palestra infecaouterina interveting-alexei
TRANSCRIPT
A major cause for reduced fertility in cattle (4-60%)
Average losses of $75.00/affected animal Delay in conception Increased cost of semen Decreased milk production Cost of medication Cost of labor (treatment)
Uterine Infections
Uterine Infections
In cattle classified as:
Puerperal uterine infections (Metritis puerperalis) Affect the uterus before the involution is completed Normally before 21d post partum
Post-puerperal uterine infections (Endometritis) Occurs after completion of uterine involution Normally starting from 4 weeks post calving
Animals between 3rd and 4th week: evaluate through rectal palpation???
Uterine infections in cattle
Uterine infections in cattle
Volume of uterine cavity in cattle1 days post calving=6 liters-9kg30 days post calving=0.2 liters – 0.5kg
Practical aspects: 1
Define the type of infection puerperal or post-puerperal degree of uterine involution time elapsed from calving
Practical aspects: 2
Define characteristics of microorganisms present in the uterus type of infection mixed microorganisms or specific (possibility
of environmental resistance) establish the most adequate choice of
antibiotic
Practical aspects: 3
Define the intensity of infection Degree of uterine lesions Average time of recovery Treatment frequency Associations (additional factors) Selection of antibiotic (persistence in uterus)
Practical aspects: 4
Define treatment scheme/program Verify the infection type Local or parenteral Adequate labor availability Cost Withdrawal time for milk
Puerperal uterine infections
Metritis Puerperalis
Occur during the involution phase Acute character – require rapid intervention Mixed bacterial flora (opportunistic) Incidence varies from 6 to 40% Predisposing factors:
- Placental retention- Calving assistance- Distocia- Poor body condition at parturition
Symptoms:- Vaginal discharge: purulent, sanguinolent, fetid- Dried discharge contaminating perineal region and base of tail- Visible abdominal contractions when expulsing uterine contents- Hyperthermia, prostrate position, anorexia- Digestive disorders (tympanus)- Mortality (generally due to toxemia or bacteriaemia)
Puerperal uterine infections
Metritis Puerperalis
Main signs- Enlarged uterus localized in
abdominal cavity- Liquid, fetid contents of the
uterine cavity- Thinned and fragile uterine wall- In general, ovarian inactivity
- Leucocytosis
Puerperal uterine infections
Metritis Puerperalis
Treatment
Must be rapid and efficacious- Number of bacteria is duplicating every 8 minutes- Life threatening condition
- acute process- high absorption capacity of the uterus- absorption of both bacteria and toxins
Treatment
PUERPERALINFECTION
ExcessiveContamination
Delayedinvolution
Antibiotics Prostaglandins
Treatment
Characteristics of antibiotics to be used
Broad spectrum of activity Low possibility for bacterial resistance Practicality of the treatment Cost
* Significativo pelo teste de ‘t’ a 5% de probabilidade
Efficacy of the treatment of placental retention with oxytetracycline HCl with or without simultaneous administration of cloprostenol (Fernandes, 1999)
Variable Oxytetracycline HCl
Oxyt+ Cloprostenol
Number of animals 90 90
Infection at 30d post partum (%) 44.4 42.2
Degree of uterine involution* (%) 1.92 2.43
Interval calving-to-conception (d)* 78.4 54.1
Breeding period (d)* 131.3 111.7
Services/conception 2.41 2.03
Treatment- Parenteral antibiotics
- Broad spectrum- Low level of resistance- Stimulation of uterine involution- Sustain physiological parameters- Re-evaluate after 15-30 days
Contraindications for infusions at this phase- Large uterine volume
- Increased risk for a transfer of the uterine contents through oviducts
- Hyperaemia
- High capacity for re-absorption through endometrium
Puerperal uterine infections
Metritis Puerperalis
Carlos Antônio de Carvalho FernandesEduardo Ramos de OliveiraBruno Fernandes Ludgero AlvesAna Cristina Silva de FigueiredoMarilu Martins Gioso
Group Treatment NAt 20 h
pp48 h post
1st application
1 Nuflor IM2x 26 20mg de Florfenicol IM/kg PV 20mg de Florfenicol IM/kg PV
2Nuflor IM2x
