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Uterine Prolapse
Uterine prolapse is always post-parturient. It is the eversion of gravid (pregnant) horn after parturition. Non-pregnant horn may come out through body of uterus in cat, bitch and even in the cattle and buffalo as a result of strong contraction.

Occurrence:
It is high in buffalo followed by cattle, mare, she-camel, bitch and cat. It is high in first 24 hrs of parturition and possibility remains up to 48 hrs. It may occur a week (7 to 10 days) after parturition, if cervix closure is very slow.

Incidence:
It is about 2 to 3 %; which is high in buffaloes.

Causes:
(i) (ii) (iii) (iv) (v) (vi) (vii) (viii) (ix) (x) Retained fetal membrane (RFM): it is the major cause of uterine prolapse. Excessive straining may result into eversion of uterus. Any injury to uterus and vagina during the act of parturition Uterine inertia: strong abdominal muscle contraction pushes the uterus out. It usually correlated with the hypocalcemia. Assisted Delivery i.e. Dystocia Hormonal imbalance; it mainly related with high level of estrogen. Hereditary factors More roughages feeding; particularly in last 10 to 15 days of gestation. Grazing of animals on plants which have high estrogen level. Esp. Alfalfa. Nutritional deficiency; associated with poor nutrition or low plan of nutrition Poor housing and managemental conditions

Treatment:
If animal is in standing position; then following recommendations must be followed. a) Movement of animal should be restricted b) No sharp object in premises c) No wall near the animal d) Manger must be taken away e) Prolapsed part should cover with moistened or wet towel. If animal is recumbent; then following points must be under consideration: a) Prolapsed part should not touch the soil; it must cover with any towel, cloth or bag.

Treatment
Reduction of prolapsed part 1) If membranes are still incontact, then first remove the membrane; it is the general principle for reduction of prolapse. 2) Use epidural anesthesia in lower doses; 4 ml in cattle, buffalo and she-camel. If you use it in higher doses, then standing animal may sit down or goes recumbent. In case of she-camel, reduction process is always performed when animal is sitting. 3) Washing of prolapsed part by using weak solution of KMnO4. 4) Lubrication; you may use simple oil or obstetric gel. 5) Process of Replacement:

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4 types of movements are provided to replace the prolapsed part back along its full length; Right, Left, and upper, lower. If it is not replaced along its entire length; then animal will feel discomfort and in long standing cases; adhesion may occur. After replacement; there are chances of reoccurance. Post-reduction Treatment 6) Immediately after replacement/reduction; administer oxytocin in lower doses (40-50 IU). It may be mixed with calcium preparation. In a normal saline bag, add Ca+ (Calcijet, or Melfon C) and oxytocin and give it intravenous. Ca+ will helps if uterine inertia is the cause of problem, and oxytocin will do early closure of cervix. 7) Give Intrauterine pessaries; i.e. Compran, Utocyl (it is not recommended because it contains estrogen). Best combination is PSK (penicillin, streptomycin and kenamycin). Non-irritant oxytetracycline is a drug of choice. 8) Use antiallergic, multivitamins 9) Use NSAIDs such as Novelgin or Dipyron to reduce straining 10) Use systemic antibiotics via intramuscular route Last three therapies (8 to 10) must be continued for 3 to 7 days. Note: In pure bred exotic breeds; it is difficult to reduce the prolapsed part back through hand even upto the cervix. Then use 10 to 14 liters of water, Introduce inside and then immediately after pushing, siphon it out. During this act; gravity and weight of water will helps to reduce the prolapsed part of uterus to its full length.

Other Preventive Measures

a) Application of truss (Nylon or cotton rope is used; but cotton rope is best one and it must apply for 4 to 7 days) b) Suturing of vulvular lips; It is possible in cow, sheep and goat. Best applied in she-camel, mare, cat, and bitch. Buffalo is not a choice for suturing; vulvular lips are thin due to which sutures can not apply. Material for suturing: Umbilical tape, if not available then use cotton bandage after soaking. Use Bhunners needle and 2 to 3 matress sutures are sufficient.

Cautions:
Passage for urination should be there. Apply sutures for 7 days then remove. Antibiotic spray must be applied around the sutures. After removing this, for other 5 to 7 days, advise the farmer to give soft feed (green fodder) to the animal. Full stomach feeding should be avoided for 7 to 10 days. Check the constipation.

