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Pathological Affections of the Uterus

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Pathological Affections of the Uterus Pathological Affections of the Uterus Endometritis 4th year bachelor students, South Valley University Pyometra Dr. Nasra Ahmed Yousef, Lecturer of Theriogenology, 13/4/2020. Uterine pathological affections: 1. Endometritis in cattle 2. Pyometra 3. Perimetritis & parametritis 4. Mucometra & hydrometra 5. Endometrial cysts 6. Sclerotic metritis 7. Uterine tumors 1. Endometritis Definition Inflammation of endometrium, common in cow not affect general health condition but affect the fertility due to failure of the conception rate. Causes It caused by mos. reaching from vagina following coitus, insemination or during parturition. The most common Campylobacter, Trichomonas (mating), Corynbacterium, Clostridium (parturition). It also transmit from infected semen or carrier bull. ودي شكوي صاحة الحالح تنطط علي الحيوان وتيرد تاني Symptoms a. Repeat breeder syndrome (failure of conception). b. Milk yield & appetite decreased (few cases) السثة في رجوع الحيوان لذورج الشثق تعذ التلقيح ان الحيوان المنوي او الثويضح المخصثح تتموخ تالمواد السامه الخاصح تالميكروب داخل الرحم. c. Mucopurulent discharge with flakes of pus. d. Estrus mucus is turbid or cloudy. Clinical findings Rectal examination: 1. Uterus large, thick wall 2. Enlarged cervix (cervicitis) 3. Doughy uterus (post-partum) 4. Ovary has CL due to inflammation of endometrium prevent PGF secretion. Vaginal examination: In follicular phase: turbid or milky mucus & in sever case: mucopurlent with pus & in luteal phase: mucus membrane is dry. Diagnosis a. Case history b. Clinical findings c. Ultrasound scanning Prognosis According to severity: 1. In mild case: recover spontaneously if infection at time of estrus (estrus mucus). 2. If infection during luteal phase become aggravated. Prevention Replace natural mating with artificial insemination, examination to bull & sanitation at parturition. Treatment Depend on the severity of the case: 1. Intrauterine infusion with irritant antiseptic as lugol,s solution (5gm iodine + 8 gm P iodide +100 ml DW) (5ml / 100ml DW) or lotagen 2-3% which stimulate the mobilization of leucocytes to endometrium & stimulate blood supply. (Bactericidal effect) 2. Intrauterine infusion with 0.5-1gm broad spectrum antibiotics as oxtetracycline in 10-50 ml saline or 0.5-1gm streptomycin /10 ml DW or penicillin 1-2 million iu/ 5-10 ml DW . 3. PGF2α 5 ml injected when presence of presistent CL. 4. Immunomodulator as lipopolysaccharide 100 μg or oyster glycogen (500 mg / 50 ml PBS). 5. Intrauterine infusion with autogenous serum or plasma from affected animal (100 ml). Equine endometritis: 1. Contagious equine metritis Definition: venereal endometritis in mare caused by Taylorella or Haemophyllus equigenitalis (gram –ve) & transmit from infected stallion which is vector (no clinical signs). Symptoms: Cervicitis & vaginitis with greyish vaginal discharge within 5 days after coitus. (Repeat breeder) Diagnosis: take sample from clitoris sinus & isolate mos. on Amies media contain charcoal then on chocolate blood agar then incubate at 37°c with max. humidity, pin point grayish colonies appear. Treated by: Injection of penicillin 5-10 million iu/week IM, intrauterine infusion of penicillin & uterine lavage with acriflavin 1%. Intrauterine infusion Contagious equine metritis with pus Endometritis by sonar Turbid milky pus from uterus Irregular space filled with fluid 2. Presistent mating induced endometritis Definition: Transient endometritis affecting some mare within 24-36 hrs after mating from contaminated semen & recover spontaneously within 72 hrs after coitus. Clinical findings: Intrauterine accumulation of fluid detected by sonar. It must differentiated from old maiden mare (sport mare). Prevention & treatment: Intrauterine infusion with antibiotics as gentamycin or penicillin after 4 hrs to 3 days after mating & antiseptic lavage with warm Ringers solution & antibiotic infusion. 2. Pyometra Definition It is chronic form of purulent endometritis (months) and characterized by accumulation of large amount of pus in uterine lumen & persistence of CL in ovary due to suppress secretion of PGF from inflamed uterus. Causes The case develop acc. to suitable environment for mos. multiplication: 1. Opened pyometra (postpartum): after parturition, open cervix facilitate mos. to invade uterus (Corynbacterium pyogenes) in case of: premature delivery or abortion with delayed uterine involution, unhygienic interference during dystocia & retained placenta for long time. 2. Closed pyometra (post-service): developed associated with coital infection with Trichomonas fetus or mos., theses mos. proliferate during pregnancy upto third month in closed cervix environment. Clinical findings A. Decrease in body weight with low systemic illness. B. Reproductive symptoms as: 1. Anestrum 2. Intermittent offensive odor vaginal discharge mucoid, yellowish or greenish when animal lie down, urinate or defecate (opened p.). 