It is not only necessary to determine wether the cow is cycling or not but also to determine the type of anoestrus (the stage of follicular development).
Question 2: Should I inseminate cows in the oestrus induced after anoestrus period?
Insemination of anoestrus cows in the first induced oestrus should generally be avoided with the exception of induction with progestagens as usually it results in very poor pregnancy rates.
After a long period of anoestrus majority of cows experience a short luteal phase after the induced oestrus associated with embryonic loss. Only systems based on progestagens provide necessary progestagen priming that reduces markedly the percentage of cows with shortened luteal phase resulting in higher pregnancy rates.
Question 1: Are all ovarian cysts associated with nymphomaniac behaviour?
No, only follicular cysts that are estrogenically active can be associated with clinical signs of estrogenisation of variable degree including nymphomania. Many follicular cysts however are not estrogenically active and will lead rather to anoestrus. Luteal cysts produce progesterone and thus will block any oestrus behaviour.
First of all it is not from the cysts that the oocyte is ovulated during this heat induced by the treatment, but from a new dominant follicle. Thus it makes a lot of sense to inseminate these cows if no other problems such as pathological vaginal discharge are observed.
It can happen. But the purpose of the treatment in view of the new concept about the pathogensis of the COD is to initiate cyclicity and induce maturation and ovulation of a new dominant follicle. The physical elimination of cyst is of less importance. Only really large cysts should be definitely removed as they exert a pressure on the surrounding ovarian tissue and can lead to its damage.
Question 4: How can I ensure that no recurrence takes place directly after the treatment?
Theoretically there are no measures that would absolutely guarantee no relapses.
One of the ways to secure high success rate is to ensure the ovulation of the dominant follicle from the new wave stimulated by the treatment. This can be achieved by additional GnRH or hCG administration at AI in cows detected in heat after treatment.
Another way is to administer one of the progestagen synchronisation systems to treat COD. See Cystic Ovarian Disease. This provides the progestagen priming and increases chances for a “healthy” ovulation in the induced heat.
Question 5: What is better hCG or GnRH for the treatment of follicular cysts?
Both substances are used and preferences are practically equally distributed among the practitioners.
It is important to remember that GnRH treatment was shown to be beneficial in follicular and luteal type of cyst, therefore if the true nature of cyst is uncertain GnRH treatment should be chosen.
Question 6: Can the complete Ovsynch protocol be applied in cows with COD?
Yes, application of the complete Ovsynch protocol is a well established therapeutic approach in COD. Numerous data from the literature indicate the advantage of Ovsynch over single GnRH application in COD as measured by higher submission rate and shorter treatment-to-conception interval.
Question 7: What to do with recurrent cases of follicular cysts?
With numerous recurrences of the COD in a dairy cow there may be a necessity to consider elimination of the affected animal from the herd. The milk production, genetic merit and age of the co have to be considered.
In case the treatment of repeated recurrent cases is economically justified, the best approach seems to be a progestagen based treatment for 7-10 days followed by GnRh/hCG injection at heat to ensure ovulation.
Question 8: What GnRH dose should one use to treat COD?
Although many publications generated in the US show encouraging results with the dose of 100mcg of gonadorelin and 0.004 mg of buserelin it is advisable to use the high dose as practised in other countries. The evidence from the literature indicates lower potency and thus efficacy of a reduced dose.
Therefore the following dose regimen is advised:
Gonadorelin – 250-500mcg
Buserelin – 0.10mcg
Question 9: What hCG dose should one use to treat COD?
There is variety of dose regimes used throughout the world, ranging from 1.500 iu to as much as 10.000 iu.
The most economically viable option is 1.500 – 3.000 iu.
Question 1: How early after calving can we talk about placental retention?
Normally we talk about retention of placenta if the cow has not expelled it within 12h-24h post calving.
In some countries more stringent approach is favoured -12h in others until 24h is considered still normal.
Question 2: Should I manually remove the placenta?
No, manual removal of placenta, especially by force and later than 24h post calving, should be avoided. Forceful removal of placenta can cause traumatisation of endometrium while passage of the hand through already closing cervical canal causes microlesions in the cervix that are replaced by connective scar tissue and affect later on the closure of the organ. On the top of that rarely all placental tissue can be removed with one manipulation.
Far more advisable is to pull delicately downwards by the placental part protruding from the vulva and then cut the visible part away. The cow can be treated with prostaglandins to enhance the separation process.
Question 3: Should intrauterine tables/pessaries be used in cows with retained placenta?
In general before applying such a treatment we have to be very clear what the purpose of the therapy is: treatment of metritis or prevention.
The second consideration is time after calving and condition of the cervical canal. At more than 12h post calving the cervical canal starts closing and such products can be administer only if a hand can be passed through the cervix comfortably. Otherwise we risk a traumatisation of the cervical wall.
Question 4: Should I use parenteral antibiotics in cows with retained placenta?
Placental retention on its own is not a direct indication for parenteral antibiotic treatment. At present the accepted approach is to use parenteral antibiotics in cows with uterine problems only if they show body temperature above 39.5C within 10 first days post calving.
Question 5: Could I use Metricure as a treatment for retained placenta?
Metricure is intended as a treatment for clinical and subclinical endometritis in later post partum period. Therefore its spectrum of activity and formulation are selected to effectively eliminate the bacterial species prevalent in later post partum period such as A. pyogenes and other anaerobes in the uterus of already reduced size.