+Ciosin28 20mg de Florfenicol IM/kg PV
+ 0,530mg de Cloprostenol20mg de Florfenicol IM/kg PV
+ 0,530mg de Cloprostenol
3 Nuflor SC1x 27 40mg de Florfenicol SC/kg PV -
4Nuflor SC1x
+Ciosin27 40mg de Florfenicol SC/kg PV
+ 0,530mg de Cloprostenol0,530mg de Cloprostenol
5 Oxitetra IM1x 29 20mg de Oxitetraciclina IM/kg PV
6Oxitetra IM1x
+ Ciosin28 20mg de Oxitetraciclina IM/kg PV
+ 0,530mg de Cloprostenol0,530mg de Cloprostenol
TOTAL 165
Treatment scheme in animals after detection of calving problems
Classification of uterine involution in cows treated with antibiotics with or without cloprostenol (Fernandes et al., 2008)
Degree of involution:1. Uterus located completely in abdominal cavity2. Palpation possible apart from the tips of uterine horns3. Palpation of more than half of the uterine body possible within the abdominal cavity4. Access to the complete uterus in the abdominal cavity5. More than half of the uterus located in the pelvic cavity
Group Treatment Type N
N and % of animals with
uterine infection
Grade 1 No and %
Grade 2 No and %
Grade 3 No and %
1 Nuflor IM2x 26 11 - 42,31 5 – 19,23 3 – 11,54 3 – 11,54
2 Nuflor IM2x +Ciosin 28 9 - 32,14 4 – 14,29 4 – 14,29 1 – 3,57
3 Nuflor SC1x 27 10 - 37,03 5 – 18,52 3 – 11,11 2 – 7,41
4 Nuflor SC1x +Ciosin 27 8 - 29,63 4 – 14,81 4 – 14,81 0 – 0,00
5 Oxitetra IM1x 29 11 - 37,93 4 – 13,79 4 – 13,79 3 – 10,34
6 Oxitetra IM1x + Ciosin 28 9 - 32,14 4 – 14,29 3 – 10,71 2 – 7,14
TOTAL 165 35,15 15,76 12,73 6,66
Occurrence and average percentage of uterine infections and characteristics of the infection in different groups of animals evaluated between 25 and 35 days pp (Fernandes et al., 2008)
P> 0,05
Group Treatment type NoCalving-to-1st
service interval (days)
Services/
conceptionBreeding
period (days)
1 Nuflor IM2x 26 75,32 + 19,87 3,27 + 1,11 169,29 + 45,76
2 Nuflor IM2x +Ciosin 28 62,45 + 19,62 2,91 + 0,99 148,63 + 39,97
3 Nuflor SC1x 27 66,27 + 16,66 2,96 + 0,86 157,33 + 41,18
4 Nuflor SC1x +Ciosin 27 56,19 + 14,09 2,48 + 0,83 135,49 + 35,64
5 Oxitetra IM1x 29 68,17 + 15,98 3,11 + 0,89 161,02 + 43,53
6 Oxitetra IM1x + Ciosin 28 60,83 + 16,37 2,92 + 0,93 149,24 + 44,60
TOTAL 165 65,08 + 17,47 2,96 + 0,98 154,56 + 42,01
Days post partum at first service, number of services per conception and breeding period in animals in different treatment groups (Fernandes et al., 2008)
P> 0,05
Post-puerperal uterine infectionsEndometritis
Occur in cows after puerperal period when the uterus completed its involution
Represent more chronic course Rarely are life threatening Predisposing factors:
- puerperal uterine infections
- nutritional deficiencies
- confinement (microbism)
- lack of proper hygiene at mating or AI
- presence of sexually transmissible diseases
Sequence of events associated with uterine infections
Infecção uterina pós-puerperal Classification:
Grade 1 (catarrhal): opaque vaginal mucus with few strings or flecks of pus
Grade 2 (muco-purulent): strings of mucus mixed with mucus
Grade 3 (purulent): discharge predominantly with purulent character
Grade 4 (pyometra): Grade 3 infection with accumulation of large quantities of purulent material in uterine cavity
Sintomas principais:
Redução da fertilidade (retorno ao estro após cobertura ou IA em intervalos regulares ou não);
Ciclos estrais irregulares (mais longos ou mais curtos) ou normais
Anestro (infecções graves com destruição do endométrio ou piometra com corpo lúteo persistente)
Contrações abdominais; Sintomatologia sistêmica: rara (febre, taquicardia,
anorexia etc.).
Post-puerperal uterine infectionsEndometritis
Post-puerperal uterine infectionsEndometritis
Post-puerperal uterine infectionsEndometritis
Mucosal discharge
Comparative efficacy of tow methods for diagnosis of uterine infections in cattle: rectal palpation and vaginoscopy
MethodNumber of
animalsEfficacy (%)
Vaginoscopy 738 100
Rectal palpation 260 35,2
Treatment:- Antibiotic therapy
- Local x parenteral
- Additional treatments:
- prostaglandins
- Estrogens
Post-puerperal uterine infectionsEndometritis
Treatment:- Antibiotic therapy- Local x parenteral- For whom infusions are not suitable!!!
