately

common full term
DIAGNOSIS
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 Based on the easily appreciable fluid distension of the abdomen with its associated
symptoms in the last third of pregnancy.
 Confirmation by rectal palpation of markedly swollen uterus, and failure to palpate the fetus
either per rectum or externally.
TREATMENT
 In mild cases, when dropsy develops shortly before term, restricted water intake,
administration of diuretics and cardiovascular stimulants may be tried.
 Resort to two stage cesarean operation.
 Corticosteroid (20 mg of dexamethasone or 5-10 mg of flumethasone) in conjunction with
oxytocin by intravenous drip for 30 minutes.
 A single intramuscular dose of 40 mg of dexamethasone is recommended.
 Administration of glucocorticoids leads to severe stress on bone marrow function;
leukopenia develops and persists for several days. Metritis, pneumonia and enteritis may
follow this.
 An intramuscular injection of PGF2 alpha analogue (Cloprostenol) can be used at any stage
of pregnancy with satisfactory results.
DROPSY OF FETUS
 Dropsical conditions affecting the fetus are of several types.
 The conditions of importance from obstetrical stand point of view are:
o Hydrocephalus
o Meningocele
o Ascites
o Anasarca
 Location and amount of the excess of fluid dictates the form of the fetus and the degree of
obstetrical problem.
 Increased diameter of the fetus leads to dystocia.
FETAL HYDROCEPHALUS
 It involves a swelling of the cranium due to an accumulation of fluid which may be in the
ventricular system or between the brain and the Dura matter (Arthur et al., 1989).
 Affects all species of animals and is seen most commonly by veterinary obstetricians in
pigs, puppies and calves.
 Generally described as being either internal or external and CSF collects passively inside or
sometimes outside the ventricles, causing pressure atrophy of cerebral tissues.
 Inherited internal hydrocephalus is recognized as a clinical entity by the animal breeding
specialists and the veterinary profession.
 Probably many cases go undiagnosed because of lack of knowledge or thorough
examination.
 It is important for the practitioner to realize that internal hydrocephalus and other cranial
abnormalities can exist without a gross distortion of the skull.
ETIOLOGY
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 There are probably several etiological factors including dietary deficiency (Vitamin A in lab
animals), infectious agents (Swine fever vaccine in pigs) and genetic factors (accompanies
achondroplasia in cattle and dogs).
 In cattle practice, it usually occurs sporadically and the cause is then not determined.
 In broad etiological sense, the so-called congenital brain hernias (Meningocele and
encephalocele) may be included with congenital hydrocephalus, as these also are associated
with an extensive prenatal accumulation of cerebrospinal fluid (CSF) with or without a
protrusion of the cerebral tissues.
 In all these cases, CSF collects passively inside or sometimes outside the ventricles, causing
pressure atrophy of the cerebral tissues.
 Such accumulations of fluid may be due to obstruction of the foramen of Monroe, the
cerebral aqueduct, or the foramina of the roof of the fourth ventricle, resulting in internal
hydrocephalus.
TREATMENT
 In more severe form, due to marked thinning of cranial bones trocarization and compression
of the skull facilitates vaginal delivery.
 In cases where trocarization and compression cannot be performed, dome of the cranium
may be sawn off with an embryotomy wire or chain saw (Arthur et.al., 1996).
 In severe cases, c- section may be performed.
FETAL ASCITES
 Ascites or dropsy of the peritoneum is a common accompaniment of infectious diseases of
the fetus and of developmental defects such as achondroplasia.
 Occasionally it occurs as the only defect.
 Aborted fetuses are often dropsical; when the fetus is full term ascites may cause dystocia.
 This can usually be relieved by incising the fetal abdomen with an embryotomy knife.
FETAL ANASARCA
 Fetal anasarca of Ayrshire cattle is a hereditary condition and is determined by autosomal
recessive genes.
 Cases of subcutaneous edema are present in the oldest obstetric literature but in recent years
a peculiar form in the Ayrshire breed has caused many instances of severe dystocia.
 The trait has been disseminated by the widespread use of bulls certain popular strains and
subsequent close breeding within herds has caused it to appear.
 Affected fetus is usually carried to term and concern is caused by the lack of progress of
second stage of labour.
 This is due to the great increase in fetal volume caused by the excess of fluid in the
subcutaneous tissues, particularly of the head and hind limbs.
 Interesting point – An undue proportion of these fetuses are presented posteriorly, enormous
swelling of the presenting limbs is very conspicuous.
 Peritoneal and pleural cavities - excess fluid with dilatation of the umbilical and inguinal
rings as well as hydrocele.
 Fetal membranes are also edematous and occasionally there is a degree of hydrallantois.
 Fetal weight varies from 39–102 Kg
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 In less severe cases, delivery may occur spontaneously or by traction, others require partial
fetotomy or multiple incisions of the subcutaneous tissues.
 In more severe cases, perform C- section.
Abdominal hernia refers to protrusion of any organ from the abdominal cavity through an
accidental or physiological opening in its walls.
9. POSTPARTUM CARE OF DAM AND NEW BORN
CARE OF DAM
IN COW
IMMEDIATE POSTPARTUM CARE
 Check for evidence of another fetus
 Check the entire birth passage to rule out any damage
 Check for signs of hemorrhage
 Check the udder for signs of mastitis
 Check for signs of metabolic disorders
 Protect the dam against infection by administration of antibiotics, and
 Administration of oxytocin 60–100 I.U. following calving depending on the size of the cow.
IN MARE
EXAMINATION OF NORMAL POSTPARTUM MARE
 Initial examination should be simple, as intervention beyond absolute necessity may disrupt
the adaptation processes that are under way during this time.
 Examination should consist of
o Evaluation of the mare’s behavior including attitude and interaction with her foal,
and
o Her general condition including:
 Character of pulse and respiration
 Color of mucous membranes
 Degree of alertness, and
 Responsive reaction to stimuli.
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 Examine the udder for consistency of mammary secretions and patency of the teats.
 Evaluate the systemic condition, such as rectal and vaginal examination, blood counts, and
clinical chemistry tests, are indicated when a specific problem is suspected based on the
general examination.
Examination of placenta
 Placenta should be thoroughly examined and weighed once it is passed.
 A normal equine placenta weighs approximately 14% of the mare’s body weight or between
10 and 18lb.
 A placenta weighing greater than 18lb is edematous and indicates that the foal may not have
received adequate gas exchange in utero.
 Foals from excessively heavy placentas need to be considered at high risk for neonatal
problems.
 The chorio-allantoic and allanto-amniotic surfaces and the umbilical cord need to be
examined.
 Irregularities in color, thickness, length of villi, and the presence of any secretions should be
noted.
 If placental abnormalities are found or the foal is born before 325 days of gestation, a blood
sample from the foal should be obtained and a complete blood count performed.
 Foals with in utero stress
o If the stress was of short duration leading to premature delivery
 A low white blood cell count (<5000 cells/µl), and
 Low fibrinogen level (<200 mg/dl).
o If the stress was prolonged
 A high white blood cell count (>8000 cells/µl), and
 A high fibrinogen level (>400mg/dl).
 Premature foals or foals that experience in utero stress have a greater chance of survival
with appropriate nursing care.
CARE OF NORMAL POSTPARTUM MARE

 Mares should foal in a clean, dry, draft-free area that has protection from excessive sun and
wind. If the climate permits, a small, clean grass paddock is best; otherwise, a well-bedded
dry stall that is at least 12 ft by 12 ft will do.
 Mares housed in paddocks can be grouped with either one or two mares or be left by
themselves. The number of mares in the paddock should be minimal to decrease
competition among the mares for food and space and to allow the mare to bond with her
foal.
 During the postpartum period mares need exercise to promote uterine involution and to
stimulate appetite and gastrointestinal function. Leaving a mare in a stall for prolonged
periods is detrimental, as the mare may accumulate intrauterine fluid leading to metritis or
septicemia. If the mare must remain in the stall because the foal is ill, the mare’s uterus
should be evaluated daily for its accumulation. If fluid accumulates, lavaging her uterus
with large volumes of warm saline until the efflux clear followed by administration of 10 to
20 units of oxytocin has been helpful in preventing metritis.
 For the first few days after foaling, feeding should be light to moderate, and laxative feeds
such as bran mashes are appropriate to reduce the incidence of constipation.
 Routine care of the mare post partum should include essential preventive medicine
procedures.
 In the ideal situation, mares will have received routine vaccinations for the common
infectious diseases during the last month of gestation. This allows maximum protection for
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the foal by way of colostrum. When vaccination history is vague or absent, the mare should
be simultaneously vaccinated with tetanus antitoxin and toxoid, at different sites.
 Most broodmares on well-managed farms are on a parasite control program whereby
antiparasiticals are given every 45 to 60 days. If the mare is not on a bimonthly program and
has not been dewormed during the last 2 months of gestation, she should be dewormed
within a few days of foaling. Broad-spectrum anti-parasitical compounds such as ivermectin
are best. Then, an intensive parasite control program, preferably deworming every 45 days,
should be implemented.
 Mares with a history of a Caslick’s operation as an essential part of infertility management
should be resutured as soon as practical. If performed within 15 minutes of parturition, local
anesthesia is not required. If the mare tears the dorsal commissure of her vulva and it is not
sutured immediately, it is best to keep the area clean until it is sutured in 3 to 4 days. If it is
sutured when inflammation is maximal, 24 to 48 h after parturition, it will likely dehisce.
COLOSTRUM MANAGEMENT
 Assessment of quality and quantity of colostrum is essential as the foal depends on
absorption of adequate quantities of colostral immunoglobulin for protection against disease
during the first month of life.
 Colostrum with a high immunoglobulin concentration is thick and sticky with either a
yellow or gray tinged appearance.
 Immunoglobulin content can be estimated by measuring the clostral specific gravity.
 Equine colostrometer (Lane manufacturing, Loveland, Co) developed for measuring
specific gravity is difficult to obtain commercially.
 A colostral specific gravity of 1.06 or greater correlates with a colostral IgG content of
greater than 3000 mg of IgG/dl (30G/L).
 Foals that suckle colostrum with specific gravity over 1.06 rarely exhibit failure of passive
transfer and have serum IgG concentrations of above 400 mg/dl at 24 h of age.
 Colostral quality can also be estimated with a sugar or an alcohol refractometer. The alcohol
refractometer is used to measure the percentage of alcohol in wine by wine makers and is
readily available.
 Colostrum with a level of 6000 mg of IgG (60G/L) read 16% with the alcohol and 23% with
the sugar refractometer.
 Colostrum with a specific gravity above 1.07 or with a 16% reading from alcohol
refractometer or 23% with sugar refractometer may be saved for colostrum bank.
 Colostrum (250 ml) from the udder after the foal first sucks can be collected and tested for
isoantibodies to ensure that the foal receives the banked colostrum does not develop
neonatal isoerythrolysis.
 Colostrum can be stored in clean labeled containers in a refrigerated freezer (-5 °C) for
approximately 18 months without degradation of the IgG.
 Frozen colostrum can be thawed in warm water or in a microwave on the defrost cycle.
IN GOAT
POSTPARTUM CARE OF DOE
 Carefully perform routine abdominal ballottement of the doe immediately after parturition
for the presence of additional fetuses.
 On abdominal palpation, a retained fetus may be detected as a firm mass, and can be
confirmed by ultrasonographic examination.
 Exercise great care to visualize the fetus once the fluid contrast is lost after the chorio-
allantoic membrane has ruptured.
 Examine the birth canal for any signs of trauma or hemorrhage.
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 After parturition, assess the doe’s vital signs and muscle tone to detect hypocalcemia, as it
may predispose to uterine prolapse.
Placenta
 The placenta is shed often within 1 h of delivery of the last kid, but it is not considered
retained until 8 to 12 h post partum.
 During this period, gentle manual traction, inj. oxytocin (if within 48 h post partum), and
systemic or local antibiotics can be administered.
Lochia
 In normal does, lochia can be discharged for up to 4 weeks.
 Before milking, carefully clean the lochia from the udder.
 Lochia from normal births may contain Chlamydia psittaci, Coxiella burnetii, or other
pathogens that are infectious to humans and other goats.
 Normal reddish brown lochia must be distinguished from the brownish, watery, malodorous
discharge that accompanies postpartum metritis.
 In metritis, does are usually febrile and partially anorectic and have depressed milk
production. It should be treated with local or systemic antibiotics and non-steroidal anti-
inflammatory drugs, and may require supportive therapy.
Colostrum
 Does should be milked soon after parturition and hand- feeding of kids ensures maximum
first feeding ingestion of colostrum by all kids.
 Udder should be palpated for evidence of mastitis and to evaluate sufficiency of milk
production, and milk should be expressed from each teat to assess the patency of the teat
and to detect abnormal secretions.
 Does with good milk production that give birth to a single kid should be considered as
candidates for cross-fostering another kid.
 Assure that both udder halves are being nursed and monitor for the presence of mastitis and
adequacy of milk production. This also facilitates the doe bonding with all members of the
litter and aids in decision-making as to whether a doe can raise her entire litter or whether
one or more kids should be hand-reared or fostered to another dam.
 Watch closely the postpartum does for signs of hypocalcemia or ketosis.
 Maximizing dry matter intake of fresh does will help to prevent metabolic disease and
ensure maximal peak milk production.
 Monitor their ability to compete at feeders (and moved if needed), and provide fresh
supplies of water and high-quality forage immediately to encourage early return to normal
feed intake.
IN SOW
POST-FARROWING CARE
 Farrowing is assumed to be complete, when the sow stops straining and begins to
demonstrate an interest in her litter.
 Complete expulsion of the fetal membranes and placentas is the final phase of parturition,
however the time required for expulsion of the fetal membranes may range from 20 min to
12 h after the last pig is born.
 Retained placenta occurs rarely in sows. Failure to find the placentas in the farrowing crate
4 to 12 h post partum suggests the presence of another pig in the birth canal, and a vaginal
examination is indicated.
 Sows that continue to strain, have a malodorous and discolored vulvar discharge, or show
signs of depression or weakness also should be vaginally examined for retained pigs.
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 Many sows are anorectic during parturition and may refuse to eat for the next 48 h. Feed
should be withheld from sows (or only a very small amount provided) the day of farrowing.
Then feed can be increased to 4 pounds daily, plus 1 pound per pig per day for the first
week, with an average intake of 10 to 12 pounds of feed per day. Water intake is essential
for optimizing feed intake and milk production during lactation. Lactating sows will drink 4
to 5 gallons of water per day, and the recommended flow rate for nipple waterers is 2
quarts/min.
 The sow is continually available for suckling by the newborn pigs for the first few hours
after parturition. This constant mammary stimulation results in a high level of circulating
oxytocin and facilitates the piglet’s ability to readily obtain colostrum.
 The sow generally is exhausted from parturition and demonstrates little interest in the
piglets. During this time, however, some sows are observed to savage their newborn pigs.
This condition tends to occur more often in primiparous sows, and the aggressive behavior
is often directed toward the first-born piglet. Separation of the piglets from the sow until
farrrowing is completed usually is all that is required to calm a sow that is savaging her
piglets. On some occasions a sow may require sedation before accepting her piglets or
fostered piglets.
 Inspect the sow’s udder for
o Color
o Consistency
o Heat, and
o Lesions likely to be associated with pain at this time to determine if the sow is
suffering from mastitis or any other puerperal disease condition.
 Approximately 24 h after birth the sow will begin to actively encourage the pigs to nurse by
grunting and positioning her mammary glands so that the nipples are available for suckling.
Cyclic nursing begins at this time, and milk letdown occurs approximately every hour for a
period of a few minutes.
CARE OF NEW BORN
IN COW
IMMEDIATE CARE AND MANAGEMENT OF NEWBORN
INTRODUCTION
 The fetus during its development inside the uterus is maintained under constant, regulated
and well protected stress free environment.
 Under the influence of hormonal changes during the latter part of gestation, a number of
maturation changes occur in the fetus so as to prepare it for survival in a free state.
 In spite of this in utero preparation, following delivery, the fetus has to quickly get adapted
to the sudden change in its immediate environment.
 Generally, when the parturition is normal, the fetus easily overcomes this transition.
 However, from birth to variable period of time afterwards, a number of important events
must occur.
 It is imperative that, the personnel supervising or assisting the parturition process has to
exercise great care to recognize the changes in the new born so that it could be rectified
quickly to enhance its survival.
 The following aspects have to be taken care of
o Onset of spontaneous respiration
o Acidosis
o Thermoregulation
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o Care of umbilicus
o Feeding of colostrum
o Protect the new born from an excitable dam.
1. ONSET OF RESPIRATION
 In normal calving, spontaneous respiratory movements of the offspring occur within 60
seconds. If there is a delay in calving, sometimes respiratory movements occur before
expulsion of the fetus.
 During the birth process the PO2 and blood pH are falling and PCO2 is rising due to start of
placental separation, occlusion of the umbilicus, thus restricting gaseous exchange. These
changes stimulate chemoreceptors in the carotid sinus for initiation of respiration.
 Tactile and thermal stimulation are also important for initiation of respiration.
 Licking and nuzzling of the dam provides some stimulus (In cow and goat).
 Immediately after delivery of the fetus, clear the upper respiratory tract of fluid and attached
membranes using fingers.
 Elevating the rear of the calf will help in escape of copious volume of fluids. Some fluid
may also come from the stomach.
 Brisk rubbing of the chest with straw and towels frequently, provide necessary tactile
stimulus for respiration.
 If spontaneous respiration is not present it may be stimulated by pinching the fetal nose,
tickling the nasal mucosa or by splashing cold water.
 Respiratory stimulants like coramine and adrenaline may be tried.
 Oxygen cylinder and resuscitator are useful. Oxygen therapy may be supplied by face mask.
If resuscitation does not result in spontaneous respiration in two or three minutes, it is
unlikely that new born will survive even though there is a strong pulse and heart beat.
2. ACIDOSIS
 During normal calving, fetus will usually have a mild metabolic acidosis, corrected within a
few hours, and respiratory acidosis, which may last up to 48 hours.
 Dystocia is likely to cause a severe respiratory and metabolic acidosis and result in adverse
effect on both respiratory and cardiac function, and in the case of the calf will reduce vigor,
the suck reflex resulting in reduced colostrum intake and impaired passive immunity
(Grove-White, 2000).
 Metabolic acidosis is primarily due to the production of lactic acid by tissues. When sodium
bicarbonate is used to neutralize the acid, CO2 and H2O are produced; the former will
exacerbate any respiratory acidosis. Thus it is important that the calf is breathing normally
so that it can expire this additional CO2.
METHODS OF ASSESSMENT
 Presence of good muscle tone and a pedal reflex: a well-oxygenated calf with fairly normal
acid-base status.
 Presence of scleral and conjunctival hemorrhages: hypoxia and acidosis - poor prognosis;
similar lesions are present extensively at necropsy in calves that die at birth.
Based on the time to the calf assuming sternal recumbency
Sr. Feature Time taken to assume sternal
No recumbency (in minutes)
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1 Normal calving 4.0 ± 2.2
2 Traction 9.0 ±3.3
3 High predictive value for death >15

of the calf
TREATMENT
 A calf requiring resuscitation is likely to be suffering from both a metabolic (low plasma
bicarbonate concentration) and a respiratory (high PCO2) acidosis. The PCO2 will be
reduced with improved alveolar gas exchange and tissue perfusion.
 Metabolic acidosis may be treated with sodium bicarbonate (Grove-White, 2000).
 Assess the degree of metabolic acidosis using blood gas analysis.
 Under field conditions this is seldom possible.
 A newborn calf with the history and clinical signs suggestive of acidosis, sodium
bicarbonate at a dose rate of 1-2 mmol/kg as a bolus intravenous injection of 50-100 ml (35
gm in 400 ml of lukewarm water) can be used quite safely (Grove-White,2000).
3. THERMOREGULATION
 Thermoregulation is controlled in two ways:
o By increased metabolic rate for which adequate glycogen reserve is required.
o Reduce heat loss:
 The new born has little subcutaneous fat and hence insulation is poor.
 Ensure that there is adequate food and arrange for birth to occur in at least a
thermally controlled environment.
 Reduced heat loss by ensuring that the coat is adequately and quickly dried.
 The neonates should be placed in a warm environment until they can be
returned to the dam.
 The new born puppy should be placed:
0
o In the first week at 95-100 F
0
o In second week at 85 F, and
0
o In the third week at 70-85 F.
4. CARE OF UMBILICUS
 The haemostatic clamp is removed from the umbilical cord, which is checked for
hemorrhage.
 Should bleeding occur the cord may be ligated with a suitable suture.
 It is important not to cut the cord too close to the abdomen, first to allow the placement of a
further ligature if needed in case of bleeding and for spontaneous vasoconstrictions of the
cord after birth to allow for the blood included in the cord to be reused by the neonate thus
reducing the amount of blood loss.
 The umbilical cord should also be disinfected with mild antiseptic.
o Umbilical care in a kid
o Umbilical care in a calf
5. FEEDING OF COLOSTRUM
 The new born should receive colostrum from the dam.
 Generally, the new born gets to identify the udder and consumes the colostrum.
 If new born is delivered by assistance or through c-section, then it has to be assisted.
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 Colostrum should be made available to the new born during the first 24 h of delivery, after
which time its abortion is greatly reduced.
 Feeding of colostrum to the young one provides antibodies.
PROTECTION FROM AN EXCITABLE OR VICIOUS DAM

 In some instances, the dam may attack the new born. In such cases it needs to be provided
with physical protection.
IN MARE
IMMEDIATE CARE OF NEW BORN FOAL

 During immediate postnatal period, the veterinarian role will vary with training and
experience of the foaling attendants.
 Veterinarian should review with the foaling attendant, the normal foal behavior and
emergency procedures.
 Guidelines indicating when veterinary assistance is needed should be discussed with the
foaling assistant.
 If parturition proceeds normally, the first veterinary examination is conducted between 8
and 24 h after birth.
 A foal that is not breathing at birth needs immediate assistance.
o Attendant can attempt to resuscitate foal by clearing the nostrils and mouth, by
pacing blunt objects into the nostrils to stimulate breathing by holding the head
upright so that fluid may in through the nostrils.
o Mouth-to-nose resuscitation may “buy time.” The veterinarian should be contacted
immediately.
o Large farms frequently have a source of humidified oxygen that may be delivered to
foals.
o Farm personnel must be trained in its use.
 The navel of the foal should be disinfected immediately after birth and again in 4 to 6 h to
reduce the number of microorganisms that colonize the umbilical stump.
o An iodine based disinfectant, preferably 3.5% solution, is preferred.
o Avoid stronger solutions such as 7% tincture of iodine as it may cause tissue
damage.
o Chlorhexidine diacetate solution (0.5%) is more effective in reducing bacterial
numbers than 2% povidone iodine and does not cause tissue destruction.
 To facilitate passage of the meconium, warm water enemas or soap-based enemas are
commonly administered.
o Enema tube should be lubricated before its placement in the rectum.
o Small amounts of enema fluid, 60 to 120 ml, should be administered slowly, and
repeated until the meconium is passed.
o If there is resistance during delivery of the enema, the procedure should be stopped
and seek veterinary assistance.
 If the dam has not been vaccinated against tetanus during the last 30 days of gestation, her
foal should receive tetanus antitoxin at birth.
o Tetanus toxoid should be given at 6 weeks of age and repeated at 12 weeks.
 In normal foals, antibiotics are not indicated at birth.
 First veterinary examination of the foal
o Usually between birth and 24 h.
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o Observe the foal from a distance to determine its behavior, ability to rise,
coordination and strength, ability and willingness to nurse, and attitude and response
to external stimuli.
o Perform a brief, but complete physical examination.
o A serum sample for measuring IgG concentration and, if a problem is detected in
either the foal or the placenta, a blood sample for a complete blood count needs to be
drawn.
o Orphan foals, foals whose dams prematurely lactate, and foals with lgG
concentrations below 200 mg/dl may need up to 1 L of colostrum.
o On a weight basis, foals require approximately 1 g of colostral IgG/kg of b.wt to
attain an IgG concentration of 800 mg/dl serum. Therapies for foals older than 24 h
of age with failure of passive transfer include intravenous plasma, purified lgG
products, and antibiotics
o Specificity of IgG administered may be more important in preventing infection than
the total concentration of IgG attained in the foal’s serum.
PARAMETERS OF NORMAL FOALS IMMEDIATELY AFTER BIRTH
Parameter Time frame

