Surgical resolution of uterine prolapse in three pet rabbits

This report describes a surgical technique for resolution of uterine prolapse in rabbits. Three pet rabbits presented within 24 hours of parturition with a red mass protruding from the vagina, which was diagnosed as uterine prolapse. In the first case, an attempt to reduce the prolapse by manual compression was ineffective. A laparotomy was used to apply internal uterine traction while simultaneously using gentle external pressure with cotton-tip applicators and resulted in successful resolution. After repositioning, an ovariohysterovaginectomy was performed in all three rabbits. All rabbits recovered uneventfully. Laparotomic repositioning of the uterus and ovariohysterovaginectomy, not previously described in rabbits, was easy to perform and permitted resolution of uterine prolapse.     

The relationships between vaginal collagen, plasma oestradiol and uterine prolapse in turkeys.

Uterine and vaginal collagen content and plasma oestradiol concentration were measured in traditional, male-line and prolapsed male-line turkeys to investigate the higher incidence of uterine prolapse in the male-line strain. The effect of exogenous oestradiol on vaginal collagen and plasma oestradiol was also tested in the traditional and male-line strains. Vaginal collagen was significantly lower in the male-line compared to the traditional-line, while it was lowest in prolapsed male-line turkeys. Plasma oestradiol concentration was higher in the traditional-line than the male-line. No difference in plasma oestradiol concentration was found between prolapsed and non-prolapsed male-line turkeys. Administration of oestradiol for 7 days significantly raised plasma oestradiol concentration but had no effect on vaginal collagen. Decreased vaginal collagen content was associated with uterine prolapse and may predispose the male-line strain to uterine prolapse. There was no evidence from these results to support an involvement of oestradiol in uterine prolapse in male-line turkeys.     

Survival and fertility after uterine prolapse in dairy cows

Sixty-eight cases of uterine prolapase in pastured dairy cows were treated in 2 consecutive spring calving seasons in East Gippsland, Victoria. Fifty cows survived (73.5%). Of 43 cows available for followup, 36 (84%) conceived in the mating period following the prolapse, taking 10 d longer to conceive than herd mates that calved on the same day. Three of the 36 cows (8%) that conceived, aborted, this occurring in the middle trimester of pregnancy. No prolapses occurred at the following calving but one case had suffered uterine prolapse 2 years previously. The conclusions drawn from these observations are that cows with uterine prolapse have a good chance of surviving if treated, that treatment is cost-effective, that uterine prolapse is unlikely to reoccur and treated cows have a good chance of conceiving. The veterinarians involved in this investigation were reasonably accurate in their ability to predict long term survival but not as good in predicting ability to conceive again.     

Packed cell volume (PCV) in connection with uterine prolapse and in parturient paresis in cows.

Packed cell volume was determined in 317 cows with uterine prolapse, the condition being in more than half of these cases associated with varying degrees of hypocalcaemia, in 133 cows with parturient paresis and in 73 clinically healthy newly calved cows. Independently of each other uterine prolapse and fall in plasma calcium were associated with a significant rise in PCV. The present investigation demonstrated a marked fall in circulating blood volume in a considerable number of cows suffering from uterine prolapse. The risk of irreversible hypovolemic shock developing in connection with uterine prolapse is not to be neglected, and may be aggravated by the simultaneous occurrence of hypocalcaemia, as several of the compensatory mechanisms are calcium dependent.     

Idiopathic prolapse of 1 uterine horn in a yearling filly

A yearling filly was presented for protrusion of a mass at the vulvar margins. A diagnosis of prolapse of the right uterine horn was made after vaginoscopy, transrectal palpation, and ultrasonography. It was confirmed later by biopsy of the tissue. Recovery was uneventful after easy replacement of the uterine horn.     

Survival and fertility of dairy cows following uterine prolapse

During the springs of the 1990-91 and 1991-92 dairying seasons, 103 cases of uterine prolapse in dairy cows were treated and then followed to determine the survival rate and the pregnancy rate of the remaining cows. It was found that 19 (18.4%) cows died within 24 hours of treatment and a further 16 (15.5%) died or were lost to the study during the course of the season. The 68 cows that remained were mated, and of these 53 (77.9%) were found to be pregnant and six (8.8%) aborted later. No cows suffered a repeat prolapse during the season. Cases were seen in all age groups, with the highest incidence in this study occurring in the 4 year-olds. All cases that survived went on to milk satisfactorily until the end of the season, indicating that prompt attention to uterine prolapse gives a reasonable survival rate and an acceptable conception rate.     

