Submitted to: Theriogenology
Publication Type: Peer reviewed journal
Publication Acceptance Date: 8/23/2005
Publication Date: 5/1/2006
Citation: Sheldon, I.M., Lewis, G.S., LeBlanc, S., Gilbert, R.O. 2006. Defining postpartum uterine disease in cattle. Theriogenology. 65:1516-1530. Interpretive Summary: The authors suggested clinical definitions for the common postpartum uterine diseases that can be readily adopted by researchers and veterinarians. Given the diagnostic criteria that are presented, it is possible to identify individual cows that are likely to have a meaningful impairment of reproductive performance. A practical question is whether it is economically beneficial to invest the time and resources necessary to find and treat cows with endometritis. The optimum answer likely varies between farms, depending on the prevalence of endometritis, the cost and accuracy of diagnosis, the efficacy and cost of treatment, the pressure for early postpartum breeding, and the use of systematic breeding programs including prostaglandin F2alpha for first insemination. Further research is needed to refine the inputs into economic decision-making tools to answer these questions under a variety of management conditions.
Technical Abstract: Uterine health is often compromised in cattle by bacterial contamination of the uterine lumen after parturition, and pathogenic bacteria often persist causing uterine disease, which is a key cause of infertility in cattle. However, the definition or characterization of uterine disease frequently lacks precision or varies between research groups. The aim of the present paper was to provide clear clinical definitions of uterine disease that researchers could adopt. Clinical puerperal metritis in a cow should be characterized by overt systemic illness (decreased milk yield, dullness or other signs of toxemia) associated with a fetid watery red-brown uterine discharge, often associated with fever > 39.5°C and an enlarged uterus. Animals that are not ill, but have an enlarged uterus and a purulent uterine discharge may be classified as having metritis. Clinical endometritis in a cow is characterized by the presence of purulent (> 50% pus) uterine discharge detectable in the vagina 21 d or more postpartum, or mucuopurulent (approximately 50% pus, 50% mucus) discharge detectable in the vagina after 26 d postpartum. In the absence of clinical endometritis, a cow with subclinical endometritis may be defined by > 18 % neutrophils in uterine cytology samples collected 20 to 33 d postpartum, or > 10 % neutrophils at 34 to 47 d, or by ultrasonic imaging of mixed echogenicity fluid within the uterine lumen after 21 d postpartum. Pyometra is defined by the accumulation of purulent material within the uterine lumen in the presence of a corpus luteum and a closed cervix. In conclusion, we have suggested definitions for the common postpartum uterine diseases, which can be readily adopted by researchers and veterinarians.