Endometritis & metritis
Prevention
Prevention and early intervention are essential strategies to limit the economic losses due to metritis.
Know the risk factors and try to avoid the risk factors to keep the risks low as possible. A proper, regular compiled and executed herd health program (monitoring estrus) is conducive in the prevention of many reproductive problems including metritis and endometritis.
A proper vaccination program helps in prevention in diseases (such as IBR and BVD) which can cause metritis as well, but is expensive.
Important is adequate housing; nutritionally balanced and structure rich rations (both for dry cows, fresh cows and lactation cows); well organized (sanitary conditions and good strawdust quality), separated calving boxes; optimal ventilation in the complete stable (also in the calving boxes and quarantine boxes) to avoid heat stress and bacterial growth. Additionally, avoidance of all kinds of stress –both physical, bacterial and emotional- such as overcrowding and disease are absolutely requirements for healthy cows. (1,16,22)
Know the risk factors and try to avoid the risk factors to keep the risks low as possible. A proper, regular compiled and executed herd health program (monitoring estrus) is conducive in the prevention of many reproductive problems including metritis and endometritis.
A proper vaccination program helps in prevention in diseases (such as IBR and BVD) which can cause metritis as well, but is expensive.
Important is adequate housing; nutritionally balanced and structure rich rations (both for dry cows, fresh cows and lactation cows); well organized (sanitary conditions and good strawdust quality), separated calving boxes; optimal ventilation in the complete stable (also in the calving boxes and quarantine boxes) to avoid heat stress and bacterial growth. Additionally, avoidance of all kinds of stress –both physical, bacterial and emotional- such as overcrowding and disease are absolutely requirements for healthy cows. (1,16,22)
Farm health management
Dry cow management
A good dry cow management is important for preventing and minimizing postpartum infections. Split up the dry period in two phases: far-off and close-up, to meet up the nutrient requirement of the cows in different stages.
The early dry period (close-up) is for the drying of the udder and restoration of rumen wall. Therefore, make a ration with little energy and a lot of rich cell wall material. The cows go much rumination which rumen pH rises and the recovers rumen wall itself.
At the end of the dry period (far-off) extra energy can be added with concentrates to feed the calve and to get ready for the new lactation period. Feed good quality feeds to keep the negative energy balance little as possible and avoid stress to keep up the resistance and immunity of the cow. (8,22)
Feeding management
A balanced ration which meets the requirement of the stage of the cow (lactating, end-lactating, far-off, close-up etcetera) to maintain the immunity of the cow. Furthermore, enough access to feedstuffs is important as well.
Calving management
The calving management is significative in prevention of inflammation of the uterus. The environment of calving should be dry, clean and only used for calving, not for ill cows. Research found right after (assistence) calving a lot of E. Coli bacteria in the uterus, together with (the same amount) of other types of bacteria causing endometritis two months after calving. However, hygiene during calving is essential. (13)
Risk factors
Endometritis can occur in any cow post-partum, but incidence is increased by the following (risk) factors. When uterine infections are excessive in the herd (> than 20%), the management of dry off cows and fresh cows should be addressed.
Retained foetal membranes
Retention of the fetal membranes is a most important cause for post-partal endometritis in dairy cows. The unshed placenta interferes with the uterine contractility and provides bacteria with a substrate for rapid growth. As a sequel, facultative anaerobic bacteria such as Escherichia coli a-haemolytic streptococci and Arcanobacterium (Actinomyces) pyogenes as well as the obligate anaerobic bacteria Fusobacterium necrophorum and Bacteroides spp. thrive (Fredriksson et al. 1985; Noakes et al. 1989; Bekana et al. 1994). The bacterial endometritis causes fever and discomfort for the animals as well as reduced appetite and prolonged negative energy balance during the early lactation. Uterine discharge causes a bad hygienic environment that is unfavourable for milk production and general health. The retained placenta as such or in combination with the bacterial infection prolongs the period for uterine involution (Marion et al. 1968; Lindell et al. 1981) and interval from parturition to ®rst insemination (Stevens and Dinsmore 1997).
A history of calving trauma, dystocia (difficult calving, Fact Sheet IRM-20), retained placenta (Fact Sheet IRM-21) or a purulent vaginal discharge during the postcalving period supports the diagnosis of endometritis. (7,29,30)
Dystocia
Dystocia (difficult calving) can have several reasons, such as:
Difficulty in calving damage the uterus, which leads to endometritis and distractions like calve losses, increased future calving problems, more retained placentas, longer calving intervals and other losses.