Time to suck Within 2-20 minutes; stimulated by placing finger in mouth
Sternal 1-2 minutes

recumbency
Time to stand 1-2 hours; longer than 2 hours is abnormal
Time to nursing 2 hours; longer than 3-4 hours is abnormal
Temperature 99-101.5º F
Heart rate 1-5 minutes post foaling >60 bpm; 6-60 min; 80-130 bpm
Respiration rate First 30 minutes post foaling: 60-80 breaths/min; 1-12 hours: 30-40
breaths/min
Blood glucose >80 mg/dl
IN GOAT
POSTNATAL CARE OF KIDS
 At the time of birth, kids should be observed for normal respiration, evidence of respiratory
acidosis, and other evidence of fetal distress such as meconium staining.
 Clearing of nasal passage: Mucus and fluids should be immediately removed from the nose
and mouth of newborn kids.
 Aspiration of meconium should be suspected in kids with extensive meconium staining that
demonstrate respiratory difficulty. For cases under intensive clinical management, oxygen
or doxapram hydrochloride, or both, may be needed to support or stimulate respiration,
especially in premature kids. Mild to moderate acidosis can be treated with intravenous
HCO at 1.OmEq/kg or as determined after the base deficit is analyzed.
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 Kids and placentas are examined for abnormalities that would suggest placentitis or other
signs of in utero infection that might warrant submission for necropsy.
 Care of umbilicus: The umbilicus of all kids should be inspected for hemorrhage or
herniation, and the umbilical stump disinfected with tincture of iodine or chlorhexidine
solution. Treatment of the umbilicus should be continued for several days is preferred.
 Kids should be examined for the presence of congenital defects such as
o Pseudohermaphroditism
o Teat anomalies
o Cryptorchidism
o Atresia ani
o Cleft palate
o Brachygnathia
o Prognathia, and
o Congenital goiter.
 In herds using pasteurized kid-rearing methods, kids are removed at birth and hand-fed
heat-treated goat colostrum or cow colostrum (heat-treated preferred) by nipple bottle.
 A sucking reflex can be stimulated by stroking the kid’s face behind its muzzle. Weak kids
can be given colostrum with the use of a soft rubber catheter as a stomach tube and the
barrel of a 60-ml catheter-tip syringe as a reservoir for gravity flow.
 Depression caused by respiratory acidosis may reduce suckling and result in decreased
colostrum intake.
 Delayed colostrum intake, inadequate colostrum ingestion, and ingestion of poor- quality
colostrum are common reasons for failure of passive transfer.
 Palpation of kids’ abdomen after nursing serves as indicators of colostrum consumption.
However, hand-feeding of colostrum to all kids is the most definitive means of ensuring
adequate colostrum intake.
 Frozen colostrum is best thawed in a warm water bath. Repeated freezing of thawed
colostrum and storage of frozen colostrum for longer than 1 year are not recommended.
Cow colostrum can be used instead of goat colostrum; however, goat owners must take
steps to ensure that the colostrum quality and freedom from Mycobacterium
paratuberculosis or other enteric pathogens meet the same standards that they would
demand from goat colostrum.
 Large cardboard boxes with clean bedding material work well for housing newborn dairy
goat kids, especially in large herds. A doe’s kids can be placed in one box, and the dam’s
identification written on the box as a means of identifying kids until they can be labeled
with paper collars and permanently identified by tattoo. Disposable boxes are a useful
means of preventing build-up and spread of enteric pathogens. Kids can be kept in these
boxes for about 2 weeks, after which the box can be destroyed and kids housed in larger
groups.
IN SOW
POST-FARROWING CARE OF NEONATE
 Newborn pigs require immediate energy intake and must be provided a microenvironment
that is draft free and dry with a temperature of at least 30° C. Heat loss can be reduced if
piglets are dried at the time of birth or shortly after by temporary placement of an additional
heat lamp at the rear of the crate.
 Piglets acquire immunoglobulins from colostrum. It is imperative that newborn pigs suckle
within the first few hours after birth. Colostral immunoglobulin G (lgG) levels drop by 50%
within 6 h of the first nursing; late-born piglets may receive significantly lower levels of
passive immunity than littermates born earlier in the farrowing order. When the piglets are
24 h old, the small intestine loses its ability to transport immunoglobulins (macromolecules)
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to the lymphatic system, and “gut closure” occurs. It is a good practice to collect excess
colostrum from newly farrowed sows and store it in the freezer for the purpose of
supplementing weak or orphaned piglets.
 As piglets are born, an effort should be made to dry each animal and dip the umbilical cord
into a mild disinfectant solution.
 Clipping of needle teeth usually is performed to reduce damage to the sow’s underline and
to minimize wounds sustained by piglets when fighting to establish dominance. The
decision to clip needle teeth will vary according to farm-specific conditions. Piglets should
be allowed to suckle colostrum before their teeth are clipped.
 Further piglet processing usually occurs at 3 to 5 days of age. Processing tools should be
sharp and should be disinfected in between litters. Sick litters should be processed last.
 Pigs have a limited iron supply at birth, and sow’s milk provides very little iron. Without
iron supplementation, piglets will develop a microcytic anemia within 2 weeks of birth. To
prevent microcytic anemia in piglets, it generally is recommended to administer an
intramuscular injection of 200 mg of iron dextran in the neck of each piglet within the first 5
days after birth.
 Tail docking often is performed at the same time the iron is administered so that any pigs
that have not received an iron injection can be easily identified. Tails can be trimmed with
side-cutting pliers to a length of about 2cm from the body. Tail docking is performed to
reduce the incidence of tail biting in the grow-finish stage of production.
 Ear notching or tattooing also can be performed before the pig reaches 5 days of age.
 Male pigs should be castrated between 5 and 14 days of age.
 Cross-fostering is the practice of moving pigs between litters to achieve uniform weight and
to ensure that adequate functional teats are available to the number of pigs suckling. This
practice is particularly important for sows with pendulous udders, which may not be able to
expose the bottom row of teats to their piglets. Pigs should be moved from one litter to the
next within the first 24 h after birth so that the fostered pig can receive colostrum from its
new dam. Care should be taken to avoid placing all small pigs on primiparous sows because
the small pigs may not provide the young sow with aggressive-enough stimulation to ensure
oxytocin release Pigs can be bottle-fed or mechanical feeding systems can be used. Feeding
pigs milk replacers requires a great deal of additional labor to maintain a high level of
sanitation of the equipment.
 Providing additional attention to individual pigs can be rewarding. Warming individual pigs
that become chilled or have limited mobility and providing nourishment by means of a
stomach tube can give them a head start before they are placed with their littermates.
 Splay-legged piglets can be assisted by providing support tape between their two rear legs.
This tape should allow the animal to walk with short steps and can b removed in 2 days,
allowing the pig to stand without assistance.
10. DISEASES AND ACCIDENTS DURING GESTATION
PYOMETRA: In Cattle
In cattle, pyometra is defined as progressive accumulation of a variable amount of purulent
exudates within the lumen of the uterus and associated with the presence of persistent corpus
luteum (PCL) in one of the ovaries.
ETIOLOGY
 Mostly occurs as sequelae to chronic endometritis
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 The corpus luteum (CL) persists due to the infection of the genital tract, abnormal uterine
contents prevents the release of prostaglandin from the endometrium or sequester it within
the uterine lumen. Thus uterus is under the continuous influence of progesterone; in turn
further depresses phagocytic activity of uterine neutrophils and allow persistence of
infection. Because the cervix remains fairly tightly closed the purulent exudates
accumulates within the uterine lumen, although occasionally there is a slight purulent
discharge.
 Occasionally occur in the presence of a luteal cyst.
 Death of the fetus, invasion of the uterus by A. pyogenes and retention of the CL of
pregnancy, a relatively infrequent cause of pyometra.
 Venereal infection with organisms such as Trichomonas fetus (T. fetus), which cause
embryonic death, also causes pyometra.
CLINICAL SIGNS
 Cows show few or no signs of ill health; the main reason for them being examined is the
absence of cyclical, activity, or, perhaps, the presence of an intermittent vaginal discharge
 Uterine horns are enlarged and distended, an unequal degree, owing to incomplete
involution of the previously gravid horn or to recent conceptus death
 In some cases, purulent vaginal discharge may be noticed
 Common presenting sign is anoestrus due to persistent corpus luteum
 Pyometra associated with T. foetus infection presents different features
 Pus is more copious and may attain a volume of many liters
 Pus is more fluid and is grayish white or white
 Greater distension of uterus
 Mucus occupying the cervix is moist and slippery, rather than sticky and tenacious, and
 Motile trichomonads can generally be found in the mucus.
DIFFERENTIATION OF PYOMETRA AND NORMAL PREGNANCY

 Uterine wall is thick, flaccid and atonic (In pregnancy, it is thinner and more resilient)
 Uterus has a more ‘doughy’ and less vibrant feel.
 Positive signs of pregnancy (Fetal membrane slip, amniotic vesicle, placentomes, fremitus
and fetus) are not present.
 Trans-rectal ultrasonography will demonstrate the absence of a fetus and the presence of a
‘speckled’ echo-texture of the uterine contents compared with the black anechoic
appearance of normal fetal fluids.
 If diagnosis is doubtful, the cow should be left untreated and reexamined 2 weeks later for
evidence of change.
PROGNOSIS
 In early cases: Fair to good
 In long standing cases: endometrium is destroyed and uterine wall becomes fibrotic –
complete recovery and conception difficult
 Pyometra associated with perimetritis: Hopeless
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TREATMENT
 Drainage of pus from the uterus using horse catheter followed by infusion of antibiotics
may produce recovery in some cases.
 Best treatment is the use of PGF2alpha or its analogues.
 Administration of PGF2alpha results in
o Regression of the corpus luteum
o Dilatation of the cervix
o Expulsion of the purulent fluid, with
o Estrus occurring 3-5 days later.
MUCOMETRA: In Cattle
 In general, mucometra and hydrometra are similar
 Difference is only the degree of hydration of the mucin in the uterus, may vary from a
watery fluid to a semisolid mass
 Secondary to cystic ovaries and cystic endometrial hyperplasia usually associated with an
anestrus period of 6 months or more
o Small cysts, 1 - 1.5 cm
o Usually two to four cysts on each ovary
o Resists rupture by manual pressure due to thick cyst wall
o In addition, characterized by cystic degeneration of the endometrium and atrophy of
the uterine wall, with an ounce to ~4500 ml of thin to viscid mucus in the uterus.
ETIOLOGY
 Observed in heifers or cows with arrests in the development of the Mullerian duct system or
segmental aplasia of the paramesonephric ducts in which part of the vagina, cervix, or
uterus may be missing or defective
 Persistence of the hymen causing mucometra and mucovagina has been previously
described
 These genetic or congenital defects may result in a distention of both horns with watery,
viscous, or even rather solid coagulated masses of mucus and cellular debris that may be
confused with pregnancy
 In these affected cattle the ovaries and endometrium are normal, and estrum therefore
usually occurs normally
 Rare cases of mucometra may be associated with a retained corpus luteum
 In the cow, as in the dog, mucometra can apparently be produced by prolonged hormonal
stimulation by estrogens and/or progesterone.
 Secondary to trauma and a line adhesion obstructing the lumen of the cervix at the region of
the internal os
 In cases of mucometra, no infection is usually present unless introduced accidentally by
trauma, service, or treatment.
DIFFERENTIAL DIAGNOSIS
 Mucometra should be differentiated from pregnancy
 This can be accomplished by a careful examination of the genital tract
o Failure to slip fetal membranes
o Presence of anomalies in the uterus, vagina, and cervix
o Ovaries palpable with a single or multiple small cysts 0.5 - 0.75 inch in diameter
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o Persistent corpus luteum on repeated examinations

o Lack of enlargement or whirring of the uterine artery
o Inability to palpate the fetus or cotyledons
o Although some cases with firm, gum- like-mucus in one horn or an apex of one horn
may simulate a fetus or mummified fetus
o Presence of a uterine wall that is usually thin and lacks tone as compared to the
normal pregnant uterus, and
o Absence of regular developmental changes that occur in a normal pregnancy are the
clinical findings on rectal examination of cattle.
PROGNOSIS
 Use as breeding animals is questionable from a hereditary standpoint
 Cows with mucometra, or hydrometra due to defects of the genital tract are often sterile
 In case of uterus unicornis, pregnancy occurs in the normal horn
 In simple imperforate hymen, it can be opened.
TREATMENT
In cows with mucometra and anestrum due to cystic ovaries
 Large dose of LH 20,000 IU of HCG or more intravenously may occasionally bring about
recovery.
In rare cases of mucometra with a persistent corpus luteum
 Old approach
o Injection of estrogens to involutes the corpus luteum (CL) or
o Manual removal of CL may be successful in correcting the condition.
 Current approach
o Injection of Prostaglandin F2 alpha 25 mg i/m.
PYOMETRA: In Bitches
In bitches,
 Pyometra refers to the accumulation of purulent material within the uterus
 Hydrometra refers to uterine distension with sterile fluid (watery secretions)
 Mucometra refers to uterine distension with sterile fluid (mucoid secretions).
INTRODUCTION
 Pyometra is a life threatening condition associated with cystic endometrial hyperplasia.
 Cystic endometrial hyperplasia and pyometra both develop during diestrus.
 Administration of estrogen increases the risk of pyometra during diestrus.
 The risk of an intact bitch developing pyometra before 10 years of age is 23% to 25%.
 Infection causes the morbidity and mortality associated with pyometra.
 Concurrent abnormalities in animals with pyometra may include
o Hypoglycemia
o Renal dysfunction
o Hepatic dysfunction
o Anemia
o Cardiac abnormalities, and
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o Coagulation abnormalities.
 Pyometra is often associated with systemic inflammatory response syndrome caused by
production and release of inflammatory mediators with systemic effects.
 Hypoglycemia is common in canine pyometra.
PATHOPHYSIOLOGY
 In normal non-gravid bitch, the diestrual period lasts approximately 70 days.
 Progesterone produced by ovarian corpora lutea exerts its influence on the uterus and:
o Stimulates the growth and secretary activity of the endometrial glands, and
o Reduces myometrial activity.
 Cystic endometrial hyperplasia is an abnormal uterine response that develops during
diestrus (luteal phase of cycle) when there is high or prolonged ovarian production of
progesterone or exogenously administered progesterone.
 Excessive progesterone influence or an exaggerated progesterone response causes the
uterine glandular tissue to become cystic, edematous, thickened and infiltrated by
lymphocytes and plasma cells.
 Fluid accumulates in endometrial glands and the uterine lumen with cystic endometrial
hyperplasia.
 Progesterone inhibition of myometrial contractility interferes with the uterine drainage.
 This abnormal uterine environment allows bacterial colonization to cause pyometra.
DIAGNOSIS
 The diagnosis of pyometra in bitches is based on
o Clinical presentation
o Physical examination
o Diagnostic imaging
o Laboratory findings
CLINICAL PRESENTATION
Signalment
 Affects intact dogs more commonly than cats.
 No breed predisposition in dogs although some indicate a modestly increased risk in various
breeds (golden retrievers, miniature schnauzers, Irish terrier, rough St. Bernard, Leonberger
Airedale terrier, Cavalier King Charles spaniel, rough collie, Rottweiler, Bernese Mountain
dogs and English cocker spaniels).
 Domestic shorthair and Siamese cats are affected more commonly than other breeds.
 Generally occurs in older (6 to 11 years, median 9 years) intact bitches and queens
 May occur in younger animals that have been given exogenous estrogen (dogs) or
progestins (cats).
 Nulliparous bitches are at moderately greater risk for pyometra than are primiparous and
multiparous bitches.
History
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 Usually occurs several weeks (i.e. in cats 1-4, in dogs 4-8) after estrus or following
mismating injections or exogenous administration of estrogens or progestins.
 May have a purulent or bloody vaginal discharge.
 Obvious abdominal distension
 Fever
 Partial-to-complete anorexia
 Lethargy
 Polyuria
 Polydipsia
 Vomiting
 Diarrhea, and/or
 Weight loss.
 Animals with closed pyometra more commonly have vomiting and diarrhea.
PHYSICAL EXAMINATION FINDINGS

 In open cervix pyometra, a purulent blood-tinged vaginal discharge may be observed.
 On abdominal palpation, uterine distension may be detected.
 Dehydration is frequent.
 If endotoxemia or septicemia is present, the bitch may be in shock, hypothermia, and/or
moribund.
 Fever is infrequent.
DIAGNOSTIC IMAGING
 A fluid-filled uterus should be detected on abdominal radiographs and / or ultrasonography
Canine pyometra
 The enlarged uterus is located in the caudal abdomen and may displace intestines cranially
and dorsally
 Open pyometra or uterine rupture may cause enough drainage so that the uterus is not
radiographically detected
 Displacing the intestines with a wooden spoon or abdominal bandage may improve uterine
visualization, but should be performed with caution if the uterus is significantly distended
because it may induce rupture
 Signs of uterine rupture and peritonitis (i.e., poor visceral detail) should be noted
 It is important to rule out pregnancy
 Radiographic confirmation of pyometra may not be possible until 41 to 43 days after
ovulation
 Radiographically, fetal calcification can be identified after approximately 45 days of
gestation
 Ultrasonography can identify fetal structures, assess fetal viability, identify uterine fluid and
determine uterine wall thickness and irregularities
 Pyometra, hydrometra, mucometra or hematometra may appear similar ultrasonographically
and radiographically. However, although mucometra and hydrometra typically are
associated with anechoic fluid within the uterine lumen on ultrasound, the fluid associated
with pyometra is typically echogenic.
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Radiographic image of pus filled Ultrasound image of uterine sacculations

and distended uterus
LABORATORY FINDINGS
 Metabolic clinicopathologic abnormalities may occur.
Most common hemogram findings

o Neutrophilia with a left shift
o Monocytosis, and
o White blood cell toxicity.
 White blood cell numbers usually exceed 30,000/ ml, with closed pyometra and may be as
high as 100,000 to 200,000/ ml. However, normal numbers of white blood cells are often
seen with open pyometra.
 Leukopenia may indicate overwhelming infection and septicemia or uterine sequestration of
Neutrophils.
 Increased leukocyte count and decreased lymphocyte count are directly proportional to the
disease severity.
 The high percentage of bands in most pyometra helps differentiate them from cystic
endometrial hyperplasia with mucometra.
 Mild normocytic, normochromic, non-regenerative anemia or non-regenerative, microcytic,
hypochromic anemia may occur.
 Clotting abnormalities and disseminated intravascular coagulation may occur in severely
affected patients.
Common biochemical abnormalities - It includes

 Hyperproteinemia
 Hyperglobulinemia, and
 Azotemia.
 Hyponatremia and hyperkalemia may occur with severe vomiting or diarrhea, mimicking
hypoadrenocorticism.
 Less common abnormalities include
o Increased alanine aminotransferase, and
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o Alkaline phosphatase activities (secondary to toxemia-induced hepatocellular

damage or dehydration).
 Hyperglycemia or hypoglycemia may be associated with concurrent diabetes or sepsis.
 Although C-reactive protein elevations help differentiate pyometra from cystic endometrial
hyperplasia with mucometra, the test is not readily available.
 Urinalysis may reveal isosthnuria, proteinuria, and/or bacteriuria.
 To prevent uterine puncture and abdominal contamination, cystocentesis should not be
performed if pyometra is suspected.
 Vaginal cytology confirms a septic exudates with open pyometra and is abnormal (i.e.,
predominantly neutrophils with some degenerative bacteria), even when the cervix is
closed.
 Bacterial culture and susceptibility are essential for selection of appropriate antibiotics.
 Canine pyometra should be differential diagnosed from that of the following conditions
o Pregnancy
o Mucometra
o Hydrometra
o Pyovagina
o Metritis
o Uterine torsion, and
o Peritonitis
MEDICAL MANAGEMENT
 In critically ill patients, use of prostaglandin therapy to evacuate the uterine contents is not
ideal because evacuation is neither immediate nor complete.
 In metabolically stable, valuable breeding animals, medical therapy with antibiotics for 2-3
weeks and with PGF2 alpha or preferably aglepristone (antiprogestin) combined with
cloprostenol (synthetic PG) can be considered.
 In open cervix pyometra, medical therapy is most preferred.
 In such cases, PG may be need in more than one series of injections.
 While resorting to PG therapy, the veterinarian should clearly discuss and inform the owner
about the serious complications such as uterine rupture or leakage of intraluminal contents
in to the abdomen and sepsis are possible.
 Transient (30-60 minutes) side effects include
o Panting
o Salivation
o Emesis
o Defecation
o Urination
o Mydriasis
o Nesting
o Tenesmus
o Lordosis
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o Vocalization, and
o Intensive grooming
 High dose of PG may lead to
o Ataxia
o Collapse
o Hypovolemic shock
o Respiratory distress, or
o Death
 Fertility may get reduced with the use of PG treatment.
 Combination of aglepristone and cloprostenol over 15 days has been reported to be safe and
effective with few side effects.
 Vulvar discharge increases and clinical signs begin to improve within 24-48 h of initial
aglepristone injection.
 Including an anti-lipopolysaccharide to reduce endotoxins may be beneficial.
 It is advisable to breed the animal during following estrus cycle.
 Chance of recurrence is 20% during subsequent oestrous cycle.
Drugs Dose Route
Antibiotics for - -
2-3 weeks
or PGF2alpha 0.1 0.25 mg/kg; BID, 3-5 days SC
or PGF2alpha 12.5 - 25 mg/kg Intra Vaginally, raise

hind quarters for 3-5
min
With 10 mg/kg; Days 1,3,8 and 15 (if not cured SC

Aglepristone based on ultrasonography)
With 1 µg/kg; Days 3 and 8, "far from feeding"; SC

Cloprostenol alternatively administer on days 3,5,8,10, 12,
and 15 (if not cured based on ultrasonography)
TREATMENT
 Surgical treatment [ovariohysterectomy (OHE)] should not be delayed more than is
absolutely necessary. Morbidity and mortality are associated with concurrent metabolic
abnormalities and organ dysfunction.
 Surgical drainage of the uterus without OHE is not recommended, but has been successful
in a few cases.
 The corpus lutea are removed and each horn lavaged and suctioned.
 Indwelling drains are placed through the cervix to allow daily lavage with diluted
antiseptics.
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PRE-OPERATIVE MANAGEMENT
 Surgery should not be delayed more than a few hours while medical therapy (i.e., fluid
therapy) is instituted especially in patients with closed pyometra.
 Urine output, glucose and arrhythmias should be monitored preoperatively.
 Hydration, electrolyte and acid-base imbalances should be corrected before surgery, if
possible (the prognosis is improved when azotemia is corrected before surgery).
 A broad-spectrum antibiotic effective against E. coli (e.g., cefazolin, cefoxitin, enrofloxacin
and ticarcillin plus clavulanate; should be given IV while awaiting antibiotic susceptibility
results. Aminoglycosides are nephrotoxic and not recommended because of the prevalence
of renal dysfunction with pyometra.
 In addition to fluid volume replacement, severely endotoxic or septicemic patients may also
be given corticosteroids (15 to 30 mg/kg prednisolone sodium succinate IV).
 Fluid input and uterine output should be monitored to help assess renal function.
 Low-dose dopamine (0.5 to 1.5 mg/kg/min IV) may be used to improve renal function or
diuretics (e.g., frusemide, 2 to 4 mg/kg IV, IM or SC or 20% dextrose IV) may be
administered in volume-overloaded patients with reduced urine production.
 Administration of anti-arrhythmic may occasionally be necessary.
SELECTED ANTIBIOTICS TO TREAT PYOMETRA
Antibiotics Dose Route
Cefazolin 22 mg/kg; TID IV or IM
Cefoxitin 30 mg/kg; TID IV
Amoxicillin plus Clavulanate 12.5 - 25 mg/kg; BID PO
Ampicillin 22 mg/kg; TID to QID IV, IM, or SC
Ticarcillin plus Clavulanate 50 mg/kg; TID to QID IV
Enrofloxacin 7- 20 mg/kg; once a day PO or IV
ANAESTHESIA
 Anesthetic protocols vary greatly depending on patient status.
 Animals that are systemically ill need to be closely monitored during anesthesia. They may
be induced with an opioid plus a benzodiazepine, given in incremental doses as necessary to
intubate.
 If intubation is not possible, etomidate or reduced dosage of thiopental or propofol may be
given. If etomidate is not available, arrhythmic dogs may be premedicated with
hydromorphone and induced with thiopental and lidocaine. For the latter, 9 mg/kg of each is
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drawn up and half is given initially, IV. Additional drug is given to allow the dog to be
intubated. To prevent toxicity, usually no more than 6 mg/kg of lidocaine is given IV.
 Isoflurane and sevoflurane are the inhalants of choice because they cause minimal cardiac
depression, and induction and recovery are usually rapid.
 The anaesthetic depth should be monitored closely in these patients.
 Hypotension should be corrected before and prevented during and after surgery in animals
with pyometra.
 The patient should be monitored for arrhythmias or tachycardia.
 Hypertonic saline with a colloid (e.g., dextran or hetastarch) improves hemodynamics and
oxygenation in animals with septic shock.
SURGICAL TECHNIQUE
Positioning
 Position the patient is dorsal recumbency for a ventral midline celiotomy
 The entire ventral abdomen should be clipped and prepared for aseptic surgery
Surgical Technique
 Expose the abdomen through a ventral midline incision beginning 2-3 cm caudal to the
xiphoid and extending to the pubis
 Explore the abdomen and locate the distended uterus.
 Observe for evidence of peritonitis (i.e., serosal inflammation, increased abdominal fluid,
and petechiation)
 Obtain abdominal fluid for culture
 Evacuate the urinary bladder by cystocentesis and collect a urine specimen for culture and
analysis if not previous submitted
 Carefully exteriorize the uterus without applying pressure or excessive traction
 A fluid-filled uterus is often friable; therefore lift rather than pull the uterus out of the
abdomen
 Do not use a spay hook to locate and exteriorize the uterus because it may tear
 Do not correct uterine torsion because this will release bacteria and toxins
 Isolate the uterus from the abdomen with laparotomy pads or sterile towels
 Place clamps and ligatures as previously described for OHE except that the cervix may be
resected in addition to ovaries, uterine horns and uterine body.
 Ligate the pedicles with absorbable monofilament suture material (i.e., 2-0 or 3-0
polydioxanone or polyglyconate) and transect the junction of the cervix and vagina.
 Thoroughly lavage the vaginal stump.
 Culture the contents of the uterus without contaminating the surgical field.
 Remove laparotomy pads and replace contaminated instruments, gloves and drapes.
 Lavage the abdomen and close the incision routinely unless peritonitis is present.
 Submit the uterus for pathological evaluation.
POST-OPERATIVE CARE
 Administer post-operative analgesics
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 Closely monitor for 24-48 h for sepsis and shock, dehydration, and electrolyte/acid-base
imbalances.
 Severe hypoproteinemia or anemia may require plasma or blood transfusions.
 Fluid therapy should be continued until the animal resumes normal feed and water.
 Antibiotic therapy should be continued based on culture and sensitivity results for 10-14
days.
 Low dose dopamine (of questionable value) or diuretics may be given if urine production is
reduced.
COMPLICATIONS
 Complications associated with elective ovariohysterectomy (OHE) may also occur
following OHE for pyometra.
 Death (5-8%) despite of appropriate therapy, especially following uterine rupture (57%).
 Septicemia, endotoxemia, peritonitis, and cervical or stump pyometra may occur.
 Stump pyometra may be associated with residual ovarian tissue. In such cases, excise the
remaining stump and remove the residual ovarian tissue.
 Other complications include anorexia, lethargy, anemia, pyrexia, vomiting, icterus, hepatic
disease, renal disease, and thrombo-embolic disease.
 Most complications resolve within two weeks of surgery.
PROGNOSIS
 Prognosis is good, if
o Abdominal contamination is avoided
o Shock and sepsis are controlled
o Fluid therapy to reverse renal damage
o Elimination of bacterial antigen
 Death usually occurs without surgical or medical therapy
 Recovery may follow corpus luteum regression and spontaneous uterine drainage.
 Death may occur when metabolic abnormalities are severe and unresponsive to appropriate
therapy.
 Mortality rates following surgery are approximately 5-8%.
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11. DISEASES AND ACCIDENTS DURING GESTATION - FETAL MUMMIFICATION,

FETAL MACERATION
Fetal death during the middle or last one third of gestation with failure of regression of the
corpus luteum and abortion of the fetus within a week or 10 days or decomposition or maceration
of the fetus within the next several months, followed by autolytic changes in the fetus, absorption
of placental and fetal fluids, and involution of maternal placenta leads to MUMMIFICATION.
INCIDENCE
 In cattle, the incidence of fetal mummification is low and sporadic.