Management of uterine prolapse in Cat and Bitch:

Use hygroscopic solution such as 20% Manitol to give a dip to the prolapsed part before reduction. Possibility for reoccurrence is reduced. Laparotomy is also recommended. Bovine uterine prolapse; tympany may develop. First resolve the tympany before reduction. For edematous prolapsed part, use luke warm water + oil. At last resort; when reduction is not possible in any way, then amputation of uterus is done.

Prognosis
It depends on certain factors; i) Type of case (either partial or complete) 2

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ii) Duration of case (delayed case; poor prognosis) iii) Injury to genital organs Prognosis is good in fresh case and if handled by an experienced obstetrician.

Vaginal Prolapse
It may be pre-parturient or post-parturient. Causes: (i) Intra-abdominal pressure; due to which parts expose to environment, thus infection and injury occur which leads to prolapse. (ii) Fatty heifers; more fat deposition around genital organs. In last 10 to 15 days of gestation, its occurrence is high. For reduction, use antibiotic paste (esp PSK paste). Suturing of vulvular lips is done. Check the constipation by giving soft feed to the animal. Note: Sometimes, it may predispose the post-parturient uterine prolapse.

Dystocia
It means difficult birth; when mother fails to deliver young one. Eutokia: Normal physiological birth

Impact on Economics
(a) (b) (c) (d) (e) (f) It increases the still birth rate and mortality in neonates It increases the chances for dam mortality It decreases subsequent fertility (fertility after calving) It decreases the milk production of animal It increases the calving interval It increased the culling rate

Decreased subsequent fertility caused by Dystocia --> Retained fetal membrane --> Puerperal or septic metritis --- > Delayed involution. Hence it also decreases the conception rate.

Causes:
These are categorized into two types: - Maternal causes - Fetal causes

Maternal Causes:
Problem in expulsive forces Inadequate space for fetus It may be primary or secondary. Primary uterine inertia: Uterine muscles are failed to initiate contractility. Causes of primary inertia may be: - Deficiency of calcium and phosphorus, hormone insufficiency (E2 , oxytocin or PGF2a) Secondary uterine inertia: Due to exhaustion and fatigue, mother is unable to sustain the contractility. Causes are:

1. Uterine Inertia:

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- Premature birth - Systemic illness - Environmental factors: includes ectopic pregnancy (pregnancy outside the uterus), Rupture of uterus (may occur during act of parturition), Torsion. Factors affecting the abdominal muscle contractility: - Age - Any type of pain - Herniation - Anesthesia - Abscess formation

2. Inadequate Space:
a) Early breeding or immaturity; It usually occurs when male and female calf kept together. In such cases, induction of abortion is recommended. At 16th to 18th month of age, breeding is recommended in females for optimum productive and reproductive performance. b) Fracture of pelvic cavity: After fracture, basically healing process narrows the passage. Breeding in such animals is not recommended; because there will be always difficult birth. Caesarian is the option in high priced animals. Underfed animals; animal at low dietary plan Bone diseases: may also affect the passage

c) d)

3. Incomplete dilatation of cervix:

i) In case of torsion: if 90 degree torsion occur; then it is a possibility that water bag may come out but delivery is not possible. In case of 120, 180 or above degree torsion, nothing come out as a result of straining, without correction delivery not possible. ii) Uterine inertia iii) Fibrosis iv) Adhesion: tendency high in she-camel v) Cyst, neoplasm or tumor in pelvic organs esp. in vagina

Fetal Causes of Dystocia

1. Oversized fetus - Semen from heavy breeds in light breeds of female For heifer; cross with Jersey male is best one. For 3rd or 4th calver; cross with Holstein and Frisian may be recommended. - It is also associated with prolonged gestation period: because fetus gains 0.7 kg weight per day. So oversized fetus may be a cause of dystocia. 2. Developmental defects: 3. Twin pregnancy 4. Ascitis, hydrocephaly, anasarca 5. Any faulty position, posture and presentation

Dystocia in Different Animal

Sheep/Goat Feto-maternal disproportion; 46 % cases of dystocia Faulty position; 26 % of total cases of dystocia Feto-pelvic disproportion is very common. If there is unilateral shoulder flexion, delivery is possible but impossible in all other animals without correction. Mare Maternal causes: 5% of total dystocia cases Fetal causes: 95% of total dystocia cases; in which faulty position is the most common.

