MANAGEMENT OF POSTPARTUM CERVICO-VAGINAL PROPLAPSE IN COWS AND BUFFALOES

MANAGEMENT OF POSTPARTUM CERVICO-VAGINAL PROPLAPSE IN COWS AND BUFFALOES

A.V. Varshini¹, M.S. Bawaskar², D.S. Raghuwanshi³, C.K. Lakde⁴, A.P. Gawande⁵ 

and M.S. Patil

 ¹ M.V.Sc. student, ^2,5,6Professor, ³ Professor & Head, ⁴ Hospital Registrar

Department of Animal Reproduction, Gynaecology and Obstetrics,

Nagpur Veterinary College,

Maharashtra Animal and Fishery Sciences University, Nagpur-440006, MHS., India.

Corresponding author email id: avijayav95@gmail.com

________________________________________________________________________

Abstract:

Two postpartum Cows and Buffaloes were presented at Veterinary Clinical Complex, Nagpur Veterinary College, Nagpur with a history of Cervico-vaginal prolapse (CVP), restlessness, abdominal discomfort, anorexia in the last 2 days. Epidural anaesthesia was administered with 2% lignocaine hydrochloride. The 3 ‘R’ principles i.e., Reduction, Reposition, Retention was followed. The prolapsed mass was reduced and repositioned into the pelvic cavity with pressure of fist. Buhner’s suture and rope truss mattress were applied for retention of the prolapsed mass. Fluid therapy, Antibiotic, Anti-inflammatory, Antispasmodic injections & Supportive therapy were given successively for 5 days.

Key words: Buffalo, Prolapse, Reduction, Reposition, Retention, Buhner’s suture

Introduction:

In cervico-vaginal prolapse, cervix and vagina protrude out of the vulvar lips (Kumar et al., 2024).  It is observed in all domestic animals, but commonly in cattle and buffaloes (Arero 2022) in late gestation and after parturition (Purohit et al., 2018). Increased estrogen levels (Noakes et al., 2019) and production of relaxin cause relaxation of pelvic ligaments and resulting in vaginal and bladder prolapse through the vulva. Other causes are low levels of serum calcium, phosphorus, magnesium, copper, selenium, zinc, seasonal factors, genetic predisposition, increase in intraabdominal pressure, excess perivaginal fat. It affects the reproductive performance i.e., abnormal and delayed postpartum return to estrus, poor conception rate and increased inter calving interval (Sachan et al. 2019). In delayed cases, vaginal mucus membrane is contaminated and necrosed thereby inflammation and edema worsen it further. The management incudes reduction and manual repositioning of prolapsed mass with retention techniques such as Buhner’s suture and trans-vaginal cervicopexy, modified Minchev’s method, rope truss and horizontal mattress suture.

Case history and observations:

Two pluriparous cows of 3 and 5 years old and two pluriparous buffaloes of 3 and 6 years old were presented with history of cervico-vaginal prolapse (Fig:1,2) one day after the normal calving. Feed and water intake were reduced with difficulty in urination. Animals were found restlessness, dull and depressed by showing continuous straining with normal rectal temperature and pale conjunctival mucous membrane. The clinical examination had revealed edematous, swollen, haemorrhagic prolapsed mass contaminated with dirt and dung. IN one of the, the prolapsed mass was injured with numerous bleeding points and lacerations.

Treatment and discussion:

The prolapse was managed by three ‘R’ principles i.e., reduction, repulsion and reposition. Epidural anaesthesia was administered with 5ml of 2% lignocaine hydrochloride to assist the manipulation and minimise the straining. The prolapsed mass was washed with tap water to get rid of dirt and dung and then with potassium permanganate solution (1:1000) followed by flushing with metronidazole solution. The ice packs and Popin spray were applied to reduce edema and volume of the mass. The urinary bladder was emptied by lifting the mass upwards. Inj. Lignocaine was given locally (Fig:3) as local anaesthetic. Lignocaine gel and soframycin ointment (Fig:4) were also applied on the prolapse mass for lubrication. The mass was gently repositioned manually by applying pressure with fist. In first cow and buffalo, Buhner’s sutures (Fig:5) were applied around the vulva. In second cow and buffalo, a rope truss (Fig:6,7) made from a cotton thread was applied following standard operation and retained for 3 days and removed thereafter as symptoms of straining stopped.

The animals were treated with Inj. 5% Dextrose Normal Saline -1000 ml, Inj. Ringer’s Lactate-1000ml, Ceftriaxone-4.5gm @10mg/kg b.wt, intravenously. Inj. Calcium borogluconate – 450ml@ 1.5 ml/kg was also administered once slowly in an intravenous route. Inj. Melonex-12 ml (0.2 mg/kg), Inj. Dexamethasone-5 ml, Inj. Chlorpheniramine maleate-10 ml (0.4 mg/kg), Inj.B₁, B₆ and B₁₂-10 ml intramuscularly for 5 days. The owner was advised to feed the animal with chelated mineral mixture @ 50 gm /day. The animals were recovered successfully without recurrence of prolapse.

