A review of the ongoing discussion about definition, diagnosis and pathomechanism of subclinical endometritis in dairy cows

Wagener, Kenneth B.; Gabler, Christoph; Drillich, M.

doi:10.1016/j.theriogenology.2017.02.005

Cited by 122 publications

(126 citation statements)

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“…Whereas several studies have evaluated PMN thresholds for the diagnosis of SE, reviewed by Wagener et al (), little information exists about the impact of uterine sampling location on the reproducibility of SE diagnosis. This study revealed a great variability between the tested sampling sites.…”

Section: Discussionmentioning

confidence: 99%

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Reproducibility of endometrial cytology using cytobrush technique and agreement for the diagnosis of subclinical endometritis between five predefined endometrial sites

Pothmann

Müller

Pothmann³

et al. 2018

Reprod Domestic Animals

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Contents The objectives of this study were as follows: (a) to assess the reproducibility of polymorphonuclear neutrophil (PMN) cell counts at five predefined endometrial sites (corpus uteri, left horn base, right horn base, left horn tip and right horn tip) and (b) to determine the agreement for the diagnosis of subclinical endometritis (SE) between the different endometrial sites. Forty milking cows between 28 and 34 days post‐partum were enrolled for endometrial sampling using cytobrush technique. Intraclass correlation coefficient (ICC) was calculated to evaluate the reproducibility of PMN counts at different sites. The right horn base was found to have the greatest agreement of PMN counts with the other endometrial sites (ICC = 0.66–0.85). Twenty‐eight of 40 cows showed no signs of clinical endometritis and were used for evaluation of agreement for the diagnosis of SE, analysed by using Cohen´s kappa (κ) statistics. Agreement for SE diagnosis with PMN cut‐off ≥5% was greatest between the right horn base and the right horn tip (κ = 0.84), and with PMN cut‐off ≥18% between the right horn base and left horn tip (κ = 1.0), respectively. The results indicate that the right horn base can be regarded as suitable for cytobrush sampling. The probability to detect an animal positive for SE (PMN ≥ 5%) with a single cytobrush sampling was 51.0%; thus, a second sampling is recommended to improve the accuracy.

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Section: Discussionmentioning

confidence: 99%

“…The diagnosis SE on cowlevel was defined by a PMN count exceeding the cut‐off value in one of the five predefined sites. The common cut‐off values of ≥5% and ≥18% PMN (Wagener, Gabler, & Drillich, ) were used for the definition of SE.…”

Section: Methodsmentioning

confidence: 99%

Reproducibility of endometrial cytology using cytobrush technique and agreement for the diagnosis of subclinical endometritis between five predefined endometrial sites

Pothmann

Müller

Pothmann³

et al. 2018

Reprod Domestic Animals

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“…The clinical definitions of postpartum uterine diseases are well established [1,2,29,30]. Metritis commonly occurs within 10 days of parturition, and is characterized by an enlarged uterus, with a watery red-brown fluid to viscous off-white purulent uterine discharge, which often has a fetid odor.…”

Section: Uterine Diseasementioning

confidence: 99%

Preventing Postpartum Uterine Disease in Dairy Cattle Depends on Avoiding, Tolerating and Resisting Pathogenic Bacteria

Sheldon¹

2019

Preprint

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Up to forty percent of dairy cows can develop metritis or endometritis when bacteria infect the uterus after parturition. However, it is unclear why other cows exposed to similar pathogens do not develop uterine disease. We suggest that resilient dairy cows prevent the development of uterine disease using the three complimentary defensive strategies of avoiding, tolerating and resisting infection with pathogenic bacteria. Avoidance maintains health by limiting the exposure to pathogens. Avoidance includes intrinsic behaviors to prevent exposure to pathogens or infected animals, perhaps signaled by the fetid odor of uterine disease. Tolerance improves health by limiting the tissue damage caused by the pathogen burden. Tolerance depends on controlling the tissue damage that pathogens cause in the endometrium by neutralizing bacterial toxins, enhancing tissue repair, and inducing adaptive metabolic responses. Resistance improves health by limiting the pathogen burden. Resistance relies on the immune system generating an inflammatory response in the endometrium to eliminate pathogenic bacteria. People who manage dairy cows can also help prevent uterine disease by using extended lactations, avoiding trauma to the genital tract, maintaining hygiene, and supplying appropriate nutrition during the transition period and after parturition to counter the metabolic stress of lactation. Developing new ways to prevent uterine disease depends on increasing our understanding of the mechanisms of avoidance, tolerance and resistance to pathogens in the postpartum uterus.

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“…A proportion of 5% PMN can be regarded as diagnostic for subclinical endometritis (Madoz et al, 2013). Research on subclinical endometritis and diagnostic techniques has been recently reviewed by De Boer et al (2014) and Wagener et al (2017a).…”

Section: Introductionmentioning

confidence: 99%

Pathogenesis of uterine diseases in dairy cattle and implications for fertility

Drillich¹,

Wagener²

2018

Anim Reprod

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Uterine diseases in cattle occur at all stages of the reproduction cycle but the majority of cases is found in the postpartum period. The inflammation of the uterus is generally defined as metritis or endometritis, with several graduations, e.g. puerperal metritis, clinical metritis, clinical or subclinical endometritis. Whether uterine diseases have a negligible, moderate or detrimental effect on fertility is still under discussion and depends on definitions and classification. In the past, it was assumed that the pregnant uterus is free of pathogens, but recent studies found several species including pathogens in the uterus and endometrium of pregnant cows. After parturition, a broad diversity of bacteria with >200 different species has been found in the early postpartum period. Not all of these bacteria, however, are considered as pathogens. Furthermore, bacteriological findings provide only evidence for infection but not for inflammation. For some bacteria, particularly Escherichia coli and Trueperella pyogenes pathogenic mechanism resulting in metritis and endometritis have been elucidated in detail. The role of bacteria that can be regarded as opportunistic or potential pathogens, e.g. Bacillus pumilus, is still under investigation. The understanding of the uterine microbiota and its interactions is increasing with the use of modern high-resolution techniques such as Fouriertransform infrared spectroscopy. Endometrial cytology provides additional information about alterations in the endometrium. Knowledge of innate uterine defense mechanism in cattle has increased a lot in the recent past. It can be speculated that improving or modulating uterine defense mechanism will be part of future prevention and treatment approaches beyond the use of antimicrobials. In this context, cellular and molecular defense mechanisms have been in the focus of interest, e.g. the role of interleukins or mucins. This review gives a short overview on some aspects of recent research on uterine diseases in cattle.

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A review of the ongoing discussion about definition, diagnosis and pathomechanism of subclinical endometritis in dairy cows

Cited by 122 publications

References 100 publications

Reproducibility of endometrial cytology using cytobrush technique and agreement for the diagnosis of subclinical endometritis between five predefined endometrial sites

Reproducibility of endometrial cytology using cytobrush technique and agreement for the diagnosis of subclinical endometritis between five predefined endometrial sites

Preventing Postpartum Uterine Disease in Dairy Cattle Depends on Avoiding, Tolerating and Resisting Pathogenic Bacteria

Pathogenesis of uterine diseases in dairy cattle and implications for fertility

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