- Fetal-maternal incompatibility. E.g. calve too big, cow (or her pelvis) too little. Genetics can play a role in dystocia through birth weight and heifer development.
- Body condition of the mother cow is overconditioned. Too much fat around the pelvis can lead to a small birth canal (such as to much muscles, most frequent cause of dystocia in beef cows/heifers.).
- Malpresentation of fetus, or deformed fetus (or mothercow).
- Torsion of the uterus.
- Lack of uterine contractions as occurs with milk fever. Milk Fever where there is a decrease in calcium which will decrease muscle tone causing the cow to become too weak to push out the calf, or uterine torsion where the cervix is twisted.
- Heifers often have dystocia because the birth canal (mainly the vagina and vulva) does not stretch enough for the calf to be delivered.
A history of calving trauma, dystocia (difficult calving, Fact Sheet IRM-20), retained placenta (Fact Sheet IRM-21) or a purulent vaginal discharge during the postcalving period supports the diagnosis of endometritis. (7,9,10,31)
Caesarean section/assisted calving
With caesarean section or assisted calving the uterus suffers from unhygienic and extreme (stressful) circumstances. Any assistance or manipulations performed during parturition can easily introduce organisms in to the uterus. The uterus get damaged (injury, trauma and lesions) while the cow’s natural defences has already lowered due to her pregnancy, it is hard for her to deal with a surgery in these. Infection of E. coli is usually caused by calving assistance. (1,12,13)
Induced parturitions
Inducing of parturition is done for various reasons: controlling time of parturition to avoid night time calving, preventing calving complications caused by relative foetal oversize associated with prolonged gestation period or small pelvic size in heifers/cows. (14)
Still birth
Rotting in the uterus by intrusion of bacteria through the open cervix. Because the dead calf is stiff, it is heavy calving.
Twin calves
Being pregnant of a twin challenges both the cow and her reproduction system. More energy and space in the uterus is needed and the resistance of the cow will even be lower than in normal pregnancy.
Unhygienic calving environment
Includes seasonal effect as indoor calving has higher endometritis rates. Cows in a stable are affected by higher infectious pressure (e.g. high herd density) and bacteria are more attracted to grow rather inside a stable than outside in the fields.
A hygienic calving environment is very important in preventing endometritis. E. Coli infections in the uterus can be caused by calving assistance and also strains of bacteria coming from strawdust were found in the uterus after calving. Very good quality (and new, clean) of strawdust is needed in the calving box. It is a must to have a separate calving box and quarantine box, cleaned after every use. (13)
Ovarian inactivity
In case of ovarian inactivity caused by a certain reason, the ovary is obviously not able to get rid of these harmful bacteria.
Parity
Around calving time/pregnancy the cow has a lower resistance, a lot of energy goes to the pregnancy and giving birth. Some cows suffer for example from stress (physically and mentally) and a negative energy balance. See ‘negative energy balance’, ‘nutrition deficiencies’ and ‘low resistance’ below.
Negative energy balance
Condition in which less energy (food) is taken in than is expended in metabolism (usually in combination with the period of gestation/start of lactation, which takes a lot of energy), resulting in a decrease in body weight and a lower resistance of the cow. A valuable and balanced nutritional management in the dry period is very important for a cow to keep her on an acceptable energy level: due to the growing volume of the uterus, the rumen has not enough space to ‘store’ roughage. Enough supply of energy from a source like concentrates (fermentable carbohydrates) is important, too much fermentable carbohydrates/a lack of structure in the feed can occur metabolic disorders like rumen acidosis and a fatty liver.
Nutrition deficiencies
Both a lack of structure in feedstuff and a lack of structured feedstuffs could be a deficiency in cattle nutrition. Just as a lack of energy in ration in high production cows: energy delivered by feeding concentrates. Enough energy and structure in the feed ration, is very important for (high production) dairy, a lack of energy/structure can result in various (metabolic) disorders, a negative energy balance and a lower resistance. In these moments the opportunistic bacteria take their chances.