 In some herds the incidence may be higher and in few instances apparent epizootics of
mummified fetuses may occur.
TYPES OF MUMMIFICATION
1. Hematic mummification
2. Papyraceous mummification
Hematic mummification
 Observed in cattle
 Maternal placenta or caruncle undergoes involution
 Between endometrium and fetal membranes, variable amount of hemorrhage occurs
 Plasma gets absorbed and leaves a reddish-brown, gummy, tenacious mass of autolyzed red
cells, clots and mucus, and
 Imparts reddish-brown color to fetus and fetal membranes.
 Incidence low and sporadic.

 Affects cattle of all ages.
 Occur at 3–8th month of gestation but most common in 4, 5 and 6th months.
 Usually affects single fetus but may occasionally involve one or both fetuses in twin
pregnancies.
ETIOLOGY
 In cattle, cause of fetal death and mummification are same as for fetal death and abortion.
 Genetic factors.
 Torsion or compression of umbilical cord.
 Fetal death due to Infectious causes includes V. fetus, moulds, leptospirosis and BVD-MD
virus.
 Administration of progesterone or progesterone like compounds if continued beyond 210
days of gestation.
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 It is often difficult or impossible to ascertain the cause, since the time of fetal death is
unknown and due to autolysis and mummification of fetus and membranes.
CLINICAL SIGNS
 Failure of oestrum.
 Not suspected until late in gestation when normal development of the fetus, body changes
related to parturition and calving fail to occur.
 Mummy remains in semi-moist state without odour or pus until spontaneous abortion in 1-2
months to 1-2 years, or until diagnosed, treated or corrected or slaughtered.
 Rectal examination reveals
o Persistent corpus luteum (PCL)
o Uterine walls contracted and tightly enclose the conceptus
o Uterine walls fairly thick
o Absence of fetal fluids
o Absence of cotyledons, and
o Uterine artery small and absence of fremitus.
o In early case
 Uterus feels doughy due to large, soft blood clot
 Difficult to palpate the fetus.
o In long standing case
 Dry, firm and more leather – like fetus (In cow).
 Vaginal examination reveals a closed cervix with a mucous seal of pregnancy.
PAPYRACEOUS MUMMIFICATION
 Observed in mares, sheep, goats, dogs and cats.

 Resorption of fetal fluids
 Shriveled and dried fetal membranes, and
 Resemble a parchment paper.
 Observed in the sow, bitch and cat, as well as in the biparous ewe and goats
In Swine
 Occurs most frequently.

 Important cause of prenatal losses.
 Economic importance by lowering the fecundity.
 In-utero death of fetuses between 40–90 days of gestation, undergo mummification and are
expelled at parturition.
 High incidence in five viral diseases
o Aujezsky’s disease or pseudo-rabies
o Japanese encephalitis B virus
o Japanese hemagglutination virus
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o Modified hog cholera virus, and

o A number of picorna, entero- or SMEDI viruses.
 No clinical sign of mummification during pregnancy.
 Draws attention at parturition, when among the normal piglets small mummified fetuses,
surrounded by parchment-like membranes, are expelled.
In dogs and cats

 Uncommon
 Sporadic
 Tendency to be associated with uterine inertia, particularly if only one normal fetus is
present.
 In cats, relatively frequent occurrence.
 Often noticed in large litters with expulsion of liver-like, partially resorbed placentae along
with normal fetuses.
 Close inspection may reveal an attached, small, resorbed fetus.
 It may represent overcrowding in the uterus and relative underdevelopment of the placenta,
leading to fetal death.
DIAGNOSIS
 Based on History and Clinical examination
 Prognosis is guarded.
TREATMENT
Two treatment options are available.
o More rational approach is to initiate parturition.

o Perform hysterectomy.
Termination of pregnancy
 Manual
o Enucleation of Persistent corpus luteum (PCL)
o Danger of trauma and damage to ovary
o Following removal of CL
 The cervix dilates and secretes fluid mucous.
 The uterus contracts and forces the fetus outwards, and
 At the same time the cow shows estrus.
 Medical
o Use of estrogen and prostaglandin preparations.
o A similar chain of events may be caused by therapeutic luteolysis using stilboestrol
or prostaglandin F2 alpha.
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o With the advent of prostaglandin F2 alpha, the above approaches have lost
importance mainly due to their less precision and reliability.
o Since mummification is characterized by a PCL, it can be treated with prostaglandin
F2 alpha preparations.
FETAL MACERATION
 Occur at any stage of gestation.

 Observed in all species, most often in cows
 When fertilized ovum or embryo succumbs to bacterial or viral infection or other diseases
or abnormality early in gestation it is usually absorbed in the uterus or a slight and often
insignificant purulent uterine or vaginal discharge may be present.
 The interval between the estrual periods may be prolonged if the embryo did not succumb
until 20-50 days after conception.
 Early embryonic death and maceration are probably caused by a variety of miscellaneous
organisms that may be found in the uterus and are of common occurrence in cows affected
with trichomoniais or vibriosis.
 Occasionally cases of pyometra seen in trichomoniais, fetal shreds and placental remnants
are often found floating in the pus.
 In cases of early fetal maceration, the cervix may be tightly sealed or some pus discharge
may be evident in the vagina or from the vulva.
 These cases are usually diagnosed and treated as pyometra or endometritis; in the former,
estrum is not present; in the latter estrum may occur.
FETAL MACERATION IN COW
 Occurs after 3 months of gestation, by which time fetal bones are fairly well developed.
 Caused by similar wound infection bacterial agents.
 Septic metritis of pregnancy, resulting in the death, emphysema and maceration of the fetus
in a closed uterus is uncommon.
 Symptoms of septic metritis of pregnancy are similar to septic metritis after parturition.
 Condition may be more serious and fatal due to the presence of decomposing fetuses, failure
of cervix and genital canal to dilate normally and a uterine inertia.
 More commonly fetal emphysema and maceration follow fetal death and beginning abortion
in which the cervix had dilated, but the fetus was not expelled due to:
o Failure of the genital tract to dilate sufficiently or
o Failure to contract normally or
o Because of fetus was dead and in an abnormal position and posture.
 In rare instances, fetal emphysema and maceration may be associated with uterine torsion
during gestation.
 Fetal emphysema and maceration follows when 2 factors are present:
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o Open cervix
o A dead fetus at body temperature
o Both cause a rapid bacterial invasion of the fetus and fetal membranes of organisms
already present in the uterus or from the more caudal portions of the reproductive
tract.
 If the bovine fetus is beyond the 3 rd month of pregnancy and if the usual expulsive efforts
are not observed or are unsuccessful, the fetus develops emphysema in 24-48 h and in 3-4
days maceration begins.
 Because of relatively smaller size of the fetus, those cases of fetal emphysema and
maceration accompanying an abortion during the middle period of gestation are treated
differently.
SYMPTOMS AND DIAGNOSIS IN COW

 History of intermittent straining for several days associated with foul, fetid, reddish-grey
vulvar discharge
 Temperature and pulse often elevated
 Anorexia
 Drop in milk production, and
 Occasionally diarrhea.
 Palpation per vaginum or rectum
o Distended, swollen fetus with gas crepitating in the tissues is diagnostic of fetal
emphysema.
In long standing cases
 Acute emphysematous stage has passed
 Straining is seldom observed
 Cervix is quite contracted
 Generalized symptom of elevated temperature, pulse and anorexia are usually not present
 There is often history of chronic, fetid, mucopurulent discharge from the vulva over a
period of several weeks or months
 Rarely cervix may be sealed
 History of gradual drop in milk flow
 Loss of weight, and
 Presence of diarrhea.
RECTAL EXAMINATION FINDINGS IN COW AND MARE

 Fetal bones may be palpated in the uterus either floating in the pus or crepitating against
each other with little pus around them.
 Uterine wall is thick and heavy.
 Cervix usually large and hard.
 Severe degenerative and sclerotic changes in the endometrium.
SYMPTOMS AND DIAGNOSIS IN DOG AND CAT

 In most cases no external symptoms of illness are seen except possibly a uterine discharge
appearing occasionally in the vulva.
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 Diagnosis is aided by abdominal palpation and radiographs besides observing symptoms.
PROGNOSIS
 Poor
 Treatment in the cow is difficult
 If much pus is present, treat as for pyometra
 Laparohysterotomy is difficult because of the small size of the uterus and its infected
contents and seldom indicated
 Future breeding life is questionable
 Longer the condition, the greater the damage to the endometrium, poorer the prognosis
 Most cases, slaughter is recommended
 In multiparous animals, hysterectomy or hysterotomy may be performed depending upon
the circumstances.
TREATMENT
In bovine
 In abortion from 3-7 months with fetal emphysema:
o If the cervix is sufficiently dilated and lubrication is used, fetus usually may be
removed by careful and gradual traction.
o In those cases in which the cervix is contracted and the fetus cannot be removed,
heroic treatment is not indicated.
In mare
 Cervix may be carefully dilated manually prior to removal of the decomposing fetus
 After removal, the uterus should be re-examined to make certain another fetus is not present
and remove the placenta if possible.
Supportive treatment
 Administration of antibiotics and sulphonamides parenterally along with large doses of
estrogens: 50-100 mg of stilboestrol or 5-10 mg of estradiol daily or every other day for 4-7
days.
 Until the cervix is relaxed enough or the fetus is macerated sufficiently to effect its removal
entirely or in pieces without injury to the cow.
 With this type of treatment, the danger of excessive traction or embryotomy causing
lacerations or rupture of the cervix and uterus is avoided.
 Because the uterus and its contents are relatively small, the development of septic metritis
and severe toxemia is prevented by supportive therapy.
 Cesarean section should be considered as a last resort in the cow.
 Cow should not be rebred for at least 3-4 months, and the outlook for her reproductive life
is guarded.
EXTRAUTERINE PREGNANCIES AND FETUSES

TYPES OF EXTRAUTERINE PREGNANCIES
 Extra uterine pregnancies are of two types
o True extra uterine pregnancy
o False extra uterine pregnancy
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 In humans, some long existing extra uterine fetuses become quite firm and encapsulated
with calcium laid down in the capsule, causing them to be spoken as "Lithopedions"
 These well encapsulated extra uterine fetuses in animals may occasionally be referred
as “Extra uterine fetal mummies".
FALSE EXTRA UTERINE PREGNANCY
In this condition the fertilized ovum, embryo or fetus develops normal placental relationship with
the endometrium and the fetus reaches recognizable size. It then escapes from the uterine cavity
either into the abdominal cavity or vagina.
 Seen occasionally in all domestic animals, and very rarely in mares.
 Occurs in last 2/3 rd of gestation.
 Almost all secondary extra uterine pregnancy fetuses are dead by the time the condition is
diagnosed
 In so called vaginal pregnancies, it is obvious on examination that the fetus came through
the cervix from the uterine cavity.
 The cause of uterine rupture is frequently unknown.
 Occurs in uterine torsion, fetal emphysema, chronic peritonitis and following dystocia, and
administration of oxytocin in bitches.
 Occur spontaneously or possibly associated with violence in advanced pregnancy.
 In multipara, uterine torsion may involve a part of one horn or the entire horn with the
enclosed fetus being separated from the rest of the uterus.
 The adhesion that takes place may cause the condition to be diagnosed as an extra uterine
pregnancy or fetus.
 In many cases in domestic animals in which a sterile fetus is released in to the abdominal
cavity with little or no external symptoms.
 The fetus dies and with its membranes becomes walled off as a sterile foreign body in the
ventral portion of the abdominal cavity and remains there as an inert mass for months.
 Often extensive adhesion develops between it and other viscera.
 Site of rupture may be small or invisible scar after the uterus involutes.
 Mild digestive disturbance may be present.
 Occasionally large extra uterine pregnancy may be diagnosed by rectal examination in cow,
if the fetus was near term when it escaped from the uterus.
 Extra uterine pregnancies should be differentiated from:
o Mummification
o Tumors, and
o Fat necrosis
PROGNOSIS
 Guarded.
 Advise Slaughter.
 Laparotomy to remove the fetus in large animals may be difficult because of extensive
adhesions whereas in dogs and cats, operation may be considered
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12. DISEASES AND ACCIDENTS DURING GESTATION - VAGINO-CERVICAL

PROLAPSE
Vagino-Cervical prolapse usually involves a prolapse of the floor, the lateral walls and a
portion of the roof of the vagina through the vulva with the cervix and the uterus moving caudal,
not infrequently the entire vagina and cervix are prolapsed through the vulva.
INCIDENCE
 Seen commonly in all species of domestic animals, but most commonly in the cow and ewe.
 In late pregnancies it is less than 1% of all obstetrical cases.
 Prolapse of the vagina and cervix will invariably recur and become more severe during
subsequent pregnancies.
 Incidence of ovine vagino-cervical prolapse is 0.5%; it may reach 20%.
 Commonly seen in young brachycephalic dogs during oestrum.
 In cats, it is practically unknown.
ETIOLOGY
 Probably multiple.
 Observed during last 2-3 months of gestation, when large amounts of estrogenic hormone
being secreted by the placenta.
 Intra-abdominal pressure.
 Due to hereditary or genetic factors.
 More common in pluripara than in primipara, injuries or stretching of the birth passage at
the first or subsequent parturitions may predispose to prolapse.
 Favoured by close confinement; in which the cow's rear quarter projects over the gutter.
 Sheep confined on lush pastures and carrying twins.
 Over distension of the abdomen or excessive amounts of loose pelvic fat favour the
condition by increasing the intra-pelvic pressure.
 In cattle occasionally observed following parturition, but often associated with cystic
ovaries.
PATHOGENESIS
 Due to a combination of some factors, when an animal becomes recumbent on an inclined
plane with its hind quarters positioned downward will lead to prolapse.
 Spontaneous reduction occurs in initial cases when the cow rises.
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 Recurrent prolapse often causes bruising, soiling and infection, and in turn leads to the
development of inflammatory swelling of the mucosa.
 As a result of inhibited venous blood return there is an increase in the swelling of the mass.
 Progressive circulatory embarrassment results in thrombosis and finally leading to necrosis.
 The mass reaches a size which precludes spontaneous reduction so that the condition
becomes permanent.
DIAGRAMATIC REPRESENTATION OF STAGES OF DEVELOPMENT OF VAGINAL

PROLAPSE
A - Slack vaginal wall, B - Prolapse following recumbency, C - Spontaneous reduction

of prolapse on standing, D - Swelling of the vaginal wall after recurrent prolapse, E -
Irreducible prolapse, and F - Devitalized vaginal wall after reduction of prolapse.
SYMPTOMS
 The symptoms of vagino-cervical prolapse are obvious and the condition is often spoken of
by the farmer as “Casting of the wethers".
 The symptoms may vary from
drvet Page 87
o A mild protrusion of the vaginal mucous membrane through the vulval lips when
the animal lies down, to a severe necrotic vagino-cervical prolapse containing a
greatly distended bladder and complicated by a prolapse of the rectum due to
constant tenesmus.
o Edema of the prolapsed vagina and cervix occurs because of the irritation
and trauma to the exposed mucous membrane, and because this portion drops over
the ischial arch thereby causing a passive venous congestion.
o The cervical seal usually remains intact; although if the cervix is prolapsed and
inflamed, the external portion of the seal may be absent.
o Occasionally the cervix relaxes, the seal is lost and abortion or premature parturition
occurs within 24-72 h.
o In neglected, severe cases the exposed mucous membrane may be necrotic resulting
in a toxemia and septicemia. Necrosis and gangrene may even involve the cervix
and the caudal portion of the uterus secondary to severe vascular insult and
thrombosis.
TREATMENT: GENERAL CONSIDERATIONS

 Method of treatment varies with the
o Species and breed of the animal
o Severity of the condition
o Stage of pregnancy
o Ability of the owner to care for, and observe the animal until after parturition.
 Early prompt treatment often permits the use of simple conservative methods and obviates
the necessity of using more heroic techniques.
 Operator should select the most conservative method possible under the circumstances and
caution the owner that as pregnancy progresses other methods may need to be used to
control the condition.
 Combinations of methods may be used.
PROCEDURE FOR MANUAL REDUCTION

 In replacing the prolapsed bovine vagina and cervix, epidural anesthesia is very helpful and
usually is necessary in more severe cases where tenesmus is present.
 It is advisable to have the animal standing, preferably with the hind quarters elevated to
facilitate easy replacement of the prolapsed mass.
 Methods to elevate rear quarters
 Portable rear quarter elevator device
 Wash the prolapsed portions free of dirt and debris with a mild, non-irritating antiseptic
solution or physiological saline.
 If irritation, infection, or straining is present, bland antiseptic oil, such as 1 oz. of bismuth
formic iodide in a pint of mineral oil; or sulfonamides or antibiotics in oil or ointment might
be helpful when applied to the prolapsed mass before replacing.
 If difficulty is encountered in replacement of the prolapsed vagina due entrapment of a
distended bladder, gently raise the prolapsed portion dorsally in order to reduce the sharp
kink in the urethra, thus permitting the escape of collected urine.
 Palpate the bladder before replacing the uterus, if distended, catheterize so that it does not
interfere with the replacement process.
 However in exceptional cases, it may be necessary to trocarize the bladder through the
prolapsed vaginal wall with a large gauge needle.
 Following replacement of floor and walls of the prolapsed mass, normal circulation is
restored and the edema in the vaginal walls and mucous membrane is rapidly reduced.
drvet Page 88
 Carefully introduce into the vagina sulfonamides or antibiotics in oil or ointment once or
twice daily for several days or more after replacement.
 If the vagina is badly infected the animal may have an elevated body temperature. In such
cases, and in those where the cervix is relaxed and dilated and abortion is likely, a course of
antibiotics or sulphonamide therapy is indicated to control infection and septicemia, and if
abortion does occur to prevent septic metritis.
DIFFERENT TREATMENT APPROACHES
 Elevation of the rear quarters is the most practical method in cattle

 Hormone: Inj. Progesterone: 50-100 mg i.m. daily or 500 mg once every 10 days - rationale
not clear
 Unilateral pudental neurectomy is unsatisfactory
 Vulvar truss is of practical value
 Pessaries are popular in Europe but not in USA.
 Vulvar tape retention sutures
 Buried or "hidden" purse string type suture, Buhner's method
 Modified Caslick’s operation
 Minchev's method: Surgically fastening the cranial portion of the vaginal wall through the
lesser sciatic foramen to the dorso-lateral wall of the sacrosciatic ligament, muscles and skin
of the croup.
 Winkler's method: fixation of the cervix to the prepubic tendon.
 Farquharson method: submucous resection of the edematous and devitalized mucous
membrane.
 Guard and Frank technique.
 In chronic prolapse in postpartum cows treatment with a gonadotropic hormone rich in the
luteinizing factor is indicated, if cystic ovaries are present.
VULVAR TAPE RETENTION SUTURES

Indications
 It is one of the simplest, most common and effective method to retain a simple or recurrent
vaginal, cervical or uterine prolapse in cattle.
 It is a temporary measure to control prolapse.
Restraint
 If the animal is standing, it is retrained in a travis.
 If recumbent, the hind quarter should be elevated using either conventional methods or
a hind quarter elevator device.
 Administer sufficient amount of epidural anaesthesia using 2% Lignocaine Hcl to produce
analgesia of the perineal skin to about 3 cm below the ventral commissure of the vulva.
Materials required
 Gerlach's perivaginal needle
 Sterile cotton umbilical tape
 Povidone iodine
 Scissors
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Procedure
 Clean and thoroughly disinfect the anus, vulva, prolapsed parts, perineal skin and the tail.
 Return the prolapsed part to its proper position.
 Locate the vulvar hairline on one side (located at least 2-3 inches lateral to the vulvar
lips) and swiftly pass the needle subcutaneously from the dorsal commissure parallel
through the entire vulval lip out of the ventral commissure.
 This affords a much tougher and thicker skin for the suture, which does not tear out as
readily nor cause as much irritation as one in the vulvar lips.
 Place one hand in the vagina for proper orientation of the needle and to maintain it at a
depth of about 5-6 cm until the eye of the needle emerges through the ventral commissure.
 A piece of sterile cotton umbilical tape, 30 cm long, dipped in povidone iodine is threaded
through the eye of the needle and in one stroke pulled out through the dorsal commissure.
 Likewise repeat the procedure on the other side.
 Both the ends are tightened and securely tied towards one side. The excess ends of the tape
are cut short.
 It is desirable to use a type of suture that can be untied or released.
BURIED OR "HIDDEN" PURSE STRING TYPE SUTURE, BUHNER'S METHOD

 It is used for the vulva following replacement of a prolapsed vagina described by
Pierson, Arthur (1966) and Woelffer.
 This technique may be used in chronic post partum prolapse as well as pre-partum
prolapse.
 Under epidural anaesthesia and with a near sterile procedure, two one-half inch incisions
are made one to two inches above the upper commissure and below the lower
commissure of the vulva.
 With a long eye point needle, a Gerlach's perivaginal needle, similar to a seton needle,
an 18 inch piece of one-eighth inch nylon cord or heavy vetafil is passed within the
tissues from one incision to the other lateral to one vulvar lip.
 The needle is withdrawn and reinserted in the opposite direction lateral to the opposite
vulvar lip to the lower incision site and again withdrawn.
 The purse string suture around the vulva is tightened sufficiently to allow 4 fingers in
the vulva, and the knot is tied and buried beneath the skin of the upper incision by
suturing the skin over the heavy purse string suture leaving it buried within the vulvar
tissues until parturition when it is removed.
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A - Insertion of perivaginal needle from the dorsal to ventral incision. B -Insertion of needle
on the opposite side for completion of loop. C - Completed loop before tightening and tying.
MODIFIED CASLICK OPERATION
 A vulva closing technique modified from the Caslick’s operation in mares is useful in the
treatment of chronic pre-partum (2 months) prolapse or in post partum prolapse.
VAGINAL PROLAPSE: In Sheep and Goat
ANTE-PARTUM VAGINAL PROLAPSE

 In most flocks the great majority of cases requiring treatment are of this typical form.
 Initially the pink mucosa of the vagina may be noticed protruding slightly between the lips
of the vulva in a ewe lying down, only to disappear from view when she stands up.
 Later the vagina fails to return to its normal position when the ewe stands and the prolapse
progresses until the vagina is completely everted and the cervix is visible. Initially the
vaginal mucosa is pink, moist and smooth but, if not treated, the vagina becomes swollen,
edematous and congested.
 It is very susceptible to injury.
 After prolonged exposure, the dried vaginal mucosa becomes rough and haemorrhagic and
gangrene may develop.
 Straining becomes a feature of the condition when the mucosa is irritated or obstruction of
the urethra leads to severe distension of the bladder.
POSTPARTUM VAGINAL PROLAPSE IN EWE

 Occasionally presented as a flock problem.
 In most cases it occurs within a few hours of lambing, while in some cases it may occur up
to 15 days post partum.
 The uterus is involved in the prolapse and its exposed surface is readily traumatized.
 Most affected ewes die from haemorrhage and shock within few hours.
PREDISPOSING FACTORS IN EWE

 Hormonal excesses and imbalances
 Hypocalcemia
 Twins or triplets
 Fat condition
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 Thin condition
 Inadequate exercise
 Excess dietary fibre
 Dietary estrogens and their precursors
 Sloping terrain
 Vaginal irritation
 Previous dystocia
 Inherited predisposition.
TREATMENT
 Administer low caudal epidural anesthesia.
 Reduce and reposition the prolapsed mass, and
 Retain the mass using either Plastic retainer or Buhner’s purse string sutures using
monofilament nylon.
PROGNOSIS
 Depends upon the
o Severity of the condition, and
o Length of time it has existed.
 Except in extreme or severe cases, the prognosis is generally fair to good for the life of the
animal and the fetus, if treatment is prompt and after care is good.
 Cows usually calve without any assistance in nearly all uncomplicated cases.
 After parturition, the prolapse is usually immediately relieved.
VAGINAL PROLAPSE / HYPERPLASIA: In Dogs
 Vaginal prolapse/Vaginal hyperplasia is referred to as the edematous enlargement of the

vaginal tissue that occurs during oestrus or proestrus. Both usually cranial to the urethral
papilla.
Synonyms
 Vaginal hypertrophy
 Vaginal oedema
 Estrual eversion
 Estrual hypertrophy
PATHOPHYSIOLOGY
 Normal estrogenic stimulation results in hyperemia, oedema and keratinization of vaginal
mucosa.
 During proestrus/estrus, occasionally at the end of diestrum or parturition, these normal
effects are accentuated to result in vaginal prolapse.
 Hyperoestrogenism or weakness of vaginal connective tissue may also lead to prolapse.
 Extent of oedema and eversion are variable.
 Vaginal tissue protrudes through the vulval lips in case of severe oedema.
 Protruding mass may be large, but the origin is usually small and located on the vaginal
floor cranial to the urethral orifice.
 Width of mass: stalk like to involving the circumference of vaginal floor.
 Prolapsed tissue promotes straining and further increase in the size.
 Edematous tissue causes mechanical obstruction and interference in normal breeding.
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 Abrasion, licking or drying cause tissue trauma and leads to bleeding.

