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Chronic catarrhal endometritis (endometritis catarrhalis chronica)
Chronic catarrhal endometritis is called chronic inflammation of the uterine mucosa, characterized by the constant discharge of catarrhal exudate from the uterus.
Etiology. Chronic catarrhal endometritis usually develops from acute endometritis, if the causes that caused it were not addressed in a timely manner. In cows, chronic endometritis is most often the result of acute postpartum and post-abortion endometritis, subinvolution of the uterus and the introduction of natural and artificial insemination of infected sperm. The cause of chronic catarrhal endometritis may be, in addition, the spread of the inflammatory process to the endometrium from the vagina and cervix. In some cases, this endometritis occurs a second time in the presence of persistent corpus luteum, cysts and functional disorders in the ovaries.
In the chronic course of catarrhal endometritis under the influence of prolonged exposure to various irritants (microbes, toxins, exudate, etc.), in addition to hyperemia and hemorrhages, a number of different persistent pathological changes occur in the uterine mucosa. In some cases, they are manifested in the degeneration of the cylindrical and ciliated epithelium with its replacement by a squamous epithelium. In other cases, atrophy or hyperplasia of the mucous membrane and atrophy or hyperplasia of the uterine glands are observed. Occasionally, clogging of the outlet openings of the glands and the formation of cysts from them are noted. Later, cysts are destroyed. Ulceration and swelling of the mucous membrane are also possible. Sometimes there is a growth of connective tissue and induction of the uterus with the displacement of muscle tissue.
Along with these changes, pathological changes often occur in the vessels of the uterus (vasodilation, thickening and sometimes degeneration of their walls), as well as in the receptors and nerve cells of the uterus, which disrupts the blood circulation in it and its innervation. In this case, functional disorders of the uterus and ovaries occur. At the same time, exudation into the uterine cavity occurs. Depending on the form of inflammation, the exudate can be mucous, mucopurulent, and purulent. With an exacerbation of the process, the secretion of exudate increases, with a decrease in the degree of inflammation, exudation decreases, and sometimes temporarily stops. All this creates unfavorable conditions for fertilization.
Clinical signs. Chronic catarrhal endometritis is characterized by constant or intermittent discharge from the uterus of cloudy flaky mucus, which is usually found on the floor where the animal was lying. The cervix is almost always ajar, its canal is filled with thick mucus coming from the uterus.
A rectal examination reveals an increase in uterine volume and fluctuation. With the accumulation of exudate in large quantities, the body and horns of the uterus are lowered into the abdominal cavity.
Uterine soreness is usually not noted, its contractility is weak or absent (uterine atony). The walls of the uterus are in places thickened and compacted or flabby.
The general condition of animals with mild forms of chronic endometritis usually does not change, but severe forms are accompanied by a deterioration in general condition, a decrease in milk productivity and a gradual thinning. With intoxication, an increase in temperature, increased heart rate, decreased appetite, atony of the pancreas, catarrh of the abomasum and intestines are observed.
Blood changes in chronic endometritis are usually not characteristic. The most common abnormalities in them, especially in cases accompanied by emaciation of the animal, are a decrease in the amount of hemoglobin and red blood cells and eosinophilia. Less commonly observed leukopenia and relative lymphocytosis or leukocytosis, neutrophilia and basophilia.
Sexual cycles in chronic endometritis are most often arrhythmic or fall out altogether.
The main sign of chronic endometritis is the temporary or permanent infertility of females and the associated complete loss of animal milk production.
Infertility in chronic endometritis occurs due to various reasons. In some cases, the cause of infertility is the lack of estrus and hunting. This is observed in cases where chronic endometritis causes pathological changes in the ovaries (lack of growth or incomplete development of follicles, their atresia, the formation of persistent corpus luteum and cysts in the ovaries, sclerotic changes in the ovaries, etc.).
In other cases, the cause of infertility is the death of sperm in the female genital tract due to a change in the environment in the uterus due to the presence of exudate in it.
In the absence of exudate in the uterus, sperm death can be caused by spermotoxins, spermolysins, bacteriolysins and phages formed in it.
Sperm death is also noted while maintaining various functional and morphological changes in the endometrium.
In addition, the cause of infertility is sometimes a change in the endometrium, which is often destroyed due to painful long-term processes in the uterus. With such changes, the possibility of fertilization is usually excluded, although sexual hunting and ovulation occur. The causes of infertility in chronic endometritis can also be the lack of ovulation, its very late occurrence, the presence of complications in the form of salpingitis, which often excludes the possibility of sperm and the egg to meet even during ovulation and some other moments.
It should be borne in mind that in some cases of chronic endometritis, fertilization occurs, but the changes in the endometrium often result in either the impossibility of implanting a zygote, or the death of an embryo in the early stage of its development, or abortion at a later stage of pregnancy. Chronic endometritis is accompanied by abortion in those cases when the changes that occur in the uterine mucosa (degeneration, cicatricial changes, etc.) cause a breakdown in the relationship between the maternal and children's placentas.
Chronic endometritis lasts for months and years. Moreover, they often go from one form to another and are exacerbated. With a change in the shape of endometritis, catarrhal discharge sometimes becomes purulent, and purulent pass into mucopurulent and mucous membranes. Simultaneously with the change in the nature of the exudate, its quantity also changes. Sometimes chronic endometritis goes into hidden. In this case, the allocation of exudate from the uterus ceases.
The prognosis for chronic endometritis depends on the duration of the course of the disease and the presence of morphological changes in the endometrium. In unreleased cases of chronic endometritis, the prognosis may be favorable, since recovery and restoration of the fecundity of the animal are possible. In the presence of irreversible morphological changes in the endometrium, causing constant infertility or habitual abortion, the prognosis for the restoration of fertility is poor. In this condition, the animals are discarded. However, in the presence of an accurate diagnosis of chronic endometritis, cows should be discarded only in the absence of a positive result from treatment and grazing. In addition, when culling cows, one should also take into account the degree of decrease in milk productivity, which often determines the inappropriateness and loss-making of further treatment.
Treatment. Given that in chronic catarrhal endometritis, the endometrium and ovaries are affected, the main task of treatment should be to restore their function. For this purpose, it is recommended to use both local and general treatment.
Local treatment for chronic catarrhal endometritis boils down to the periodic release of the uterus from the contents and to weakening or suspension of microflora, and the general - to increase the tone of the body, contractility of the uterus muscles and stimulate ovarian function. To increase the tone of the body, a full-fledged diet, regular walks, a 10% solution of calcium chloride (intravenously) and vitamin preparations are prescribed. In the presence of a persistent corpus luteum in the ovary, ovarian massage or enucleation of the corpus luteum are performed. To restore the function of the endometrium and myometrium, subcutaneous administration of hormonal drugs is recommended.
Prevention Prevention of chronic catarrhal endometritis is achieved by timely elimination of acute forms of endometritis. Animals suffering from chronic endometritis are isolated. Insemination of animals in which signs of chronic endometritis are observed do not produce until complete recovery. In order to identify animals with chronic endometritis and treat them in a timely manner, it is necessary to conduct obstetric and gynecological medical examinations on a monthly basis with the results of the studies entered in the “Log Book for Insemination and Calving of Cattle”. Otherwise, prevention is the same as with acute endometritis.
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