Low resistance
Since the bacteria which causes endometritis are opportunistic bacteria, a low resistance is undesirable. A opportunistic bacteria is an infectious microorganism that is normally a commensal or does not harm its host but can cause disease when the host’s resistance is low. Due to the inadequate immune system, too few white blood cells are in the blood to make the offensive bacteria harmless. (13,15)
List of sources
1. Manspeaker, Dr. J.E., Metritis and endometritis IRM-22 - Dairy Integrated Reproductive Management, University of Maryland. Available from: <http://www.wvu.edu/~exten/infores/pubs/livepoul/dirm22.pdf> [24 May 2014]
2. Gilbert, R.O., Metritis and Endometritis in Large Animals, 2011. The Merck Veterinary Manual. Available from: < http://www.merckmanuals.com/vet/reproductive_system/metritis_in_large_animals/metritis_and_endometritis_in_large_animals.html#v3291743> [24 May 2014]
3. Endometritis – Cattle. Available from: <http://en.wikivet.net/Endometritis_-_Cattle> [24 May 2014]
4. Finegold, S.M. [1996], ‘Chapter 20 Anaerobic Gram-Negative Bacilli’ Medical Microbiology. 4th edition. Galveston (TX): University of Texas Medical Branch, Galveston
5. MSD Animal Health, Chronische baarmoederontsteking. Available from: http://www.rundvee-msd-animal-health.nl/vruchtbaarheid-en-reproductie-aandoening-baarmoederontsteking [24 May 2014]
6. Rodriguez-Martinez, H., Reproduction in Domestic Animals [2012] Reproduction in Domestic Animals. ISI Journal Citation Reports. Available from: < http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1439-0531 > [24 May 2014]
7. Manspeaker, Dr. J.E., Metritis and endometritis IRM-22 - Dairy Integrated Reproductive Management, University of Maryland. Available from: <http://www.wvu.edu/~exten/infores/pubs/livepoul/dirm22.pdf> [24 May 2014]
8. Gamroth, M. And Carroll, D. (1995) Dry Cow Feeding and Management. Available from: <
http://ir.library.oregonstate.edu/xmlui/bitstream/handle/1957/14790/em8624.pdf> [24 May 2014]
9. Cady, Dr. R.A., Dystocia—Difficult calving, what it costs and how to avoid it IRM-20 - Dairy Integrated Reproductive Management, University of New Hampshire. Available from: < http://www.wvu.edu/~exten/infores/pubs/livepoul/dirm20.pdf> [24 May 2014]
10. Causes of Dystocia. Integrated Livestock Management, Colorado State University. Available from: <http://www.cvmbs.colostate.edu/ilm/proinfo/calving/notes/causes.htm> [24 May 2014]
11. Mee, J.F. [April 2008], Prevalence and risk factors for dystocia in dairy cattle: A review. The Veterinary Journal Volume 176, Issue 1. Available from: < http://ac.els-cdn.com/S1090023307004285/1-s2.0-S1090023307004285-main.pdf?_tid=4363777e-e322-11e3-b226-00000aab0f02&acdnat=1400922385_49a66ca4a3e40baaafaa612ce719ed0c> pp. 93–101 [24 May 2014]
12. Cuneo, S.P., Card, C.S., Bicknell, E.J. [1993], Diseases of beef cattle associated with post-calving and breeding, Animal Care and Health Maintenance. Available from: http://ag.arizona.edu/arec/pubs/rmg/4%20animalcare&healthmaintenance/23%20diseasepostcalving93.pdf [24 May 2014]
13. Gilbert, R., van der Knaap, J., [2008] Gezond, maar onvruchtbaar. Veeteelt 1 September 2008. Available from: http://edepot.wur.nl/152414 [24 May 2014]
14. Nakao, T., [2001] Induction and synchronization of parturition in cattle, Arch. Tierz Dummerstorf 44 Special Issue. Laboratory of Animal Science, Graduale School for International Development and Cooperation, Hiroshima University, Japan. Available from: <http://arch-anim-breed.fbn-dummerstorf.de/pdf/2001/at01si1p145.pdf] pp. 145-150 [24 May 2014]
15. Opportunistic Pathogens. Available from: <http://www.slideshare.net/gurya87/opportunistic-pathogens> [24 May 2014]