 Compression of surrounding structures may lead to stranguria, hematuria, or tenesmus.
 Following reduction in estrogen levels, spontaneous resolution occurs, but may recur in
subsequent estrus.
DIAGNOSIS
Diagnosis is based on
 History
o Protrusion of mass from the vulva
o Vulvar discharge or bleeding
o Refusal to intromission during breeding
o Signs referable to fecal or urinary difficulties.
 Clinical signs
o A mass protruding between vulval lips
o Perineal enlargement and swelling
o In acute and non-protruding prolapse: Glistening, edematous, pale pink vaginal
mucosa.
o In chronic prolapse: Appear leathery, corrugated, and sometimes ulcerated or
fissured.
o Perineal licking
o Dysuria.
 Physical examination
o Carefully examine the mass to locate
 Origin
 Size at the base
 Locations of vaginal lumen and urethral opening
 Extent of tissue damage.
o On vaginal palpation
 Should identify the mass arising from ventral vaginal floor, if it is not
protruding.
 Vaginal areas other than those just cranial to the urethral orifice should feel
normal.
 Laboratory findings
o Vaginal cytology reveals RBCs in the absence of cornified vaginal epithelial cells.
 Uterine prolapse
 Vaginal tumors
o Fibroleiomyoma
o Lipoma
o Leiomyosarcoma
o Squamous cell carcinoma
o Transmissible veneral tumor
 Non-Neoplastic differentials
o Vaginal cysts
o Septa
o Congenital malformations
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TREATMENT
Medical Management
 Spontaneous resolution of vaginal prolapse occurs following decline in estrogen levels,
provided the protrusion is not circumferential.
 Administer gonadotrophin releasing hormone (GnRH, 50 µg/40 lbs, IM) to cause shortening
of estrus.
 Administer human chorionic gonadotrophin (HCG, 500-1000 IU, IM) to cause ovulation.
 Do not use for breeding.
 In valuable bitch that does not allow intromission, but owner's insist breeding, artificial
insemination may be considered.
Surgical Management
 To prevent recurrence and injury to the everted mass, ovariohysterectomy (OHE) is
recommended.
 Perform episiotomy and manually reduce the large, protruding mass and apply vulvar
sutures, to prevent recurrence until oedema reduces.
 Resection of protruding tissue without OHE is not recommended as it
o Results in severe hemorrhage, and
o Does not prevent recurrence during subsequent oestrous cycles.
 Resection is recommended, if protruding tissue is severely damaged or necrotic.
 Reduction without OHE may require hysteropexy, cystopexy, and/or colopexy to prevent
recurrent prolapse and herniation, respectively.
PRE-OPERATIVE MANAGEMENT
 Lavage the protruding mass with warm saline or water to remove the debris and necrotic
tissue.
 Apply an antibiotic or antibiotic/steroid ointment to the exposed tissue.
 Replace the mass within the vagina or vestibule.
 To prevent self mutilation, apply Elizabethan collar, bucket or side bars.
SURGICAL CORRECTION OF VAGINAL PROLAPSE

 Perform an OHE
 Replace the protruding mass into the vagina or vestibule
 Lavage, lubricate and reduce the mass by digital manipulation
 Apply 2-3 horizontal mattress sutures between the vulvar lips using 2-0 nylon or
polypropylene.
If resection of necrotic or severely traumatized tissue is necessary
 Position the animal in a perineal position
 Perform an episiotomy to expose the mass
 Place and maintain a urethral catheter during the procedure
 In stages, incise the base of the edematous tissue
 Control hemorrhage with pressure, ligatures, and electro-coagulation
 Appose adjacent mucosal edges with interrupted or continuous approximating sutures.
POST-OPERATIVE CARE AND PROGNOSIS

Post-operative care
 Administer fluids and analgesics.
 Immediately after episiotomy, apply cold compress and on the next day warm compress to
reduce inflammation and swelling.
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 Apply Elizabethan collars to avoid self mutilation of episiotomy and/or vulvar sutures,
which otherwise may lead to dehiscence.
 Examine the vagina 5-7 days following the reduction of mass.
 Remove the vulvar sutures if there is no reccurrence of prolapse.
 Amputation of edematous protruding tissue may lead to hemorrhage - Self limiting, if good
surgical technique is adopted.
Prognosis
 Excellent following OHE

 If OHE is not performed, recurrence during subsequent estrus and conception problem
 At the end of estrus, edema subsides following decrease in estrogen levels.
13. DISEASES AND ACCIDENTS DURING GESTATION - TORSION
 Uterine torsion is commonly referred to as the twisting or revolving of the gravid uterus on
its longitudinal axis.
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UTERINE TORSION IN COW

INCIDENCE
 European study: 3-4 %
 North American study: 3-7 %
 British study: 5-6 %
 Reported in all domestic species
 Most commonly prevalent as a cause of dystocia in cattle and usually develops during the
late first stage or early second stage of labour
 Most cases involve only the uterus but some may be complicated by incarceration of other
organs eg. Jejunum and bladder
 Common in cows and buffaloes; relatively high in surti buffaloes
 Occasionally in ewe and goats; rare in mare, bitch, cat and sow
 Occurs in both uniparous and multiparous animals
 In uniparous animals, both gravid and non-gravid horns are involved in torsion because of
the strong intercornual ligament and the distension of the uterine horns and body with
placenta and fluid
 In multiparous animals, only a portion of one uterine horn containing usually only one fetus
may be twisted or rotated (at the point of its junction with the body, the horn entire rotates)
 Common in pluriparous (large abdominal cavity together with decreased uterine tone and
mesometrial stretching) than in primiparous animals.
ETIOLOGY
 Predisposing causes
 Environmental causes, and
 Exciting causes.
CLINICAL SIGNS
 Torsion with degree of 45-90 lacks clinical symptoms; if 180° or more definite clinical
symptoms are noticed
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o Colicky pain
o Teeth grinding
o Restless
o Anorexia
o Lack of rumination
o Rapid pulse
o Tachycardia
o Treading and tail switching, and
o Displacement of dorsal commissure (Fig. a and b)
Fig. a: In Normal cow Fig .b: In Uterine torsion cow
o Tucked up udder
o Vulval edema, and
o Slight depression of the lumbo-sacral vertebrae.
 Normal Position of Broad ligaments

and vagina.
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 Clockwise (Right side torsion).

 On rectal examination: The ligament
and middle uterine artery (MUA) on
the right side is stretched and pulled
vertically downward under the uterus,
whereas the ligament on the left side is
stretched and pulled tightly across the
top of the uterine body.
 Counter clockwise (Left side torsion).

 On rectal examination: The ligament
and MUA on the left side is stretched
and pulled vertically downward under
the uterus, whereas the ligament on the
right side is stretched and pulled tightly
across the top of the uterine body.
Vaginal examination
 Abrupt stenosis of the vagina with the vaginal wall spirally twisted and external Os of the
cervix not palpable depending on the degree of torsion.
DEGREE OF UTERINE TORSION

 The degree of uterine torsion may be 45°, 90°,180°, 360°, and 540°
Per Vaginum examination

 In Post cervical uterine torsion: Cervix is not palpable with abrupt closing of the vagina.
o In less than 90°: Hand could be passed to palpate the external Os of the cervix with
some resistance.
o In 90°-180°: One or two fingers can be passed.
o In more than 360°: Abrupt stenosis.
 In Pre cervical uterine torsion: Cervix is palpable and fetus is not palpable.
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POSITION OF UTERINE TORSION

Based on the site of occurrence it is either
Post cervical: Involvement of vagina Pre cervical: Involvement of uterus
Uterine torsion should be differentiated from conditions such as
o Indigestion
o Pyelonephritis
o Traumatic gastritis, and
o Internal intussusceptions.
PROGNOSIS
 Prognosis of uterine torsion depends on the

o Degree of torsion
o Severity of torsion, and
o Length of time of existence of torsion.
Prognosis
 In cattle
o Good: If the condition is diagnosed early, before the occurrence of fetal emphysema,
secondary contraction of the cervix, uterine rupture and peritonitis.
o Poor: In torsion of uterus with extensive rupture of uterus, hemorrhage, or severe
uterine edema and gangrene secondary to thrombi in the large uterine vessels.
 In other species
o Guarded to poor: Because an early diagnosis is difficult or impossible to make
without an exploratory laparotomy operation.
Prognosis with respect to life of fetus

 Poor. In most cases, it is presented too late with the fetus having reduced oxygen supply
leading to death due to asphyxiation.
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 In most cases, unrelieved uterine torsion results in death of the dam.

 In rare cases, the fetus remains in the uterus and macerates, with extensive adhesions
developing around the uterus; the condition may not be diagnosed for several months.
Mortality
 Mortality in mares may be equal to or probably greater than that in cattle.
TREATMENT APPROACHES
 Various methods have been described for relieving uterine torsion in bovines.
 The choice of method depends on:
o The degree of uterine torsion
o Stage of gestation
o The condition of the dam, fetus and the uterus.
Different approaches
 Manual detorsion per vaginum
 Manual detorsion per vaginum in combination with external pressure on the abdomen
 Stimulation of vigorous fetal movements
 Abdominal ballotment
 Suspension of the cows body
 Detorsion by simple rotation
 Schaffer’s method (Modified rolling technique)
 Intra abdominal manipulation / Flank laparotomy
 Cesarean section, and
 Medical termination of pregnancy.
DETORSION BY SIMPLE ROTATION

 Oldest and simplest method
 Requires assistance of 3-6 men depending on the size of the animal
 Rolling should be done out- of – doors, on a sand pit.
 If the animal is large and vigorous – Give tranquilizers – Intra venous or intra muscular as a
sedative 20 minutes prior to rolling.
OBJECTIVE OF SIMPLE ROLLING

 Rotate the body of the animal in the same direction as the torsion of the uterus, rapidly
enough to rotate the body around or faster than the inert uterus and fetus.
 The rapidly rotating body of the animal thereby overtakes the more slowly rotating inert
gravid uterus.
TECHNIQUE OF SIMPLE ROLLING

 Assess the side of uterine torsion and cast the animal on the same side as the direction of
torsion
 Cast the animal adopting squeeze method
 The two hind legs of the cow are fastened together and two front legs are tied together
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 The animals head is held extended

 The front and hind feet should not be tied together, because this compresses the abdominal
cavity and tends to make the gravid uterus rotate with the animal
 Animal should be rapidly rotated in the same direction of uterine torsion, by strong co-
ordinate pulling
 After the animal has been rapidly rolled 180 degrees, her body must then be either rolled
back slowly to the original position or be pushed, usually slowly, over her legs and sternum
so that she is once more in lateral recumbency on the same side as the direction of the
torsion, ready to be rapidly turned over again.
 Some clinicians advise the operator to keep the hand in the vagina or even to grasp the
fetus, in order to hold the gravid uterus in place. This is a very awkward position to assume
or maintain as the animal is being rolled and is unnecessary unless the operator is uncertain
as to the direction in which the uterus is rotated.
 Place the hand in the cranial portion of the vagina; if rolling is in wrong direction,
then spiral folds in the vagina will tighten.
 After each 2 or 3 rapid rotations of the animal’s body, the birth canal should be examined to
determine if uterine torsion is corrected.
 If so, the spiral folds and stenosis disappear, if cervix is dilated, the fetus may be palpated
with ease.
 Occasionally, there may be gush of fetal fluids from the uterus as torsion is relieved.
 If uterine torsion is not relieved, repeat the rolling procedure 4-5 or more times before
failure is admitted and another technique is attempted.
 Rolling might result in rupture of the uterus, especially when the uterus is edematous.
SCHAFFER'S METHOD (Modified rolling technique)

 Described by Arthur (1966).
 Requires less assistance.
OBJECTIVE OF ROLLING
 The animal is rolled slowly instead of rapidly.
 The uterus and its contents are held in place by the plank and the weight of man standing on
it while the animal is rotated around them.
TECHNIQUE OF ROLLING
 Cast the animal on the same side as the direction of uterine torsion
 Tie in a manner similar to that described in rolling technique
 Place the plank (9–12 feet length and 8–12 inches wide) on the animal’s abdomen with the
lower end of the plank on the ground.
 An assistant stands on the plank and the animal is slowly rolled in the same direction as the
torsion by pulling on the ropes around the front and hind feet.
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 The plank creates pressure first on the upper abdominal wall, then the floor and finally the
opposite side of the abdomen resulting in a correction of the uterine torsion that can be
determined by examining the genital tract
 If there is any question concerning the direction of the uterine torsion, the operator, by
placing his hand in the canal, can readily determine whether the torsion is being relieved or
not as the animal is slowly rolled
 As in the initial rolling technique, if uterine torsion is not relieved the first time the animal
is rolled, the procedure may be repeated several times
 In most cases, the uterine torsion is corrected on the first rolling.
14. DYSTOCIA - Causes and Forms/ General Handling
 Eutocia refers to safe, easy, natural, or physiological parturition.

 Dystocia (Greek terminology) refers to difficulty in birth. When the first or usually the
second stages of parturition gets markedly extended, it becomes difficult or impossible for
the dam to deliver without artificial interference.
BASIC AND IMMEDIATE CAUSES

CLASSIFICATION OF CAUSES FOR DYSTOCIA
 The causes of dystocia may be classified into
o Basic, and
o Immediate causes.
 A better understanding of the basic causes will help to prevent the occurrence of dystocia.
BASIC CAUSES OF DYSTOCIA

 It may be divided into the following categories:
o Hereditary
o Nutritional and management
o Infectious, and
o Traumatic
 Many cases of dystocia may have two or more basic causes.
HEREDITARY CAUSES
This may be divided into as those that have produced defects in the dam which predispose to
dystocia or those hidden or recessive genes which may produce a defective fetus.
 Persistence of the median wall of the mullerian duct with a large band inside or caudal to
the external os of the cervix.
 Twining in cattle commonly result in dystocia.
 The hidden and recessive genes produce a variety of pathological conditions affecting the
foetus or foetal membranes.
o Dropsy of foetus
o Hydro amnion - achondroplastic calves results from in breeding.
o Acroteriasis congenitia, hydrocephalus.
o Foetal anasarca
o Autosomal recessive gene causing prolonged gestation.
o Muscle contracture monsters are usually produced by general functional ankylosis
with an abnormal development of muscle and tendons causing an immobility and
extreme rigidity of affected lambs.
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NUTRITION AND MANAGEMENT CAUSES

The nutrition of a pregnant animal and its management at parturition may be the basic causes of
dystocia.
 Improper nutrition of the growing heifers was the most important factor in retarding body
and pelvic growth.
 Dystocia may arise due to
o Small pelvis
o Under developed juvenile genital tract, and
o Lack of strength to expel the foetus.
 Breeding a poorly grown, underfed female that may be old enough to breed, but the body
growth has been greatly retarded due to poor nutrition, parasitisms or diseases. It has been
suggested that dairy heifers may be bred by size or weight rather than by age.
 High feeding levels may favour dystocia
o By excessive deposition of fat in the pelvic region predisposing to difficult
parturition, especially in heifer.
o Favour the development of a larger fetus (especially high feeding during the last
third of pregnancy).
 The balance between fetal size and pelvic or genital tract diameter is thus upset and dystocia
is favoured.
 Malformation of the pelvis such as pelvic rickets due to improper mineral balance or lack of
vitamin-D is seen in humans.
 Close confinement of pregnant animals without exercise, are prone to
o Torsion of uterus, and
o Uterine inertia.
 Exercise increases
o Body tone
o Strength and resistance, resulting in stronger labour contractions.
 During parturition all animals should be watched closely, if possible, so that prompt aid
may be given if parturition is not normal.
 This aid may prevent
o Secondary uterine inertia
o Death of the foetus
o Rupture of the uterine or birth canal
o Septic metritis
o Retained placenta, and
o Obturator nerve paralysis.
INFECTIOUS CAUSES
 Any infection or disease affecting the pregnant uterus and its contents may cause dystocia.
 In infection of the uterus, the uterine wall may lose its tone or ability to contract a condition
resulting in complete dilation of the cervix and uterine inertia.
 To help control infections that predispose to uterine disease and foetal death, both the sire
and dam should be free of infection at the time of service.
 All known infectious diseases such as brucellosis, leptospirosis, vibriosis, viral and other
septic diseases should be controlled according to our best knowledge at the present time.
TRAUMATIC CAUSES
 The traumatic causes for dystocia are not common.
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 Ventral hernia and rupture of the prepubic tendon late in gestation may occur from
traumatic causes. These injuries render the abdominal wall incapable of strong contractions
resulting in inability to force the foetus through the birth canal.
 A fracture of the pelvis with secondary deformity and exostosis is seen most commonly in
small animal, which may result in a stenosis of the birth passage resulting in severe
dystocia.
 The basic causes of dystocia are multiple, but by properly applying our knowledge, its
incidence may be kept at a minimum.
IMMEDIATE CAUSES OF DYSTOCIA

 Dystocia is regarded as being either maternal or fetal in origin.
 Practically dystocia should be considered in relation to defects in the three components of
birth process:
o Expulsive forces (Expulsive defect)
o Adequacy of the birth canal (Constriction), and
o Size and disposition of fetus (Over size and faulty disposition).
COMMON FORMS OF DYSTOCIA
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COMMON FORMS OF DYSTOCIA IN COW

 Both relative and absolute fetal oversizes are common, especially in the Friesian.
 Disproportion due to emphysema is frequently encountered, an outcome rather than a
primary cause.
 Local or general edema of fetus is a rare cause of oversize seen in Ayrshire.
 Monsters are relatively high; generally distorted and celosomian types: Schistosomus
reflexus and Perosomus elumbis are common.
 Abnormal longitudinal presentation is uncommon.
 Anatomical arrangement of the uterine cornua and absence of a distinct uterine body do not
favour transverse presentation.
 Postural irregularities of the head and limbs are common, usually carpal flexion, lateral
deviation of the head and breech presentation.
 Simultaneous presentation of twins is well recognized cause of dystocia.
 In pluriparous cows, uterine inertia is often associated with hypocalcemia.
 Uterine torsion has highest incidence.
 Incomplete dilatation of cervix is occasionally seen.
COMMON FORMS OF DYSTOCIA IN MARE

 More serious dystocias are of maternal origin (5%), and mainly uterine torsions.
 Abnormal presentation, position and posture of fetus: Most common single cause is lateral
deviation of head.
 Feto-maternal disproportion and uterine inertia are rare.
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 Transverse presentation of foal across the uterine body (either dorso -transverse or ventro-
transverse) is well known.
 Transverse disposition in which the extremities of the fetus occupy the uterine horns is
notorious and peculiar.
 An obliquely vertical or dog sitting position is well known and peculiar.
 Failure of fetus to rotate into the dorsal position and its consequent engagement at the
maternal pelvis in the ventral or lateral position is often encountered. May be complicated
by laceration of the dorsal wall of the vagina and even rectum and anus.
 All forms of postural abnormality
o Lateral and downward deviation of the head and neck.
o May be further complicated by rotation of the cervical joints
o Limbs are frequently presented abnormally. Either one, several or all of the joints of
the limbs may be flexed.
o Irregularities classified according to their clinical significance
 Carpal flexion
 Shoulder flexion
 Hock flexion, and
 Hip flexion. Bilateral hip flexion is known as Breech presentation.
o Exceptional anterior presentation postural abnormality-displacement of one or both
extended forelimbs above the fetal neck (Foot-nape posture).
 Gross fetal abnormalities are rare.
 Developmental anomalies such as wry neck (fixed lateral deviation) and hydrocephalus
occasionally observed. Wry neck is likely to occur with transverse bicornual pregnancy.
COMMON FORMS OF DYSTOCIA IN EWE

 Feto-pelvic disproportion is most common.
 If pelvic size of the dam is a major factor in the disproportion it is likely to have repeated
dystocia.
 In certain breeds and flocks the incidence of dystocia due to malposition exceeds that due to
feto-pelvic disproportion. More common in pluripara than in primipara and is more frequent
with twins than with still births.
 Among maldisposition: shoulder flexion commonest followed by carpal flexion, breech
presentation, lateral deviation of head and transverse presentation.
 Twining does not significantly increase overall dystocia.
 Posterior presentation markedly predisposes to difficult births.
COMMON FORMS OF DYSTOCIA IN SOW

 Maternal forms being almost twice as common as fetal forms.
 Incidence of fetal dystocia increases when the litter is small, for in these the size of the
individual tends to be large and obstruction may result.
 Irregularities of limb posture and even uncomplicated posterior presentation often cause
dystocia when the litter is small whereas had the litter been large and its individuals small,
these irregularities would not have interfered with normal expulsion.
 Monstrosities are common, generally of double type. But schistosomus, perosomus and
hydrocephalus also occur.
COMMON FORMS OF DYSTOCIA IN BITCH

 Two principal causes of dystocia are:
o Primary uterine inertia
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o Feto-pelvic disproportion
 Dachshund and Aberdeen terrier prone to uterine inertia
 Corgi shows extreme variation in the size of its puppies; absolute and relative oversize may
occur.
 Brachycephalic breeds together with Sealyham and Scottish terrier are prone to obstructive
dystocia due to fetuses having comparatively large heads and the dams having narrow
pelvis.
 Absolute fetal oversize is commonly encountered in bitches gravid with only one or two
young; it may also result from pathologic fetus.
 Primigravid bitch of small breed often has trouble from relative fetal oversize with her first
puppy but provided timely assistance is forthcoming she usually expels the remainder
normally. If assistance is delayed the outcome becomes serious.
 Irregularities of limb posture are of little importance provided puppy is normal size.
 Many puppies are born with their fore or hind limbs flexed, if fetuses relatively large cause
dystocia.
 Not infrequently in a bitch attempting to expel a fetus with forelimbs retained partially
succeed. Head is born, but the thorax with limbs becomes obstructed in the maternal pelvic
inlet. Similarly puppy may have hind parts born while its distended thorax is obstructed.
 Irregularities of head posture are common; vertex (Butt) presentation and lateral deviation
of the head frequently encountered. Interesting feature of later abnormality, often involves
last puppy.
 Fetal hydrocephalous and anasarca occasionally seen.
 Other forms of monster are rare.
 Abnormalities of position are common in both anterior and posterior presentation.
 Failure of fetus to rotate prior to presentation results in its engaging in the pelvic inlet in the
ventral or lateral position.
 Transverse presentation is rare. When it occurs, the bitch is generally gravid with a single
fetus only and gestation is of bicornual type and generally accompanied by uterine inertia.
UTERINE INERTIA
 The expulsive force of labour comprises the contractions of the uterine and abdominal
muscles. Because the abdominal muscles do not come into play until the uterine muscles
has lifted the conceptus into the pelvic inlet it is logical to consider first the expulsive
deficiencies that may occur in the myometrium. These are known as
o Primary uterine inertia, and
o Secondary uterine inertia.
PRIMARY UTERINE INERTIA

 Primary uterine inertia implies an original deficiency in the contractile potential of the
myometrium.
 It is less common than secondary uterine inertia and is seen most often in the dog and sow,
occasionally in cow but rarely in other species.
 Incidence in cattle is more as age advance.
PRIMARY UTERINE INERTIA: ETIOLOGY

 Intrinsic muscular weakness of myometrium - Idiopathic.
 Over stretching of the myometrium due to excessively large fetus (eg) hydrallantois, fetal
ascites.
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 Toxic degeneration in bacterial infections.