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Transverse presentation is common. Dog sitting position and breech presentation is also major causes of dystocia. Normal presentation: Forelegs extended and head rested on them. Foot Nape: Forelegs upside above the ears on the head Cattle/Buffalo Feto-maternal disproportion is the common cause of dystocia Dog/Cat Maternal origin is common i.e. uterine inertia.

Cystic Ovaries
Occurrence is high in postpartum period; first 30 to 60 days following the parturition. Syn: COD, Cystic ovarian disease, Cystic ovarian, Cystic follicle, Ovarian cyst, Luteal cyst Types: These are of three types: Follicular cyst Luteal cyst Cystic corpora lutea (i) Follicular cyst: If a follicle of size 2.5 cm or larger persists on ovaries for 10 days, usually in the absence of corpus luteum. (ii) Luteal cyst: Mature follicle is unable to ovulate but partial luteinization occurs to form a cyst. Follicular and luteal cysts are an-ovulatory cysts; ovulation does not take place. (iii) Cystic corpora lutea: There is accumulation of fluid (water or serum) under the CL. Conception rate is very low because progesterone conc. is very low produced from such luteal tissue.

Clinical Differentiation
Follicular cyst: Animals show nymphomenia (80% cases) and then an-estrus (20% cases). It must be differentiated from delayed ovulation. Luteal cyst: Animals show an-estrus for a longer period. Cyst is the cause of anestrus. Cystic corpora lutea: It does not disturb the normal estrus cycle of animal; but low progesterone conc. is responsible for low conception rate. It may lead to infertility. Cystic ovaries: due to high level estrogen in later stages, uterus becomes very soft. There is mucometra (accumulation of mucus in uterus) due to rise in estrogen level. Incidence of cystic ovaries ranges from 10 to 20 % in beef breeds. Occurrence is low as compared to dairy breeds.

Factors influence the occurrence of C.O.D

a) Season b) Age

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c) d) e) f) -

Nutrition plan Exogenous estrogen Anytype of stress Postpartum period (length of postpartum period) Insufficiency of LH hormone Insufficiency of GnRH hormone Pituitary ovarian dysfunction: hormones are there but receptors are nor responsive.

Etiology

DDx
A case of cystic ovarian degeneration must be differentiated from: Delayed ovulation, oophoritis, ovarian neoplasm, adhesion of fallopian tube, and parovarian cyst.

How a case of delayed ovulation is handled?

Animal is insaminated 4 or 5 times a day till the ovulation. But it will not improve the conception rate due to this fact that fertilizable life of ova is very short i.e. 18 hrs. Treatment for delayed ovulation: Palpate the wall of the follicle, if it is hard then do simultaneous administration of GnRH and LH hormone after insamination. It will cause ovulation. Oophoritis: Ovaries seems to be hard mass due to severe inflammation. Ovarian neoplasm: For example granulosa cell tumor.

Diagnosis:
i) History: of nymphomenia, prolonged estrus period, and anesterus ii) Rectal palpation: especially of ovarian structures include size and thickness of follicle. Uterine wall becomes soft, and there is abundant secretion of mucus. Thus, mucometra develop in follicular cyst. In later stages, uterine wall is soft that it becomes difficult to palpate it. iii) Ultrasonography: iv) Endocrine profile: Check the level of LH, estrogen, progesterone and testosterone. Adrenal virulism: In chronic cases; this condition develops due to high level of testosterone; female develops heavy muscles on neck, change in behaviour and voice. Hormonal Profile in COD LH hormone: Low Estrogen: High Testosterone: High (in chronic cases) Progesterone: Low Note: Hormonal profile must be correlated with the history and rectal palpation.

Sterility Hump
It is a typical stage in long standing cases of follicular cyst when recovery is impossible. How it develops: Follicular cyst --> estrogen -- > It causes relaxation of sacro-sciatic ligament --> due to which there is elevation of base of the tail --- > known as sterility hump.

