Uterine torsion followed by jejunal incarceration in a partially everted urinary bladder of a cow

A case of bladder eversion with intestinal entrapment in a cow is described. The condition occurred in conjunction with a 180 degrees right side uterine torsion. The cow responded well to corrective surgery.     

Cesarean section and ovariohysterectomy after severe uterine torsion in four cows

OBJECTIVE: To report a technique for intra-partum ovariohysterectomy (OVH) in cows after severe uterine compromise after uterine torsion. STUDY DESIGN: Clinical case report. ANIMALS: Four cows with uterine torsion. METHODS: After a ventrolateral cesarean section, uterine closure, and uterine detorsion, the laparotomy incision was elongated (20 cm) caudally so that the uterus can be completely exteriorized. The uterus was separated from broad ligaments by transection between 2 rows of overlapping interrupted sutures placed in the broad ligaments to a point approximately 2 cm caudal to the external os of the cervix. The vagina was occluded with 2 clamps directly caudal to the external os of the cervix and closed with 5 single cruciate sutures that penetrated all layers, and then the vagina was transected between the suture line and external os to remove the uterus. The abdominal incision was closed in layers. Results- All cows survived the surgery; however, 1 died the next day from Escherichia coli sepsis and 1 was euthanatized at 8 days because of unresponsive E. coli mastitis. One cow, 28 days after surgery developed a 15 cm perivaginal abscess, which resolved after drainage. This cow and the fourth cow survived and lactated. CONCLUSIONS: Intra partum OVH is technically possible after cesarean section in cows with uterine compromise or necrosis after uterine torsion. CLINICAL RELEVANCE: Ovariohysterectomy should be considered in cows with severe uterine torsion that have uterine tissue compromise to improve survival.     

Uterine torsion in cattle - frequency, clinical symptoms and theories about the pathogenesis

Aim of the present study was to summarize the available literature about the incidence, frequency, clinical symptoms and ideas as to the pathogenesis of uterine torsion in the cow. MATERIALS AND METHODS: Analysis of the literature using electronic libraries (Pub Med, Medline), German veterinary medicine journals and obstetrical textbooks. RESULTS: Uterine torsion is a very important maternal reason for dystocia as most cases occur during parturition. The post-cervical torsion (combined uterine and vaginal torsion, Torsio uteri and vaginae) is more commonly diagnosed than an intra-cervical or pre-cervical torsion. Torsions to the left occur more frequently than to the right. Clinical symptoms clearly vary depending on the degree of torsion. The frequency in relation to all parturitions is described as between 0.5 and 1%, whereas the percentage of uterine torsions presented to the veterinarian as a reason for dystocia varies between 2.7 and 65%. The pathogenesis of uterine torsion remains unclear; however, general agreement exists that the cow is predisposed to uterine torsion due to its anatomy. It appears that the Brown Swiss is more often affected than other cattle breeds.     

Uterine torsion in a Sprague Dawley rat (Rattus norvegicus)

Uterine torsion is a twisting of the uterus or uterine horn perpendicular to its long axis. We report a case of uterine torsion in an adult breeding Sprague Dawley rat. The rat died a month after her last recorded delivery. Post mortem examination of the rat revealed 270 degrees torsion of the right uterine horn. The uterus contained a single foetus. The liver was pale and enlarged. The rest of the viscera appeared normal. Histopathological examination showed acute hepatic necrosis and pulmonary congestion with mild lymphocytic infiltrates peribronchially. The acute hepatic necrosis may have been associated with septicaemia due to compromised blood vessels following the uterine torsion. The presence of a single foetus could have resulted in foeto-maternal disproportion with resultant uterine torsion. Torsion of the uterus can be accompanied by haemostatic and metabolic complications, which could have caused the death of the rat. Although uterine torsion is a rare condition in rats, it should be considered as a potential complication of gestation in animal breeding units.     