 Fatty infiltration of the myometrium.
 Senility - rare.
 Chemical environment of the uterus:
o Ratio between progesterone and estrogen concentration.
o Lack of oxytocin: The hormonal causes may be inherited.
o Lack of calcium: The transmission of inherited neuro-hormonal stimuli depend on
the presence of calcium.
o Metabolic disorder (eg) ketosis, hypomagnesemia.
 Late abortion, premature birth and twin birth in cattle.
 An innate nervous disposition as well as environmental disturbances - These interfere with
the hypothalamic regulation of oxytocin secretion.
 Rupture of uterus or twisting of the uterus causes cessation of myometrial activity.
 Lack of exercise.
PRIMARY UTERINE INERTIA: CLINICAL SIGNS AND DIAGNOSIS

o History
o Examination of the birth canal and presenting fetus
 The animals with primary uterine inertia are obviously parturient and in the first stages of
labour as denoted by mammary changes, ligamentous relaxation and discharge of mucous
from the vulva.
 The animal may be standing or lying down and exhibits little or no labour activity.
 There is no sign of progression of labour.
 The animals shows no distress and the second stage of labor does not occur for 6 to 36 h or
more.
 In cases of hypocalcaemia, the cow may be depressed and recumbent with a characteristic
lateral bend in the neck or the head turned into the flank.
 In multiparous species after an adequate beginning of second stage labour, all further
activity has ceased.
Vaginal examination
 The cervix is relaxed and dilatable beyond which fetus with its membranes can be felt.
 In some cases the cervix fails to dilate normally.
 There is usually no abnormality in presentation, position or posture of the fetus.
Prognosis
 Good in most cases that are diagnosed early.
PRIMARY UTERINE INERTIA: TREATMENT

 In large uniparous species
o Treatment is generally simple.
o By vaginal manipulation the membranes are ruptured, and the fetus delivered by
gentle traction.
o If cervix is dilated and obstructive dystocia is not present, oxytocin at 20-100 IU
large animals and 10-20 units for small animals may be given to stimulate uterine
contraction. Oxytocin injection in saline by i/v drip over a period may help.
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o Administration of 20% calcium borogluconate i/v 500 cc in large animal and 10 cc

in small animal - Repeat the treatment after 1 - 2 h if no progression is made.
 In multiparous animals
o Calcium solutions and oxytocin are the drugs of choice in cases of uterine inertia.
o Oxytocin has a direct action on the rate of calcium influx into the myometrial cell,
which is essential for myometrial contraction.
o Many do not respond to oxytocin alone but require prior administration of a calcium
solution. Therefore, some 10 minutes before the administration of oxytocin, 10%
calcium gluconate, 0.5-1.5 ml/kg BW should be given by slow i.v. infusion (1
ml/min) with careful monitoring of the heart rate.
o The dose of oxytocin in bitch is between 1-10 IU maximum/dog. It can be repeated
2 or 3 times at 20-30 min. intervals.
o Oxytocin administered early in second stage of labour is advantageous.
o In late stages, it may cause contraction of cervix and thus interfere with expulsion of
a puppy or fetal membranes and by promoting placental separation of unborn
fetuses, their survival may be jeopardized.
 Hypoglycemia may be another cause of secondary inertia and may be observed as sole
cause of the problem or associated with hypocalcemia. In such cases, a dilute (10-20%)
glucose solution can be added to the infusion or given i.v. in doses of 5-20 ml.
 If no satisfying responses are observed surgery is certainly recommended.
 If inertia extends into the third stage of parturition and beyond leads to retained fetal
membranes, metritis, pyometra and delayed involution of the uterus.
 Immediately after removal of fetus, parental antibiotic therapy may help prevent septic
metritis and other complication.
SECONDARY UTERINE INERTIA

 This usually follows a prolonged dystocia and is characterized by exhaustion of the uterine
muscles.
 It is essentially a result of, rather than a cause of dystocia.
o This condition is seen in all species of animals and is more common in large
animals.
o Secondary uterine inertia is frequently followed by retention of fetal membranes and
retarded uterine involution.
SECONDARY UTERINE INERTIA: CLINICAL SIGNS AND DIAGNOSIS
Clinical Signs
 After an initial period of strong but unproductive labor all expulsive efforts by the dam
cease.
 Irregular bouts of straining may resume when intra uterine pressure rises because of
developing fetal emphysema.
Diagnosis
 Based on the history of prolonged dystocia, in multipara on the birth of one or two fetuses
with cessation of labour.
 Intrauterine examination reveals the nature of the condition causing dystocia, usually an
abnormal P1, P2 and P3.
Prognosis
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 In secondary uterine inertia, prognosis is more guarded than in primary uterine inertia
because the fetuses may be weak, dead or emphysematous.
Sequelae
 Retained Placenta
 Metritis.
SECONDARY UTERINE INERTIA: TREATMENT

 The condition causing the original dystocia should be corrected by mutation and the fetus
then removed by moderate, careful traction.
 Lubrication of the fetus and birth canal is usually necessary.
 Excessive traction should be avoided since rupture of the uterus may occur.
 Fetotomy or cesarean section.
FAILURE OF ABDOMINAL EXPULSIVE FORCE

 Usually seen in very old animals.
 Hydrops of fetal membranes causing over stretching beyond the capacity of their natural
elasticity.
 Tears in muscles in case of ventral hernia.
 Rupture of prepubic tendon.
 Painful conditions of the abdomen, diaphragam or chest: Traumatic reticulitis/Pericarditis.
FAILURE OF ABDOMINAL EXPULSIVE FORCE: CLINICAL SIGNS AND DIAGNOSIS

Clinical signs
 Birth fails to occur.
 Vaginal examination reveals dilated cervix.
 P1, P2, and P3 are normal.
 In ventral hernia, the fetus may be just palpable beyond the reach.
Diagnosis
 Based on clinical signs and vaginal examination.
FAILURE OF ABDOMINAL EXPULSIVE FORCE: TREATMENT

 Delivery by traction.
 The fetus may be raised by assistant’s lifting the abdominal floor.
 Delivery done by patient lying down.
 In traumatic conditions – Elective surgery may be performed.
15. DIAGNOSIS AND TREATMENT OF DYSTOCIA

PATHOLOGICAL PRESENTATIONS/POSITIONS/POSTURES OF FETUS
PRESENTATION (P1): It is relationship between longitudinal axis of dam with the longitudinal
axis of foetus and parts present towards birth canal. The presentation may be divided into three
parts:
(i) Longitudinal presentation (normal).
(ii) Transverse presentation (abnormal).
(iii) Vertical presentation (abnormal).
Longitudinal presentation: When longitudinal axis of dam is parallel to the longitudinal axis
of vertebral column of foetus, the presentation is called longitudinal presentation. It is of two types:
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(a) Anterior longitudinal presentation: When foetus is in longitudinal presentation and its
anterior most parts i.e. both fore limbs and head are present towards birth canal, the presentation is
called anterior longitudinal presentation
(b) Posterior longitudinal presentation: When foetus is in longitudinal presentation and posterior
parts of the foetus i.e. both hind limbs are present towards birth canal, the presentation is called
posterior longitudinal presentation
• Transverse presentations are either dorsal or ventral, depending upon which portion of the
fetus is towards the birth canal.
• True Vertical presentations are not possible. A type of presentation which is considered
partially vertical is the dog sitting posture.
POSITION [P2]:
 The position includes the dorsum of the fetus in longitudinal presentation, or the head in
transverse presentation, to the quadrants of the maternal pelvis.
 The quadrants are the sacrum, the right ilium, the left ilium and the pubis.
 Anterior Presentation:-
 Posterior Presentation :-
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Posture [P3]
 The posture signifies the relation of the extremities of the fetus or head, neck and limbs to
the body of the fetus
 The normal presentation in uniparous animals is the anterior longitudinal presentation,
dorso-sacral position with the head resting on the metacarpal bones and knees of the
extended fore legs.
 Birth can also take place without assistance, if the fetus is in the posterior longitudinal
presentation, dorso- sacral position.
(1) Fore limb flexion:
(a) Shoulder flexion: Unilateral or bilateral.
(b) Knee flexion: Unilateral or bilateral.
(c) Fetlock flexion: Unilateral or bilateral.
(2) Hind limb flexion:
(a) Hip flexion: Unilateral or bilateral.
(b) Hock flexion: Unilateral or bilateral.
(c) Metatarsal flexion: Unilateral or bilateral.
(3) Flexion of head & neck:
(a) Upward deviation.
(b) Downward deviation.
(c) Lateral deviation (Right or left)
OBSTETRICAL OPERATIONS ASSESSMENT OF FETAL VIABILITY

 The assessment of the viability of the presented fetus is necessary at an early stage in the
examination because this influence the options for treatment.
 Assessment can be done by attempting to elicit reflexes such as corneal/palpebral, suckling,
anal if they are in posterior presentation, and limb withdrawal.
 If the fetus is dead, then it may be important to be able to estimate the time interval since
death.
 When there is fetal emphysema and detachment of hair, then the fetus has been dead for at
least 24-48 h
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 If after the fetus has been removed there is no emphysema and the cornea is cloudy and
grey, then the fetus has been dead for 6-12 h.
 Obstetrical operations are as:- Mutation, Forced extraction or Traction, Foetotomy and
Caesarean section
 MUTATION
 Mutation refers to procedures such as
o Repulsion
o Rotation
o Version, and
o Adjustment or extension of the extremities carried out on the fetus thereby restoring
it to a normal presentation, position and posture.
o In monotocus animals, normal delivery will occur only if the fetus is presented in
anterior or posterior longitudinal presentation (P1), dorso-sacral position (P2) and
with the head, neck and limbs extended posture (P3).
o In polytoccus animals, due to small and flexible limbs, normal delivery can occur
even though the limbs are retained alongside of or beneath the body.
1. REPULSION (Retropulsion)
 Repulsion refers to the act of pushing the fetus from the vaginal passage into the uterine
cavity, in order to create space and thereby rectify the defects of presentation, position and
posture.
POINTS OF REPULSION
 In anterior presentation: Arm or instrument is placed between the shoulder and chest or
across the chest beneath the neck of the fetus.
 In posterior presentation: Arm or instrument is placed in the perineal region over the ischial
arch.
PROCEDURE
 Epidural anesthesia is indicated to prevent abdominal straining.
 Since it has no effect on myometrial contractions, spasmolytics such as clenbuterol may be
used.
 Essential to have the animal standing or in recumbent animals with its rear quarter elevated.
Repulsion is difficult or impossible in recumbent animals resting on its sternum.
 Repulsion is effected by pressure with the operator’s arm or with the use of crutch repeller.
If an obstetrical instrument is used, the operator should guard the instrument from slipping
and causing injury to the birth canal. If it slips, it should be immediately withdrawn.
 Repelling force should be exerted in the intervals between bouts of straining.
 In protracted cases of dystocia, excessive repulsion may be dangerous.
 In neglected dystocia or fetal emphysema cases, repulsive forces should be carefully
controlled.
2. ROTATION
 Rotation refers to the act of turning the fetus on its long axis to restore the fetus in to a
dorso-sacral position. More often required in mares than in cows.
PROCEDURE
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 Easily effected on the responsive live fetus by applying digital pressure on the eyeballs,
protected by the lids; evokes a convulsive reaction and slight rotational force then completes
the maneuver.
 If digital pressure fails to correct the defect or in case of a dead fetus, intrauterine liquid
replacement is essential.
 After thorough lubrication, rotational force can be exerted on the crossed extended limbs 3.
either by hand or instruments such as cammerer’s torsion fork or Kuhn’s crutch.
3. VERSION
Version refers to the act of rotation of the fetus on its transverse axis into an anterior or
posterior presentation.
 Version is usually limited to 90 °
 Transverse presentation is corrected to either anterior or posterior longitudinal presentation
by repulsion of either the cranial or caudal portion of the fetus, and exerting traction to the
other end.
 Converting transverse presentation into posterior longitudinal presentation is preferred, as
this prevents the complications of corrections of abnormal presentation or posture.
4. EXTENSION AND ADJUSTMENT OF EXTREMITIES

 Extension and adjustment of extremities refers to the process of correction of abnormal
postures usually due to flexion of one or more of the extremities leading to dystocia.
 To effect a prompt, easy correction of a flexed extremity, it is essential to follow three basic
mechanical principles
o Repulsion of the proximal portion of the extremity such as the shoulder or chest in
anterior presentation and on the buttocks, stifle, or tarsus.
o Lateral rotation of the middle portion of the extremity, carpus, tarsus, or neck, and
o Traction on the distal portion of the extremity such as the pastern, lower jaw or, until
these distal structures can be reached, the structures between the body and the distal
portions of the extremity.
 FORCED EXTRACTION
 Forced extraction refers to the delivery of the fetus which is in normal presentation, position
and posture through the birth canal of the dam with the aid of external force or traction.
INDICATIONS
 Uterine inertia
 Following epidural anesthesia and mutation operation.
 Fetus is relatively too large to be expelled through the birth canal without assistance.
 In primipara with a small birth canal.
 In cases where birth canal compressed by tumors or fat or other pathological conditions.
 In posterior presentation of the fetus to hasten delivery and prevent the death of the fetus.
 To save time or in order to avoid fetotomy or cesarean section.
 In case of emphysematous fetuses after thorough lubrication of the birth canal and fetus.
 As an aid in fetotomy operations.
RESTRAINT
 Epidural anesthesia is recommended, but not always necessary.
MATERIALS AND ASSISTANCE
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 Nylon snares
 Obstetrical chains
 Long blunt obstetrical hook
 Calf puller
 Obstetrical lubricants
 Soft and flexible rubber tube
 Inj. 2% Lignocaine, and
 One to three assistants.
POINTS OF TRACTION
In anterior presentation
 Applied to pasterns or above the knee or elbow.
 Around the lower jaw. Around the neck in dead fetus.
 Loop around the poll, under the ears and through the mouth.
 Inner canthus of the orbit.
In posterior presentation
 Applied to pasterns or above the hocks.
 In dead fetus, on top of the fetal croup and turned ventrally to engage the posterior border of
the ischium or sacrosciatic ligament.
TRACTION FORCE
 Vary greatly with the species of animal and the condition causing the dystocia.
 Even though simple and quick it is potentially dangerous to the fetus and to the dam.
 In old or young primiparous mares, to dilate the birth canal and vulva gradually, traction
force is applied with obstetrical chains by one or two men.
 Care should be exercised to avoid lacerating the vulva or the perineal region. In normal
circumstances the force of 2 to 3 or more men apparently causes no harm and may be
indicated. With the help of fetal extractor one can exert great force in the proper manner, if
necessary.
 Traction should be synchronous and as far as possible, with the dams explusive efforts.
 Apply traction in a direction initially parallel to the dam’s posterior spine and then, as soon
as the fetal head and shoulders (in anterior presentation) and fetal pelvis (in posterior
presentation) has been delivered, in an increasingly ventral manner.
CONTRAINDICATIONS
 Exercise great care in cases of abnormal presentation, position or postures.
 Excessively large or defective fetus.
 Birth canal is obviously small.
 In secondary uterine inertia
 Cervical stenosis or failure to dilate.
 Obturator nerve paralysis.
 Severely lacerated birth canal.
 In the multiparous animals (sow, dog, and cat) should not be used when one is short of time
or patience as it may require a number of hours of intermittent work to complete the
delivery of all the fetuses.
 FETOTOMY
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 Fetotomy refers to those operations performed on the fetus for the purpose of reducing its
size by either its division or removal of certain of its parts. In most cases these operations
are performed within the uterus of the dam.
 In veterinary obstetrical practice, fetotomy has its own significance and relevance and
should not be considered as a substitute for cesarean section.
 Both techniques are important in veterinary practice, the choice of method in individual
cases being influenced by the circumstances.
 In a case of dystocia, where the fetus is dead, the decision should be made entirely based on
the life of the dam.
TYPES OF FETOTOMY
 Fetotomy can be performed in 2 ways
o Subcutaneous or intra fetal method
o Percutaneous or extra fetal method.
 The methods can be combined or modified according to need.
ADVANTAGES OF FETOTOMY
 Rapid reduction in the size of the fetus facilitates safe delivery per vaginum.
 Subjecting the dam to major abdominal surgery is avoided.
 The dam is spared inhumane treatment and possible trauma associated with application of
excessive force to extractive devices (fetal extractor).
 Post fetotomy care is generally minimal.
 Recovery time is shorter.
 The general condition of the dam tends to remain more stable after c - section.
 The monetary return is equal to that from cesarean section.
DISADVANTAGES OF FETOTOMY
 More time consuming than cesarean.
 Exhausting to the obstetrician.
 Operator may have the risk of injury from the instrument or from sharp projections of fetal
bone.
 Risk of causing injury to the dam.
 Most of the unsatisfactory results of fetotomy are attributable to the operator's lack of
experience, to poorly designed instruments, to improper fetotomy technique, and to the use
of fetotomy only as a last resort.
INSTRUMENTS AND ASSISTANCE

Fetotomy instruments
 A large number of instruments have been designed for use in fetotomy, some are practical,
others quite inadequate and unsafe.
 Recommended instruments are
o Thygesens Fetatome
o Wire saw handles
o Fetatome threader
o Krey hook
o Obstetrical chains
o Saw wire introducer
o Williams long cutting hook,
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o Long cutting chisels (Williams-slight concave flat bed, Guards-V-shaped head and
Ames-resembling a nasal septum chisel) and
o Fetotomy knife.
Assistance
 Although fetotomy can be performed with the help of only one assistant, two assistants are
desirable.
Instruction in the use of instruments

 Assistants must be thoroughly instructed in the use of the instrument and in the sawing
technique.
 A little time spent in instruction before the operation may save the obstetrician much time
during the actual fetotomy.
Lubrication
 Proper lubrication is often the key to success to the dam and fetotomy instruments
 If at all possible, the cow should be in the standing position throughout the operation.
Perfection in fetotomy depends upon four factors

 Technical knowledge
 Adequate training and experience
 Correctly designed instruments
 Proper lubrication.
DYSTOCIA IN ANTERIOR PRESENTATION

 Deviations of head and neck are common types of abnormal posture in anterior presentation
causing dystocia in all species.
 In swine, because the neck is so short this type of dystocia is very rare.
LATERAL DEVIATION OF THE HEAD

 The head may be displaced to either side and this constitutes one of the commonest types of
dystocia.
Diagnosis
 In cow, this condition is easily made by finding the two fore limbs in the birth canal but not
the head. By passing the hand and arm alongside the fetal body as possible and then
carrying it around the body, the head and neck are found and the direction of the deviation
determined.
 In mare, this may be more difficult because the head is usually out of reach of the hand. By
locating the withers, mane and trachea of fetus these may be followed to the left or right.
Correction
 If the bovine fetus is alive, the deviation may be corrected with least amount of difficult.
This is performed under epidural anesthesia with the animal standing. If the animal is down,
it should be placed in lateral recumbency with rear parts higher.
 The fetus is repelled by pressing forwards at the base of its neck. The hand is then quickly
transferred to the muzzle of the calf, which is firmly grasped and brought in line with the
birth canal. In a more in accessible case the muzzle may be reached after preliminary
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traction on the commissure of the mouth. The incisor teeth should be guarded to prevent
laceration of the uterus. A head snare and fore limb snares are now affixed and traction
synchronously applied with the cow’s expulsive effects, leads to delivery.
 If mutation fails because the fetus is emphysematous or because the uterine wall is
contracted tightly around the fetus, fetotomy and amputation of the head and neck is
indicated.
WRY - NECK
 Is seen in equine but rarely in bovine fetuses.
 It usually occurs in transverse bicornual pregnancy in the mare in which movement of the
fetal head and neck is restricted during most of the gestation period.
 The cervical vertebrae are curved and the articulations and atrophied muscles produce a
sharply bent "muscle contracture" condition of the neck that cannot be strengthened.
 Correction is impossible and decapitation is required.
DOWNWARD DEVIATION OF THE HEAD

 Downward deviation of the head between the fore limbs is occasionally seen in all species
except swine.
 In mild cases, only the nose of the fetus is caught on the brim of the pelvis with the fore
head entering the pelvic inlet, vertex presentation.
 In severe flexing of head and neck, the ears and the poll of the head are presented, poll
posture.
 In more severe cases, the neck extends between the fore limbs and the head is against the
fetal sternum or abdomen, nape presentation.
 In this type of nape presentation, the fore limbs do not come together and that in the mare
the mane of the fetus may be felt between the legs.
Correction
 Repelling the fetus and grasping the muzzle of the foetus and raising it into the pelvic cavity
usually correct vertex posture and poll presentation.
 Neglected cases may require epidural anesthesia and fetal fluid supplement.
 During the correction of nape after the fetus is repelled, a forelimb may be flexed along side
the body. This gives room for the head to be rotated laterally and then brought upward and
forward over the pelvic brim.
 The leg is then extended and the fetus removed by traction. In very difficult case it may be
advantageous to replace both forelimbs into the uterus.
 Casting the cow and placing her in dorsal recumbency greatly facilitate extension of fetal
head.
 When manipulative delivery fails fetotomy may be done.
DEVIATIONS OF THE FORELIMBS

 These are relatively common cause of dystocia in uniparous animals.
 They are rarely seen in multiparous animals because their forelimbs are short and flexible.
Carpal flexion
 One or both limbs may be affected. In unilateral cases, the flexed carpus is engaged at the
pelvic inlet and the other foot may be visible at the vulva.
Correction
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 Requires retropulsion of the fetal head and the retained foot is then grasped and as the
carpus is pushed upwards the foot is carried outwards, forwards and extended alongside the
other limb.
 More difficult case requires a snare attached to the retained fetlock to help extend the limb.
Shoulder flexion
 This type of dystocia may be unilateral or bilateral.
 The diagnosis of bilateral retention is usually obvious by observing that the head is partly or
completely born, but there is no sign of feet.
Correction
 Retropulsion is necessary and if the head is much swollen, the calf being dead, the head
should be amputated outside the vulva.
 Following repulsion, the calf forearm is grasped and the defect is easily converted into
carpal flexion and then relieved.
DYSTOCIA IN POSTERIOR PRESENTATION

 This is relatively more common than dystocia in anterior presentation.
 Posterior presentation is considered pathological in all except the multiparous animals.
 The frequency of physiological birth in posterior presentation in mare and cow is quite low.
 The fetal mortality in posterior presentation is high.
HOCK FLEXION
 This condition is usually bilateral.
 They are caused by failure of the hind limbs to extend into the pelvic cavity or by the foot or
fetlock catching on the birth canal or pelvic brim; causing the hind limbs to become flexed.
 It may be diagnosed by palpation of the perineal region and tail.
Correction
 The fetus is first repelled by pressing forward in its perineum and the hand then grasps the
fetal foot.
 As the foot is drawn back through, the hock is firmly flexed and retropulsion maintained as
far as possible, eventually with the digit in the cupped hand the foot is lifted over the pelvic
brim and the limb extended in the vagina.
Alternate method
 Supplement manual extension by traction on a snare fixed to the retained foot on the pastern
and the snare is placed between the digits, so that when traction is applied to it the fetlock
and pasterns joints are flexed.
 The flexed hock is grasped and repelled forward, while the foot is drawn caudally and
extended through the birth canal.
 In occasional case, where it is impossible to extend the hock, simple embryotomy may be
performed. Achilles tendon may be severed so as to make maximum possible flexion or the
limb may be amputated below the point of hock by means of wire saw.
HIP FLEXION
LATERAL VIEW OF A BREECH PRESENTATION IN BOVINE FETUS
Diagnosis
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 On vaginal examination, the buttocks and tail are in the pelvic cavity and occasionally the
tip of the tail is hanging from the vulva.
 In many cases, no part of the limb can be reached until the fetal buttocks are repelled
cranially out of the pelvic inlet.
Correction
 The aim of the treatment is to convert the condition into one of the hock flexion posture.
 The manipulative procedure is to repel the calf perineum forwards and upwards with a view
to bring the retained limbs within reach, by grasping the cranial aspect of the tibia with the
hand or pass a cord around the tibia and pull the fetal leg back into hock flexion posture.
 Now the hock flexion can be relieved by repulsion on the buttocks and traction on the tibia
the leg is drawn in to hock flexed posture. upward repulsion and lateral rotation on the hock
and medial and caudal traction on the fetlock and pastern, the leg is extended into the pelvis.
ABNORMAL SIZE OF FETUS / MONSTERS / TWINNING

FETO-PELVIC DISPROPORTION
Feto-pelvic disproportion
 Includes relative and absolute fetal over size, small maternal pelvis and narrow birth canal.
 This can be regarded as one syndrome in which both fetal and maternal factors interplay.
 This is type of dystocia is caused by a disparity in size between the fetus and maternal
pelvis when the cervix is fully dilated and vagina and vulva are relaxed.
INCIDENCE
 In dairy cattle it ranges to about 30%.
 Incidence is higher in primiparous and in heifers less than 2 years old.
 Dystocia due to feto-pelvic disproportion is frequently observed in bitch.
 The incidence of this type of dystocia is higher in cross breeding lamb for meat purpose.
ETIOLOGY AND PATHOGENESIS

Birth weight of calf
 Most important single factor associated with feto pelvic disproportion. Birth weight is
affected by the nutritional status of dam during late pregnancy and autosomal recessive
gene.
Sex of the calf
 Male calves are heavier and larger at birth and are more frequently associated with dystocia.
Breed
 Mating a bull of a large breed to a heifer of a smaller breed leads to dystocia.
Absolute fetal oversize
 Dystocia may occur as a result of fetal gigantism, excessive volume of parts of the fetus
excessive volume of fetal fluids, and multiple births in uniparous animals.
 The area and shape of the dam’s pelvic inlet and volume of the pelvic cavity constitute
another group of important factors associated with feto pelvic disproportion.
 The pelvic in let undergoes the least change in size during parturition when compared to
other parts of maternal birth canal. The size of the maternal pelvis also varies with the age
of the dam. Heifers on a low plane of nutrition will have a sub optimal body weight and
growth rate. Obesity often leads to fat deposits narrowing the pelvic canal.
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Following changes may take place when the fetus becomes impacted in the vagina
 Compression of the umbilical cord may cause interruption of fetal blood supply and death
within 4 minutes.
 Presence of tightly impacted fetus in the vagina also causes continuous stimulation of nerve
receptor areas and excessive reflex straining.
 This may cause in coordinated uterine contractions culminating in myometrial spasm and
straining finally ceases.
 Decomposition of fetus commences soon after the death.
CLINICAL SIGNS AND DIAGNOSIS

 Strong and continuous but unproductive straining may be observed initially.
 When fetal head cannot pass through the pelvic inlet, little straining may be observed.
 Extremity of one or two limbs protrudes from the vulva.
 On vaginal examination
o The passage is found to be dry, and
o It is difficult or impossible to pass the hand alongside the fetal parts
o Both the vulva and vagina are relaxed
o The cervix is fully dilated while the foetus lies anterior to the pelvic inlet
o The calf is in normal P1, P2 and P3
o Traction fails to bring the fetus into the pelvic cavity
o Abnormal enlargement of parts of the fetus may be found.
TREATMENT
 Replacement of intra uterine liquid and lubrication of birth canal.
 Traction is applied after administration of spasmolytic drugs.
 Traction is done by effort of three persons.
 When delivery cannot be achieved by traction within 10 or 15 minutes one of the following
methods should be employed.
o A caesarean operation is done if traction is unsuccessful. It is preferable to choose
this method if the calf is alive.
o Fetotomy is the only feasible method when calf is dead.
16. Post-partum complications in animals

