College of veterinary science

& Animal husbandry , Anjora

Durg
DEPARTMENT OF TEACHING
VETERINARY CLINICAL COMPLEX
VETERINARY CLINICAL PRACTICES Ⅱ
(Gynaecology section)
ASSIGN
MENT – Retention of placenta &
Pyometra in Bitches
2nd assignment

Submitted to Submitted by
Dr.S.K. Maiti Vibha Singh
(Professor & head) Roll no 201601080
Dr.H.K.Ratre 4 THYEAR (New VCI)
(Assistant professor) B.V.Sc.&A.H
Dr.M.R.Poyam “A-batch”
(Assistant professor)
Dr.P.D.S.Raghuvanshi
(Assistant professor
RETENTION OF PLACENTA
”When the normal processes of placental membrane
dehiscence and expulsion fails, ROP occurs”

A placenta should fall within 8-12hrs in Cattle, Buffalo ,

sheep , goat & within 2hrs in horses, if it is not expelled
within this time it is considered as RETAINED. In such
animals a portion of the fetal membranes hang from the vulva
12 hours or more following abortion, normal parturition or
dystocia.
The fetal membranes are normally expelled during the third
stage of labour whenever the third stage of labor is prolonged
beyond its normal duration ROP occurs.
Retention of Fetal Membranes is one of the most common
post partum disorders encountered in cattle and less common
in other domestic species.

Lack of
detachement
PRIMARY from maternal
caruncles
ROP
Mechanical
difficulty in
SECONDARY expelling the
already detached
placenta

Retained fetal membranes in cattle have adverse effects on;

Fertility & Production and predisposes the animal to utrine
infection. ROP is mostly associated with the increased risk of
endometritis, ketosis, metritis, mastitis, delayed involution,
poor conception rates and severe toxaemia if not treated
timely.

MANAGEMENT OF ROP
Treatment
Generally, uncomplicated cases of ROP do not need
treatment. It is advisable to wait atleast 12-14hrs for normal
expulsion, if not then proceed for manual removal or
medicinal treatment
Commonly practised method is manual removal but is
contraindicated as it result in damage of endometrium,
leading to haemorrhage and infection. If the animal has fever,
uterine damage increases the risk of septicaemia and
perimetritis.So if animal shows elevated body temperature
then Manual removal should be avoided. Careful, clean and
quick manual removal within 10-20minutes should be done.
By applying continuous traction and rotational force the
membranes should be gently removed. Prior to inserting hand
for examination and removal, properly clean the vulvar region
using antiseptic.
Tying a weight on the hanging placenta or cutting it close to
the vulva are not desirable.

ANTIOBIOTICS
Manual removal of placenta should be followed by parentral
and local administration of antibiotics.
Tetracycline @ 2-6 gm intrauterine or Nitrofurazone ,
Metronidazole & urea bolus .
Ceftiofur @2.2mg/kg intramuscularly for 5 days.
Enrofloxacin @2.5-5mg/kg .
ECBOLIC AGENTS
Oxytocin @ 40-60 IU intramuscularly.- In case of secondary
ROP.
PGFα and its analogues – do not cause membrane
detachment but can improve reproiductive performance.

COLLAGENASE
Infusion of collagenase into the stumps of the umbilical
arteries for correcting the lack of cotyledon proteolysis.
Bacterial collagenase (200,000 IU) from Clostridium
histolyticum dissolved in 1 L of saline is infused.

PREVENTION
-Providing comfort to the pregnant dam.
-Reducing stress around parturition.
-Careful nutritional management including supplementation
of cows with Vitamin E and selenium (at 3weeks prepartum.
 PYOMETRA
Pyometra refers to the accumulation of purulent material
within the uterus. It is an infectious and inflammatory
condition of the uterus typically occurring in adult, intact
bitches during or immediately after the luteal phase of the
estrous cycle.
A hormone mediated disorder characterised by Cystic
endometrial hyperplasia with secondary bacterial infection.
Escherichia coli is the pathogen most commonly isolated from
bitches with pyometra.

DIAGNOSIS The diagnosis of pyometra in bitches can be

done on the basis of-
1)Clinical presentation
2)Physical examination
3)Diagnostic imaging
4)Laboratory findings
PYOMETRA can be either OPEN or CLOSED :
In Open pyometra the cervix is open allowing the purulent
vaginal discharge and drainage of the infected fluid /pus. In
the closed form of pyometra, the cervix is closed and all the
toxic material is held within the body. Generally occurs in
older (6 to 11 years) intact bitches but young bitches can also
suffer.
HISTORY & SIGNS- Usually occurs 4-8weeks after estrus.
The clinical signs depend on whether cervix is open or
closed. . If it is open, pus will drain out from the uterus
through the vagina to the outside. Pus or an abnormal
discharge is often seen on the skin or hair under the tail.
Fever, lethargy, anorexia, and depression may or may not be
present.
If the cervix is closed, pus t is not able to drain to the outside.
It collects in the uterus ultimately causing the abdomen to
distend. The bacteria release toxins that are absorbed into the
bloodstream. They are anorectic and depressed. Vomiting or
diarrhea may also be present.
Increased water consumption may occur in both open- and
closed-cervix pyometra..
PHYSICAL EXAMINATION In open cervix pyometra, a
purulent blood-tinched vaginal discharge may be observed.
On abdominal palpation, uterine distension may be felt. In
closed-cervix pyometra, vaginal discharge may not be present.
DIAGNOSTIC IMAGING - Abdominal ultrasonography
and radiography.
Abdominal ultrasonography is the preferred method for
diagnosis of pyometra. The most common ultrasonographic
finding is distention of the uterus with an anechoic to
hyperechoic fluid. Abdominal ultrasonography can also be
used to exclude other conditions that can cause uterine
enlargement or vaginal discharge, such as early pregnancy.

An ultrasonographic image of an enlarged and tortuous uterine

horn filled with an anechoic to hypoechoic fluid
 A lateral abdominal radiograph of a dog with pyometra. The
largely distended uterus can be visualized filling the caudal and
mid-abdomen

However, radiography cannot distinguish pyometra from

other causes of uterine distension, such as mucometra or early
pregnancy ( before bone development).
LABORATORY FINDINGS
-Neutrophilia with a left shift
-Monocytosis,
-White blood cell toxicity.- but normal WBC count is often
foyund in open pyometra.
- increase in alkaline phosphate, alanine aminotransferase.
-Vaginal cytology in open-cervix pyometra will reveal
excessive numbers of degenerate neutrophils and intracellular
and extracellular bacteria whereas, in close pyometra it will
only demonstrate the stage of estrous cycle.
 Degenerative neutrophils with intracellular bacteria present in
vaginal discharge from a dog with open-cervix pyometra.

TREATMENT
The usual treatment for pyometra is surgical removal of the
infected uterus and ovaries.

MEDICAL TREATMENT
In young healthy , valuable breeding animals, medical therapy
with antibiotics for 2-3 weeks and with PGF2 alpha or
preferably aglepristone (antiprogestin) combined with
cloprostenol (synthetic PG) can be considered.
PGF2 alpha @ 100μg/kg BID for 3-5 days.
Aglepristone@ 10 mg/kg; Days 1,3,8 and 15.
Cloprostenol @1 µg/kg; Days 3and 8.
Amoxicillin plus Clavulanate @ 12.5 - 25 mg/kg; BID PO or
Ampicillin@ 22 mg/kg; TID IV/IM.
Animals for which anaesthesia and surgery can be unsafe,
should be managed using medicinal therapy. In open
cervix pyometra, medical therapy is most preferred.
OPEN PYOMETRA- Discharge can be seen