Uterine horn torsion in a non-gravid cat

An 11-year-old female domestic shorthair cat with a previous history of having been spayed, presented with signs of abdominal distension, lethargy and anorexia of 1 week's duration. On the basis of radiological and ultrasonographic findings a tentative diagnosis of pyometra was made. Exploratory coeliotomy revealed a 900 degrees left horn uterine torsion along the longitudinal axis. Ovariohysterectomy was performed without correction of the torsion. To the authors' knowledge this is the first case report of uterine torsion in a non-gravid cat.     

ULTRASONOGRAPHIC DIAGNOSIS: CRANIAL VENA CAVA THROMBOSIS IN A COW

A 5-year-old Hereford cow was donated to Oregon State University, College of Veterinary Medicine. Two weeks before presentation the cow was treated by a left-flank laparotomy to correct a uterine torsion that revealed an excessive amount of abdominal fluid and a full term dead fetus. Ultrasonographic evaluation of the right cranioventral thoracic cavity was performed owing to physical examination (muffled heart sounds, areas of silence) and thoracocentesis findings suggestive of pleuritis. Ultrasonography revealed hypoechoic pleural effusion and a mass of mixed echogenicity visible within the right atrial lumen extending into the cranial vena cava. A diagnosis of cranial vena cava thrombosis was demonstrated at necropsy. The clinical, ultrasonographic, and pathological features of this less common condition (cranial vena cava thrombosis) in cattle are discussed.     

Factors Affecting Dystocia in Cattle

The paper reviews the various factors affecting dystocia in cattle. It is based mainly on the recent studies found in the literature of the subject but refers occasionally to some older papers as well. The factors are grouped into four main categories: direct factors, phenotypic factors related to calf and cow, non-genetic and genetic factors. The first group includes malpresentations and uterine torsion. The second one includes: calf birth weight, multiple calvings, perinatal mortality, cow pelvic area, cow body weight and body condition at calving, gestation length. The non-genetic factors are: cow age and parity, year and season of calving, place of calving, maintenance practises, disorders, calf sex and nutrition. Other non-genetic factors are the level of hormones in the periparturient period, in vitro production of embryos and embryo cloning. Finally, the genotypes of cow, bull and calf, inbreeding, muscular hypertrophy, selection and quantitative trait loci form the fourth group of genetic factors.     

The effect of uterine torsion on mare and foal survival: a retrospective study, 1985--2005

REASONS FOR PERFORMING STUDY: Anecdotal speculation suggests that prognosis for survival of mares and foals following correction of uterine torsion has improved over the past 30 years. OBJECTIVES: To determine statistically the outcome of uterine torsion according to duration of clinical signs, stage of gestation, parity, physical examination findings, method of correction, prognosis for survival and reproductive health of the mare, and prospects for the foal within the neonatal period. METHODS: This retrospective study combined cases from 4 equine referral hospitals. RESULTS: The stage of gestation at which uterine torsion occurred was a risk factor for survival of mare and foal. Overall mare survival was 53/63 (84%); when uterine torsion occurred at < 320 days gestation, 36/37 (97%) of mares survived compared to 17/26 (65%) survival rate when uterine torsion occurred at > or = 320 days gestation. Overall foal survival was 54% (29/54). When uterine torsion occurred at < 320 days gestation, 21/29 (72%) foals survived compared to 8/25 (32%) when uterine torsion occurred at > or = 320 days gestation. Thirty mares were discharged from the hospital carrying a viable fetus following uterine torsion correction and 25/30 (83%) of these mares delivered live foals that survived beyond the neonatal period. CONCLUSIONS: Prognosis for survival for mares and foals following uterine torsion is good and improves if torsion occurs < 320 days compared to > or = 320 days gestation. CLINICAL RELEVANCE: Gestational timing of uterine torsion should be considered when advising clients about the prognosis for survival of the mare and foal. The prognosis for a mare delivering a live foal is good if the mare is discharged from the hospital following uterine torsion correction with a viable fetus.     