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Treatment:
Spontaneous recovery: There is a possibility of spontaneous recovery (20-30%) without any treatment. It is high in following estrus after 1st estrus of postpartum. Manual rupture or removal: It was practiced in past in case of follicular cyst. Along with rupture, suction of fluid from follicle through syringe may also be done. Manual rupture or removal is not recommended because it may cause: - Injury upon rupturing - Adhesion of fallopian tube Hormonal method: a) Use GnRH preparations: in initial stages of developing cyst. Best one is Receptal for intramuscular injection. This hormone is also used in true anestrus for induction of estrus. Dose: 200-300 g Other preparations are: Cystorelin and Gonadrolin Gonadrolin should not be used in treatment of COD because it contains estrogen. b) Use LH hormone; if problem is associated with insufficiency of LH. LH preparation: Pregnyl Dose: 4500 IU LH like preparation (contains hCG): Physex Leo Dose: 3000-5000 IU through IV route. It can be given up to 10,000 IU. c) Progestrone preparations: These include sponges, IM and SC preparations. Mostly PRID and CIDR are used; placed intravaginally for 8 to 10 days. When removed, then sudden drop in progesterone level stimulate the hypothalamus for GnRH release which ultimately responsible for release of LH and FSH from anterior pituitary. Ultimate aim of hormonal therapy is the presence of CL. If animal is not responding for the first time, then you may repeat.

Incidence of C.O.D in other Farm Animals

Sheep/Goat: Same as in bovine Cat/Bitch: Symptoms are different: i.e. abdominal pain, fluid accumulation in abdomen. Mare: Term cystic ovaries is contraindicated. Mature follicle at term of breeding season may persist for upto next breeding season. Thus term cyst for such structure is not appropriate.

Prophylactic Measures to reduce Chances of C.O.D

(i) Selective breeding: it can decrease upto 2.5 to 10% (ii) GnRH in lower dose @ 20-25 day postpartum (iii) Take steps to reduce stress (environmental, nutritional) (iv) Improvement of nutrition (balanced ration) particularly in high yielding animals, because occurrence is high in high milk producing animals.

Retention of Fetal Membranes

Some people called Retention of placenta, but it is inappropriate term. Becausee placentation is the attachment of fetal membranes. Thus, most appropriate term is RFM.

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Functions of Placenta
a) b) c) d) e) It provides hydrostatic bed to the fetus It protects the fetus from any injury It involves in the gaseous exchange It provides nutrition to the fetus It is responsible for secretion of hormones; e.g. PMSG, placental lactogen, hCG and progesterone

Types of placenta
There are four types of placenta; i) Cotyledonary type placenta: For example: placenta of cattle, buffalo, sheep, and goat Specific points called caruncles gives attachment to the membranes. Combined structure (cotyledon+caruncle) known as placentome. These are arranged in four rows (2 dorsal and 2 ventral rows). Surface is convex in cow and buffalo (Total number ranges from 90 to 120) while these are concave in sheep and goat (Total number: ranges from 70-90). ii) Diffused type placenta: For example: placenta of mare, she-camel and sow It is also known as micro-cotyledonary placenta iii) Zonary type placenta: For example: placenta of cat, bitch and other wild animals. Separate zone formed for each fetus. iv) Discoid type placenta: Placenta of primates is an example of discoid type placenta.

Normal Time of Expulsion

Time of expulsion differs as type differs. Cotyledonary type placenta : 3 to 6 hrs If it increased upto 12 or 18 hrs, then it must consider pathological Diffused type placenta: 1 to 3 hrs Zonary type placenta: appears along with the fetus Discoid type placenta: 30 to 60 min Chances of RFM are more in cotyledonary type of placenta. If it retains in discoid type, then it is always dangerous and cause threat to the life of dam. Toxication/toxemia develops within 1 hr. Like discoid, zonary type of placenta is also dangerous; it leads to development of pyometra within nex 2-3 days; which may be close cervix or open cervix pyometra. Retention of cotyledonary type placenta is least dangerous.

Causes of R.F.M
(i) (ii) Premature delivery: cause is immature placentomes Delayed gestation: Proliferation of epithelium of placenta forms band like structure between villi and caruncles. Other cause is pathological lesion in the pituitary of fetus. (iii) Placentitis and cotyledonitis (iv) Uterine inertia (v) Dystocia cases

Steps in Expulsion of Fetal Membranes

a) Matura of placentomes: It is indicated by the flattening of the sharp edges of the villi.

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b) Reduction in the surface area: by dilating the crypts from upper side. c) Strong uterine contraction: which is helpful for expulsion of fetal membranes. Manual removal is easy in diffused type placenta. d) Release of pressure changes; ultimately initiate the process of expulsion of fetal membranes.