Complete uterine prolapse without uterine mucosal eversion in a queen

A five‐year‐old female cat weighing 3 kg was presented by the owner after noticing a large pink, bilobed mass protruding through the vulva during labour. The cat was in good condition, with appropriate lactation, and the newborn kittens were nursing normally. The uterus was not reverted or invaginated at examination, and there was rupture of the mesovarium, mesometrium and uterine‐vaginal connection around the cervix. Manual reduction of the prolapsed uterus was not possible because of torn ligaments. A coeliotomy was performed to remove the ovaries, and the apex of the uterine horns was passed by the vaginal route. The remaining part of the mesometrium was disconnected, and the prolapsed uterus was removed. The queen and kittens were discharged from the hospital on the second day after surgery. An unusual feature of this case is that the prolapse was complete, without eversion of any part of the uterus through a vaginal tear.     

Effectiveness of a bipolar vessel sealant device for sealing uterine horns and bodies from dogs

OBJECTIVE: To compare the bursting strength of a vessel sealant device (VSD) with that of an encircling suture on uterine horns and bodies from dogs. SAMPLE: Uteri from 24 shelter dogs with unknown reproductive histories. PROCEDURES-Uterine horns and bodies were allocated to groups to be sealed with suture or a VSD. Uteri were then infused with saline (0.9% NaCl) solution until the seals burst or the uteri reached a maximal pressure of 300 mm Hg. Variables recorded included dog age, uterine body and horn diameter, and maximal pressure. RESULTS-The median (range) bursting pressure reached in sealed uterine horns was 300 (0 to 300) mm Hg for the VSD group and 300 (200 to 300) mm Hg for the suture group. Within the VSD group, seals of 2 of 3 uterine horns with a diameter ≥ 9 mm burst before intraluminal pressure reached 100 mm Hg, compared with 1 of 21 uterine horns with a diameter < 9 mm. The median bursting pressure for uterine bodies was 237 (0 to 300) mm Hg for the VSD group versus 300 (175 to 300) mm Hg for the suture group. Within the VSD group, seals in uterine bodies with a diameter ≥ 9 mm failed at a significantly lower pressure (125 [0 to 125]) mm Hg than those with a diameter < 9 mm (275 [125 to 300]) mm Hg. CONCLUSIONS AND CLINICAL RELEVANCE-The failure pressure for both sealing techniques was high, which indicated that the VSD may be a safe instrument for sealing the uterine horn in dogs. Given the low mean bursting pressure for seals in uterine bodies with large diameters, the VSD cannot be recommended for sealing uterine bodies ≥ 9 mm in diameter.     

Uterine prolapse in a mare leading to metritis,systemic inflammatory response syndrome,septic shock and death

This Case Report describes severe complications associated with uterine prolapse in a mare. A 6‐year‐old Trakehner mare was examined for depression, moderate pain and vaginal discharge 3 days after correction of a uterine prolapse. The clinical examination and haematology revealed that the mare had an infection with systemic inflammatory response syndrome and shock. Due to the uncontrollable, persistent pain, an exploratory celiotomy was performed which revealed severe metritis. During anaesthesia, the mare developed severe cardiovascular compromise and died in recovery. In previously reported cases of uterine prolapse in the mare, the authors warn of uterine injury, broad ligament haemorrhage, metritis, endotoxaemia and laminitis but often have a successful outcome with conventional therapy. This case describes a mare that developed severe complications and death after uterine prolapse. Mares with uterine prolapse require appropriate treatment and vigilant monitoring post treatment to prevent life threatening complications.     

Emergent diseases in reptiles

This article reviews basic clinical techniques necessary for emergency treatment of reptile patients. Approaches to common emergency presentations of reptile patients, including trauma, burns, dystocia, renal failure, sepsis, dyspnea, gastrointestinal foreign bodies, cloacal prolapse, and toxicosis are covered.     