Bilateral segmental aplasia with unilateral uterine horn torsion in a pomeranian bitch

Bilateral segmental aplasia of the uterine horns with unilateral pyometra and uterine horn torsion were diagnosed in a Pomeranian bitch that presented with chronic abdominal distension and an acute onset of anorexia and lethargy. Because radiographic and ultrasonographic findings revealed the presence of markedly enlarged bilateral uterine horns filled with fluid in the caudal abdomen, a tentative diagnosis of either pyometra or hydrometra with uterine horn torsion was made. Exploratory laparotomy showed bilateral, segmentally distended uterine horns with unilateral uterine horn torsion. Ovariohysterectomy was performed, and bilateral segmental aplasia of the uterine horns with the development of unilateral uterine horn torsion was diagnosed histopathologically. To the authors' knowledge, this is the first report of uterine horn torsion in conjunction with segmental aplasia of the uterine horn in a bitch.     

Torsion of the uterus in an Awassi ewe

The treatment of a 4-year-old pluriparous Awassi ewe with torsion of the uterus at parturition is described. At presentation, all the signs of imminent parturition were present and the rostral portion of the vagina was spirally twisted to the right causing complete stenosis of the birth canal with no foetal fluid exiting the uterus. A 360 degrees clockwise uterine torsion was diagnosed. Attempted treatment by rotation of the ewe's body proved unsuccessful. The condition was then corrected surgically via a left flank caesarean operation, and a dead foetus and foetal membranes were removed. The animal made an uneventful recovery and the sutures were removed on the 12th postoperative day.     

A study of 55 field cases of uterine torsion in dairy cattle

Two-hundred and seventy-three animals were enrolled in a case-case comparison of uterine torsions and other dystocias. The purpose of the study was to describe field cases of uterine torsion and their clinical management, compare them with other types of dystocia attended by field veterinarians, and evaluate the effect of season and housing on the incidence of torsions. Fifty-five cases of uterine torsions representing 20% of the dystocias were diagnosed. Most cases of uterine torsion were successfully corrected and followed by the vaginal delivery of a live calf. When compared with other types of dystocia, cows were at greater risk for uterine torsion than were heifers (OR = 5.2; P < 0.0001), while animals suffering from fetopelvic disproportion or carrying twins were at a lesser risk (OR = 0.05; P < 0.0001 and OR = 0.09; P = 0.007, respectively). Heifers had a lower risk when calving alone in a pen versus a tie-stall (OR = 0.2, P = 0.04). There was no significant effect of season on the risk of uterine torsion.     

清宫散对小白鼠离体子宫收缩力的影响

子宫内膜炎是一种常见的奶牛生殖系统疾病,是造成奶牛不孕的主要原因之一。它严重影响奶牛的繁殖力,给奶牛业造成巨大的经济损失。清宫散为纯中药复方制剂,临床上用于治疗和预防奶牛子宫内膜炎,效果显著,为探讨其疗效机理,利用小鼠进行离体子宫收缩实验。结果显示：清宫散对小鼠离体子宫的收缩有明显的促进作用,能促使其收缩振幅加大,频率加快,子宫收缩力加强,与加药前相比较差异极显著（P〈0．01）,与益母草组相比,差异显著（P〈0．05）。     

Surgical treatment of uterine torsion using a ventral midline laparotomy in 19 mares

