The cost of each case of metritis averages £180. Diana Mills from Diva Vets based in Aldford, Cheshire, compiles some guidelines on how to tackle this damaging disease.
What is metritis?
Metritis is the veterinary term for inflammation of the lining and the muscular wall of the cow’s uterus and is generally caused by bacteria.
It is painful and some cows will have raised temperatures and depressed appetites.
In severe cases metritis will lead to shock, sudden death from toxicity or to peritonitis, because infection can transfer through the wall of the uterus in to the abdomen.
Cows are incredibly resilient.
In many cases metritis goes undiagnosed and untreated because “she’s milking alright” but long term effects can be costly, often because of subsequent effects on fertility.
Scale of the problem
Metritis is increasing in the UK herd with some sources suggesting 15 to 25% of fresh calved cows are affected.
In cows which retain foetal membranes (RFM) the incidence is more like 80%.
Obviously it varies from farm to farm due to other management influences.
The problems
The follow on to metritis is often endometritis (whites).
Both lead to more days open, repeat services and therefore increased semen costs.
DAISY (1999) figures suggest that each case of vulval discharge costs about £137.
Assuming an incidence of 17%, that works out at more than £2,300 lost each year for every 100 cows Endometritis can become chronic and lead to culling especially in block calving herds where it will cause cows to slip out of the calving pattern.
As well as longer term effects on fertility, in the short-term metritis increases susceptibility to ketosis, abomasal displacement and other infections such as mastitis.
The economic impact is significant when you add up the cost of treatment, reduced appetite, reduced yield, discarded milk and reduced fertility.
Most cows do not recover their early lactation production even when they have recovered from metritis.
Why do cows get metritis?
The fresh calved uterus is an ideal environment for bacteria.
The bacteria include E coli and others that are associated with summer mastitis, digital dermititis and fouls.
Virtually all fresh calved cows will have bacteria inside the uterus but not all get metritis.
Whether they get it or not depends on the immune status of the cow, the environment in the uterus and the number and type of bacteria present.
The immune status is dependent on nutrition in the dry period and body condition; fat cows are more at risk from metabolic disease, more likely to have impaired immunity and also more likely to have assisted calvings.
Immunity will be reduced when there is another disease such as mastitis or IBR, exacerbating the risk of metritis.
Other factors, which increase the risk of metritis include:
- Incomplete cleansing 24 hours after calving
- Twins
- Stillbirths or abortion
- Induced calving
- Assisted calving
- Retained twin
- Poor nutrition
- Stress
- Milk Fever
Detecting metritis
Sometimes detecting metritis is easy (usually due to the smell linked to the bacteria) but often it can go unnoticed in the early stages.
It is sensible to monitor cows which have a high risk during the first few days after calving.
The best way to do this is by taking rectal temperature regularly; normal body temperature is 38.6C.
Raised or lowered body temperature indicates a problem and will help you detect other problems such as mastitis as well as metritis.
It is also useful to present fresh calved cows at routine vet checks for vaginal examination.
Early detection and prompt treatment will save you money.
Prevention
Most problems in fresh calvers can be prevented if dry cow nutrition and management are right.
If nutrition is not correct, metabolic diseases such as milk fever and ketosis are more likely.
These conditions will result in supressed immunity.
Retained cleansings will be more common, as will assisted calvings and contraction of the uterus (involution) to its non-pregnant state will be impaired.
Involution helps to expel fluid and bacteria from the uterus so the quicker it occurs after calving the less the risk of metritis.
Stress is a big factor influencing infectious and metabolic disease in the fresh calved cow.
This can arise due to overcrowding, inadequate feed space, impaired access to feed, temperature and poor stockmanship.
Good hygiene at calving is essential; dirty hands and dirty calving ropes will introduce bacteria.
In some cases intervention is necessary, in which case it should be done as cleanly as possible.
The treatments
In high risk cows it is advisable to start treatment as soon as a problem is suspected.
There are numerous products available to treat metritis.
Intra-uterine products such as pessaries and washouts can be used for high risk calvings.
However, they can be expelled from the uterus when it contracts and may not be effective when copious discharge is present within the uterus.
Injectable antibiotics should have a broad spectrum of activity because a wide range of different bacteria can be found in the uterus.
The chosen treatment must be able to penetrate uterine tissue in high enough concentration to be effective against these bacteria.
Products that are specifically licensed for the treatment of metritis will have been tested to make sure they meet these criteria.
Anti-inflammatories are essential where there is evidence of pain, which is a common symptom of metritis.
They are also useful where there is an elevation in body temperature and are given alongside antibiotics.
Electrolyte requirements are high in fresh calved cows and even greater when there is an infection.
Cows with high temperatures have a higher requirement for fluids but often don’t drink enough themselves.
The vet may administer electrolyte products by a rumen pump as a quick and easy way to provide significant volumes of fluids and aid the cow’s recovery.
In some cases the vet may give an injection to aid contraction of the uterus.
The scoring chart (below) maybe useful to decide when, and with what, to treat.
Finally, don’t overlook food, water and a stress-free environment.
They are critical for good recovery of any sick cow.
devavets@btconnect.com
Metritis: What’s the score? |
| Score |
Clinical Signs |
Action |
| 1 |
Mild discharge, normal temperature and demeanour |
Monitor temperature |
| 2 |
profuse discharge, foul smell +/- retained cleansing, normal temperature |
Remove cleansing (vet or stockman) insert pessaries and continue to monitor temperature |
| 3 |
As above with slightly elevated temperature but normal demeanour |
Treatment as above but with the addition of suitable injectable antibiotic |
| 4 |
As 3 but accompanied by some loss of appetite and performance |
Pessaries, injectable antibiotic and anti-inflammatories, plus oral fluids |
| 5 |
Sick cow, depressed appetite, foul smelling red/brown discharge, high temperature, dehydration, reduced milk yield |
Vet attention needed |