Metritis

Metritis (inflammation of the uterus) is caused by bacterial infection.

Metritis, an inflammation of the uterus, is caused by bacterial infection, and usually is seen following calving. It occurs most commonly after calvings complicated by dystocia, retained fetal membranes, twins or stillbirths. Metritris can range from a mild disease with a high rate of spontaneous cures to a severe, acute disease that can be life threatening. As the interval from calving increases, the manifestations of the disease become less severe and the disease manifestation changes from clinical metritis to clinical endometritis (inflammation of the lining of the uterus) to a subclinical endometritis. Clinical metritis is characterized by fever, a foul-fetid vulvar discharge, a uterus with excess fluid and lacking tone, and a cow that appears depressed and off-feed. Clinical metritis is most commonly seen in the first 10 days post-calving. Cows that have clinical metritis exhibit poor reproductive performance with irregular estrous cycles, lower conception rates and greater intervals from calving to pregnancy.

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Etiology

Infection of the uterus with E. coli appears to pave the way for subsequent infection with other bacteria. It appears that certain strains of E. coli are necessary to initiate an environment that promotes the growth of Arcanobacterium pyogenes and Gm-negative anaerobes. Clostridial spp of bacteria may be part of the bacterial mix that results in the most acute and severe clinical metritis.
The cow’s immune system is normally suppressed at the time of calving. The normal suppression can be further aggravated by ketosis, milk fever, and trace mineral and vitamin deficiencies. In addition, difficult calving, stillbirths, twins and retained fetal membranes put the cow at greater risk for the development of metritis.

Symptoms

The primary symptoms of metritis are fever, a foul-fetid vulvar discharge, a uterus that lacks tone when palpated per rectum, an abnormal uterine discharge, and a depressed attitude with a decreased appetite.

Diagnosis

Diagnosis is based upon the prescience of clinical signs and a foul-fetid vulvar discharge in particular.

Treatment

The treatment of choice is a 5-day regimen of an antibiotic labeled for the treatment of metritis and appropriate supportive therapy.

Prevention
The primary measures for prevention are:
Appropriate supplementation of trace minerals and vitamins.
Feeding a diet to with appropriate levels of calcium and a negative Dietary-Cation Difference to prevent milk fever.
Minimization of negative energy balance around calving time by managing pen moves and preventing over-crowding and feeding appropriate transition rations.
A clean, dry maternity environment.
Well managed assistance when a calving difficulty occurs.

Economic Impact
The average case of metritis of metritis costs dairy producers between $304 and $354 from losses in production and performance.
Costs from culling within the first 60 days of milk are estimated at $71 per case.
Total losses from all cows due to declines in milk production caused by metritis are $77 per case.
Costs associated with a decrease in fertility and reproductive performance due to metritis are estimated at $98 per case.
Treatment costs and associated milk withdrawal range from $58 to $108 depending on antibiotic chosen.