Treatment:
1. Manual removal of the fetal membranes: Now-a-days it is not a recommended practice. It require 1 to 3 hrs for complete detachment of placentomes. Manual removal is easy in diffused type of placenta. 2. Hormonal treatment: - Oxytocin: L.A. 60-100 IU S.A. 10-30 IU Bitch: 2-5 IU - Prostaglandin: 2 ml in cattle - Estrogen: see below Use of oxytocin: (i) After expulsion, animal must go for milking within 1 hour. (ii) It is recommended that oxytocin should only use when membranes are hanging via vulvular lips or passed via cervix and present in the vagina. (iii) After 18-24 hrs of delivery; there may be no effect but there would be priming oof uterus with estrogen. Use of PGF2a: (i) It is the drug of choice in habitual cases of R.F.M. (ii) It should be given within 1 hour after delivery. Use of estrogen: (i) It is not a good choice. (ii) Chances of prolapse of uterus increases. (iii) Administer 1-1.5 ml in 50-60 ml distilled water and give I/V. It is not recommended through I/M route. Note: Hormonal Rx is effective if cause is lack of uterine contraction (i.e. uterine inertia). Recommended practice: Now a days, recommended practice for treatment of RFM is: to just control the development of toxemia by giving antibiotics and diuretics. In the meantime, there will be putrefaction of retained fetal membranes; which will ultimately expelled out within 23 days by animal. Treatment after removal of fetal membranes: Recommend intrauterine (I/Ut) antibiotic pessaries. Administration of intrauterine antibiotic pessaries is not recommended when fetal membranes are incontact.

Uterine Torsion
Define: It is the twisting of uterus around the pregnant horn. Its incidence is high in buffalo, followed by cattle, mare, she-camel, sheep and goat. Its occurrence is high in bovine due to following reasons: (a) Anatomical difference: genital organs are more relaxed in abdomen while in others like mare genital organs hang on the lumber region. (b) Habit of frequent standing and sitting (c) In later stages of pregnancy, uterus is U-shaped; there is more fluid accumulation in the anterior part of the horn; thus imbalance occur. 9

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(d) (e) (f)

Transportation of animal in the later stages of pregnancy; especially on the bumpy roads. Jerky movements leads to the torsion of uterus. Animal carrying hyperactive fetus In buffalo, nocturnal habit of rolling may be an important cause of torsion uteri.

Degree of uterine torsion: Complete torsion: 180o, 360o or above Incomplete torsion: 90o Type of uterine torsion: Pre-cervical torsion: If cervix is involved Post-cervical torsion: If cervix is free from torsion Side of uterine torsion Right sided torsion: Left sided torsion Broad ligament (3 parts- mesovarian, mesosalpix, mesometrium) supports the genital organs. Usually uterine torsion is right sided which occur due to the ruminal pressure and usually occur in the last 10-15 days of gestation. In 90o torsion: there is possibility of expulsion of water bag but above 90o torsion: nothing comes out at term of gestation.

Diagnosis:
Rectal palpation: Degree of torsion is manifested by position of the broad ligament Vaginal examination: twisting of the vaginal muscles tells about the side of the torsion. It also includes the palpation of the cervix to declare either it is pre-cervical or post-cervical. Check either it is partial (90o) or complete (above 90o)

Treatment/Correction:
(i) Rolling method: It was practiced in past, but now it is not recommended. Animal is rolled from a high to lower area. If right sided; then right side of animal must touch the surface. (ii) Planks method: Plank dimension: 10-12 feet length, 3-4 inch thickness, 8-10 inch width. Plank is fixed on the flank and pressure applied. Ligament rotate but uterus remains fixed. (iii) Use of detorsion rod: In 90o torsion; there is an opening in cervix, pass the rod and fix it with the fetal limb or body and rotate it from external side. First indication after correction: Fluid from the vulva start coming in a fresh case. If you give 30-40 min, then normal delivery is also possible. Otherwise, you may go for hormonal treatment. (iv) Hormonal treatment: Estorgen, prostaglandin and Ca+ preparations. After treatment, wait for 48-72 hours. If cervix not open; then sole option is C-Section. In mare, she-camel, straight go for C-Section; no other option. In sheep and goat; arms are used in planks method instead of planks to fix the organ. Confirmation via vaginal exam is done by using glass speculum with light or simply go for ultrasonography.

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In cat and bitch: laparotomy is also another option. Manual stimulation against the cervical rings is useful to cause dilation of cervix. If hormonal treatment fails to respond after 2 treatments then go for laparotomy. Ca+ therapy must be instituted.

