Review/Oorsig Volume 22, Issue 03 - Page 17

Volume 22 • Issue 03 • 2018 frequency in cows that have suffered from acute puerperal metritis (Galvão et al., 2010). Direct evidence for the presence of cervicitis, diagnosed by cytology, has recently been presented by Deguillaume et al. (Deguillaume et al., 2012). They found that cervicitis existed independently of endometritis. Prevalence of endometritis alone in their study was 13%, cervicitis only was 11 % and 32 % of cows had both conditions. Both contributed to reduced hazard of pregnancy, and cows with both conditions fared worse than those with either one. Identification of cervicitis as a common postpartum disorder does not completely clarify the question of origin of purulent exudate in the vagina. Approximately half of cows with cervicitis have purulent vaginal discharge, and vice versa (Deguillaume et al., 2012, LeBlanc, 2014). In some cases, purulent vaginal discharge may reflect more sever endometritis. However, the source of exudate in some cases still remains unresolved, and may indicate primary vaginitis in some animals. Whatever the source, presence of purulent vaginal exudate is associated with reduced reproductive performance. Presence of purulent material in the vagina may be conveniently detected by use of a dedicated instrument, the “Metricheck®.” This device scoops mucus or exudate from the cranial vagina for examination. Depending only on visible exudate or palpation findings will result in missing as many as 40 % of cases of purulent vaginal exudate (LeBlanc et al., 2002). There are few effective treatment options for purulent vaginal exudate. A formulation of cephapirin specially fabricated for intrauterine administration (Metricure®) has been shown convincingly to improve reproductive performance in treated cows when administered to affected cows after 4 weeks postpartum. Metricure is not available in the USA. There is no evidence in favor of intrauterine infusions other than cephapirin, and they should be avoided. Although PGF2α is often used for treating purulent vaginal discharge, evidence for its efficacy is equivocal (Dubuc et al., 2011b, LeBlanc, 2014), although it may have beneficial effects on reproduction independent of endometritis / cervicitis. Despite the weak evidence in its favor, PGF2α may be the best treatment option, especially in the USA; it avoids additional antibiotic use, is inexpensive, and has other beneficial effects on reproduction (including presynchronization for controlled breeding programs). References available online THE VETERINARY LABORATORY DIAGNOSTIC TEAM AT YOUR SERVICE Dr Maryke Henton - BVSc, M.Med.Vet (Bacteriology) 2 Dr Rick Last - BVSc, M.Med.Vet (Pathology) 1 Dr Samantha Tompkins - BVSc, M.Med.Vet (Pathology) 2 Dr James Hill - BVSc, M.Med.Vet (Clin Pathology) 1 Dr Sandy May - BVSc, M.Med.Vet (Clin Pathology) 3 Dr Johan Vorster - BVSc, M.Med.Vet (Pathology) 1 Vetdiagnostix KZN 1 LABORATORY 257 Boshoff Street Pietermaritzburg Vetdiagnostix Gauteng 2 LABORATORY 96 Poplar Road Bl ue Hills, Midrand Vetdiagnostix Cape Town 3 LABORATORY 01 Kontiki Way Glen Ive, Bellville Tel: (033) 342 5014/5 (033) 342 6144 082 558 4016 074 137 9132 (Main Lab) 074 162 0559 (Main Lab) 071 563 6947 (Duty Cell) Tel: (021) 910 2243 (021) 910 1413 078 436 2560 (Duty Cell) 17