16. Baarmoederontsteking. Zoetis. Available from: < https://www.zoetis.be/nl/conditions/rundvee/baarmoederontsteking.aspx> [24 May 2014]
17. Formularia antibiotica [2012], Werkgroep Veterinair Antibiotica Beleid – KNMVD. Available from: <http://wvab.knmvd.nl/wvab/formularia/formularia> [24 May 2014]
18. Juniperus sabina, Natural Medicinal Herbs. Available from: http://www.naturalmedicinalherbs.net/herbs/j/juniperus-sabina=savine.php [24 May 2014]
19. Vruchtbaarheidsproblemen, Virbac. Available from: <http://www.virbac.nl/producten/rund/algemene-gezondheidsinformatie/vruchtbaarheidsproblemen> [24 May 2014]
20. Groot M., Kleijer-Ligtenberg, G., van Asseldonk T., Hansma, H., [2011] Stalboekje Melkvee – Natuurlijk gezond met kruiden en andere natuurproducten. Available from: <http://edepot.wur.nl/162983> [24 May 2014]
21. Deru, J., Ellinger, L., Baars, T., [2006] Homeopathie bij rundvee een verkenning van behandelingen, succesfactoren en patroonherkenning in het kader van Bioveem – Bioveem Intern Rapport 16. Available from: http://www.centaurea.nl/wp-content/uploads/2010/04/Homeopathie-bij-rundvee.pdf [24 May 2014]
22. Baars, E., Baars, T., van Asseldonk, T., de Bruin, A., Ellinger, L. [2002] Deskstudie homeopathie en fytotherapie in de biologische veehouderij. Available from: <http://www.louisbolk.org/downloads/1302.pdf> [24 May 2014]
23. Homeopathie stalkaart bij koeien, Louis Bolk Instituut. Available at: <http://www.louisbolk.org/downloads/1903.pdf> [24 May 2014]
24. Hunter, F. (2004) Everyday homeopathy for animals, Beaconsfield: Beaconsfield Publishers LTD.
25. Meijer, I., [2014] Animal Health, lectures and extra help at van Hall Larenstein, Wageningen in April, May and June 2014.
26. Finke, E. (2011) Bedrijfsnetwerk op weg naar minder antibiotica. Available from: < http://edepot.wur.nl/185222> [24 May 2014]
27. Laven, R. (2014) Fertility in Dairy Herds – Uterine infection. Available from: http://www.nadis.org.uk/bulletins/fertility-in-dairy-herds/part-7-uterine-infection.aspx [24 May 2014]
28. Haynes, B.N. (2001) Keeping livestock healthy, Versa Press USA.
2. Gilbert, R.O., Metritis and Endometritis in Large Animals, 2011. The Merck Veterinary Manual. Available from: < http://www.merckmanuals.com/vet/reproductive_system/metritis_in_large_animals/metritis_and_endometritis_in_large_animals.html#v3291743> [24 May 2014]
3. Endometritis – Cattle. Available from: <http://en.wikivet.net/Endometritis_-_Cattle> [24 May 2014]
4. Finegold, S.M. [1996], ‘Chapter 20 Anaerobic Gram-Negative Bacilli’ Medical Microbiology. 4th edition. Galveston (TX): University of Texas Medical Branch, Galveston
5. MSD Animal Health, Chronische baarmoederontsteking. Available from: http://www.rundvee-msd-animal-health.nl/vruchtbaarheid-en-reproductie-aandoening-baarmoederontsteking [24 May 2014]
6. Rodriguez-Martinez, H., Reproduction in Domestic Animals [2012] Reproduction in Domestic Animals. ISI Journal Citation Reports. Available from: < http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1439-0531 > [24 May 2014]
7. Manspeaker, Dr. J.E., Metritis and endometritis IRM-22 - Dairy Integrated Reproductive Management, University of Maryland. Available from: <http://www.wvu.edu/~exten/infores/pubs/livepoul/dirm22.pdf> [24 May 2014]
8. Gamroth, M. And Carroll, D. (1995) Dry Cow Feeding and Management. Available from: <
http://ir.library.oregonstate.edu/xmlui/bitstream/handle/1957/14790/em8624.pdf> [24 May 2014]
9. Cady, Dr. R.A., Dystocia—Difficult calving, what it costs and how to avoid it IRM-20 - Dairy Integrated Reproductive Management, University of New Hampshire. Available from: < http://www.wvu.edu/~exten/infores/pubs/livepoul/dirm20.pdf> [24 May 2014]