In cows with retained placenta and acute puerperal metritis the prevalent bacteria is E. coli. Also the uterus is still of large size as the involution process just has started.
Other products therefore should rather be used than Metricure. We should select products with high activity against E.coli and formulation that enhances the action in a still non-involuted uterus.
Question 6: Can vitamin E and Selenium supplementation be used as prevention of retained placenta?
Supplementation with vitamin E and Selenium is widely discussed as one of the preventive measures in placental retention. Although some reports indicate beneficial effect of such a treatment there is no solid data to indicate and quantify the reduction in the occurrence of placental retention due to such a treatment.
Nonetheless, in the areas where deficits of selenium are confirmed in cows this therapeutic direction should be taken into consideration as vitamin E and Selenium deficiencies can have a negative effect on the myometrial function and immunity of endometrium.
Question 1: Can metabolic disorders be a cause for high incidence of endometritis in dairy herd?
Yes, it has been well established that metabolic disorders and especially ketosis and fatty liver syndrome affect negatively the function of endometrial defence mechanisms predisposing cows to uterine infections.
Simultaneously however a revision of the treatment should also be made for correct choice of anti-bacterial products and administration.
For years this had been an object of many discussions and controversies as prostaglandins were believed to bring only the benefit of improved contractility of the uterus and elimination of immunosuppressive action of progesterone. At present there are data indicating that prostaglandins may have a direct stimulatory effect over endometrial defence cells.
Nonetheless it should always be defined on the basis of cost-benefit ratio whether apply the additional treatment with prostaglandins before the cows started to cycle.
Question 3: What methods can be used to diagnose uterine infections?
The most important aspect is to match the type of diagnosis with the logistic and technical capabilities of your practice and of the client. Any sophisticated method would be prone to mistakes if applied incorrectly or struggling through logistic steps such as samples transportation or obtainment of the results from a distant lab.
The basic should always be a thorough clinical examination of the reproductive tract. A good and simple means is the examination of the vagina with a gloved hand as this will give direct information about the presence and character of the discharge and the status of cervical orifice.
Should the logistics allow for the cytological examination of uterine swabs and bacterial culture with sensitivity evaluation, these should be the next choice.
Question 4: Does it make sense to use NSAIDs in acute metritis?
In acute puerperal metritis cows definitely will benefit from auxillary treatment with nonsteroidal anti-inflammatory drugs such a flunixin meglumine, meloxicam or others. The treatment will not only improve the comfort of the cow but also minimise the lesions induced to endometrium by the inflammatory process itself.
Question 5: Should I use parenteral antibiotics in cows with puerperal acute metritis?
Acute puerperal metritis can be a life threatening condition and often require the use of parenteral antibiotics and NSAIDs. At present the accepted approach is to use parenteral antibiotics in cows with uterine problems that show body temperature above 39.5C within 10 first days post calving.
Question 1: What is better to use PG followed by Metricure or the two simultaneously?
As the purpose for the use of prostaglandin is elimination of immunosuppressive effect of progesterone and evacuation of the pathological exudates from the uterus it makes more sense to administer prostaglandin first and after 3 days administer Metricure. With simultaneous administration we do run the risk that contraction of the uterus will lead to losses of some portion of the product.
Question 2: Is Metricure a good choice for the treatment of pyometra?
Yes, the proper sequence of actions however has to me adopted. Prostaglandin should be administered first to resolve the corpus luteum and evacuate pus from the uterine lumen. Then Metricure can be applied approx. 2-3 days later.
Question 3: What about the portion of Metricure that is left in the pipette after administration?
The portion of the product left in the administration pipette is less than one ml and is not included in the treatment dose. Therefore there is no need to aspirate air and push this small portion through the pipette into the uterus.
Question 4: Is the use of Metricure after AI really safe for the embryo?
Yes, with the administration of Metricure between 12 and 24h post AI the product will exert its action on the endometrium after the spermatozoa have reached the oviduct and before the blastocyst will reach the uterus after the next 6 days.
Question 5: Can I use Metricure immediately after AI?
We do not have data regarding the effects of Metricure on spermatozoa therefore cannot recommend this approach.
Question 1: When can a cow be regarded as a repeat breeder?
There are various criteria for repeat breeding, but in general a cow that did not get pregnant after being inseminated in three consecutive oestrus cycles and not showing any clinically defined condition such as endometritis, COD etc. is considered a repeat breeder.
Question 2: What gives better results GnRH at 12d post AI or hCG at 4-6d post AI?
It is very difficult to give a direct answer. Both treatments were shown to give a substantial improvement in pregnancy rates at certain conditions and in certain herds.
In general it is thought that in case of cows that can be classifies as early repeats (new oestrus <21d post AI) better results are obtained with hCG. Cows that can be called the late repeats (new oestrus 35-40d post AI) generally seem to benefit more from GnRH treatment at mid-cycle.
The essence of the treatment with GnRH post AI is the induction of ovulation or/and luteinisation of the follicles growing during the early luteal phase after insemination. With the indication coming from publications suggesting a decreased ability of the reduced dose to induce ovulation it is even more advisable to use the dose recommended in Europe and other countries.
The available literature gives a very variable indication ranging from no improvement to as high as 20%.
In general in dairy herds with high PR (60% and more) we should not expect such spectacular results and normally range of 1-5% is experienced.
In herds with evident repeat breeding problem and low pregnancy rates an improvement of on average 10-15% can be reached provided that there are no other factors involved such as BVD, IBR, subclinical endometritis or even poor semen management or incorrect insemination technique.