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.