10. Causes of Dystocia. Integrated Livestock Management, Colorado State University. Available from: <http://www.cvmbs.colostate.edu/ilm/proinfo/calving/notes/causes.htm> [24 May 2014]
11. Mee, J.F. [April 2008], Prevalence and risk factors for dystocia in dairy cattle: A review. The Veterinary Journal Volume 176, Issue 1. Available from: < http://ac.els-cdn.com/S1090023307004285/1-s2.0-S1090023307004285-main.pdf?_tid=4363777e-e322-11e3-b226-00000aab0f02&acdnat=1400922385_49a66ca4a3e40baaafaa612ce719ed0c> pp. 93–101 [24 May 2014]
12. Cuneo, S.P., Card, C.S., Bicknell, E.J. [1993], Diseases of beef cattle associated with post-calving and breeding, Animal Care and Health Maintenance. Available from: http://ag.arizona.edu/arec/pubs/rmg/4%20animalcare&healthmaintenance/23%20diseasepostcalving93.pdf [24 May 2014]
13. Gilbert, R., van der Knaap, J., [2008] Gezond, maar onvruchtbaar. Veeteelt 1 September 2008. Available from: http://edepot.wur.nl/152414 [24 May 2014]
14. Nakao, T., [2001] Induction and synchronization of parturition in cattle, Arch. Tierz Dummerstorf 44 Special Issue. Laboratory of Animal Science, Graduale School for International Development and Cooperation, Hiroshima University, Japan. Available from: <http://arch-anim-breed.fbn-dummerstorf.de/pdf/2001/at01si1p145.pdf] pp. 145-150 [24 May 2014]
15. Opportunistic Pathogens. Available from: <http://www.slideshare.net/gurya87/opportunistic-pathogens> [24 May 2014]
16. Baarmoederontsteking. Zoetis. Available from: < https://www.zoetis.be/nl/conditions/rundvee/baarmoederontsteking.aspx> [24 May 2014]
17. Formularia antibiotica [2012], Werkgroep Veterinair Antibiotica Beleid – KNMVD. Available from: <http://wvab.knmvd.nl/wvab/formularia/formularia> [24 May 2014]
18. Juniperus sabina, Natural Medicinal Herbs. Available from: http://www.naturalmedicinalherbs.net/herbs/j/juniperus-sabina=savine.php [24 May 2014]
19. Vruchtbaarheidsproblemen, Virbac. Available from: <http://www.virbac.nl/producten/rund/algemene-gezondheidsinformatie/vruchtbaarheidsproblemen> [24 May 2014]
20. Groot M., Kleijer-Ligtenberg, G., van Asseldonk T., Hansma, H., [2011] Stalboekje Melkvee – Natuurlijk gezond met kruiden en andere natuurproducten. Available from: <http://edepot.wur.nl/162983> [24 May 2014]
21. Deru, J., Ellinger, L., Baars, T., [2006] Homeopathie bij rundvee een verkenning van behandelingen, succesfactoren en patroonherkenning in het kader van Bioveem – Bioveem Intern Rapport 16. Available from: http://www.centaurea.nl/wp-content/uploads/2010/04/Homeopathie-bij-rundvee.pdf [24 May 2014]
22. Baars, E., Baars, T., van Asseldonk, T., de Bruin, A., Ellinger, L. [2002] Deskstudie homeopathie en fytotherapie in de biologische veehouderij. Available from: <http://www.louisbolk.org/downloads/1302.pdf> [24 May 2014]
23. Homeopathie stalkaart bij koeien, Louis Bolk Instituut. Available at: <http://www.louisbolk.org/downloads/1903.pdf> [24 May 2014]
24. Hunter, F. (2004) Everyday homeopathy for animals, Beaconsfield: Beaconsfield Publishers LTD.
25. Meijer, I., [2014] Animal Health, lectures and extra help at van Hall Larenstein, Wageningen in April, May and June 2014.
26. Finke, E. (2011) Bedrijfsnetwerk op weg naar minder antibiotica. Available from: < http://edepot.wur.nl/185222> [24 May 2014]
27. Laven, R. (2014) Fertility in Dairy Herds – Uterine infection. Available from: http://www.nadis.org.uk/bulletins/fertility-in-dairy-herds/part-7-uterine-infection.aspx [24 May 2014]
28. Haynes, B.N. (2001) Keeping livestock healthy, Versa Press USA.