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Metritis and Pyometra Harvey Price Iowa State College Volume 8 | Issue 1 Article 5 1945 Metritis and Pyometra Harvey Price Iowa State College Follow this and additional works at: https://lib.dr.iastate.edu/iowastate_veterinarian Part of the Large or Food Animal and Equine Medicine Commons, and the Veterinary Physiology Commons Recommended Citation Price, Harvey (1945) "Metritis and Pyometra," Iowa State University Veterinarian: Vol. 8 : Iss. 1 , Article 5. Available at: https://lib.dr.iastate.edu/iowastate_veterinarian/vol8/iss1/5 This Article is brought to you for free and open access by the Journals at Iowa State University Digital Repository. It has been accepted for inclusion in Iowa State University Veterinarian by an authorized editor of Iowa State University Digital Repository. For more information, please contact [email protected]. Metritis and Pyometra Methods of diagnosis and treatment Harvey Price, '46 HE value of dairy and beef cows de­ ing cattle with histories of breeding T pends upon their ability to reproduce trouble. Other agents include the Proto­ healthy, viable calves at regular intervals. zoa, Trichomonas fetus and Vibrio fetus, Since pregnancy is the greatest burden of the Staphylococci, Streptococci, mycotic reproduction, a healthy genital system is organisms, Corynebacterium, Necrophor­ essential to realizing this value. The us bacillus, and other bacteria. Except for anatomical location of the bovine external trichomoniasis, Vibrio infection and bru­ genitalia plus the frequent insanitary cellosis, metritis and pyometra may be husbandry in many dairies subjects this considered as relatively noncontagious. important system to infection. Most other uterine infections are intro­ Invading pathogens find conditions well duced by attendants at parturition or as suited to rapid growth. If pregnancy is mentioned above through improper hus­ not terminated by this infection it is quite bandry practices. Trichomoniasis is chiefly likely that parturition and labor will so transmitted from infected bulls to non­ weaken the uterus that the existing infec­ infected cows and heifers, but may also tion will appear in a more virulent form. be transmitted mechanically. From these, According to Williams,1 parturition and other bulls become infected and the cycle the puerperium supply the greatest mor­ is continued. tality of any period in the breeding fe­ Metritis and cervicitis are closely re­ male's life. lated and the former is seldom present Sterility without the latter also being present in some degree. When the uterus is the site In cases of metritis not ending fatally of the infection the disease progresses the result is sterility. This may be either caudally and usually involves all of the temporary or permanent. Metritis is an cervix. Metritis may develop into a rap­ inflammation of the uterus. Often qualify­ idly fatal septicemia or into a chronic ing prefixes are used to indicate the exact form ending in sterility. Since the former seat of infection such as pyometra, an ac­ usually ends in the death of the animal cumulation of pus in the uterus; endome­ before veterinary assistance is sought, the tritis, an inflammation of the endome­ chronic type is most frequently encoun­ trium; and perimetritis, an inflammation tered. of the peritoneal coat of the uterus. Niel­ Diagnosis son? describes pyometritis as an endo­ metritis of the third degree. There is no The accurate diagnosis of chronic me­ specific etiological agent responsible for tritis depends largely upon an accurate metritis and pyometra. Brucella abortus history and a careful clinical examination is recognized as a major cause of metritis, of the reproductive system, including rec­ abortion, and sterility, but since brucel­ tal palpation and examination with the losis is a subject in itself it will not be speculum. Accurate histories are difficult discussed here. Suffice it to say that it to obtain, especially if the owner has re­ should not be overlooked when examin- sorted to home treatment at the last par- 20 The Veterinary Student turition. If there was a history of retained the catheter with the other, palpating the placenta at the last parturition there may instrument at all times. Should this meth­ have been much damage to the uterine od fail the procedure should be repeated mucosa and caruncles. If the damage was during estrum. Gould et aU use epidural extensive pregnancy is impossible or pre­ anesthesia to facilitate this manipulation. maturely terminated due to insufficient Since complete anesthesia causes balloon­ nutrition to the developing embryo. In ing of the rectum and difficult manipula­ such cases clinical examination is unsatis­ tion, do not carry anesthesia too far. factory without a complete history. Rarely does atresia playa part in prevent­ ing passage of the catheter. Examination Once a catheter is passed, warm physio­ Upon examination of the genital tract logical saline is