3. In closed p. discovered at pregnancy diagnosis. C. Rectal examination: 1. Distended uterine horn as in pregnant thick & static. 2. Vaginal discharge of pus when pressed on uterus. 3. In closed pyometra, absence of +ve signs of pregnancy as (presence of fetus, FMS & Placentoms). D. Vaginal examination: relaxed cervical opening and leakage of pus from uterus to cranial vagina. Diagnosis a. Case history (previous dystocia, inseminate from 3 months). b. Clinical findings c. Ultrasound scanning of uterus. Prognosis Early diagnosis is favorable with good prognosis but in long standing case, destruction endometrium occurred & fibrosis of uterine tissue. Closed pyometra Opened pyometra Closed pyometra Greenish pus from opened pyometra Pyometra by sonar Treatment The same treatment of both type closed to opened: 1. Injection of Estrogen (5-10 mg) to induce cervical dilatation and PGF2α (5 ml estrumate) for uterine contraction & evacuation of pus & Oxytocin 20 iu. 2. Intrauterine infusion of warm 1-2% sodium bicarbonate for liquefaction of the pus. 3. Complete evacuation of the pus followed by intrauterine infusion of antibiotics as oxtetracycline. 4. Systemic antibiotics course for 3-5 days. 5. Repeated intrauterine lavage with saline and antibiotics 3 times /week till complete evacuate of the pus. 6. After treatment, animal not bred for 3-4 estrus cycles. 3. Perimetritis and parametritis Perimetritis: Inflammation of the peritoneum (serous coat of uterus). Parametritis: Inflammation of the parametrium (uterine serosa & surrounding wall adjacent to uterus resulting in adhesion between uterus & broad ligament). Causes: 1. Sever septic metritis & pus forced from oviduct to peritoneum. 2. Perforation of uterine wall by catheter or inseminating gun or ruptured uterine wall during parturition, forced traction during dystocia & uterine torsion. 3. Perforation of vaginal wall by penis or catheter. 4. Hemorrhage following manual enculation of CL. 5. Bad technique during Fetotomy, cesarean section & rough removal of retained placenta. Abscesses of broad ligament Clinical findings: 1) In acute phase of condition as same peritonitis: off food, arched back, pain, tenesmus during rectal exanimation & urination & adhesion or abscesses of broad lig. formed. 2) Temperature elevated for 1-2 days & drop in milk yield. 3) In chronic cases: the adhesion become encapsulated abscesses (hard adhesion between pelvic organs). Prognosis & treatment: • Slight adhesions pass without troubles but in sever cases when adhesion included ovary & oviduct become hopeless. • Slight adhesions easily broken by hand & supportive treatment with antibiotic, antipyretic & anti-inflammatory. • Excessive adhesions: fattening & slaughtering. 4. Mucometra & hydrometra: • Mucometra: accumulation of mucus fluid in uterus. • Hydrometra: accumulation of watery fluid in uterus. • These conditions are secondary to cystic ovaries. • The main cause is congenital malformation of cervix & uterus (hypertrophy of endometrium). • The affected animal show anestrum. • On rectal palpation: reveal false positive diagnosis of early pregnancy. • Treatment the real cause of cystic ovaries & induction of cervical dilatation & opening. 5. Endometrial cysts: • Cyst of more than 10 cm Ф in endometrial gland (old mare) & associated to low conception rate, fetal losses due to obstacle during ova migration. • By ultrasound scan; large cyst as fertilized vesicle but not movable. • Treated by intrauterine lavage with Mg sulphate solution. 6. Sclerotic metritis: This case resulted from sever chronic metritis in which endometrium & crancles are completely destructed & fibrosed. The uterine lumen become thick, firm & dense cartilaginous fibrous tissue with purulent exudate. The animal showed anestrum. No treatment, animal discard from breeding & slaughtered. 7. Uterine tumors: Epithelial tumor of uterus are malignant (endometrial carcinoma & lymhosarcoma) but mesenchymal tumor are benign (fibroma & fibrosarcoma). The affected animal show wasting disease & affect fertility. Through rectal palpation, tumor enlarge & firm. Theses tumors observed at slaughtering of the animals. Nasra Ahmed .
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