The post-partum period in animals is related with complications, diseases and metabolic
disorders. Post-partum fertility and productivity is directly related with smooth parturition.
Veterinary control of parturition is possible with preventive strategies, hygiene and prompt
treatment for healthy uterine repair. Parturition is ideally a physiologically sterile process in
animals. However, the process is most unhygienic, neglected and always coupled with post-partum
complications. Post-partum complications are expected irrespective of normal or dystocic
parturition. Post-partum period phase extends from completion of second stage of parturition to
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complete involution of uterus. It is possible to control postpartum complications with prompt

veterinary aid and treatment but it is most appropriate to effect preventive measures during pre-
partum period at stage of advance pregnancy to avoid post-partum complications.
Post partum reproductive challenges:-
1. Prompt expulsion of placenta

2. No metabolic disorder
3. Speedy uterine involution
4. No adverse effect of negative energy balance
5. Constant increase in milk production
6. Early resumption of estrus cycle.
Post partum complications are classified into four broad categories
1. Reproductive problems
2. Traumatic complications
3. Metabolic disorders
4. Infectious or inflammatory conditions
Reproductive problems Placental retention, prolapse of vagina /+ cervix /+ uterus /+ rectum

(post partum atony), Extended labour (post parturient straining),
Delayed uterine involution, post partum infertility
Traumatic Rupture of vulva / vagina / cervix / uterus / bladder / perineum /
complications sacrosciatic ligament, Bleeding, Hematoma, lacerations, Paralysis
Metabolic disorders Hypocalcemia / Parturient paresis / Milk fever, Ketosis,
Hypophospetimia / haemoglobinourea, Hypomagnesemia /
Parturient eclampsia, Aidosis
Infectious or Metritis, Pyometra, Mastitis, Laminitis, Taxaemia
inflammatory
conditions
All above complications are acute possibly fetal in neglected cases or atleast they lead to
immediate productivity and future fertility losses. Similarly, these complications also increase
risk of death of new born due to incomplete nutrition.
RETAINED FETAL MEMBRANES
In Cattle
 Retention of Fetal Membranes (RFM) is one of the most common post partum disorders
encountered in cattle and less common in other domestic species.
 This condition is considered pathologic and has been associated with
o An increased incidence of metritis
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o Reduced subsequent fertility

o Increased mastitis incidence, and
o Increased culling.
DEFINITION
In strict sense, parturition is completed only after expulsion of the fetal membranes, which
normally gets detached and expelled within 12 hr following the delivery of the fetus. When the
dehiscence is prolonged beyond 12 hr, delay in expulsion occurs. Fetal membranes when not
expelled within 24 hr are considered as retained.
Placental changes:
During the last 5 days of gestation, there are changes in the placenta.
 Collaginisation of the placentome.
 Flattening of maternal crypt epithelium.
 Leukocyte migration and increased activity.
 Reduction of binucleate cells in the trophectoderm.
 Weakening of the acellular protein layer between cotyledonary and caruncular epithelium.
Contractions
 Open endometrial crypts

 Foetal villi have shrunk due to the escape of blood from the foetal side of the placenta when the
umbilical cord ruptures.
 Myometrial contractions aid exsanguinations of the placenta.
 Separation of foetal membranes.
 Apex of the allanto-chorionic sac becomes inverted.
 As the sac is 'rolled' down the uterine horns, foetal villi are drawn out of the crypts.
 When a large portion becomes detached and inverted, it forms a mass in the maternal pelvis.
 Stimulates reflex contractions of abdominal muscles.
 Completes expulsion of the allanto-chorionic sac.
 In polytoccus species, dehiscence and expulsion of foetal membranes are interspersed with
births of the young.
 Only expulsion of the last afterbirth stimulates abdominal contractions.
 The final stage of allanto-chorionic expulsion lasts 1 hour (mare) - 6 hours (cow).
 Domestic animals normally eat the afterbirth.
Placental expulsion:
In most species, expulsion of foetal membranes quickly follows expulsion of the foetus.
 After the birth of the young, regular abdominal contractions largely cease.
 Myometrial contractions persist.
 Decreased amplitude, but become more frequent and less regular.
 Important for dehiscence and expulsion of foetal membranes.
 Waves of contractions from uterus to the cervix persist.
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 Act in a peristaltic fashion in the cow and sow in the reverse direction.
INCIDENCE
 Placental retention tends to increase with parity, and there is an individual tendency to
recurrent retention.
 Incidence is very high with twins and late abortions (but not with early abortions in which
the whole conceptus is easily expelled).
 Genetically high-yielding dairy cows and cows on high nutritive planes at parturition are
more prone to placental retention.
ETIOLOGY
 When the normal processes of dehiscence and expulsion fails, RFM occurs.
 Three main factors involved in the separation and expulsion of the fetal membranes are:
o Maturation of the placenta.
o Exsanguinations of the fetal side of the placenta when the umbilicus ruptures, which
causes collapse and shrinkage of the trophectodermal villi and their physical
separation from the maternal crypts.
o Uterine contractions, which aid the exsanguinations of the fetal side of the placenta
and cause physical separation of the placenta by distorting the shape of the
placentomes (thereby causing ‘unbuttoning’ of the cotyledon from the caruncle,
expulsion of the dependent and detached parts of the fetal membranes, can then
occur.
 Retained Fetal Membranes have been associated with the following myriad of causes
o Selenium or Vit. A deficiency
o Excessive weight gain during dry period
o Increased age
o Heat stress
o High milk production
o Late winter, early spring calving
o Premature calving - short gestation
o Uterine atony
o Milk Fever
o Stillbirths
o Twins
o Dystocia
o Abortions
o Hydrops.
o Brucellosis
o Induced parturition
o Fetotomy
o Caesarean section
EXPLICIT CAUSES
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Group-I Group-II
Interference with normal loosening process between Uterine inertia

maternal caruncle and fetal cotyledon.
 Immature placentomes  Uterine distension

 Edema of chorionic villi  Uterine fatigue associated with
 Prolonged gestation dystocia
 Hyperemia of placentomes  Metabolic disorders –
 Necrosis Postpartum hypocalcemia
 Inflammation
CLINICAL FEATURES
 Symptoms are obvious, a portion of the fetal membranes hang from the vulva 12 h or more
following abortion, normal parturition or dystocia.
Retention of Fetal Membranes
 Occasionally membranes do not hang from the vulva but are entirely within the vagina or
uterus.
 If fetal membranes are not expelled within 36 h or so are likely to retain it for 7-10 days.
 Myometrial contractions largely cease from 36 h after expulsion of fetus, so, if the
membranes have not been expelled by this time, freeing of the fetal villi from the maternal
crypts eventually occurs as a result of autolysis and bacterial putrefaction. This process
starts within 24 h of calving but takes several days to complete.
 Natural sloughing of the maternal caruncles also contributes to the subsequent dehiscence of
the membranes, such that eventual expulsion of the membranes depends upon uterine
involution.
Duration of retention depends on

o Extent of the areas of attachment of the fetal membranes
o Rate of uterine involution
o Amount of uterine exudates, and
o Proportion of the afterbirth which had already passed through the cervix when
retention began.
 The toxic products of putrefaction accumulate within the uterus causing a fetid odour which
pervades the atmosphere and, more importantly, taints the milk, and makes it unacceptable
for human consumption.
 Delayed involution of the uterus and a variable degree of metritis commonly accompany
retention.
 In cows with RFM which have calved spontaneously after a normal length of gestation there
are subtle changes in health. Whereas, if retention occurs following extensive assisted
delivery in dystocia, a severe metritis and toxaemia can supervene within 2 or 3 days which,
if untreated, can be fatal.
 If RFM is accompanied by metritis, the symptoms depend upon the severity of the uterine
disease.
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GENERAL CONSIDERATIONS OF RFM TREATMENT

 Stillbirths, obstetrical procedures and RFM can impair the cow's defense mechanisms.
Normal phagocytosis is decreased and intrauterine infusions or chemical curettage may be
necessary to decrease bacterial colonies in the uterus.
 An inflamed uterus is friable. Therefore, any physical manipulation can tear the uterus and
produce adhesions or a systemic illness (Septicemia).
 Cattle owners are concerned with the cost of treatment and any added labor for intensive
care. The economics must be justified for the use of the animal.
 Does the owner have the facilities to treat the cow? Is individual attention possible?
 Evaluate the history of the cow
o What are the uterine contents?
o What about the size of the uterus?
o Whether the membranes were retained?
o What was the calving date, was it a dystocia?
o What was the physical condition of the cow?
 A decision for rational treatment is based upon how well the animal and its reproductive
tract will respond to the drug(s) selected.
 There are different types of medications available
o An infusion requires a specific volume to dilute the character and quantity of uterine
fluid. Thick, purulent exudates are less likely to be responsive to a small amount of
antibiotics deposited intrauterine.
o The endometrium is a sensitive lining that will overreact to irritating compounds
such as Lugol's solution.
o A bolus can be placed through the cervix but the question is left unanswered if or
when the bolus dissolves?
o A gelatin capsule filled with tetracycline powder retards normal involution by being
acidic and causing tissue necrosis.
INSTRUCTIONS TO THE FARMER

The veterinarian should properly inform the farmer the following points to avoid complications
 Tying extra weight to the hanging portion of the membranes should be strictly avoided, as it
might cause tearing.
MANUAL REMOVAL OF RFM IN CATTLE

 Manual removal procedure has been in practice for years.
 It is advisable to exercise caution, if there is an existing metritis or a friable uterine wall. In
such cases, the cow can become septic or toxic.
 Whether manual removal has an adverse effect on future fertility is still under debate.
 RFM will lead to constant straining. Hence postponing treatment will only increase the
chances for complications.
 The approach would be to try to separate the RFM without causing damage to any
caruncles. If the membranes are not easily separable, it is advisable to push the placenta
back in and redistend with warm saline.
PROCEDURE FOR MANUAL REMOVAL OF RFM

 A clean, manual examination of the uterus should be done.
 The operator should wear rubber coveralls or an apron and boots, a rubber glove and long
sleeve on one arm and a surgical glove on the other to protect him from brucellosis or an
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infection of the arm or hand. Disposable plastic gloves and sleeves of good quality are more
sanitary and practical than rubber gloves and sleeves.
 Epidural anesthesia may be used to prevent frequent defecation or straining.
 The cow’s tail should be held out of the way by an assistant or tied with a tail rope over the
back to one of its fore legs.
 The perineal region of the cow should be carefully cleaned and washed with soap, water,
and mild antiseptic, and kept clean during the operation.
 Insert the left hand in to the uterus and squeeze the fetal cotyledon from the base of the
maternal caruncle. Twist the free part of the fetal membranes together in to a ‘rope’ with the
right hand. Apply a continuous steady traction and rotational force to withdraw the
membranes.
 If much fluid is present in the uterus it should be siphoned off by a sterile soft rubber horse
catheter or stomach tube held in the first to keep the fetal membranes from plugging the end
of the tube. The siphon may be started by filling the rubber tube with water and holding it
pinched off as it is introduced.
 Manual removal should be done gently and quickly within 5 to 20 minutes, in a clean
manner, and with as few withdrawals and reintroductions of the arm as possible.
ANTIBIOTICS
 One antibiotic of choice is tetracycline @ 2-6 gm intrauterine.
 Treatment should begin 12 h postpartum and continue daily until total expulsion of the
membranes.
 Systemic penicillin can be given for possible septicemia.
ECBOLIC AGENTS
 To physically cause the caruncle and cotyledon to separate, Oxytocin and Prostaglandin F2α
injections are used within 72 h of parturition.
Oxytocin
 Oxytocin injections (20-40 IU) are continued for 3 days after calving to contract an estrogen
primed uterus.
 It should be given as IM injections in small doses and often.
 High doses exaggerate uterine contractions, may force premature closure of the caruncles,
and favours retention.
Prostaglandin F2α (PGF2α)
 After 3 days, 25 mg of PGF2α injections must be administered IM.
 It can be administered once or twice a day. PGF2α are used because there is no withholding
time for milk.
 Multiple injections stimulate myometrial contractions and luteolysis for a return to oestrus.
PREVENTIVE APPROACH
 Supplementation of anionic salts to the diet. RFM is thought to be influenced by electrolyte
concentrations.
 Uncomplicated cases of RFM require no treatment.
POSTPARTUM DISEASES AND COMPLICATIONS - Part I: Uterine Prolapse

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TOTAL UTERINE PROLAPSE - In Cattle and Goats

When the gravid horn following the expulsion of the fetus gets everted along with the non
gravid horn and protrudes through the vulva it is referred to as post-parturient total uterine prolapse.
 Uterine prolapse is a common complication encountered in the cow, buffalo, sheep and
goats during the third stage of labour.
 It is generally referred to as casting of wethers or casting of the calf bed.
 Most often it occurs immediately after parturition, occasionally up to several hours
thereafter and in rare instances it may occur 48-72 h after parturition.
INCIDENCE
 In cow, there is high occurrence of prolapse compared to other domestic animals.
 In bovine, it is observed in 0.5 % of all assisted dystocia cases. However, the condition
occurs mostly in unassisted deliveries.
 Observed in 0.3-0.5% of all parturitions.
 Occurs in all age groups, but more in pluriparous and debilitated animals.
ETIOLOGY
 Not clear, but it occurs during third stage of labour shortly after delivery of the calf.
Predisposing factors
 Long and relaxed mesometrial attachments and lack of suspension of anterior portion of the
gravid horn allows excessive mobility in longitudinal direction.
 Violent or strong tenesmus.
 Relaxed, atonic and flaccid uterus.
 Retention of placenta at the ovarian pole of the gravid horn in cows and non gravid horn in
mares.
 Excessive relaxation of the pelvic and perineal regions.
 Dairy cows that calve after long confinement in stables with their rear quarter sloping
downwards and hanging over the gutter.
 In the relief of dystocia, use of great force in forced traction of fetus predisposes to
tenesmus.
 In dystocia, when the uterus is contracted tightly around the dry fetus, forced extraction is
likely to result in prolapse.
 Most common in pluriparous cows.
 In poorly grown, thin debilitated dairy heifers.
 In milk fever, atonic uterus may prolapse due to increased abdominal pressure to labour.
 Low plane of nutrition.
PATHOGENESIS
 During the process of fetal expulsion or immediately after delivery, an intussusceptions
which begins at the ovarian end of the gravid horn gradually progresses posterior leading to
the eversion of the mass.
 When abdominal straining begins, the mass suddenly gets prolapsed through the vulva.
 The gravitational force accelerates the intussusceptions and eversion in recumbent or
standing animals with the hind quarters in an inclined plane.
 Subsequently, the stretching of the myometrium and uterine ligament leads to abdominal
discomfort.
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 Further the prolapse is accelerated due to straining as a result of the stimulation of receptor
areas by the everted mass.
CLINICAL SIGNS IN TOTAL UTERINE PROLAPSE

 Animal will be usually recumbent or standing with the prolapsed uterus hanging up to the
level of the hocks.
 Retention of the placenta may also accompany the fetal membranes and/or mucous
membrane of the uterus is exposed.
 Except in fresh cases, the prolapsed mass would usually be covered by dung, dirt, or blood
clots.
 If the uterine prolapse exists for 4–6 h or longer, it will usually be enlarged and edematous
 In the cow, the gravid horn prolapses or everts sufficiently so that the cervix is usually seen
at the vulva.
 Because of the strong intercornual ligaments, the non-gravid horn is held inside the
peritoneal surfaces of the prolapsed gravid horn and does not evert.
 An oval or slit like orifice observed near the vulva on the ventral or lateral side of the
prolapsed gravid horn is the opening of the non-gravid horn.
 In the doe, uterine prolapse is similar to that observed in the cow.
PROGNOSIS
 Varies greatly.
 In most cases, Prognosis for the life: GOOD, If observed early
o prompt veterinary aid,
o cow able to stand and
o no severe injury of the uterus
 Future breeding: GOOD or POOR depending upon the severity of the uterine lesions, the
promptness of treatment and the rate of involution.
 Prognosis is more GUARDED, If
o uterus grossly contaminated, or
o dried due to exposure to sun, or
o if lacerations are present
 Future breeding life: QUESTIONABLE - due to possibility of a septic metritis, perimetritis
or peritonitis.
 It is surprising how much trauma, irritation, and contamination the uterus can withstand.
 After replacement of uterus this infection is overcome, the traumatic lesions heal, and the
animal recovers.
 Prognosis: POOR to HOPELESS
o if animal is prostrate.
o unable to rise and
o Conditions complicated by shock, internal hemorrhage, or incarceration of the
intestines.
Treatment:
Treatment of expulsion of placenta is possible at three level, preventive approach before
term, preventive approach after term and curative approach after placental retention.
Prolapse of Uterus Treatment:

Treatment of prolapse consists of three steps like reduction, reposition and retention
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1. Reduction: the prolapse mass needs to be reduced size with all efforts to reduce
emphysema. It is possible to use ice cubes, application of herbal spray for reduction in mass
size also cold water and hypertonic sugar solution, local application of oxytocin and
adrenaline in uterine musculature can reduce size of prolapsed mass.
2. Reposition: reposition necessitates applications of force on centre of prolapsed mass. it is
necessary to lubricate prolapsed mass for facilitating reposition. Once centre of prolapsed
mass is reposed, it’s possible to push the reminder peripheral part of prolapsed mass at site.
As uterine contractions are going on continuously, many reposed parts prolapse within no
time after reposition and care is necessary. While reposing the mass, no pressure should be
applied with figure tips. Palm pressure is most suitable to repose prolapse mass starting
from lateral walls, middle portion and roof of vagina.
3. Retention: once prolapsed mass is properly reposed, it is possible to retain the same at
appropriate site by reducing luminal diameter of birth canal . the best approach is to
applying rope truss. It is recommended to prepare loose loop of only cotton rope to reduce
vulval opening. Vulval opening is closed partially can be applied sutures after reposing of
prolapsed mass. Use of vulval suture and negligence towards reproductive infection lead to
forceful and violent contraction leading to rupture of suture and severe damages to vulvar
portions.
All prolapsed cases needs to appropriate managemental approaches after treatment which
includes:
1. Provide laxative feed and fodder

2. Reduce abdominal load by overfeeding
3. Supply fodder in divided parts
4. Continue antibiotic and uterine tonic therapy
GENERAL CONSIDERATION IN TREATMENT
 Instruct the farmer to keep the uterus of the animal moist and clean by either wrapping in a
wet towel or sheet or place in a plastic bag until replaced.
 Until arrival of the veterinarian, the uterus in a standing animal should be raised and kept
supported in level with the vulva.
 In recumbent animals, uterus should be supported and prevented from hanging. By doing
so, edema formation in the uterus and possibly rupture of the uterine vessels can be
prevented.
 Prompt and easy replacement is facilitated by proper restraint of the animal.
 Epidural anaesthesia should be administered in sufficient dose to provide good anaesthesia
and at the same time keep the animal standing. In some recumbent animals that refuse to
stand may rise up after administration of epidural anaesthesia. Further, it controls and
prevents defecation during the process of reduction and repositioning of the uterus.
 In bovines, for certain types of obstetrical maneuvering it is advisable to have the animal
standing and preferably with elevated rear quarters.
METHODS TO ELEVATE REAR QUARTER OF THE ANIMAL
 An inclined platform is the most practical method to elevate the rear quarters of the cow.
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 In recumbent animals, in order to elevate the hindquarters the following are employed:
o Sandbags
o Straw stuffed bags, and
o Inclined ramps
 These improvised conventional methods have many disadvantages.
 PORTABLE BOVINE REAR QUARTER ELEVATOR DEVICE
ADVANTAGES
 It is very useful in
o Reducing total uterine prolapse
o Repulsion of fetus in dystocia, and
o During intrauterine liquid replacer therapy.
 There is no stress to the animal due to the inclined posture.
 The device provides comfortable and effective working space for the obstetrician and can be
used with advantage in veterinary institutions.
HANDLING OF TOTAL UTERINE PROLAPSE IN BOVINE

 Carefully prepare the prolapsed uterus for replacement.
 During the replacement process, hold the uterus in level with the ischial arch or vulva so as
to relieve the pressure on the broad ligament and uterine veins and to restore normal
circulation in the prolapsed uterus. Further edema of the uterine wall is prevented which
leads to absorption and disappearance of the edema already present.
 The position of the uterus facilitates the bladder and intestines to return to their original
sites.
 Animal is more comfortable in this position and the possible rupture of vessels in the broad
ligament is greatly reduced.
 Uterus can be supported in a towel or sheet held by an assistant on either side of the rear
quarters of the animal, or on a wooden or metal tray.
 If placental attachment is present, it should be gently separated.
 Placenta may be left undisturbed, if removal is difficult without severe trauma and
hemorrhage. After complete reduction and repositioning of the uterus, the case should be
treated in the same manner as severe retained placenta in an animal not affected with
prolapse of the uterus.
 Uterus should be cleansed thoroughly with a warm physiological saline solution or with
water and small amount of mild antiseptic.
 The adjacent vulva and perineal region should be washed and cleansed including the folds
and creases in the skin.
 If laceration, tear, or perforation is present in the uterus, it should be carefully sutured.
 In case of severe uterine hemorrhage, the vessel should be ligated.
 If the prolapse of the uterus has been present for some time and edema is severe, the
massage or washing the uterus and the holding of the uterus level with the vulva may not be
sufficient to readily reduce its size so that it can be replaced.
 Vigorous massage of the uterus with the palm of the hand, with the fingers extended but
held tightly together, may be accomplished by wrapping a towel or piece of sheeting tightly
around the uterus and applying pressure through the towel without the danger or possibility
of forcing a finger through the uterine wall or edematous mucosa.
 Palpate the bladder before replacing the uterus, if distended, catheterize so that it does not
interfere with the replacement process.
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PROCEDURE FOR REPLACING PROLAPSED UTERUS

 Hold the uterus above the level of the floor of the pelvis.
 Pull apart the vulval lips, and first the ventral portion and then the dorsum of the prolapsed
portion of the uterus should be replaced, starting at the cervical end of the uterus nearest to
the vulva.
 Pressure should be exerted with the palm of the hand, with the fingers extended but held
tightly together, to avoid perforating the uterus.
 Finally the ovarian pole of the uterus is pushed by the fist through the vulva, vagina and
cervix, into the uterine cavity.
 If the cervical rings are contracted, pull them gently backward with one hand and work the
uterus through with the other.
 The ovarian pole is pushed through the vagina, cervix and uterus with the clenched fist and
arm by a piston like or shaking motion on various parts of its perimeter until the horn is
completely straightened out and no invagination is present.
 Exercise care not to tear or remove the caruncle and thus cause bleeding.
 Even if the animal shows no clinical signs of hypocalcemia, calcium borogluconate therapy
should be given, together with parenteral antibiotics to control uterine infection after
replacement.
 Temporary suturing of the vulva with an umbilical tape in to the vulval hair line for 1-3
days.
FIELD APPROACH TO CORRECT UTERINE PROLAPSE

 In cow, the replacement of total uterine prolapse places considerable stress on the animal.
Severe straining which occurs during replacement can be controlled to some extent by the
administration of epidural anesthesia. Unless the prolapse is of very recent origin, it
becomes swollen, hardened and friable, making the reduction more difficult. The method
outlined below has been the standard practice for atleast 30 years and found to be very
successful.
Technique
 Roll the animal over in to lateral recumbency.
 If placental attachment is observed, gently detach it.
 Two wide belts, such as those used in a foot paring crush, are used to loop over the hock
joints and tighten proximal to the joint.
 Two belts, linked by a short rope are attached to a fore end lifting tractor and raised until the
vulva of the cow is about one meter from the ground level.
 Wash the prolapsed mass with Luke warm water.
 Gently raise the mass above the level of the vulva.
 With minimal help and guidance replace the mass. Ensure that there is no rotation of the
uterus and thus no uterine torsion.
 Once returned to the inside of the cow, ensure complete repositioning of the uterus through
the cervix.
 Apply vulval tape retention sutures after replacement.
 After replacing the uterus, lower the cow to the ground, so that the cow regains her feet.
Advantages
 Quick, easy and essentially a practical method
 No evidence of damage to the muscular skeletal system as a result of the hoist.
 Involved only 6 minutes of suspension, and the whole procedure from approaching the case
to the cow standing up with uterus replaced, took 25 minutes.
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 Above all, the physical effort required of the veterinarian is minimal.
POSTPARTUM DISEASES AND COMPLICATIONS - Part III: Infections and Metabolic