Signs/Symptoms:
(a) Strong straining by the animal but nothing come out; in complete torsion. (b) In chronic cases, there will be adhesion of uterus. Dryness of udder indicates a chronic case. In fresh cases, uterus is soft and chances of correction are more. (c) Retention of urine in pre-cervical torsion Note: Postural defects may be resulted by the torsion. Hormonal treatment is required in chronic cases but correction is more successful in fresh cases.

Endometritis
It refers to the inflammation of the endometrium. It is the major cause of low conception rate or conception failure in all the species.

Types of endometritis
1st degree: It does not affect the length of estrus cycle (interestrus interval) but responsible for fertilization failure and low conception rate. Minor pus flakes come out at the time of estrus along with estural mucus. History of repeat breeding (ii) 2nd degree: Yellow thick pus flakes may come out at any stage of the cycle. (iii) 3rd degree: It is usually regarded as pyometra. It is a chronic condition; irreparable changes has occurred. Uterus becomes fibrosed. Size of the uterus is about 3 to 4 mon pregnancy. At this stage, get uterine sample and send for histopathology which reveals the periglandular accumulation of leukocytes and fibrin. Along with histopathalogy, also go for culture and sensitivity test. Take sample for biopsy from the body of the uterus. Treatment is only possible in 1st and 2nd degree endometritis. In 3rd degree endometritis, culling is the only option. (i)

Diagnosis:
- Clinical symptoms (Pus + repeat breeding) - In 3rd degree, it seems to be like 3 to 4 mo pregnancy - Histopathology reports - Ultrasonography (pus present in crypts) - Cotton swabs used for sampling; then shifted to nutrient broth. In mare and she-camel, Tempon method is used for sampling form the uterine body.

Causes:
In mare: Infections: it may be specific or non-specific. Other disorders in foaling; preparturient vaginal prolapse, postparturient uterine prolapse. Environmental factors: ascending infections Winking: it occurs in mare at the time of estrus. There is exposure of clitoris and opening of vulvular lips due to which there are chances of ascending infection.

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Wind sucking: In this, vulva sucks the air which leads to ascending infection in mare. To resolve this condition, there is no medical treatment. You just go for suturing of vulvular lips (1 or 2 sutures are sufficient). Cattle and buffalo: Mating, pregnancy problem, assisted delivery, prolapse. Infection persists --- > prolonged intercalving interval with history of repeat breeding. Overall it affects the reproductive efficiency of animals in a herd.

Treatment:
1st Degree: i) Sexual rest for 2 or 3 cycles. It is important as: Contents will flush out along with estural mucus. More phagocytosis activity occur at the time of estrus, thus by stimulation of body defense mechanism, infection will eliminated. ii) Use of post A.I. antibiotic (non-irritant): PSK (penicillin+streptomycin+kenamycin) infusion is the best one. It is given after insamination. While genatmycin and tetracycline are irritant. Max. 20-25 ml. It should be given preferably 24 hours after insamination. iii) Use of non-antibiotic alternatives: In this, hormones are used such as estrogen and prostaglandin (PGF2a). Estrogen:1-1.5 ml in 10 ml distilled water I/Ut. and give 3 infusions on alternate days PGF2a: It is administered via I/M route in diestrus. Mucus and phagocytosis plays main role in the elimination of infection. iv) Use of antibiotic infusion: It is only recommended after culture and sensitivity test report. Near some researchers, double dose of insamination may be required in 1st degree endometritis to compete with low conception rate. 2nd Degree: Thick yellowish pus i) First give treatment for diution of pus. ii) Give infusion of estrogen; it may be repeated. It helps in dilution and evacuation of thick yellowish pus. Use of PGF2a in diestrus: will cause lysis of corpus luteum. iii) After flushing and removal of pus, go for antibiotic infusion. iv) Certain enzyme preparations i.e. trypsinase also recommended to resolve the fibrosis. rd 3 Degree: It is usually non-treatable. Culling is recommended. But certain fibrolytic enzymes are used with satisfactory results. After flushing, it may possible that some pus may accumulate in the vagina which may lead to vaginitis. So after every flushing, use any antiseptic solution or cream for washing and leaping the vagina especially near the cervix.
----------------------------------------------------------------------------------------------------------------Final Course Continued..

Efforts Never Goes in Vain..

In appreciation of my academic services for veterinary field, Curriculum Committee Establishment Division Islamabad has owned my services for a project of Rs. 20,000/-. [M.S.Hussain]

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