Endometritis,causative agent,pathogenesis,diagnosis,treatment

1. Endometritis & Case Study
• Group: K
• Members Roll# (08, 09, 23, 30, 36, 42, 45, 46, 49,
50)
Table of Contents
 Introduction to Endometritis
 Predisposing Factors
 Etiology
 Pathogenesis
 Diagnosis
 Control & Treatment
 Case Presentation

2. ENDOMETRITIS

3. INTRODUCTION
Endometritis is an inflammation of the
endometrium not associated with systemic
illness.
It is characterized by:
a) Purulent discharge from the vulva.
b) Decreased fertility and
c) Repeat Breeding.

4. It is a prevalent uterine disease in
postpartum cows which reduces the fertility
and cause repeat breeding.
Subsequently it affects the productivity and
profitability of dairy farms which is
associated with considerable economic
losses.

5. ETIOLOGY
1. Specific organisms
Actinomyces pyogenes.
Fusobacterium necrophorum
Bacteroid spp.
2. Non-specific organisms
Escherichia coli
Streptococci spp.
Staphylococci spp.

6. Predisposing Factors
Nutritional
Environmental
Genetical
Managemental
Pathological

7. Environmental Factors
Moist Environment:
• The moist environment is good for multiplicat
ion of the pathogenic bacteria
• The pathogens during parturition can enter re
productive tract.
• Causing uterine diseases like endometritis.

8. Nutritional Factors
1) Proteins
 Deficiency; reduces cellular immunity and p
hagocytosis
 Excess; high serum ammonia and reduces ly
mphocytes production.
2) Vitamins (A,B&C)
 Deficiency favors the pathological bacteria t
o grow and delays the phagocytosis process
and reduces the immunity of uterus.

9. 3) Minerals
 Calcium deficiency delays uterine involution.
 Magnesium involves in opsonization process.
 Selenium involves in neutrophils function an
d reproductive health.
 Copper, zinc, and iron intervene in lysosome
production.
(Excess or deficiency of all these minerals
result in growth of pathological bacteria in
uterus and development of endometritis)

10. Pathological Factors
1) Dystocia
2) Retained Fetal Membrane
3) Abortion
4) Twin Birth
5) Induced Parturition

11. Classification of Endometritis
Clinical Endometritis
• The uterine discharge is mucopurulent.
• No signs of clinical illness.
Sub-Clinical Endometritis
• The uterine discharge is almost clear but white
side test is positive.

12. Degree of Endometritis
1st Degree
• No disturbance in estrous cycle.
• Clear vaginal discharge.
• Flakes of pus may present 4 days post AI.
2nd Degree
• Estrous cycle may be prolonged or normal.
• Clear Vaginal Discharge (May become cloud
y/dirty on uterine milking).
• The genital tract is slightly thick and heavy.

13. 3rd Degree
• The estrous cycle disturbed (prolonged).
• Discharge is mucopurulent especially during
estrus.
• The genital tract is felt distinctly thick and enl-
arged.

14. PATHOGENESIS

17. Similarly Bacteriods spp. Also produces
substances that decrease body’s
phagocytic ability.
These bacteria act synergistically to
produce disease.

18. Diagnosis
1. Rectal Palpation
2. Observation of Vaginal Discharge
3. Vaginoscopy
4. Endometrial Cytology
5. White side test

19. Endometrial Cytology
Done by uterine lavage.
Using of 2 way foley catheter 20% of Salin
e is flushed into uterus and collected, cent
rifuged and sediment examined.
 Presence of variable amount of Neutroph
ils 8 to 12% indicate endometritis.

20. White Side Test
(Specific for Subclinical Endometritis)
1ml cervical mucous.
1ml 5% NaOH solution.
Appearance of dark yellow colour- Clinical metritis.
Appearance of yellow colour- Subclinical metritis.
Appearance of no colour- Normal

21. Endometritis Scoring Scheme
 0: Clear mucus
 1: mucus with off white flecks
 2: mucus with ≤ 50% pus
 3: mucus with ≥ 50% pus but ocassionally san
guineous.

22. Control
Clean hygienic practice at farm.
Provide required nutrition to cows.
Routine diagnostic procedures.
Use of clean disinfected equipment.
Healthy managemental practices to contr
ol of postpartum problems and diseases.

23. Treatment
Antibiotic Therapy (Intra-uterine if needed).
Parenteral administration(Penicillin or Oxy-
tetracycline).
Hormonal Therapy
– Oestradiol valerate.
– Oxytocin.
– PGF2α (If CL present).

24. CASE
PRESENTATION

25. Animal data:
Specie : Bos Indicus
Breed : local (Sahiwal)
Identity: Tag # 022

26. History
Subject was an experimental animal at
RCVETs clinic. Students performed AI Rod
practice many times on the subject. There
was a chances of bacterial infection in
reproductive tract and may be injury.

27. General Examination
General body condition:
The patient was fully conscious, alert but with poor
BCS.
Vitals:
 Temperature: 101
o
F.
 Pulse : 54 beats per minute.
 Respiration: 12 respiration per minute.
 Heart rate : 52 beats per minute.

28. Temperature Pulse Respiration

29.  CRT: less than 2 seconds.
 Lymph nodes: No abnormal swelling found.
 Heart: No murmurs.
 Lungs: No sounds.
 Ruminal motility: 2 waves in 3 minutes.
 Musculoskeletal system: No joints swelling and
no lameness.

30. Transrectal Examination

31. Vulva: Normal edematous.
Evidence of uterine discharge: Yes.
Nature of uterine discharge: Clear stringy.
Cervix: Fibromuscular hypertrophy of externa
l-os (>5cm in diameter).

32. • Examination of uterine horns: Flaccid both
horns
• Examination of ovaries:
• Length 3cm both
• Palpatable structures on right and left ovaries:
• Multiple regressed CL on both ovaries and dev
eloped follicles
• Stage of estrous cycle: Estrus
• Reproductive status of the animal: Cyclic

33. Washing of Perineum &
Sample Collection

34. Packing, Labelling and
Transport

35. Tentative Diagnosis
On the basis of uterine discharge and trans
rectal palpation we diagnosed this case as
first degree endometritis. This diagnosis is
also based on history because these animals
are used for A.I rod practicing and there are
chances for contamination of reproductive
tract.

36. Inoculation/Culturing

37. Gram Staining

38. Gram Staining Result
Gram positive, spore forming bacilli and arranged singly.

39. Antibiotic Sensitivity Test

40. Test Results

42. Antibiotic Selection
• According to sensitivity test we selected
STREPTOMYCIN for treatment as it is ea
sily available in market and broad spectru
m in action.

43. References:
Applied Veterinary Gynecology and Obste
trics (Dr. Radeep Kumar)
Veterinary Obstetrics and Genital Diseases
(Stephen J. Roberts)
Clinical Metritis and Endometritis in Dairy Ca
ttle (Journal by Kassahun A. Negasee)
https://www.intechopen.com/chapters/63404
https://www.ncbi.nlm.nih.gov/pmc/articles/PM
C2706386/

44. Thank You