Diseases
INFECTIONS OF UTERUS
1. PUERPERAL METRITIS
ETIOLOGY
 Occurs within a few days to 2 to 8 weeks or more postpartum.
 Usually follows an abnormal first or second stage of labour, especially when there has been
a severe dystocia.
 Also associated with uterine inertia, twin births, RFM, prolonged traction and damage to the
vulva and/or birth canal.
 Bacteria colonise the non-involuted uterus, producing toxins which are absorbed and cause
severe symptoms.
 Many species of bacteria can be recovered. The most important are A. pyogenes, group
C streptococci, haemolytic staphylococci, coliforms, and Gram-negative anaerobes,
particularly Bacteroides spp. In rare cases, clostridia are present which rapidly produce
disease that is serious and often fatal.
SYMPTOMS
 Local and general symptoms
 Toxaemia, septicemia and pyrexia.
 Temperature may be elevated to 40—41°C, but is more often subnormal.
 Rapid pulse rate (in the region of 100/minute)
 Respirations may be sufficiently frequent to suggest a respiratory disease.
 Anorexic and dehydrated
 Often have toxaemia-induced diarrhea and exhibit signs of shock.
 Infection may extend through the uterine wall into the peritoneum, causing a localized or
generalized peritonitis.
 Uterus contains a large volume of toxic, fetid, reddish, serous exudates, containing pieces of
degenerating fetal membranes
 Exudates is discharged from the vagina by frequent expulsive straining efforts.
 Vaginal and uterine exploration of an affected case causes acute discomfort and is
accompanied and followed by the most severe and persistence of expulsive efforts.
 Cotyledons are swollen and the fetal membranes often remain firmly attached.
 Vulva and vagina are swollen and deeply congested.
 Primary pneumonia
 Traumatic reticulitis and pericarditis,
 Milk fever, and
 Acute mastitis.
TREATMENT
 Good nursing care and vigorous medication.
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 The cow should first be kept warm and made as comfortable as possible by transferring it to
a well-bedded and warm loose-box.
 By gentle external traction, attempt to remove the fetal membranes, but avoid performing
per vaginum examination. Rough attempts at removal of the fetal membranes or even
careful exploration of the vagina and uterus can cause severe damage and predispose to the
absorption of toxins and entry of bacteria.
 If straining persists, caudal epidural anaesthesia can be used; local anesthetic alone gives
transient relief for 1-2 h and sometimes it will ‘break the cycle’ and stop the straining.
 If it is within 2-3 days of parturition, 50 IU of oxytocin by intravenous injection may cause
contraction of the uterus and expulsion of fluid and debris.
 Systemic administration of broad-spectrum antibiotics and supportive therapy.
 Choice of antibiotic and the route of its administration has been the subject of much debate.
 Intrauterine antibiotics are unlikely to eliminate the infection - nitrofurazone, neomycin and
some sulphonamides, may be detrimental to the endometrium.
 Intrauterine infusions of dilute iodine are considered to be more harmful than helpful.
 Intrauterine infusions of tetracyclines may be effective against mild cases of endometritis,
but they do not penetrate far enough into the uterine wall to be effective against full-
thickness metritis.
 Systemic broad- spectrum antimicrobials, fluid therapy and non-steroidal anti-inflammatory
drugs are widely recommended.
 Use of estrogens is contra- indicated in cases of acute puerperal metritis, as they increase
the blood flow to the uterus and, thereby, increase the absorption of bacterial toxins.
 When temperature returns to normal and the cow shows some signs of improvement, uterine
lavage with several litres of warm (49°C) sterile saline and drainage may be beneficial.
 Parenteral and intrauterine antibiotics should be administered daily.
TREATMENT RESPONSE
 Resumption of appetite.
 Cessation of diarrhea, and
 Presence of a less fetid and thick vaginal discharge.
 Recovered cases inevitably show a mucopurulent discharge or leucorrhoea, due to chronic
endometritis.
PROGNOSIS FOR SUBSEQUENT FERTILITY

 Guarded, due to lesions such as
o Ovaro-bursal adhesions
o Uterine adhesions, and
o Occluded uterine tubes.
 Other complications of metritis include
o Pneumonia
o Polyarthritis.
CERVICITIS
 Cervicitis is referred to as an inflammation of the cervix.
 The cervix appears more resistant to infections than either the uterus or the vagina.
 In cow, commonly observed and associated with metritis.
 The internal portions of the cervix appear rather resistant to the introduction of
miscellaneous infections.
 Most cases of cervicitis originate at the time of or following parturition and often are
associated with a metritis.
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VAGINITIS
Vaginitis refers to the inflammation of the vagina.
 Mucopurulent, yellow-grey pus is usually discharged from the vulva at irregular intervals
 Matting of the hair of the vulva, tail and buttocks.
METABOLIC DISEASES
MILK FEVER
Milk fever, the clinical manifestation of parturient hypocalcemia, is a metabolic disease of
considerable importance for dairy cow welfare and economy.
 The peri-parturient or transition period of 4 weeks before and 4 weeks after calving is
characterized by greatly increased risk of disease.
 Homeorhetic processes are the long term physiological adaptations to changes in state, such
as from non-lactating to lactating or non-ruminant to ruminant, and involve an orchestrated
series of changes in metabolism that allow an animal to adapt to the challenges of the
altered state.
 An acute disturbance in calcium metabolism with hypocalcemia occurring just before,
during, or most often within 72 h after parturition.
INCIDENCE AND ETIOLOGY

 Affects usually 4 years or older cow
 Parturient paresis is observed in all dairy breeds but most commonly in Jerseys.
 Recurrent attacks of milk fever may occur at subsequent parturitions.
 Considered as an adaptation disease
 Predisposing factors include age and both yield and persistency of production
 Parathyroid glands and the production of parathyroid hormone is normal and not a factor
 In dry cow, a high total dietary calcium intake together with a high Ca:P ratio may stimulate
calcitonin release from the parafollicular cells of the thyroid gland, thus inhibiting bone
resorption by parathormone. Thus at the beginning of lactation when there is an increased
demand for calcium, the cow is forced into a hypocalcemic state and parturient paresis
ensues
 Injecting large amounts of calcium intravenously produced a hypercalcemia lasting for
several hours in cows with milk fever or in normal parturient cows. This hypercalcemia
suppressed parathormone secretion and stimulated the secretion of calcitonin, a substance
that lowers blood calcium concentration by inhibiting bone resorption. These effects tend to
retard the normal adaptation of the cow toward the loss of calcium at the onset of parturition
and lactation and result in a high incidence of relapse of milk fever cases.
SIGNIFICANCE OF BLOOD CALCIUM LEVELS

 Blood serum calcium level drops from a normal of 8 to 12 mg per 100 ml to 3-7 mg with
symptoms of parturient paresis becoming progressively more pronounced as the calcium
level drops.
 Hypocalcemic paresis is due to a depression of neuromuscular transmission of motor
stimuli.
 Hypocalcemia with calcium levels below 8 mg per 100 ml of serum may last for 11-32 h in
parturient cows without paresis developing.
 Paralysis was usually associated with calcium levels below 5 mg per 100 ml serum.
SYMPTOMS
 Anorexia
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 Cold extremities
 Lowering of the body temperature
 Stiff gait
 Staggering
 Inco-ordination
 Inability to rise
 An S-curve in the neck
 Failure of the pupil to contract on stimulation by light
 Suppression of urination and defecation
 Constipation
 Slight tympany of the rumen
 Cessation of parturition, if it develops during that period, and
 Coma, and finally death usually occurring in 6 to 24 h if treatment is not instituted.
DIAGNOSIS
 Based on clinical signs
 A practical field test for determining the blood serum calcium levels based on the amount of
EDTA is needed to prevent the coagulation of blood.
TREATMENT
 Administration (depending on the size of the cow) of 20% calcium gluconate, one half of
the amount injected intravenously and one half subcutaneously.
 For 2-3 days, remove only a small amount of milk from the udder. Complete emptying of
the udder should be avoided if possible during this period.
 Udder insufflations to raise the plasma calcium concentration by reducing milk secretion
and transferring calcium in the udder back into the circulation.
 Use of irradiated ergosterol or large amounts of vitamin D to prevent the occurrence or
prevent relapses of the disease is questionable.
PROGNOSIS
 Spontaneous recovery is rare.
 With proper care and prompt handling: Prognosis is good
 In uncomplicated cases that do not injure themselves in attempting to rise: mortality should
be less than 2 to 3%.
CONTROL MEASURES
 Several milk fever control principles and control factors have been described in the
literature within the last 50 years. Currently, for a variety of reasons only four of these are
widely used on commercial dairy farms.
Oral drenching around calving with a supplement of easily absorbed calcium
 Administration of 3-4 doses (30-40 g of calcium per dose as bolus, a gel, a paste or a liquid)
distributed evenly during the period from 12-24 h before calving to 24 h after calving.
 Prevent significant proportion of relapses when given as a 1or 2 dose supplement to
intravenous calcium therapy.
 Drawbacks
o Single cow handling
o Risk of aspiration pneumonia
o Products based on calcium chloride and calcium formate may cause irritation to the
gastrointestinal mucosa and uncompensated systemic acidosis.
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The feeding of acidifying rations by anionic salt supplementation during the last weeks of
pregnancy
Feeding of low calcium rations during the last weeks of pregnancy

 Low calcium principle is highly effective, approaching 100% in preventing milk fever,
provided dietary calcium intake is kept below 20g/d, and exposure period for at least the last
2 weeks before calving.
 Using commonly available feeds, a calcium level of < 20g/d is difficult to obtain
 A possible solution to this may be addition of a calcium binder to the feed.
Pre-partum administration of Vitamin D, vitamin D metabolites and analogues

 Controversial
 Efficacy varies greatly
 Timing of treatment is important
 Injection given 2-8 days before calving has been considered optimal. If the cow fails to
calve after the 8th day, another injection may be given and repeated every 8 days until
calving.
 Disadvantages
o Dose required is very close to toxic dose causing clinical symptoms including
 marked anorexia
 loss of body weight
 dyspnoea
 tachycardia
 recumbency
 torticollis, and
 severe cardiovascular calcifications.
o Risk of hypocalcemia and clinical signs of milk fever 10-14 days postpartum.
LESS SPECIFIC CONTROL MEASURES

 Other possible but less specific control measures for the prevention of milk fever include
management practices such as
o Dietary magnesium level control peri-partum
o Body condition control
o Controlling dietary carbohydrate intake peri-partum
o Shortening of the dry period
o Pre-partum milking
o Reduced milking in early lactation.
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POSTPARTUM PARAPLEGIA, "Downer cow syndrome"

 “Downer” cow syndrome is referred to an animal that fails to rise after dystocia or that
goes down and is unable to rise late in gestation or soon after parturition without any
apparent reason prior to development of the sequelae of recumbency.
 When a specific diagnosis is made, the term downer should not be used.
 This condition by itself is not a disease, but it is a complication.
 Most of these cases occur for the most part, around calving and an early recovery is often
imperative and a prompt accurate diagnosis is desirable from the standpoint of the animal’s
future production and even life.
 When a cow becomes alert and gains control of fore quarters following calcium therapy but
remains recumbent due to inability to use the hind quarters, it is referred to as “Creeper
Cow”.
 Downer cow syndrome is a common, challenging and perplexing diagnostic problem for the
veterinarian.
RISK FACTORS
 Peak lactation yield of high producers
 Complications due to delayed or incomplete treatment of various diseases after parturition
 Poor housing conditions
 Excess body weight
 Septic conditions
 Malnutrition.
CHECK LIST OF ETIOLOGICAL FACTORS

Metabolic and/or Nutritional Disturbances
 Parturient paresis, hypocalcemia, milk fever
 Tetany, hypocalcemia and/or hypomagnesemia including grass and transport tetany
 Ketosis, usually postparturient
 Debility, cachexia, or weakness—due to starvation, senility, acute or chronic wasting
diseases including internal or external parasitisms and Johne’s disease
 Zenker’s degeneration of muscle—due to a lack of selenium, vitamin E, and the presence of
other factors including poor quality hay and muscle stress following a lack of exercise or
following vigorous attempts to rise in cows with milk fever, nerve paralyses, or cows that
are cast.
Traumatic and/or Physical Injuries:

Often occur during attempts to rise especially where the footing is slippery or in cows affected with
milk fever.
 Paralyses- injuries to the obturator, peroneal, gluteal, femoral and brachial nerves or
compression of spinal cord. Lymphosarcoma and abscesses may produce spinal
compression
 Dislocation of the hip or sacroiliac joints
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 Fractures of the leg, pelvis, spine, and skull

 “Cast” often associated with myositis, Zenker’s degeneration, tendinitis, arthritis, muscle
asthenia and ischemia, phlebitis and thrombosis, and contusions
 Rupture of the gastrocnemius muscle, usually secondary to Zenker’s degeneration
 Exhaustion from attempts to rise or exertion from dystocia may produce a circulatory crisis,
low blood pressure and myocarditis, may be related to a lack of exercise
 Hemorrhage, anemia, or shock as in rupture of the uterine or pelvic blood vessels in torsion
or prolapse of the uterus, laceration of the genital tract, transportation in advanced
pregnancy, abomasal or duodenal ulcers, coccidiosis, anaplasmosis, leptospirosis and
postparturient hemoglobinuria.
Infectious Diseases or Inflammatory Processes

 Septic metritis, with or without a retained placenta or a vulvar discharge
 Septic mastitis
 Peritonitis, or pericarditis,’ secondary to traumatic gastritis, uterine rupture or abomasal
ulcers with perforation
 Acute laminitis
 Septic arthritis—knee, hocks, and coffin joint
 Miscellaneous diseases—severe pyelonephritis, shipping fever, blackleg, anthrax,
necrobacillosis, rabies, listeriosis, meningitis, and brain or cord abscess.
EXAMINATION OF RECUMBENT CATTLE

 A complete painstaking physical examination of each system of the animal should be
performed, despite the fact that the animal can’t “cooperate” and stand for the examination.
 In cases where traumatic and physical injuries are present, use of hip slings may aid in
arriving at a diagnosis.
o History
o Observation
o General examination
o Special examination
o Laboratory examination
History
 The following questions should be asked to owner
o Was the calving difficult?
o Had it got up since calving?
o Had treatments been given by the farmer?
o When the recumbency started?
o Before / during/soon after calving?
o How long had it been recumbent?
o Had position changed since recumbent?
o How long had it been in current position?
o Whether the floor is slippery?
 Other particulars like proceeding symptom, early disease, frequency of paresis and mineral
feeding 6-8 weeks prior to calving also should be checked.
Observation of recumbent cattle
 General appearance
 Position of the head, neck limbs, and tail in relation to body.
 Angles of limb joints
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 Swelling / injuries
 Unusual movement
 State of feet
 Surroundings.
General examination
 General state of health
 Mental status
 Respiration
 Pulse
 Temperature
 Udder/reproductive and circulation system CNS
 Rectal and Vaginal examinations.
Special examination
 Locomotor system
 Nervous system
Laboratory examination
 Dung examination
 Urine analysis
 Hemogram
 Blood chemistry.
BASED ON CLINICAL SIGNS
Characteristics Downer Cow Creeper Cow
Mental status Depressed Alert
When stranger No response Tries to get up

approaches
Temperature 100 °F/Less 100 - 101 °F
Head restraint No resistance Resistance
Nose muzzle Dry Moist
Head posture Drooping Hindleg- fetlock erect
Ears Drooping Partly erect
Eyelids Not tensed open Snapping shut
Eye Vacant look Bright look
Pupil Dilated Not marked
Pupillary light reflex Slight/Sluggish Photophobia- Pupil constricts to a mere

slit
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Gluteal palpation Resistance, not fluid No tone, fluid like

like
Abdominal muscle No loss of tone Loss of tone
Fetlock while rising No attempt to rise Pronounced flexure
Dung Stasis No stasis
Response to injection Negative Objects

17. ANIMAL BIRTH CONTROL
OVARIOHYSTERECTOMY (OHE)
 Neuter refers to ovariohysterectomy (OHE), the surgical removal of the ovaries and uterus.
INDICATIONS FOR OVARIOHYSTERECTOMY (OHE)
Most common reasons to perform OHE in dogs are
 To prevent estrus, and
 Unwanted offspring.
Other reasons for OHE include
 Prevention of mammary tumors or congenital anomalies
 Prevention and treatment of pyometra
 Metritis
 Neoplasia (i.e. ovarian, uterine, or vaginal)
 Trauma
 Uterine torsion
 Uterine prolapse
 Vaginal prolapse and Vaginal hyperplasia
 Control of some endocrine abnormalities (i.e., diabetes and epilepsy), and
 Dermatoses (e.g., generalized demodex).
ANESTHETIC CONSIDERATIONS FOR ELECTIVE SURGERIES OF THE

REPRODUCTIVE TRACT
 General anesthesia is recommended
 Careful pre-operative screening
 In apparently healthy animals, complications may arise due to
o Uncorrected hydration
o Electrolyte or acid-base balance
 Since the viscera is exposed during abdominal surgery, the water evaporation
rates are increased
 To replace this loss, fluid administration should be increased
 Hypothermia occurs due to body heat loss as a result of vasodilatation and exposed viscera
 Exercise care to maintain body temperature during surgery and rewarm the patient post
operatively.
OPEN SURGERY
TECHNICAL VARIATIONS
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 Many technical variations of OHE have been described, which includes

o Flank approach
o Laparoscopic approach, and the use of stapling equipment
o Ultrasonic scalpel
o Vessel sealing devices
o Tran fixation ligatures, or
o Miller’s Knots.
NON-SURGICAL INTERVENTIONS
 A perfect contraceptive should have nearly 100 per cent efficacy with no risk to the patient
that is widely acceptable and available at a reasonable cost.
 The cheapest and most effective contraceptive is physical confinement to prevent breeding.
POPULATION CONTROL IN BITCHES

 IMMUNOLOGICAL METHODS
 Antibodies to luteinizing hormone (LH) to prevent LH from reaching the target organs has
worked for varying periods of time with unpredictable results.
 Antibodies to gonadotropin releasing hormone (GnRH) are promising but not commercially
available to the practitioners.
 Immunization with preparations of porcine zona pellucida prevents sperm from binding to
the ova or masks sperm binding sites and prevents conception.
 Immunologic methods are temporary and require a booster program to have long term
effects.
 INTRAVAGINAL AND INTRAUTERINE AGENTS

 Anatomical location of the cervix in the bitch makes it impossible to cannulate per vagina,
thus placement of an intrauterine device (IUD) would require laparotomy adding the cost
and risk of major surgery. Hence IUD’s are not feasible in bitches.
 Intra-vaginal devices were available at one time but were discontinued as a proper fitting
device to a wide range of sizes of dogs was not possible, cost, foreign body vaginitis made it
objectionable with poor acceptance with many of the owners.
 PHARMACEUTICAL AGENTS
Progestagens
 The commonly used agents are progesterone, hydroxy-progesterone acetate, medroxy-
progesterone acetate and megestrol acetate.
o Side effects of chronic progesterone administration is cystic endometrial hyperplasia
with or without infection, positively correlated with mammary neoplasia and may be
diabetogenic.
Megestrol acetate
 It is a potent orally active progestagens that is used for prevention of estrus and
postponement of estrus prior to proestrus.
o For prevention of estrus megestrol is administered at a dose rate of 2.2 mg/kg daily
for 8 days during the first 3 days after observing sanguineous discharge and vulvar
swelling.
o For postponement of an anticipated estrus megestrol is administered at a dose rate of
0.55 mg/kg daily for 32 days beginning at least a week prior to the onset of proestrus
based on the patient history.
o Vaginal cytological examination is often useful in timing the therapy.
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o Temporary side effects include increased appetite, decreased activity, weight gain,
and may rarely induce lactation.
Androgens
Testosterone
 It is used to prevent estrus in working dogs especially in racing greyhounds.
 Oral and parental routes have been used.
 Bitches administered with 25 mg of testosterone orally at weekly intervals prevented estrus
for 5 years.
o Side effects include clitoral hypertrophy and vaginitis.
o Silicone implants containing testosterone effectively prevented estrus for 840 days.
Mibolerone
 It is an androgenic, anabolic anti-gonadotropic steroid that does not possess progestational
or estrogenic activity.
VGO - 421 (Veterinary Obstetrics) Terminology:
Gynaecology: (From Greek, gynae means woman and logos means discourse or study). It pertains
to the diseases of the female, but the term is generally used for diseases related to the female genital
organs. "A branch of science which deals with the study of physiopathology of reproduction,
infective and non-infective conditions of genital tract affecting efficiency of reproduction is called
Gynaecology".
Theriogenology: (Greek word 'therio = animal or beast and gen = coming into). The branch of
science which deals with all aspects of veterinary obstetrics, genital diseases and animal
reproduction, is called theriogenology. The term was first proposed by D. Bartlett and others.
Reproduction: "Reproduction is the ability of all living organisms to produce young ones similar
to themselves in most of the characters". Reproduction is a luxury function of the body not
physiologically necessary for life of the individual and usually not performed until the animal
reaches nearly to adult size.
Obstetrics: (Latin word means/midwife'). The branch of science which deals with the care of
female during gestation, parturition and puerperium is called obstetrics.
Andrology: The branch of science which deals with the investigation and problems of infertility in
male animals is called andrology.
Paediatrics: The branch of science that deals with the care of newborn in most critical stage of life
when it is exposed to various external stimuli is called paediatrics.
Uniparous or Monotocous animal: The animal in which only one ovum is released at each
ovulation and one foetus develop in the uterus is called uniparous or monotocous animal. The
uniparous group of animals are characterized by the presence of a well developed cervix e.g., cow,
buffalo and mare.
Multiparous or polytocous animal: The animal in which more than one ova are released at
ovulation and more than one foetus develop in the uterus, is called polytocous animal. In general,
multiparous animals have a poorly developed cervix. e.g., bitch, cat and sow.
Nullipara: Females that never conceived or carried young are called nullipara.
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Primipara: Females that have conceived and have had only one gestation period are called
primipara.
Pluripara: Females that have conceived two or more times and have had two or more gestation
periods are called pluripara.
Dyspareunia: Painful or difficult coitus is called dyspareunia.
Induced ovulators: Animals that require copulation for ovulation are called as induced ovulators
e.g. cats, rabbits, ferrets, minks, camels, llamas and alpacas.
Oogenesis or Ovogenesis: Formation and development of the egg or ovum which begin from the
embryonic stage and is completed when a spermatozoon penetrates the zona pellucida is called
oogenesis OR Formation of ova from oogonia is called oogenesis.
Ovulation: The process whereby a secondary oocyte (Primary oocyte in bitch and mare) is released
from the ovary following rupture of a mature Graafian follicle and becomes available for
fertilization is called ovulation.
Fertilization: The process of fusion of a sperm with a mature ovum is called fertilization. It begins
with sperm-egg collision and ends with formation of mononucleated single cell (zygote).
Zona reaction: When sperm come in contact with zona pellucida, their head secrete acrosin (or
zonalysin) enzymes which dissolve the zona pellucida and a sperm penetrates the zona pellucida.
After entry of sperm to zona pellucida, some changes occur in the ovum which prevents entry of
rest of the spermatozoa, called zona reaction.
Vitelline block: At the time of contact between sperm and vitelline membrane, a reaction occurs in
the membrane, which makes it unresponsive to other sperm, called vitelline block.
Embryology: The study of the physiological development and growth of prenatal individual is
called embryology.
Implantation: The attachment of the conceptus to the tissues of the uterus, which commences at
the blastocyst stage of development, is called implantation.
Zona hatching: The process in which a blastocyst hatches or escapes from the zona pellucida in
the uterus, is called zona hatching.
Intrauterine migration and spacing: Intrauterine migration and spacing of embryo or conceptus
occurs in uterus for the survival of embryo in polytocous species.
Trophoblast or trophoectoderm: Differentiation of two distinct cell populations occur after

blastocyst formation. The single peripheral layer of cells is termed as trophoblast or
trophoectoderm. Later in development, the trophoblast forms chorion.
Embryoblast or inner cell mass: A group of cells residing at one pole beneath the trophoblast is
called embryoblast or inner cell mass, which develops into three primary germ layers of embryo
(ectoderm, mesoderm and endoderm) during the process of gastrulation.
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Uterine milk or histotrophe: The uterine glands under the influence of estrogen and progesterone
secrete "uterine milk" which is composed of protein, fat and traces of glycogen, give nourishment
to embryo.
Maternal recognition of pregnancy (MRP): The critical period before the attachment of
conceptus to the endometrium, trophectoderm secretes a substance (interferon tau) which prolongs
the life span of the cyclic corpus luteum beyond the period of the oestrous cycle. This phenomenon
is called MRP.
Progesterone block: Under the influence of progesterone, the uterine endometrium releases very
little PGF2 alpha and appears insensitive to estrogen or oxytocin stimulation. This phenomenon is
called" Progesterone block".
Ovine trophoblast protein (oTP-l) or ovine interferon tau (oIFN): The ewe conceptus
synthesizes and secretes an anti-luteolytic product between days 12 and 21 of pregnancy called
oTP-1 or oIFN- t.
Gestation or pregnancy: The condition of female characterized by presence of developing unborn

young in the uterus is called pregnancy.
Gestation period: It is the period from fertilization to parturition.
Period of ovum or blastula: It is the period during which the conceptus sheds its zona pellucida
and transforms to blastocyst. It is the period up to 10-12 days after fertilization in cows.
Period of embryo: It is the period between blastocyst and organogenesis. During this period, major
tissues, organs and systems of the body are formed and changes in body shape occur so that by the
end of this period, the species of the embryo is readily recognizable. It extends from 13th to 45th day
of pregnancy in cow.
Period of foetus: It is the period during which most of the growth of placenta and foetus takes
place and lasts until parturition.
Placenta: It is a fusion of foetal membranes to endometrium for physiological exchange.
Placentation: The process of formation of placental membranes around the foetus is called
placentation.
Telogony: It is the misconception that a pure bred animal mated accidentally by a mongrel may
never breed true again. Believed occasionally by some dog & horse breeders.
Extra uterine pregnancy (or ectopic pregnancy): The fertilized ovum, embryo or foetus which
establishes nutritive relations with organs or tissue other than the endometrium and undergoes some
degree of embryo logical development is called ectopic pregnancy.
False extra uterine pregnancy: An embryo or foetus develops normal placental relationship with
the endometrium and the foetus reaches recognizable size. Thereafter, it escapes from the uterine
cavity either into the abdominal cavity or the vagina, is called false extra uterine pregnancy.
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Parity: It refers to the number of complete gestations (include the delivery of term or near term
fetuses).
Placentome: It is the unit of close apposition of specialized area of endometrium (caruncle) with
specialized area of the foetal membrane (cotyledon).
Pseudo-pregnancy: The condition, in which a female has most signs of pregnancy but is not
pregnant, is called pseudo-pregnancy. This condition is commonly found in bitch. The bitch comes
in estrus and is served but without fertilization or without development of any conceptus, she
considers herself pregnant.
Pseudocyesis: The onset of lactation without parturition is called pseudocyesis. Generally, lactation
without pregnancy in a bitch is commonly referred to as pseudo-pregnancy by most of the owners
and veterinary practioners. Actually pseudo-pregnancy is a misleading name for this because the
bitch does not show signs of pregnancy but is only lactating.
Parturition: The process of giving birth to fully developed and viable offspring at the end of
pregnancy is called parturition.
Lochia: The normal uterine discharge during the first three-weeks after parturition, which consists
of mucus, detritus and blood initially and later becomes serous, is called lochia.
Involution: The process by which the uterus returns to its non-pregnant size within specified time
after parturition is known as involution of the uterus.
Puerperium: The period after completion of parturition during which the genital system is
returning to its normal non-pregnant state is called puerperium.
Still-birth: Expulsion of dead foetus at the time of parturition is called still-birth.
Premature birth: Expulsion of live foetus before completion of gestation period.
Abortion: The expulsion of dead foetus of recognizable size from the uterus before full term of
gestation is called abortion.
Vulva: The vulva is the external genitalia of female and consists of right and left labia. It is
predominantly adipose tissue in which some fibres of the constrictor vulva muscle are embedded.
Clitoris: The clitoris in the female is the homologue of the penis in the male. It is situated just
dorsal to the ventral commissure within the vulvar cleft.
Vestibule: The vestibule is the lumen of the urogenital tract between the vulvar cleft caudally and
the hymen or transverse folds cranially or it is the tubular portion of the vulva connecting the labia
with the vagina.
Vagina: The vagina is the muscular, tubular organ between the vestibule and cervix.
Vulvar cleft: The external opening of the vulva is called vulvar cleft.
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Endometrium, myometrium and perimetrium: The tunicae mucosa, muscularis and serosa of the
uterine wall are commonly called endometrium, myometrium and perimetrium.
Endosalpinx: The mucosa of the oviduct is called endosalpinx.
Middle uterine artery: It is a large branch of the internal iliac artery which supplies blood to most
of the uterus.
Cervical Star: An irregular spot on the chorion found over the internal os of the cervix of mare is
called cervical star. It is constituted by necrotic tips of the chorion found at the apices of the chorio-
allantois.
Hippomanes: Amorphous, semisolid, amber-colored, irregular shaped masses or bodies commonly

