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REVIEW
INTRODUCTION
Postpartum metritis is one of the most economically important disorders in cattle. Prolonged intercalving intervals leads to involuntary culling. Lowered conception rates, increased calving intervals ,Key cause of infertility.
Pathogenesis
Uterus of over 90% off all cows become contaminated with range of bacteria not always associated with clinical disease. Infection Adherence of pathogenic organisms to mucosa. Colonization and penetration of epithelium. Release of bacterial toxins leading to establishment of uterine disease.
Pathogenesis Contd..
The development of uterine disease depends on Immune response of the cow. Species and number of bacteria capable of overwhelming the uterine defense mechanism. Mild to sever form occurs in 90% of postpartum cows during 2nd to 4th postpartum weeks.
Contd..
Both Gm +ve and Gm ve aerobes and anaerobes can be isolated from early postpartum uterus. A normal PP uterus resolve infection by Rapid involution of the uterus and cervix. Discharge of uterine content. Mobilization of natural host defenses viz., mucus, antibodies and phagocytic cells.
Estradiol and Progesterone have both opposing and complementary effects on the female genital tract. Estradiol stimulate epethelization of vaginal and endometrial gland . vascularization of the endometrium. Increase cervical and oviductal secretions. Progesterone Endometrial gland differentiation. Enhance uterine gland secretion, reduce cervical mucous production and prevent uterine contractility. Counter influence to estradiol in immune responses.
Role of Estradiol
Maximum Estradiol influence for about one day ( immediately preceding standing estrous) Change in the number of WBC causing neutrophelia and shift to left. Increase blood supply to uterus. Increase quantity and nature of vaginal mucous, which flush out the bacterial contaminats.
Role of Progesterone
Antagonistic effect to estradiol. Immune function is down regulated during luteal phase. Hence, uterus is capable of supporting a conceptus ( fetal allograft ). These two hormones together orchestrate uterine immune function in the favour of the animal.
1. Status of the uterus During the periparturent period physiological changes will depress the defense mechanism. Polymorphonuclear killing mechanism is impaired. Uterus is more prone to puerperal infection.
Diagnosis
1. Clinical signs : Clinical sings vary with the virulence of the causative agent and presence of the factor that predisposes the disease. Abnormal white or whitish yellow mucopurulent malodorous uterine discharges. When complicated by septicemia, toxemia, milk yield is reduced with fever, depression and anorexia. The volume of discharge is variable.
Diagnosis
2. Rectal palpation. 3. Vaginal examination. 4. Bacterial culture. A uterine swab is most accurate means of obtaining the sample. True uterine culture can be taken from the uterus without contamination by extraneous bacteria. 5. Endometrial biopsy. 6. Endometrial cytological examination. 7. Ultrasound.
TREATMENT
Success in the treatment of uterine infection depends upon : Evacuation of the uterine fluids. Susceptibility of the infectious agent to the drug used. Concentration and number of times the drug used. Exposure of entire endometrium to the drug.
TREATMENT
1. Antibiotics : Broad spectrum antibiotic that is active in the presence of organic debris is indiated. Antibiotic should be present in sufficient concentration at the site of infection. The preparation should not inhibit the normal defense mechanism and should be well tolerated.
TREATMENT
2. Hormones : Effective use needs knowledge of both normal reproductive endocrinology and therapeutic properties of the available hormonal preparations. The decrease in progesterone and increase in estrogen concentration associated with luteolysis and follicular growth results in maximal resistance of the uterus to bacterial infections.
Estradiol has been recommended for stimulation of myometrial contraction, phagocytosis and mucus production.