MANAGEMENT OF PREPARTUM PROLAPSE IN BOVINE
Vaginal prolapse is protrusion of vagina out through the vulval lips. It is one of the reproductive disorders of the mature female buffaloes during their last trimester of pregnancy. This condition mostly encounter the buffaloes due to the hormonal changes that occur during this last trimester of pregnancy, especially the increase of estrogen and the production of relaxin cause a relaxation of the pelvic ligaments and surrounding soft tissue structures (Wolfe, 2009) . Important predisposing factor for vaginal prolapse is tissue relaxation with the increased intraabdominal pressure during pregnancy (Kahn 2005) . Some of the minor factors have capacity to increasing the intra-abdominal pressure such as intra-abdominal fat accumulation, rumen distention; large foetuses, more than one foetus and the occasionally hilly terrains also make their contribution to the occurrence of vaginal prolapse (Drost, 2007) . Dietary factors such as hypocalcaemia and clover in grazing pastures have also been linked to the disorder (Miesner and Anderson, 2008) . A vaginal prolapse begins just cranially of the vestibulovaginal junction as a folding of the vaginal floor. Irritation and swelling of vaginal mucosa after eversion tend to increase straining and formation of extensive prolapse (Kahn 2005) . A vaginal prolapse may not directly be considered an emergency but, if not treated, the vagina becomes swollen, oedematous and congested and is therefore very susceptible to injury .
Rectal prolapse is a protrusion of one or more layers of the rectum through the anus (Ettinger and Feldman, 1995). The condition may be a result of prolonged tenesmus or increased intra-abdominal pressure. Cervicovaginal prolapse is a common complication in pluriparous cows and buffaloes due to relaxation of pelvic ligaments in mid to late gestation. Although it may be of multiple etiologies but placental estrogen production during second half of gestation in cattle causing relaxation of pelvic ligament, vulva and vulval sphincter muscle are most feasible proposition although hereditary predisposition may not be undermined (Purohit, 2012). Other pre disposing factors include Intra abdominal pressure, peculiar gait while walking, grazing hilly terrain feed and fodder containing phyto-estrogen (Roberts, 1971).
Post-partum prolapse of uterus is an obstetrical complication that occurs 48 to 72 h after parturition (Arthur, 1996; Roberts, 1971). It usually occurs in third stage of labor in the cow (Joseph et al., 2001). In crossbred cattle, prolapse of uterus is usually associated with hypocalcaemia. Main causative factors that lead to uterine prolapse are excessive straining, poor uterine tone, increased intra-abdominal pressure, tympany and excessive estrogen content in the feed (Hanie, 2006; Jackson, 2004). The incidence rate of 0.3 to 0.5% of uterine prolapse has been reported (Luktuke and Chaudhary, 1965). Hormonal changes occurring before parturition such as increase in levels of estrogen and relaxin hormone lead to relaxation of pelvic ligaments and softening of cervical canal, which predisposes the animal for prolapse.
General Line-of-Treatment of Prepartum or Post Partum Prolapse in Cattle at Field Level
Animal is properly restrain in a trevis and repositioned the prolapsed vagina in original anatomical position after thoroughly washed with potassium permanganate solution at the dilution rate of 1: 1000 under epidural anaesthesia done with 2% lignocaine at the dose rate of 1 ml for 100 kg body weight to reduce straining. Horizontal mattress suture was applied. On the next day, vulval lips got tear at the place of suture due to the straining caused by the abdominal pressure. To prevent the further complication, parturition is induced by two doses of 500 µg cloprostenol injections with the interval period of 12 hours and single dose of 40 mg dexamethasone. After 22 hours from the initial time of induction, a live female calf is delivered with mild assistance. Foetal membranes are removed manually and again repositioned the prolapsed vagina to the normal position. The vulval lips are closed by buhner’s purse string suture by using jerlac needle and vulval retention tape. Postoperatively, animal is treated with inj. Ringers lactate @ 10ml/kg body weight i.v, inj DNS @10 ml/kg body weight i.v, inj ceftriaxone 10 mg/kg bodyweight i.m, inj. Meloxicam @ 0.5mg/Kg body weight i.m, inj. Chlorpheniramine maleate @ 0.5mg/ Kg body weight i.m continuously for five days. Animal attendant is advised to kept the hind quarter of animal at elevated level and provide less quantity of green roughage combine with required quantity of dry roughage and concentrate until the involution of uterus occurs.
Vaginal prolapse is the common reproductive problem in buffaloes during the third trimester of pregnancy. During the last stage of pregnancy, High plasma estrogen level initiates the relaxation of muscles and ligaments in pelvic region where as the low plasma calcium level decrease the tonicity and loosening of muscles of genetic tract make the animal easily prone to prolapse. The increasing of serum estradiol concentration with decreasing in progesterone concentration as a cause of vaginal prolapsed in affected buffalo has also been reported by Akhtar et al., (2012) and cow (Vincenti et al., 1992) .
When Clinical examination revealed uterine prolapse to be bilateral. After giving caudal epidural anesthesia (5 ml of 2% Lignocaine HCl), the whole prolapsed mass is washed with weak potassium permanganate solution (0.1 % KMnO4 ) to remove the debris. To decrease the edema and reduce the size, cold water is poured on the mass. Catheterization of the urinary bladder is done to evacuate the bladder. Herbal POP-IN spray is applied to reduce the edema. This procedure is repeated three times in order to reduce the size of both prolapsed horns. The prolapsed uterine mass is held on a clean and moist piece of cloth. With gentle pressure applied on the ventral floor of the vagina in the form of fist supported by bilateral pressure, the prolapsed mass is pushed back into the pelvic cavity till complete repositioning of the uterine horns which was later assessed by per-rectal examination. Once the prolapsed mass is reposed inside, a mixture of Lignocaine jelly and Soframycin ointment is applied to reduce sensation of uterus there by reducing the straining and providing the antibacterial cover. After reposing the prolapsed mass inside the pelvic cavity, Buhner’s sutures are applied on the vulva using a bandage dipped in betadine solution . The animal is treated with antibiotic Ceftiofur 2 mg/kg b. wt. I/M; NSAID. Tolfine 15 ml I/M (4 % w/v Tolfenamic acid/ml); antihistaminic. Avlin 10 ml I/M (Chlorpheniramine maleate). Tonophosphan 15 ml I/M (Sodium salt of 4-Dimethylamino-2 methylphenylphosphinic acid); Repronol 10 ml I/M (vitamin E and selenium) and I/V fluid therapy. Dextrose saline 1800 ml/ day; Mifex 450 ml slow I/V (Calcium boro-gluconate). The prescribed treatment is repeated for three days excluding Mifex.
Among reproductive disorders, prolapse of reproductive organs occurs as a common gestational accident. The ruminants are predisposed to post-partum uterine prolapse due to the long myometrium contractions, violent straining, low plane of nutrition, hypocalcaemia, relaxed atonic flaccid uterus, lack of exercise and extreme laxity of perineum and vulvar lips etc. (Roberts, 1971; Noakes et al., 2001; Kumbhar et al., 2009). Post squeal to the uterine prolapse can be hemorrhagic shock, septic metritis, infertility or death. Immediate and proper treatment of this condition not only saves the life of animal but also the future fertility of the animal.
NB-TREATMENT SUGGESTED ABOVE IS JUST A SUGGESTION.PLZ DNT DO THE SAME WITHOUT CONSULTING YOUR REGD.VET
Compiled & Shared by- Team, LITD (Livestock Institute of Training & Development)
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