used to douche the uterus the symptoms may be marked or very and the character of the return flow is slight. A purulent discharge, when pres­ noted. When little pus is in the return flow ent in the vagina, usually comes from the it may have come from the cervical canal, uterus or the cervical canal. The vaginal but when the amount of pus is extensive speculum is useful to determine the origin it indicates much damage to the endom­ of the discharge. The cervix frequently trium. The future breeding value of such shows much inflammation and induration. cows is questionable. In some cases the cervix may be enlarged to the size of the fist or larger, exposing Rectal Palpation the first or second cervical folds. For Rectal palpation should always be prac­ closer inspection or digital examination ticed when examining for metritis. En­ the cervix may be retracted with two largements of the cervix and sclerosis of pairE'. of uterine forceps. The forceps are the corpora uterinum and cornua are placed on either side of the os uteri ex­ easily recognized. The detection of adhe­ ternum. Steady traction will present the sions of the uterus to other organs indi­ cervix in the vulva except in animals ac­ cates a prior severe metritis and peritoni­ customed to constant pasturing in which tis. Also the presence of a mummified fe­ the tubular organs are more firmly at­ tus and pyometra is diagnosed rectally. tached. Once the cervix is retracted as far Pyometra may be confused with preg­ as possible the vulva can be spread by nancy. Rowson and Spriggs~ suggest these applying lateral pressure on the forceps differential points. handles. With the cervix fixed in such 1. In pyometra there is no fremitus in <I. position it should be examined for the middle uterine artery. stenosis, induration, character of dis­ 2. The uterine wall is thickened in charge and the extent of the inflammatory pyometra contrasted to the thin pli­ process. able wall of the pregnant uterus. According to AlbrechtsenR there is nearly always a discharge from the cervix 3. A bilateral enlargement of the uterus in metritis. Where the cervical canal alone is seldom seen in pregnancy with a is involved, a whitish, viscous, greasy se­ single corpus luteum. cretion covers the external orifice. When 4. In pregnancy the fetal membranes the secretion is more purulent it usually can be palpated. When the uterine come~ from the uterus. Since the cervix wall is rolled between the fingers the is usually open, Williamsl advocates ex­ membranes can be felt as they slip ploratory catheterization. Patience is re­ away. auired to introduce the catheter through The presence of a partly digested fetus the tortuous canal as any great pressure may cause some confusion. If there is any may injure the mucosa or pierce the wall doubt as to the uterine contents another of the cervix or uterus. In some instances. examination should be made at a later best results are obtained by removing date and the cotyledons noted. The con­ the forceps and grasping the cervix per dition of the ovaries and the tone of the redum with one hand and manipulating uteruE'. should also be noted at the time Smnme1',1945 21 of the rectal examination. In all cases of equipped with a rubber bulb material can metritis and pyometra bacterial cultures be aspirated from the os uteri externum. should be made as the prognosis and If the quantity of secretion is not suffi­ treatment depends upon the causative cient, a small amount of sterile saline may agent. The technique for obtaining sam­ be used to wash the cervical orifice and ples is described below. the resulting admixture aspirated for At this time it is well to consider tricho­ diagnostic purposes. A cotton swab may moniasis as a cause of metritis and pyo­ be used instead of the pipette if preferred. metra. Early investigations of this disease If the material is to be examined immedi­ were conducted by Emmerson,5 and Mc­ ately no preservative is necessary, but if Nutt, Walsh and Murray.') Classification the material is to be sent to a laboratory of trichomoniasis as a venereal disease it should be preserved by refrigeration has been established without doubt. during transit. Because of the periodic According to the British Ministry of appearance of T. fetus several days prior Agriculture7 trichomoniasis may be sus­ to estrus, Hammond and BartlettH recom­ pected when: mend examination at that time. They also a. Several cows and heifers are re­ recommend the examination of recently turned to service. Estrum may recur bred virgin heifers in herds where T. fetus in three weeks, but usually the in­ is suspected. The best time to examine terval is six, nine or twelve weeks. such heifers is twelve to nineteen days b. Abortions occur early in pregnancy, after breeding or if estrum returns the commonly between the sixth and six­ examination should be a few days prior teenth week. In trichomoniasis abor­ to the next anticipated estrum.
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