Transrectal ultrasonography and blood lactate measurement: a combined diagnostic approach for severe uterine torsion in dairy cattle

Abstract

In this study, we aimed to elucidate the utility of transrectal ultrasonography (TRUS) and blood lactate concentration (bLac) measurement to diagnose cows with severe uterine torsion. We investigated the association of TRUS and bLac measurement with macroscopic findings on laparotomy for severe uterine torsion in nine cows. We found that an increased ultrasonographic cross-sectional thickness (15–25 mm) and multiple hypoechogenic areas corresponded to macroscopic vascular compromise in the uterus on laparotomy. In addition, bLac was elevated (≥5.0 mmol/l) in cows showing uterine necrosis on laparotomy. A combined diagnostic approach with TRUS and bLac measurement enables assessment of the uterine vascular status and has utility for selecting the treatment option (including laparotomy) and predicting the outcomes.

Ultrasonographic and haematology findings as an indicator of uterine torsion prognosis in cattle

“…An increase in uterine wall thickness during uterine torsion was reported by Murakami et al 21 ; however, our ultrasonographic findings were quite different from theirs. In addition to the multiple hypoechogenic areas described by those authors, we also observed an inner hypoechogenic layer with a coarse appearance that, at necropsy, was characterised as severe large subendometrial suffusion, detaching the endometrium from the other uterine layers, causing necrosis and marked oedema involving the uterine wall and chorion and allantois membranes.…”

“…Depending on the severity of the coagulopathy, hypoproteinaemia, thrombocytopenia and hypofibrinogenaemia, 30 as observed in this case, suggest a high consumption condition. Despite not being evaluated, the concentration of blood lactate 21 should be used as a prognostic tool, as it reflects a severe lack of blood supply, indicating the presence and degree/severity of uterine torsion, necrosis and fetal death. In addition, coagulopathy and hypoxia are indicators that signal a poor evolution related to multiple organ failure and death of the dam 31 …”

“…1,17 Other factors that seem to favour the condition are feeding cows with concentrate diets, the way cows rise (initially rising on their hindlimbs and only later on forelimbs) 18 and when the cow falls and rolls over. 9,18 Although ultrasonography is a valuable tool for the reproductive evaluation of livestock animals, 19,20 only one study reported ultrasound findings in cows with uterine torsion, 21 where the presence of marked thickness of the uterine wall and multiple hypoechogenic areas was associated with necrosis of the uterine wall and poor prognosis.…”

“…Although ultrasonography is a valuable tool for the reproductive evaluation of livestock animals, 19,20 only one study reported ultrasound findings in cows with uterine torsion, 21 where the presence of marked thickness of the uterine wall and multiple hypoechogenic areas was associated with necrosis of the uterine wall and poor prognosis.…”

Use and adequacy of non‐pregnancy diagnosis in cow. Which future?

“…In the mid‐1980s, B‐mode ultrasonography began to be used as a complementary examination in bovine reproductive management (DesCôteaux et al, 2009). This technique was initially used for pregnancy diagnosis (Photo 1) (Fissore et al, 1986; Szenci et al, 1999) but soon was utilized to study follicular dynamics, corpus luteum (Acosta & Miyamoto, 2004; Kito et al, 1986), embryonic and foetal development (Curran et al, 1986; Kraisoon et al, 2018), uterine pathologies (Fissore et al, 1986; Meira et al, 2012), gestational losses (Chaffaux et al, 1986; Chaudhary & Purohit, 2012) foetal sexing (Photo 2) (Ali & Fahmy, 2008; Fricke, 2002) physio‐pathology of ovary (Photo 3) (Díaz et al, 2019; Gnemmi, 2001; Quintela et al, 2012) and uterus (Bollwein et al, 2002; Debertolis et al, 2016; Sharma et al, 2019) (Photo 4), diagnosis of twin gestation (Photo 5) (Colloton et al, 2010; López‐Gatius et al, 2017; Silva del Rio et al, 2009), diagnosis of embryo and foetal death (Photo 6) (Colloton et al, 2010; Gnemmi, 2004b), diagnosis of foetal malformation (Photo 7) (DesCôteaux et al, 2010; Gnemmi, 2004b; Gorjidooz et al, 2021) diagnosis of gestational diseases (Photo 8) (DesCôteaux et al, 2009; Murakami et al, 2019) and recently also to improve the efficiency of selecting donor cows/heifers for embryos and oocytes and to improve efficiency of selecting recipients for embryo transfer (Pugliesi et al, 2018; Stroud & Durocher, 2010).…”