Patterns of uterine prolapse in dairy cows and prognosis after treatment

A 12-month study was undertaken in a 9-veterinarian dairy practice to determine patterns of uterine prolapse and factors associated with posttreatment survival. Of 220,000 cows in herds visited by veterinarians from the practice, 200 (0.09%) developed prolapses mostly (155/169 with data) in the first 24 hours after calving. Most cows (130/200) had prolapses during fall and winter months, and assistance was required in 47 of 200 calvings that resulted in prolapses. Treatment of affected cows (n = 196) consisted of cleansing and replacement of the uterus, insertion of perivulvar retention sutures, local and systemic administration of antibiotics, and parenteral administration of dexamethasone and oxytocin. Calcium was administered to cows with milk fever (n = 117) and to multiparous cows without milk fever attended by veterinarian 9 (n = 8). Crude recovery rate after 2 weeks was 72.4%, but recovery was significantly better if the calf was born alive (P = 0.001), the cow was primiparous (P = 0.03), the cow did not have stage-3 milk fever (P = 0.003), or if the cow was attended by veterinarian 9 (P = 0.01). Time to treatment was not significantly associated with recovery, but affected cows were treated mostly (127/156) within 2 hours of occurrence of the prolapse. By multivariable analysis, presence of a liveborn calf, parity, and lack of stage-3 milk fever, but not attending veterinarian, were significant (P less than 0.05) prognostic indicators of 2-week survival.     

Uterine prolapse in 2 dromedary camels

Two cases of uterine prolapse in dromedary camels in a herd with concomitant cases of white muscle disease are described. Serum selenium and glutathione peroxidase in whole blood were investigated in both patients and showed statistical difference compared with a control group. Results suggest that selenium deficiency could promote uterine prolapse in dromedary camels.     

A preliminary study of uterine derived polymorphonuclear cell function in mares with chronic uterine infections

From 6 mares with chronic uterine infection, polymorphonuclear neutrophils (PMNs) were obtained from the uterus. In order to recover an adequate number of viable PMNs, 0.1% oyster glycogen was infused into the uterus as a mild irritant 12 h prior to the uterine flushing. Phagocytosis and chemotaxis of the uterine derived PMNs were determined. The supernatant from the uterine flushing was compared with autologous serum for its capacity as an opsonin and chemoattractant. There was a significant increase of both phagocytosis and chemotaxis when autologous serum was used compared with the supernatant from the uterine flushing. This study indicates that autologous serum has a greater opsonizing capacity than uterine secretion from mares with chronic uterine infection. Since all mares conceived following this study, the use of oyster glycogen was not considered to have deleterious effect on the uterine mucosa.     

Relationships between uterine and fetal traits in rabbits selected on uterine capacity

The aim of this study was to investigate whether uterine capacity (UC) in rabbits was related to uterine horn length and weight and whether these uterine traits and vascular supply were related to fetal development and survival. Data from 48 unilaterally ovariectomized (ULO) does of the High and 52 ULO does of the Low UC lines of a divergent selection experiment on UC were used. Does were slaughtered on d 25 of fifth gestation. The High line showed higher ovarian weight (0.08 g, P < 0.05) linked to a higher ovulation rate (1 ovum, P < 0.05) and greater length of the empty uterine horn. There were no differences between lines in the remaining doe traits. The number of implanted embryos and live fetuses, fetal survival, and uterine weight and length were positively associated and explained most of the observed variation. Average weights of the live fetuses and their fetal and maternal placentae were not related to uterine weight and length. The linear regression coefficient of full uterine horn length on the number of live fetuses was 2.43 +/- 0.21. The weight of the full uterine horn showed a small quadratic relationship (P < 0.05) with the number of live fetuses. Full uterine horn length, after adjusting for the number of embryos, was negatively associated (P < 0.001) with the number of dead fetuses. The linear regression coefficient of average fetal placental weight of the live fetuses on number of implanted embryos was higher (P < 0.10) in the Low line (-0.23 +/- 0.04 vs. -0.12 +/- 0.04). The linear regression coefficient of average weight of the live fetuses on the average weight of their fetal placentae was higher (P < 0.10) in the High line (2.56 +/- 0.47 vs. 1.27 +/- 0.57). The High line was more efficient, most likely because an increase in intrauterine crowding has a lesser effect on the development of fetal placentae and fetuses. The fetal position within the uterus did not affect the proportion of dead embryos. Fetuses with placentae receiving a single blood vessel had a higher probability of death (P < 0.001) and the lowest weight. There was no difference between lines for individual weight of the live fetuses, but the High line showed higher individual weights of fetal (P < 0.01) and maternal placentae (P < 0.10). Live fetuses in the midportion of the uterus were lighter in weight (P < 0.05) than in the oviductal and cervical regions (20.3 vs. 21.6 and 21.7g). Increasing uterine capacity increases uterine length and decreases weights of fetus and fetal placenta in rabbits.     