OBJECTIVE: To report on the outcome of surgical treatment of uterine torsion in preterm mares. DESIGN: Retrospective case series of pregnant mares with uterine torsion presented to the Clinic for Obstetrics, Gynaecology and Andrology of Large and Small Animals. METHODS: Hospital records of all pregnant mares that underwent ventral midline laparotomy for uterine torsion between 1998 and 2004 were reviewed. The signalment, history, clinical signs, results of diagnostic procedures, direction and degree of the uterine twist, treatment and outcome were retrieved from each case record. RESULTS: This study comprised 19 mares between months 5 and 11 of pregnancy (8.7 +/- 1.9) and suffering from uterine torsion. In all cases ventromedian laparotomy was carried out under general anaesthesia. Gastrointestinal disorders were also present in 52.6% of horses. Postoperative complications included subcutaneous seromas (five mares), peritonitis (one mare) and abortion (two mares). In four mares (21%) the operation was unsuccessful (i.e. these mares had to be euthanased intra- or postoperatively). Of the surviving 15 mares, 13 (86.6%) gave birth to viable foals at full term. The foals developed normally. Only two mares aborted. CONCLUSIONS: Because of its versatility the ventral midline approach should be considered for correction of uterine torsion. The approach has many advantages, including rapid and clear access to the abdominal cavity, safety, visual assessment of uterine wall viability, correction of concomitant gastrointestinal tract problems, and performance of hysterotomy or hysterectomy, if indicated. In this study, managing uterine torsion in this way resulted in a high percentage of cases (86.6%) in which pregnancy was maintained, with the birth of a viable, mature foal.     

Torsion of the descending colon in a cow

An acute intestinal obstruction caused by a torsion of the descending colon with incarceration and strangulation of the apex of the cecum was diagnosed in a mature Holstein cow. The clinical signs manifested were acute anorexia, depression, signs of abdominal pain, and absence of feces. Rectal examination revealed a sharp decrease in luminal size of the descending colon and taut bands at that level. The final diagnosis was obtained by exploratory celiotomy. Although surgical correction was attempted, the cow died of acute fecal peritonitis 18 hours postoperatively.

Acute intestinal obstruction caused by torsion of the descending colon in the cow has not been reported in the literature.

     

Uterine torsion and uterine tear in a mare.

A 15-year-old Standard-bred mare was examined because of signs of abdominal discomfort in late gestation. Palpation per rectum revealed tight broad ligaments above and below the uterus, with the right broad ligament running across the top of the uterine body down toward the left, ventral side of the abdomen. A diagnosis of counterclockwise uterine torsion was made and surgical correction was approached via a left, flank laparotomy with the horse standing. The uterus was repositioned and a uterine tear encompassing 180 degrees of the uterine surface was found in the lateral, uterine body just cranial to the cervix. A live colt was delivered vaginally after uterine repositioning and the laparotomy incision was closed. The uterine tear was then repaired via a blind, vaginal approach. The mare was discharged 10 days after surgery. Repair per vaginum of a uterine tear is presented as an alternative treatment in cases for which the tear is recent, abdominal contamination is minimal, and the tear is easily accessible from the vaginal approach.     

Obstruction of the descending colon due to torsion of the cecum through a mesocolic defect in a cow

A cow was evaluated for acute onset of abdominal pain and decreased milk production. Physical examination revealed narrowing of the descending colon. Exploratory laparotomy revealed mesocolic defect and torsion of the cecum around the descending colon. After surgical correction of the cecal torsion, the cow recovered rapidly. The mesocolic defect could not be closed, and the history did not indicate a cause for the mesocolic defect.     

Influence of uterine torsion in water buffaloes (Bubalus bubalis) with insights into the hematological and biochemical prognostic values regarding to manual correction

