Diagnosis of uterine infections in cattle

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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Clinical examination with detailed evaluation of the reproductive tract

  • Rectal examination
  • Vaginoscopy:
    • Requires additional equipment
    • Provides valuable information: presence of discharge from the cervical canal, condition of the vaginal mucosa, status of the external cervical orifice

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.

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Scoring system to evaluate endometritis

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)

 
DescriptionScore
Mucus character
Clear or translucent mucus0
Clear or translucent mucus containing flecks of white pus1
< 50ml exudate containing < 50% white or cream pus2
> 50ml exudate containing > 50% white, cream or bloody pus3
Mucus odor
No unpleasant odour0
Fetid odour3

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Additional laboratory investigations

  • Cytology- of uterine contents gives valuable information and allows for a diagnosis of subclinical cases (Gilbert et al., 2004; Kasimanickam et al., 2004).
    Important points:
    • Sample collection
    • Staining technique
    • Interpretation of results
  • Bacterial culture and sensitivity- Provides important information about the infection and indicates which antibiotic to be used.
    Important points:
    • Proper sample collection is essential to avoid false positive results (double sheeted
      swabbing pipette, avoid side contamination from vagina, vulva and environment)
    • Transportation of samples
    • Bacterial culture (both aerobic and anaerobic)
    • Interpretation of results
  • Biopsy and histology- Provides information on the extent of inflammation , and the heath and functional status of the endometrium. Biopsies are helpful for formulating a prognosis.
    Important points:
    • Sample collection
    • Interpretation of results
    • Equipment and costs

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uterine discharge

Uterine discharge from the cervix as seen on vaginoscopic examination

uterine discharge

Uterine discharge from the cervix as seen on vaginoscopic examination

rectal exam

Palpation of the uterus rectally

ultrasound

Ultrasound evaluation of the uterus