found floating in the allontoic fluid are called hippomanes. Hippomanes are allontoic calculi.
Simple uterus: When a uterus has a pear-shaped body with no uterine horns, it is known as simple
uterus. e.g., woman's uterus and other primates.
Duplex uterus: When a uterus consists of two uterine horns each with a separate cervix, it is called
duplex uterus. e.g., rat, rabbit, guinea pig and other small animals.
Bicornuate uterus: When a uterus has a small uterine body and two long uterine horns, it is called
bicornuate uterus e.g. sow, bitch, cat, cow, ewe and doe.
Bipartite uterus: When a uterus has a prominent uterine body and two uterine horns that are not as
long and distinct as in the bicornuate type, it is called bipartite uterus. e.g. Mare.
Teratology: The division of embryology and pathology dealing with abnormal development and
malformation of the antenatal individual is called teratology.
Teratogens: The non-genetic anomalies or monsters are caused by a variety of environmental

factors or agents. These agents are called teratogens.
Anomaly: If the malformation involves only an organ or part of the body, it is called an anomaly.
Monster: If the deformity or malformation is extensive, the animal is called monster.
Intersex: An individual having some of the characteristics of both the sexes and therefore showing
abnormalities of sexual development is called intersex.
Chimeras: A chimera is an individual composed of two or more types of cells, each type arising
from a different source and containing different chromosome constitutions. This condition is called
chimerism. Especially in livestock, a chimera containing cells derived from two different zygotes.
This usually arises due to fusion between placentas during pregnancy and subsequent anastomosis
of the foetal blood circulations. Free-martin is an example of chimera.
Mosaic: Mosaic is an individual consists of two genetically different cell types containing different
chromosome constitutions but both derived from the same zygote. This condition is called
mosaicism. A mosaic usually results from mitotic non-disjunction in a single zygote.
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True hermaphrodite: An individual having both testis and ovary or ovotestes, is called true
hermaphrodite.
Pseudo hermaphrodite: An individual having gonads of only one sex (either ovary or testis) but
external genitalia and secondary characters of opposite sex is called pseudo hermaphrodite.
Male pseudo hermaphrodite: An individual having testes but phenotypically resembles to female,
is called male pseudo hermaphrodite.
Female pseudo hermaphrodite: An individual having ovaries but phenotypically resembles to

male, is called female pseudo hermaphrodite.
Freemartin: (Free = sterile; martin = bovine) The infertile female with a modified genital tract
born cot-win with a male foetus with which it has exchanged whole blood is called freemartin.
Twins: The two individuals that are born at the same time and from the same parents are called
twins.
Monozygotic or identical twins: In this type, twins are derived from a single zygote that divides at
an early stage of embryonic development. They are of the same sex and genetically identical.
Dizygotic or fraternal twins: In this type, twins are developed from separate zygotes during the
same oestrous cycle.
Fused or Siamese twins: These are monozygotic twins which result from the incomplete division
of a single embryo.
Schistosoma reflexus: The monster in which acute angulation of vertebral column takes place
causing dorsal approximation of head and tail. The main defect is in skeleton. The thoracic and
abdominal tunics are absent or incomplete ventrally exposing the visceral contents.
Perosomus elumbis: The monster in which vertebrae and spinal cord is absent after the thoracic
region to tail. Therefore, the pelvis remains deformed, small and flattened and the hind limbs are
strongly ankylosed and flexed. There is also muscular atrophy of lumbar and sacral regions with
rigidity of joints.
Hydrocephalus: Hydrocephalus monster is characterized by swelling of cranium due to

accumulation of fluid in the ventricular system (internal hydrocephalus) or between the duramater
and brain (external hydrocephalus).
Polysarcia or lard claves: Polysarcia is the accumulation of excessive quantities of fat in the
subcutaneous tissues.
Wryneck: A congenital deformity, in which the head and neck are fixed in flexion due to ankylosis
of the cervical vertebrae, arises during the peculiar bicornual gestation of solipeds.
White heifer disease: Due to arrested development of the Mullerian duct system, the uterus and
the vagina are incompletely developed but the ovaries and vulva are always normal. This
abnormality in heifer is called white heifer disease.
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Eutocia: The safe, easy, natural or physiological parturition is called eutocia.
Dystocia: When the first or especially the second stage of parturition is markedly prolonged and
becomes difficult or impossible for the dam to expel out the foetus without artificial aid, the
condition is called dystocia.
Mutation: It is defined as those operations by which a foetus is returned to a normal presentation,

position and posture by repulsion, rotation, version and adjustment of the extremities.
Repulsion (or retropulsion): Pushing of foetus out of the maternal pelvis or birth canal into the
uterus, where space is available for correction of position or posture of the foetus and its extremities
is called repulsion.
Rotation: Turning of the foetus on its long axis to bring the foetus into a dorso-sacral position is
called rotation.
Version: Rotation of the foetus on its transverse axis into anterior or posterior presentation is called
version.
Extension and adjustment of the extremities: Correction of abnormal posture is called extension
and adjustment of the extremities.
Force extraction or Traction: Pulling of the foetus through the birth canal by means of
application of outside force or traction is called force extraction of foetus.
Foetotomy or embryotomy: It is defined as those operations performed on the foetus for the
purpose of reducing its size by either its division or the removal of certain parts.
Caesarean section: Caesarean section is the delivery of the foetus, usually at parturition by
laparohysterotomy.
Obturator paralysis: Injury to the obturator nerve generally observed after correction of hip lock
in anterior presentation, characterized by the paralysis of adductor muscles of thigh.
Peroneal paralysis: Due to injury or trauma of peroneal nerve during struggle to rise (peroneal
nerve passes over the dorso-lateral condyle of tibia & fibula) resulting knuckling of the fetlock and
dropping of the hock, and difficulty in rising, standing and walking.
Episiotomy: The technique to incise the vulva to increase its diameter for safe delivery is called
episiotomy.
Butt or Poll or Vertex posture: The downward displacement of head in which foetus nose is
towards the trachea and the poll is presented at the pelvic inlet in anterior presentation and dorso-
sacral position is called vertex posture.
Nape posture (nape means back or hind part of neck): The downward displacement of head in
which the head is flexed more than vertex posture so strongly that not only the poll but also the part
of nape of neck is presented at the pelvic inlet in anterior presentation and dorso-sacral position is
called nape posture.
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True breast-head posture: The downward displacement of the head in which the entire head of
the foetus gets dropped down between the fore limbs in anterior presentation and dorso-sacral
position, is called true breast-head posture.
Foot-nape posture: The upward displacement of one or both expanded fore limbs so that the limbs
come to lie above the extended head in the vagina in anterior presentation and dorso-sacral position
is called foot-nape posture. It is common in horse.
Breech presentation: The bilateral hip flexion i.e. both hind limbs are retained in the uterus in
posterior presentation and lumbo-sacral position is called 'breech presentation'.
Dog-sitting position: Anterior presentation with rear legs extended beneath the foetus called 'Dog-
sitting' posture. It is oblique ventro-vertical presentation in which the foetal head, neck and
forelimbs are in the vagina accompanied by the distal extremities of both hind limbs. This form of
dystocia is seen very occasionally in the mare and extremely rare in the cow. Roberts considers that
the dog-sitting posture is an abnormal posture of anterior presentation while almost all other
authors (Arthur, Jackson, Benesh and Wright etc.) consider it as oblique ventro-vertical
presentation.
Retention of placenta: The non-separation and failure of expulsion of foetal membranes within a
certain time limit for particular species (for cow 8-12 hours), is called retention of placenta.
Uterine inertia: The lack of normal physiological uterine contraction during or after parturition is
called uterine inertia.
Primary uterine inertia: The failure of the uterine muscles to contract normally at parturition due
to hormonal imbalance, lack of receptor on muscles, diseases of muscles etc is called primary
uterine inertia.
Secondary uterine inertia: The failure of the uterine muscles to contract due to exhaustion of the
uterine muscles during prolonged dystocia is called secondary uterine inertia.
Mummification: The process in which foetus dies within the uterus, autolysis occurs without
putrefaction and the remaining shriveled mass of bones gets enclosed by skin with persistency of
corpus luteum is called mummification.
Maceration: The process in which a foetus dies after ossification within the uterus and the foetus
undergoes microbial digestion or putrefaction in the fluid of uterus till only the mass of bones
remains is known as maceration.
Hydramnios: The accumulation of excess amniotic fluid in the amniotic cavity during the
development of foetus is called hydramnios. This is often associated with inherited or acquired
malformation of the foetus.
Hydrallantois: The accumulation of excess allantoic fluid in the allantoic cavity during the
development of foetus is called hydrallantois.
Foetal anasarca: The excess amounts of fluid in the tissue beneath the skin of foetus, is called
foetal anasarca.
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Uterine torsion: The twisting of the uterus on its long axis is called uterine torsion.
Vagino-cervical prolapse: A condition in which outward displacement of vagina and cervix

occurs through the vulva is called vagino-cervical prolapse.
Uterine prolapse: The outward displacement of the uterus through the vagina and vulva is called
uterine prolapse. It is also called casting of 'wethers' or casting of the calf bed.
VGO - 411 (General Gynaecology) Terminology:

Puberty: It is the period when a male or female is first able to release gametes. In case of female,
the first estrus is the visible sign for attainment of puberty.
Fertility: Ability of an animal to reproduce maximum within the stipulated time as per the norms
of the species is called fertility.
Infertility: Temporary inability of the animal to reproduce is called infertility.
Sub-fertility: Less than normal reproductive capacity is called sub-fertility.
Sterility: Permanent inability of an animal to reproduce is called sterility.
Oestrous cycle: It is a chain of physiological events that begins at one oestrous period and ends at
the next or it is a cycle of reproductive activity exhibited by sexually mature non-pregnant female
mammals (except primates), is called oestrous cycle.
Monoestrus: The females which exhibit one oestrous cycle in a year is called monoestrus animals
e.g., wild animals and bitches.
Polyoestrus: The females which exhibit regular oestrous cycle throughout the year, is called
polyoestrus animals e.g., cow, sow and doe.
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Seasonally polyoestrus: The females which exhibit many oestrous cycles during a particular
season are called seasonally polyoestrus animals. e.g., mare, ewe, buffalo.
Proestrus: It is an ill-defined period during which the Graafian follicles grow under the influence of
FSH and produce increasing amounts of estradiol.
Oestrus: It is the fairly well-defined period characterized by the intense sexual desire and
acceptance of the male.
Metoestrus: It is a poorly defined period following estrus during which the corpus luteum grows
rapidly from the granulosa cells of the ruptured follicle under the influence of LH.
Dioestrus: It is a longest phase of the oestrous cycle marked by mature corpus luteum.
Folliculogenesis: The process whereby immature follicles develop into more advanced follicles
and become candidates for ovulation is referred to as folliculogenesis.
Anoestrus: Lack of estrus expression at an expected time is called anoestrus.
Silent heat: A condition characterized by normal cyclical activity but without well-marked
behavioral signs of heat or estrus is called silent heat.
Pseudo-menstruation: Several domestic animals shed blood from their uteri at certain phase of the
oestrous cycle. This phenomenon is called pseudo-menstruation.
Copulation or coitus: The insertion of erected penis into the vagina and subsequent ejaculation of
semen is called copulation.
Calling: It is the term used to describe the vocalization of the queen (cat) when she is in heat.
Flagging: In case of stallion when intromission is achieved, ejaculation takes place over a period of
a few minutes. During this time the tail of stallion is lifted up and down. This is called flagging.
Corpus haemorrhagicum: The blood-filled follicle devoid of the ovum is commonly called
corpus haemorrhagicum.
Corpus luteum albicans: The degenerating avascular non-functional corpus is termed as corpus
luteum albicans.
Yellow body: The mature corpus luteum (CL) of the cow contains a yellow lipochrome pigment
which gives a light brown to yellow appearance. Because of this colouration, the CL is frequently
referred to as the 'yellow body'. As the CL ages and begins degeneration, the colour darkens until it
finally becomes deep orange to brown.
Supernumerary sperm: The extra sperm which succeed in entering the vitelline membrane, in
spite of both zona reaction and vitelline block are called supernumerary sperm.
Polyspermy: The condition, in which more than one sperm get entry in the ovum, is called
polyspermy.
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Polygyny: The condition in which incomplete maturation of egg occurs due to failure to expel the
second polar body resulting in a triploid zygote after fertilization is called polygyny.
Superfoecundation: The condition, in which offspring from more than one sire are conceived at
the same estrus period, is called superfoecundation. Superfoecundation is observed more commonly
in bitches because it resemble to ovulate two or more ova and have long heat periods. Therefore it
has opportunity for mating by different males.
Superfoetation: Superfoetation occurs when an animal which is already pregnant comes into
estrus, is bred again and conceives a second litter. This condition is more common in multiparous
animals e.g., sow.
Conception rate: Percentage of cows becoming pregnant after first service. It should be around
60% for chilled semen and 45-50% for frozen semen. Number of services per conception: It is the
average number of services required for one conception. It should be 1.5 services per conception.
Non-return rate: Number or percentage of cows not observed for estrus after A.I.
Calving rate: Percentage of cows giving normal birth after first A.I.
Calving interval: The time interval between two successive calvings is called calving interval.
Service period: The period between calving to fertile estrus is called service period.
Ovarian Cysts: are defined as follicle-like ovarian structures having 2.5 cm in diameter or larger
and persist for 10 days or more in the absence of a corpus luteum.
Follicular cysts: are anovulatory follicles that persist on the ovary for 10 days or usually much
longer, have a diameter greater than 2.5 cm. and are characterized by nymphomania.
Luteal cysts: are anovulatory follicles over 2.5 cm in diameter that are partially luteinized and
persist for a prolonged period and are usually characterized by anoestrus.
Cystic corpora lutea: are non-pathogenic ovarian cysts which arise following ovulation.
Adrenal virilism: is characterized by a long standing cystic ovarian disease in which the cow
becomes heavy and coarse, develops a thick neck and head and a steer-like appearance.
Paraovarian cyst: are found in broad ligament around the ovary and oviduct. These cysts are
vestiges of the Mullerian duct system.
Hypoplasia of ovary: Failure of migration of primordial germ cells from the yolk sac to the
developing gonad during embryonic stage is the cause of hypoplasia of ovary.
Repeat breeder: The repeat breeder is one that has normal or nearly normal oestrous cycles and
estrus period, and has been inseminated three or more times with semen from known fertile bull but
fails to conceive.
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True anoestrus: When the ovaries have no any structure like Graafian follicles or corpus luteum
i.e. ovaries are smooth, then the condition is called true anoestrus.
Apparent anoestrus: When the ovaries have corpus luteum or Graafian follicles but show
anoestrus, then the condition is called apparent anoestrus.
Embryonic mortality: When the death of conceptus occurs before the completion of embryonic
period, it is called embryonic mortality.
Pneumovagina: Aspiration of air into the vagina, resulting in inflammation of the vagina/and
uterus and causes infertility.
Oophoritis or ovaritis: Inflammation of ovary is called oophoritis.
Salpingitis: Inflammation of fallopian tube is called salpingitis.
Endometritis: Inflammation of endometrium is called endometritis.
Metritis: Inflammation of whole thickness of the wall of uterus is called metritis.
Septic metritis or puerperal metritis: The metritis which occurs just after parturition i.e. within
1-10 days with systemic symptoms is called septic metritis.
Post-partum metritis: The metritis which occurs after 2 to 8 weeks or more after parturition is
called post-partum metritis. Here the animal does not show systemic symptoms.
Perimetritis: Inflammation of the serosa of uterus.
Parametritis: Inflammation of the uterine ligaments.
Sclerotic metritis: The complete destruction of endometrium as a result of severe chronic

endometritis and replaced by fibrous tissue, is called sclerotic metritis.
Cervicitis: Inflammation of cervix.

Vaginitis: Inflammation of vagina.
Vulvitis: Inflammation of vulva.
Hydrosalpinx: The accumulation of fluid in fallopian tube is called hydrosalpinx.
Pyosalpinx: The accumulation of pus in fallopian tube is called pyosalpinx.
Hydrometra and mucometra: The accumulation of thin or viscid fluid in the uterus is called
Hydrometra or mucometra. Both hydrometra and mucometra are similar except for the degree of
hydration of the mucin present in the uterus which may vary from a watery fluid to a semi solid
mass.
Pyometra: Accumulation of pus in the uterus.
Metrorrhagia: Bleeding from genital tract is called metrorrhagia.
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Embryo transfer technology (ETI): The technique by which fertilized embryos are collected from
a donor female and transferred to recipient females that serve as surrogate mothers for the
remaining period of pregnancy is called embryo transfer technology.
Superovulation: The artificial production of an abnormally large number of ova from an ovary is
called superovulation. This is achieved by administration of FSH or eCG, which increases the
number of follicles maturing and ovulating. OR superovulation can be defined as increased
ovulatory response above a normal level by means of external hormonal therapy that would not be
expected to occur naturally.
Synchronization of estrus: Oestrus synchronization involves manipulation of the reproductive

process by means of external hormonal therapy so that groups of females can be bred during a short
predefined interval with normal fertility.
In vitro Fertilization (IVF): The fertilization of an oocyte by a spermatozoon outside the body of
a living animal is called IVF. Oocytes obtained from living or recently slaughtered animals, are
cultured to reach a certain stage of development before mixing with a culture capacitated
spermatozoa.
PRID (Progesterone releasing intra-vaginal device): A stainless steel coil covered with an inert
elastomer containing progesterone (1.55gm) and estrogen (10 mg) is kept in the vagina of a heifer
or cow in order to influence the animal's oestrous cycle (oestrous synchronization).
CIDR (Controlled internal drug release device): A 'T' shaped device with flexible arms
containing 1.9 gm of progesterone, is kept in the vagina of a heifer or cow in order to influence the
animal's oestrous cycle (oestrous synchronization).
Transgenic animals: The animal in which a gene has been transferred during the embryonic stage
through the genetic engineering is known as a transgenic animal.
Molecular farming: When the transgenic animals serve as bioreactors for the large-scale
production of specific proteins; this approach has been popularly referred to as molecular farming.
Endocrine glands: The ductless glands of the body whose secretions go directly into the blood
stream are called endocrine glands.
Hormone: A chemical produced by specific ductless endocrine organs which is transported by the
blood vascular system and is able to affect distant target organs in low concentration is called
hormone. However organs like the uterus and the hypothalamus produce hormones, which do not
meet the criteria per classic definition of a hormone.
Base levels of hormones: Basel levels refer to a low and relatively constant level of the hormone in
the blood.
Hormonal pulses: Pulses refer to a sharp and increased concentration of the hormone in the blood
above the basal level of plasma concentration, lasting for short periods, usually less than 1 hour.
Hormonal surge: A surge is defined as a large, statistically significant increase in the

concentration of a hormone in the blood above the basal level, lasting for more than 1 hour. The
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massive secretion of gonadotrophin particularly LH for a period, responsible for ovulation is called
LH surge.
Episodic / tonic release: The episodic/ tonic release of hormones (FSH and LH) means continuous
basal secretion of gonadotrophin which stimulates the growth of both germinal and endocrine
components of the ovary.
Growth factors: The hormones related substances controlling the growth and development of
several organs, tissue and cultured cells are called growth factors. Unlike hormones, growth factors
are produced and secreted by cells of different tissues (not specific endocrine glands) and diffuse
into target cells.
Positive feedback mechanism: In this system, an increasing level of hormone (s) causes
subsequent increase of another hormone. For example, increasing levels of estrogen during the
preovulatory phase triggers an abrupt release of LH.
Negative feedback mechanism: This system involves reciprocal inter-relationships between two
or more glands and target organs.
Short-day breeder: An animal which starts to breed when the days are shortening, is called short-
day breeder e.g., sheep.
Long-day breeder: An animal which starts to breed when the days are lengthening, is called long-
day breeder e.g., mare.
Pheromone : The chemical compound that allow communication among animals through the
olfactory system are called pheromone or substances produced by an animal that act at a distance to
produce hormonal, behavioral or other physiological changes in another animal of the same species
have been called pheromone. In primates, including humans, pheromones also have effects. For
example, women who are good friends or room-mates tend to synchronize their menstrual cycles.
The armpit odour of women has been shown to be capable of modifying the menstrual cycle.
Sex pheromone: The pheromone by which sexual behavior is affected is called sex pheromone.
Ram or boar effect: The exposure of ram or boar to the females advance the timing of the onset of
puberty and is referred to as ram or boar effect. This is mediated by pheromones which influence
the hypothalamic GnRH secretion.
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VGO 421 Obstetrics

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VGO 421 Obstetrics

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April 11, 2020 [DRVET.

1. Types and functions of placenta in different species

1. Gestation In Domestic Animal

PERIOD OF OVUM OR BLASTULA

PERIOD OF EMBRYO AND ORGANOGENESIS

PERIOD OF FETUS AND FETAL GROWTH

HORMONAL CONTROL OF GESTATION

o Endometrial gland growth.

Species Duration (in days)

Horse 327 - 357

Sheep 140 - 155

Swine 111 - 116

Goat 148 – 156

Water buffalo 316 – 318

FACTORS INFLUENCING DURATION OF GESTATION

PROLONGED GESTATION IN DOMESTIC ANIMALS

PROLONGED GESTATION IN CATTLE

PROLONGED GESTATION IN SOWS

 High doses and continued injection of progesterone or progestins delayed parturition.

PROLONGED GESTATION IN EWES

PROLONGED GESTATION IN MARES

INCIDENCE AND ETIOLOGY

At the time of implantation:

MATERNAL RECOGNITION OF PREGNANCY (MRP)

Time of Maternal Recognition of Pregnancy (MRP) in domestic animals

PRE-ATTACHMENT DEVELOPMENT OF EMBRYO

DEVELOPMENT OF EXTRAEMBRYONIC MEMBRANES

FORMATION AND DIFFERENTIATION OF GERM LAYERS

3. Development of fetal membrane

NON-REJECTION OF PLACENTA IN PREGNANT ANIMALS

B. Classification based on the tissues or structures that intervene

CLASSIFICATION OF CHORIOALLANTOIC PLACENTAS

Species Classification of Chorioallantoic Placentas

Attachment or fusion of the placenta to the endometrium of the uterus.

Placental Anatomy and Function

CLASSIFICATION OF TRANSFER OF SUBSTANCES

RESPIRATION (O2 and CO2)

SYSTEMS OF GAS EXCHANGE

TRANSPORT OF INORGANIC NUTRIENTS

Relaxin: Relaxin is a hormone thought to act synergistically with progesterone to maintain

5. PARTURITION IN DOMESTIC ANIMALS SYMPTOMS OF

Queen (Cat) Kittening

SIGNS OF APPROACHING PARTURITION

SIGNS FEW DAYS PRIOR TO PARTURITION

D. CHANEGS IN BODY TEMPERATURE

SIGNS WITHIN FEW HOURS OF PARTURITION

 Frequent lying down and rising.

THEORIES ON THE INITIATION OF PARTURITION

Fall in progesterone Blocks myometrial contractions during pregnancy, near term

Rise in estrogen Overcomes the progesterone block of myometrial contractility

Increase in uterine volume Overcomes the effects of progesterone block of myometrial

Release of oxytocin Leads to contractions in an estrogen sensitized myometrium

Release of prostaglandins Stimulates myometrial contractions; induces luteolysis leading

Activation of fetal Fetal corticosteroids cause a fall in progesterone, a rise in

 Possible mechanisms of initiation of parturition in farm animals

Cattle PGF2 alpha induced luteolysis initiates parturition. Fetal cortisol

SCHEMATIC REPRESENTATION - ROLE OF UTERUS AND CERVIX

INITIATION OF PARTURITION IN COW AND GOAT

INITIATION OF PARTURITION IN SHEEP

INITIATION OF PARTURITION IN MARE

INITIATION OF PARTURITION IN SWINE

INITIATION OF PARTURITION IN BITCH

Possible factors responsible for initiation of parturition