Primary uterine inertia in four labrador bitches

Uterine inertia is a common cause of dystocia in the bitch and is designated as primary (i.e., uterine contractions fail to ever be initiated) or secondary (i.e., uterine contractions cease after a period of time but before labor is completed). The etiology of primary uterine inertia is not well understood. The accurate diagnosis of primary uterine inertia requires the use of tocodynamometry (uterine monitoring). Primary uterine inertia has been postulated to result from a failure of luteolysis resulting in persistently elevated progesterone concentrations. In this study, primary uterine inertia was diagnosed in a series of four bitches in which luteolysis was documented suggesting some other etiopathogenesis for primary uterine inertia.     

Uterine prolapse with associated rupture in a Podengo bitch

A case of uterine prolapse coexisting with uterine horn rupture in a 3-year-old Portuguese Podengo bitch, which is an uncommon occurrence, is described. The female was presented with a history of recent parturition, with delivery of four healthy puppies that were normally tended and nursed. The situation developed after an uneventfully pregnancy, and no direct causative factor was identified. The duration of the prolapse was unknown, but considered to be recent because of the swollen reddish appearance of the tubular everted mass. No foetus was found in the uterus or the abdominal cavity. The female was presented in good physical condition, without signs of shock or haemorrhage. During surgical treatment, the uterus was replaced to its normal position followed by ovary-hysterectomy at 12 h from admittance.     

Observations on Uterine Prolapse in Beef Cattle

Serum samples were obtained from 26 beef cows with uterine prolapse and from 15 with minor dystocia (controls). The serum of animals with uterine prolapse had significantly lower calcium concentration (mean ± S.D. = 8,22 ± 0,69 mg/dL, P≤0,01), higher phosphorus concentration (mean ± S.D. = 4,78 ± 1,75 mg/dL, P≤0,05) and lower calcium to phosphorus ratios (mean ± S.D. = 1,99 ± 0,88, P≤0,01) than for the control animals (means ± S.D. = 8,91 ± 0,75 mg/dL, 3,54 ± 1,41 mg/dL and 2,99 ± 1,41 respectively). Mild hypocalcemia (6,9 mg/dL-7,9 mg/dL) was present in 11 (42,3%) of the cows with prolapse as compared to only one (6,7%) of the controls. Hypophosphatemia was present in 11 (42,3%) of the animals with prolapse and in ten (66,7%) of the controls.

Eighteen (69,2%) of the animals with prolapse were alert and ambulatory when treated and 15 (57,7%) were known to have required help to deliver the calf. Of the cattle group with uterine prolapse, 14 (53,8%) were two years old, six (23,1%) were three years old, and six (23,1%) were four years of age or older.

It was concluded that mild hypocalcemia and some degree of dystocia were associated with the uterine prolapses. The phosphorus results were equivocal but the high incidence of hypophosphatemia may reflect a phosphorus deficient diet.

     

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.     

Management of uterine and vaginal prolapse in the bovine.

Uterine prolapse in cows is a historic topic that is well discussed in scientific veterinary literature and texts, argued at legendary proportion between practitioners, and even referenced in western poetry. The condition occurs sporadically and is recognized easily, but sometimes it is not so easily repaired. This article discusses the replacement, repair, and removal of the uterus and helpful techniques and potential complications. Because the veterinarian occasionally encounters situations where manual eversion (iatrogenic prolapse) of the uterus is helpful, particularly for efficiently repairing the traumatized uterus in the field, a technique for iatrogenic prolapse is discussed.     

Vaginal and uterine microflora of adult dogs

Aerobic and anaerobic microflora were identified and quantitated in 82 vaginal and 78 uterine samples obtained from mature bitches during different stages of the estrous cycle. The mean +/- SD of total bacterial counts/100 mg of vaginal contents of the 82 bitches was log 5.0 +/- 1.5, ranging from log 2.4 to log 8.8. The count at the estrous stage (log 7.8 +/- 0.7) was significantly higher (P less than 0.05) than that at the anestrus (log 4.4 +/- 1.0), pregnancy (log 5.9 +/- 1.3), and postpartum (log 5.1 +/- 1.5) stages. The common organisms isolated from the vaginas were Bacteroidaceae, streptococci, Pasteurella spp, and mycoplasmas. Organisms were isolated from 48 (68%) of 78 uterine samples. The range of total counts/100 mg of uterine contents was from log 1.6 to log 8.3. Staphylococci and mycoplasmas were frequently isolated from the uterine contents. Although many uterine microfloras were similar to vaginal microfloras, some uterine culture had a single isolate identified. There were no pathologic findings in most of the uteri. Seemingly, vaginal bacteria frequently flow into the uterus, yet they rarely cause uterine infection.