Diagnosis of metritis within the first 10 days post partum is relatively easy. It is associated with the presence of pyrexia, fetid pus within the uterine lumen, vagina and discharging from the vulva accompanied with delayed uterine involution.
Clinical and subacute endometritis may be more difficult to recognize. A complete clinical examination sometimes followed by laboratory tests is required for a definitive diagnosis.
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Under field conditions, endometritis is diagnosed after evaluation of the uterus and characteristics of the vaginal mucous. The use of vaginsocopy or manual examination of the vagina and mucous discharging from the cervix is thus highly recommended.
Manual examination is quick and inexpensive. Additional information such as the presence of vaginal lacerations and odour of the discharge is also obtained.
Metricheck (Metricheck, Simcro, New Zealand), a device consisting of a stainless steel rod with a rubber hemisphere, can also be used to retrieve vaginal contents.
The vaginal mucus is scored for character and odour using the given descriptions. The two scores are totalled to give the endometritis score.
Endometritis Clinical score (Sheldon and Dobson 2004)
| Description | Score |
|---|---|
| Mucus character | |
| Clear or translucent mucus | 0 |
| Clear or translucent mucus containing flecks of white pus | 1 |
| < 50ml exudate containing < 50% white or cream pus | 2 |
| > 50ml exudate containing > 50% white, cream or bloody pus | 3 |
| Mucus odor | |
| No unpleasant odour | 0 |
| Fetid odour | 3 |

Uterine discharge from the cervix as seen on vaginoscopic examination

Uterine discharge from the cervix as seen on vaginoscopic examination

Palpation of the uterus rectally

Ultrasound evaluation of the uterus