Bovine uterine torsion refers to the rotation of the gravid uterus around its longitudinal axis. It is the dominant cause of dystocia in buffaloes. A total of two hundred and seventeen dystocia’s Egyptian buffaloes were examined, and another twenty were apparently normal at the full term (healthy pregnant group). From the dystocia’s buffaloes, twenty-three percentage (n = 50) was uterine torsion after gynecology inspection at presentation (Ut group) and 5 days after the manual correction (Utc group). The buffaloes with uterine torsion exhibited loss of appetite, constipation, colic, and straining. The incidence of torsion was mostly at first parity that accounting for 50% of cases. Regarding to the pregnancy stage, torsion mostly occurred at full term, where it primarily occurred in buffaloes at 3 years of age. Right-sided torsion ensued in 90% of all cases. The survival rate of the pregnant buffaloes was 90% (45 buffaloes), and 10% (5 buffaloes) was directed to the culling. Regarding to the fetal survival outcome, 30% of fetuses was survived where the other 70% was died. The hematological results denoted leucocytosis in Ut and Utc groups that attributed to neutrophilia, monocytosis, and eosinophilia. Biochemical assessments were denoted an augments in the levels of serum AST, LDH, CPK, creatinine, blood urea nitrogen, progesterone, cortisol, MDA, NO, TAC, blood lactate (bLac), TNF-α, and IL-6. Where there were a non significant fluctuations in the ALT, GGT, calcium, and phosphorus levels in the torsion cases. The significant declines in 17-β-oestradiol, total proteins, albumin, magnesium, and GSH levels in the dams suffering from Ut were observed. The robust elevations in AST (156 ± 3.47) and bLac (16.12 ± 0.18) with severe hypomagnesaemia (2.69 ± 0.15) were evident in 10% of the torsion cases that directed to the culling. This can conclude that robust elevations in AST and bLac with severe hypomagnesaemia are factors denoting a poor prognosis for uterine torsion in the buffaloes.

     

Unilateral uterine torsion secondary to an inflammatory endometrial polyp in the bitch

A 9-year-old bitch was presented because of lethargy and abdominal distension. Abdominal ultrasound revealed an enlarged, fluid-filled uterus and associated mass. Subsequent exploratory laparotomy revealed unilateral uterine torsion involving the mass. Recovery following ovariohysterectomy was uneventful and the histopathological diagnosis was of a benign endometrial inflammatory polyp. Reports of uterine torsion in the English-language literature are reviewed to identify factors associated with the incidence of uterine torsion. The aetiology of the cystic endometrial hyperplasia/pyometra complex and its possible role in the development of inflammatory polypoid lesions in the bitch is also discussed.     

Successful surgical removal of fibroma from the uterus of a cow: a case report

A Holstein-Friesian cow aged 6 years aborted twice at 3-4 months of gestation. On rectal palpation a growth was palpable in the apex of one uterine horn. The growth was removed by right flank laparotomy under sedation and paravertebral nerve block. The growth was diagnosed to be a fibroma. The cow conceived and calved normally after the operation.     

Use of ultrasonic Doppler waveforms to estimate changes in uterine artery blood flow and vessel compliance

Previous data from our laboratory have demonstrated that uterine blood flow (UBF) and uterine arterial smooth muscle tone vary regularly during the estrous cycle of the cow. Uterine blood flow is highest and uterine arterial tone is lowest at estrus, whereas UBF is lowest and uterine arterial tone is highest during the luteal phase of the cycle. Blood flow through arteries is highly pulsatile; changes in arterial wall properties affect shape of the velocity waveform. This study was conducted to evaluate changes in uterine arterial velocity waveforms throughout the estrous cycle of the cow and to relate these changes to fluctuations in UBF and concentrations of estrogen and(or) progesterone in systemic blood. Pulsatile velocity waveforms were obtained daily from pulsed-wave ultrasonic probes placed surgically on the middle uterine artery of five beef cows exhibiting estrous cycles of normal duration (d 0 = day of estrus). Velocity waveforms varied regularly during the estrous cycle of each cow in association with changes in UBF and steroid concentrations. Further, two distinct velocity waveform shapes were observed during the estrous cycle. The first waveform shape, which was observed during periods of high UBF (d -4 to +4 of the estrous cycle), was characteristic of a highly compliant vessel and was associated with a high estrogen:progesterone ratio. The second waveform shape, which was observed from d 7 to 14 of the estrous cycle, was characteristic of a less compliant vessel and was associated with a depressed estrogen:progesterone ratio. These data suggest that compliance of the uterine artery changes during the estrous cycle in association with the changing estrogen:progesterone ratio in blood.