Local:
•Lower Cost
•Less risk of WTD
Parenteral:
•Practicality of administration
• Does not interfere with uterine defenses???
ADVANTAGES
Post-puerperal uterine infectionsEndometritis
“Recent” information
Estradiol does not have immunostimulatory properties
Progesterone is immunosuppressive
During estrogenic phase (heat) uterus is more resistant to infections than during the luteal phase
Facts
Estradiol must have some immunostimulatory propertiesConclusions
Actual conclusions
Effects of prostaglandin on uterine immunity
Prostaglandins have direct effect on the phagocytic activity of endometrial immune cells
This efect is even stronger if the uterus is under the effect of progesterone
Even in the absence of luteal tissue, prostaglandins remain important for the function of uterine defence mechanisms
- Promote activation of the immune cells
- Increase chemotaxis
- Enhance diapedesis
Bruno Fernandes Ludgero Alves1; Eduardo Ramos e Oliveira1, Carlos Antônio de Carvalho Fernandes2; Marilu Martins Gioso2
Efficacy of cloprostenol (Ciosin®) in the treatment of uterine infections in cattle
Group Ovarian Grade of Uterine Infection
(treatment)Activity(class)
N Grade 1 Grade 2 Grade 3
Controle CL (+) 15 5 5 5
CL (-) 15 5 5 5
1 dose CL (+) 32 15 10 7
CL (-) 32 15 10 7
2 doses-24Horas Com CL 32 15 10 7
CL (-) 32 15 10 7
2 doses-48Horas CL (+) 32 15 10 7
CL (-) 32 15 10 7
Total 222 100 70 52
Treatment scheme and number of animals in accordance with the classification of the uterine infection and presence of ovarian activity (CL)
Average and percentage occurrence of different types of uterine infections in animals with or without corpus luteum in accordance
with the characteristics of uterine discharge detected with vaginoscopy (Alves et al., 2008)
Average and percentage occurrence of different types of uterine infections in animals with or without corpus luteum in accordance
with the characteristics of uterine discharge detected with vaginoscopy (Alves et al., 2008)
Group Development of the condition Improvement (treatment) N Improvement Cure and cure
Control 15 2 (13,33%) a 2 (13,33%) a 4 (26,67%) a
1 dose 32 5 (15,62%) a 10 (31,25%) b 15 (46,88%) b
2 doses-24Horas 32 5 (18,75%) a 20 (65,62%) c 25 (71,88%) c
2 doses-48Horas 32 7 (21,85%) a 15 (46,87%) b 22 (68,75%) c
Total 111 19 (17,12%) 47 (42,34%) 66 (59,46%)
Eficiência média geral (Número e Percentual) dos tratamentos de infecção uterina em animais com presença ou não de Corpo Lúteo (Alves et al 2008).
Group Development of the condition Improvement (treatment) N Improvement Cure and cure
Control 15 2 (13,33%) a 1 (6,67%)a 3 (23,33%)a
1 dose 32 5 (15,63%) a 10 (31,25%)b 15 (46,87%)b
2 doses-24Horas 32 5 (15,63%) a 16 (50,00%)b 21 (65,63%)b
2 doses-48Horas 32 8 (25,00%) a 12 (37,50%)b 20 (62,50%)b
Total 111 20 (18,02%) 39 (35,14%) 60 (50,05%)
CL (+)
CL (-)
Average percentage of positive development (improvement and cure) of the uterine infections in animals with or without CL, independently from the type of treatment (Alves et al., 2008)
Carlos Antônio de Carvalho Fernandes2; Marilu Martins Gioso2;Bruno Fernandes Ludgero Alves1; Eduardo Ramos e Oliveira1
Group Development of the condition
(treatment) N Improvement CureImprovement
and Cure
1: Control 30 3a 3a 6 (20,00%)a
2: Preloban 64 9b 17b 26 (40,62%)b
3: Metricure 64 11b 30c 41 (64,06%)c
4: Preloban + Metricure
64 14b 36c 50 (78,12%)c
Total 222 37 86 123
Average efficacy (numeric and percentage) of the treatments independently from the presence of CL
Average efficacy of evaluated treatment approaches in cows with or without the presence of CL
Average interval treatment-to-conception in different treatment groups in cows with or without the presence of CL
“O sucesso nasce do querer. Sempre que o homem aplicar a determinação e a persistência para um objetivo, ele vencerá os obstáculos, e, se não atingir o alvo, pelo menos fará coisas admiráveis”.
José de Alencar
Carlos Antônio de Carvalho Fernandes
Med. Vet. D.Sc.