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Uterine Disease in Dairy Cows: A Comprehensive Review Highlighting New Research Areas

Zsóka Várhidi, György Csikó, Árpád Csaba Bajcsy and Viktor Jurkovich

Vet. Sci. 2024, 11(2), 66; https://doi.org/10.3390/vetsci11020066

[2.1. Forms of Uterine Disease of Dairy Cows

2.1.1. Metritis: First 21 Days after Calving Metritis is defined as the inflammation of the uterine wall, including the endometrium, the muscular layers and the serosa, which occurs until the first 21 days after calving—primarily within 7–10 days—and can affect up to 40% of dairy cows. Clinical signs include a watery, red-brown uterine discharge, usually with a fetid odour. The uterus of a metritic cow is enlarged and flaccid and does not have the longitudinal folds that typically characterize involution. Metritis is classified into three grades based on the accompanying systemic symptoms. In Grade 1 metritis, there is no sign of systemic signs of illness or fever. In Grade 2, or acute puerperal metritis, clinical signs include fever (>39.5 °C), reduced appetite, decreased milk production and prolonged resting periods (lethargy). In Grade 3, or toxic metritis, the cow is recumbent and shows toxaemic signs .

2.1.2. Endometritis: From 21 Days after Calving Endometritis is defined as inflammation of the endometrium only that does not extend beyond the stratum spongiosum. Endometritis occurs from 21 days after calving onwards and is classified as clinical or subclinical . The disease can affect about 20% of dairy cows .Clinical endometritis is characterized by visible mucopurulent (50% mucus; 50% pus) or purulent discharge at the vulva or in the vagina. The severity of clinical endometritis is usually graded by evaluating the vaginal discharge. In Grade 0, or normal (without endometritis), the discharge is clear or translucent. In Grade 1, the mucoid discharge contains flecks of white or off-white pus. In Grade 2, the discharge contains less than 50% white or off-white mucopurulent material. In Grade 3, it is purulent, usually with a white or yellow colour, but sometimes it can contain blood too . In subclinical endometritis, the infection and inflammation of the endometrium do not result in discharge.

2.1.3. Pyometra: Between 42 and 60 Days after Calving Pyometra is sometimes also considered a type of endometritis; however, usually, it is discussed separately . It is characterized by the accumulation of pus in the distended uterus with a closed cervix and a persistent corpus luteum in an ovary. Some pus my leak into the vagina too. Bacterial infection of the oviducts and salpingitis can occur and influence fertility as well. Pyometra occurs between 42 and 60 days after calving, with a relatively low prevalence rate of less than 2% .]