Fig.1: Cervico-vaginal prolapse in cow            Fig.2: Cervico-vaginal prolapse in buffalo

   Fig.3: Injecting 2% lignocaine HCl              Fig.4: Applying lignocaine gel and soframycin

as local anaesthetic                                                 ointment for lubrication

Fig.5: Buhner’s sutures application in cow and buffalo

              Fig.6: Rope truss applied in cow                   Fig.7: Rope truss applied in buffalo

CVP is an emergency that needs immediate intervention before any further complication that can lead to a poor prognosis (Yimer et al., 2016) and can be life threatening. It is more common than uterine prolapse and appear as a pink mass of tissue of volleyball size (Patil et al., 2014).  Increase in intra-abdominal pressure and lack of myometrial tone can worsen this condition (Kapadiya et al., 2015). Elevating the prolapsed mass causes straightening of urethra which is way for urination thereby reduce the straining. Ice packs provide reduction and soothening of the pain and compatible with necrosed and haemorrhagic tissue

Buhner’s sutures (Kapadiya et al., 2015) and rope truss (Jahangirbasha, 2016) are the different methods used for the retention. The rope truss is non-invasive, effective and economic method in dairy bovines ((Selvaraju, 2023). The reduction in intensity of straining upon treatment with calcium borogluconate noted that the prolapse may occured due to hypocalcaemia. Postoperative treatment will be done by antibiotics, non-steroidal anti-inflammatory drugs (Patel et al., 2024) for reducing the pain, inflammation and secondary bacterial infection respectively. The success of treatment depends on the duration, severity of damage due to laceration, bacterial contamination and involvement of other organs such as urinary bladder (Beheshti et al. 2011).

CONCLUSION:

Reduction, Reposition and Retention of prolapsed mass followed by administration of calcium magnesium borogluconate, 5% DNS, Antibiotic, Antihistaminic, Anti-inflammatory, vitamins and minerals successfully manage the CVP. Early correction and proper management with timely intervention of a veterinarian helps the farm animals to conceive successfully and deliver live calves in the future.

References:

1. Arero, G. B. (2022). Major Reproductive health disorders in dairy cows. Journal of Animal Biology and Veterinary Medicine, 2:1-11.
2. Beheshti R., Valiei, K, Valilu, M. R., and Ghalekandi, J. G. (2011). Genital prolapse fixation in buffalo. International Journal of Animal and Veterinary Advances. 3:361-365.
3. Jahangirbasha, D. (2016). Rope truss in management of prolapse in bovines. Blue Cross Book. 33:47-50.
4. Kapadiya, P. S., Chauhan, P. M., Nakhasi, H.C., Sharma, V. K., and Sutaria, T. V. (2015). Recurrent post-partum uterine prolapse in a primiparous Mehsana buffalo – A case report. Journal of Livestock Science. 6:109-112.
5. Kumar, S., Kumar, B., Biswas, N., Warghat, C., and Ghosh, S. K. (2024). Clinical management of pre-partum cervico-vaginal prolapse in an advanced pregnant Murrah buffalo. International Journal of Veterinary Science and Animal Husbandry. 9 (5):89-91.
6. Noakes, D. E., Parkinson, T. J., England, G. C. W., Arthur, G. H. (2019).  Prolapse of the Cervix and Vagina. In: David, E. Noakes., Timothy, J. Parkinson. and Gary, C. W. England. (Eds.), Arthur’s Veterinary Reproduction and Obstetrics. 10th ed., Elsevier Saunders, England. 195-201.
7. Patel, M. K., Parsani, H. R., & Chandel, B. S. (2024). Therapeutic management of pre and post-partum vagino-cervical prolapse in bovine by homoeopathic formulation Prolapse Cure. International Journal of Veterinary Science and Animal Husbandry, SP. 9 (2):402-405.
8. Patil, A. D., Narwade, P. S., Raghuwanshi, D. S. (2014). Management of prepartum cervico-vaginal prolapse in 37 dairy animals. Intas Polivet. 15(2): 459-460.
9. Purohit, G.N., Arora, A.S., Gocher, T., Gaur, M., Saraswat, C.S. and Mishra. (2018). Uterine prolapse in buffaloes: A review. Asian Pac. J. Reprod. 7:
10. Sachan, V., Singh, V and Saxena, A. (2019). Study on biochemical changes during peri-parturient prolapse in Murrah buffaloes. Haryana Veterinarian. 58:98-101.
11. Selvaraju, M., Prakash, S., Varudharajan, V., Periyannan, M., Ravikumar, K., Palanisamy, M. (2023). Modified vulval truss technique to prevent recurrence of cervico-vaginal prolapse in water buffaloes. Buffalo Bulletin.42 (2):133-141.
12. Yimer, N., Syamira, S. Z., Rosnina, Y., Wahid, H., Sarsaifi, K., Bukar, M. M., & Yap, K. C. (2016). Recurrent vaginal prolapse in a postpartum river buffalo and its management. Buffalo Bulletin. 35 (4):529-534.

Please follow and like us: