Endometritis in the mare: A comparison between reproductive history and uterine biopsy as techniques for predicting susceptibility of mares to uterine infection

Thirty mares with no clinical signs of endometritis were categorized as being susceptible or resistant to uterine infection depending on whether or not they had a history of recurrent endometritis. The same mares were then independently classified as susceptible or resistant on the basis of their uterine biopsies; those with significant endometrial degeneration were considered to be susceptible to endometritis. The mares then received an intrauterine inoculation of pathogenic Streptococcus zooepidemicus . Those mares which eliminated bacteria by 10 d after inoculation were considered truly resistant to endometritis, whereas those still infected at 10 d were considered susceptible. The original classifications based on history or biopsy were compared to the inoculation results. A history of recurrent endometritis provided a more sensitive (0.90) and specific (0.95) indication of susceptibility to uterine infection than a uterine biopsy with significant endometrial degeneration (sensitivity 0.5, specificity 0.75).     

Inflammatory cytokine concentrations in uterine flush and serum samples from dairy cows with clinical or subclinical endometritis

The objective of this study was to compare the concentrations of inflammatory cytokines in uterine flush and serum from healthy postpartum dairy cows and cows with clinical or subclinical endometritis. Clinical endometritis was diagnosed by observation of vaginal discharges (>50% pus) and subclinical endometritis was diagnosed by evaluation of uterine cytology (neutrophils >18%) at 4 weeks postpartum. Uterine flush was obtained from 48 cows at 4, 6, and 8 weeks postpartum for evaluation of tumor necrosis factor-α (TNF-α), interleukin (IL)-1β, IL-6, IL-8, and IL-10 concentrations. Serum samples were obtained from 34 cows just after calving and at 1, 2, 4, 6, and 8 weeks postpartum for evaluation of TNF-α, IL-1β, and IL-6 concentrations. Concentrations of TNF-α, IL-6, and IL-10 were greater (P < 0.05) in cows with clinical endometritis than in cows with subclinical endometritis and healthy controls, whereas concentrations of IL-8 in both cows with clinical and subclinical endometritis were greater (P < 0.005) than in controls. Overall, IL-6 and IL-10 concentrations decreased during the postpartum period. IL-1β concentrations in cows with clinical endometritis decreased (P < 0.0005) during the postpartum, whereas concentrations in cows with subclinical endometritis and controls did not change significantly with time; at 4 weeks postpartum, concentrations were greater (P < 0.0001) in cows with clinical endometritis. There were no significant effects of group, sampling time, or interaction on serum cytokine concentrations. In conclusion, cows with endometritis have greater inflammatory cytokine concentrations in uterine flush than healthy cows, but no differences were observed in serum.     

Defining postpartum uterine disease in cattle

Uterine function is often compromised in cattle by bacterial contamination of the uterine lumen after parturition, and pathogenic bacteria often persist, causing uterine disease, a key cause of infertility in cattle. However, the definition or characterization of uterine disease frequently lacks precision or varies among research groups. The aim of the present paper was to provide clear clinical definitions of uterine disease that researchers could adopt. Puerperal metritis should be defined as an animal with an abnormally enlarged uterus and a fetid watery red-brown uterine discharge, associated with signs of systemic illness (decreased milk yield, dullness or other signs of toxemia) and fever > 39.5 degrees C, within 21 days after parturition. Animals that are not systemically ill, but have an abnormally enlarged uterus and a purulent uterine discharge detectable in the vagina, within 21 days post partum, may be classified as having clinical metritis. Clinical endometritis is characterised by the presence of purulent (> 50% pus) uterine discharge detectable in the vagina 21 days or more after parturition, or mucuopurulent (approximately 50% pus, 50% mucus) discharge detectable in the vagina after 26 days post partum. In the absence of clinical endometritis, a cow with subclinical endometritis is defined by > 18% neutrophils in uterine cytology samples collected 21-33 days post partum, or > 10% neutrophils at 34-47 days. Pyometra is defined as the accumulation of purulent material within the uterine lumen in the presence of a persistent corpus luteum and a closed cervix. In conclusion, we have suggested definitions for common postpartum uterine diseases, which can be readily adopted by researchers and veterinarians.     

Evaluation of the effectiveness of intrauterine treatment with formosulphathiazole of clinical endometritis in postpartum dairy cows

In cattle, elimination of bacterial contamination from the uterine lumen after parturition is often delayed or compromised, and pathogenic bacteria can persist, causing uterine disease and infertility. The aim of this study was to compare the clinical and bacteriologic recovery following a single intrauterine administration of formosulphatiazole, cephapirin or placebo in cows with clinical endometritis. Cows (n = 80), no less than 28 days postpartum, with clinical endometritis were enrolled in the study. Endometritis was diagnosed by a complete reproductive examination, including rectal palpation, ultrasonography, vaginoscopy and uterine swab. All cows were randomly assigned to receive one of three intrauterine treatments (T0): 2500 mg of formosulphatiazole (Group A); 500 mg of cephapirin (Group B); placebo (4250 mg of propylene glycol; Group C). Cows were examined at the first estrus after treatment or no more than 30 days after (T1). Bacteria isolated were E. coli, A. pyogenes, Pasteurella spp. and Streptococcus spp. After treatment, in Group A and B only 6/30 (20.0%) and 6/24 (25.0%) cows showed a positive bacteriologic culture (P > 0.05), while in Group C the number of positive animals was significantly higher (19/26; 73.1%; P < 0.05). At T0, total clinical scores were similar between the three groups (Group A: 5.84 ± 1.07; Group B: 5.91 ± 1.0; Group C: 5.62 ± 1.17; P > 0.05) and indicative of clinical endometritis. At T1, endometritis scores were significantly lower than those reported before uterine infusion (P < 0.05); however, Group A and B score, 0.4 ± 0.9 and 1.0 ± 2.1, respectively, correspond to no and slight endometritis, while animals in Group C reported a total endometritis score significantly higher (4.6 ± 3.5; P < 0.05) corresponding to endometritis. In the present study, a commercial formosulphatiazole preparation was as effective as cephapirin and more effective than placebo for the treatment of clinical endometritis.     

A clinical approach to determine false positive findings of clinical endometritis by vaginoscopy by the use of uterine bacteriology and cytology in dairy cows

Clinical endometritis in dairy cows is defined as mucopurulent or purulent vulvar discharge 21 days or more after parturition. The diagnosis of clinical endometritis is commonly based on vaginal examination. Techniques to reduce the proportions of false negative findings have been described. This paper discusses a clinical approach to determine the proportion of false positive findings that might occur by vaginal inspection. The consequences of false positive findings in dairy practice are unnecessary or inadequate treatments. In research, incorrect diagnoses have an impact on the interpretation of studies on the diagnosis and treatment of clinical endometritis. The objective of the present study was to compare intrauterine bacteriology and endometrial cytology in cows diagnosed with clinical endometritis with findings obtained by vaginoscopy. Clinical endometritis was defined as mucopurulent or purulent vulvar discharge. On two commercial dairy farms, cows were examined 21 to 28 d postpartum. Uterine samples (n = 230) were collected from cows with clinical endometritis with the cytobrush technique to determine the proportion of polymorphonuclear neutrophils (PMN) and to culture smears for aerobic bacteria. Two threshold values for the proportion of PMN (5 and 18%) were chosen as possible indicators for an inflamed endometrium. Common uterine pathogens A. pyogenes and E. coli were found in 33.5 and 10.4% of the samples, respectively. With increasing vaginal discharge score, proportion of samples positive for A. pyogenes increased significantly. The proportion of cows exceeding the thresholds for PMN increased with vaginal discharge score and the presence of A. pyogenes.Considering only the presence of aerobic uterine pathogens and a proportion of PMN above the threshold values of 5 and 18% as indicative for endometritis, a proportion of 17.3 and 28.5%, respectively, of diagnoses by vaginoscopy were false positive.     

大鼠子宫内膜炎模型复制及其中西药复方乳剂治疗

目的人工复制大鼠子宫内膜炎模型;应用自制中西药复方乳剂对子宫内膜炎模型大鼠进行治疗。方法对实验大鼠子宫眼观病变、子宫内容物及单侧子宫指数进行检查,对实验大鼠子宫进行病理组织学检查。结果应用3％冰乙酸对大鼠子宫进行刺激,第4天对大鼠子宫接种混合病原菌,能够稳定复制大鼠子宫内膜炎模型;中西药复方乳剂能明显降低大鼠子宫内细菌浓度、种类及单侧子宫系数,能明显减轻子宫的病理变化。结论中西药复方乳剂对子宫内膜炎模型大鼠有良好的治疗作用。     

Uterine clearance and resistance to persistent endometritis in the mare

The objective of this article is to review the role of uterine defense mechanisms in natural resistance to chronic or persistent endometritis. A breakdown of uterine physical clearance mechanisms is currently believed to play a major role in susceptibility to persistent endometritis. Mares with increased susceptibility to persistent endometritis have impaired myometrial contractility in response to an acute inflammation, resulting in an accumulation of fluid and inflammatory products within the uterine lumen. The origin of this defect remains unknown. Recent studies have demonstrated that spermatozoa trigger PMN chemotaxis into the uterine lumen. This observation suggests that a transient endometritis is a normal physiological response to breeding. However, in mares with impaired uterine defense mechanisms, the condition may develop into a persistent endometritis and subsequent subfertility. In contrast to spermatozoa, seminal plasma has a suppressive effect on complement activation and PMN chemotaxis (65). The exact role of seminal components in breeding-induced inflammation needs further investigation.     

Risk factors for clinical endometritis in postpartum dairy cattle

Bacterial contamination of the uterine lumen after parturition occurs in most dairy cattle. The presence of clinical endometritis beyond three weeks post partum depends on the balance between microbes, host immunity, and other environmental or animal factors. The present study tested the hypothesis that clinical endometritis is associated with animal factors, such as retained fetal membranes, assisted calving and twins, as well as fecal contamination of the environment. The association between selected risk factors and the lactational incidence risk of clinical endometritis was examined in 293 animals from four dairy herds. Multivariate analysis was used to identify risk factors and quantify their relative risk (RR) and population attributable fraction (PAF) based on the proportion of cows exposed to each factor. The lactational incidence of clinical endometritis was 27% and significant risk factors for clinical endometritis were retained fetal membranes (RR = 3.6), assisted calving (RR = 1.7), stillbirth (RR = 3.1), vulval angle (RR = 1.3), primparity (RR = 1.8), and male offspring (RR = 1.5) but not the cleanliness of the environment or the animal. The highest PAF was associated with male offspring (0.6) so the use of sexed semen has the greatest potential to reduce the incidence of clinical endometritis. The dominant association between retained fetal membranes and clinical endometritis was supported by an expert panel of clinicians. The risk factors for clinical endometritis appear to be associated with trauma of the female genital tract and disruption of the physical barriers to infection rather than fecal contamination.     

Endometritis treatment with a PGF2alpha analog does not improve reproductive performance in a large dairy herd in Argentina

In Argentina, most dairy cows with endometritis are treated with prostaglandin (PGF(2alpha) or its analogs) and insemination is withheld until there are no signs of endometritis. The objective of the present study was to evaluate if this method of managing endometritis enhances reproductive performance. Three experiments were conducted over 4 years in a large farm in the west of Buenos Aires province. In Experiment 1, half of the cows diagnosed with endometritis (>1.5-fold difference in diameter of uterine horns, as determined by rectal palpation) received standard endometritis management (treatment with tiaprost, a PGF(2alpha) analog, rectal palpation every 20 days, and withholding of AI until endometritis apparently resolved) and the other half was untreated, with AI at the first estrus after the voluntary waiting period. Untreated cows were inseminated and conceived 20 days earlier than treated cows, and the pregnancy rate by Day 90 postpartum was higher in the untreated group. In Experiment 2, cows with endometritis were divided into four groups according to the severity of symptoms; within each group, cows were allocated to treatment or control, as in Experiment 1. Although first service conception rate decreased as endometritis severity increased, reproductive performance in treated versus control cows was similar to that of Experiment 1 (with no interaction due to degree of endometritis). Re-evaluation of the treated cow (to confirm uterine "normality") may have been responsible for the delay in conception in both experiments. The objective of Experiment 3 was to determine the effects of tiaprost treatment on clinically normal postpartum cows (no evidence of endometritis). Tiaprost treatment reduced the interval from calving to conception in multiparous cows, but it delayed conception and reduced the conception rate in primiparous cows. In conclusion, treatment with tiaprost impaired reproductive performance in primiparous cows (in the absence of endometritis). Furthermore, the standard treatment for endometritis (treatment with a prostaglandin analog and withholding insemination until clinical signs abated) impaired reproductive performance and increased costs.     

Relationship between endotoxin and prostaglandin (PGE2 and PGFM) concentrations and ovarian function in dairy cows with puerperal endometritis

Blood concentrations of progesterone, 13,14-dihydro-15-keto-prostaglandin F2alpha (PGFM) and endotoxin, and uterine fluid concentrations of prostaglandin E(2) (PGE(2)), PGFM and endotoxin were evaluated in 14 dairy cows with puerperal endometritis (mild (n=6) and heavy (n=8)). Endotoxin was measured using a quantitative kinetic assay. Cows with heavy endometritis had significantly higher concentrations of plasma PGFM (P<0.01) and uterine fluid PGE(2) and endotoxin (P<0.05) than cows with mild endometritis. Concentrations of PGFM in plasma and uterine fluid, of PGFM and PGE(2), and PGE(2) and endotoxin in uterine fluid were positively and significantly (P<0.05) correlated. The presence of endotoxin in plasma was detected in one out of six mild and in eight out of eight heavy endometritis cows. Peak plasma endotoxin concentrations (0.08-9.14 endotoxin units/ml (EU/ml) were observed between 1 and 12 days postpartum (pp) and thereafter amounts generally remained below 0.1 EU/ml (last day of detection: Day 27 pp). Abnormal ovarian function was observed in six cows (four with prolonged anoestrus and two with long luteal phase after the first postpartum ovulation). Plasma endotoxin concentrations were detected in the anoestric cows. The results suggest that: (i) concentrations of uterine fluid endotoxin and PGE(2) and of plasma PGFM are related to the degree of endometritis; (ii) absorption of endotoxin from the uterus to the bloodstream occurs, mainly in heavy endometritis cows; and (iii) there is a relationship between uterine infection, endotoxin production and resumption of pp ovarian activity.     

Expression of genes associated with immunity in the endometrium of cattle with disparate postpartum uterine disease and fertility

Background  

Contamination of the uterine lumen with bacteria is ubiquitous in cattle after parturition. Some animals develop endometritis and have reduced fertility but others have no uterine disease and readily conceive. The present study tested the hypothesis that postpartum cattle that develop persistent endometritis and infertility are unable to limit the inflammatory response to uterine bacterial infection.     

Non-specific uterine infection and bovine fertility. I. Infection patterns and endometritis during the first seven weeks post-partum

From a total of 93 dairy cows which were sampled repetitively throughout the non-gravid period, 14 cows developed persistent purulent endometritis, failed to complete uterine involution and were chronically infertile. The remaining 79 cows had completed uterine involution prior to 50 days post-partum. Forty-seven of these cows subsequently proved to be fertile and 32 cows were infertile. Fertility was not influenced by the variable uterine flora or by the endometritis which was found in all the cows within the first two weeks post-partum. Cows which had uterine infection with $\text{Corynebacterium pyogenes}$ subsequent to Day 21 developed severe endometritis and were almost invariably infertile to the first service. Fertility to subsequent services was not necessarily impaired in those cows which eliminated $\text{C. pyogenes}$ sufficiently early to allow complete uterine involution prior to Day 50. Cows with abnormal oestrous cycles were not particularly susceptible to uterine infection.In all the cows the composition of the uterine flora fluctuated constantly throughout the first 7 weeks pp. as a result of spontaneous contamination, clearance and recontamination. Contamination of the uterus by other non-specific bacteria during the 3 to 4 week period which is required for resolution of severe endometritis induced by $\text{C. pyogenes}$ could lead to a false correlation between the endometritis and the bacterial flora as determined by a single sample. It is concluded that the information which is derived from $\text{in vivo}$ sampling of the uterus in clinically normal cows during the first 7 weeks pp. is of little value in predicting subsequent fertility.     

Comparison of three diagnostic methods to identify subclinical endometritis in mares

The objective of this study was to compare the accuracy of a uterine swab (US), a cytological brush (CB) and an endometrial biopsy (EB) to detect subclinical endometritis in mares. Cytological and bacteriological results of all three techniques were related to histological occurrence of polymorphonuclear neutrophils (PMNs) in the stratum compactum, commonly known as ‘best standard'; to diagnose endometritis.Samples were taken from 55 mares of different breeds without clinical signs of endometritis. Samples for US, CB and EB were collected, smeared on a microscopic slide and cultured for bacterial growth. Endometrial biopsy samples were additionally stored in 4% formaldehyde for histological analysis. Bacteriological cultures and cytological samples of all techniques were classified as negative (no uterine pathogens in monoculture; < 2% PMNs) or positive (uterine pathogens in > 90% of the grown colonies; > 2% PMNs) for endometritis. Uterine pathogens were diagnosed in 20.0% of the mares. Isolation of pathogens was not associated with positive cytological findings (r = −0.23; P = 0.87). None of the six mares with an Escherichia coli infection (10.9%) showed a positive cytological result. In contrast, two of five mares infected with Streptococcus zooepidemicus had a positive cytological result.Histologically, the presence of PMNs in the stratum compactum was regarded as positive for endometritis when the mare was in diestrus at time of sampling. Compared to the ‘best standard', sensitivity for cytology of CB, US and EB was 0.17, 0.00 and 0.25, respectively. Specificity for cytology of CB, US and EB was 0.83, 0.93 and 0.85, respectively. Sensitivity of uterine culture was 0.25, 0.33 and 0.25 for CB, US and EB, respectively. Specificity for culture of CB, US and EB was 0.80, 0.83 and 0.95, respectively. In conclusion, cytological or bacteriological examinations alone provide a high incidence of false negative results. Sensitivity of cytology combined with bacteriology of CB was 0.42. A combination of a bacteriological and a cytological examination of a CB sample improved the diagnostic performance in subfertile mares. Based on these results, we can recommend the CB to improve the diagnosis of subclinical endometritis in the mare compared to the US alone as currently used routine method.     

Baogong decoction treats endometritis in mice by regulating uterine microbiota structure and metabolites

Endometritis is persistent inflammation caused by bacteria, which can lead to infertility. Although traditional Chinese medicine (TCM) has been used to treat endometritis, the underlying mechanism is still unclear. Here, Baogong Decoction (BGD), a TCM compound, was used to treat mouse endometritis induced by Escherichia coli (E. coli), and then 16S rRNA sequencing and non-targeted metabolomics were used to investigate the change of uterine microbiota and metabolomes in serum and uterine after BGD treatment. Finally, the therapeutic effect of potential metabolites for treating mouse endometritis screened by combined omics analyses was verified using pathological model. The results showed that BGD treatment could effectively treat endometritis associated with the increasing relative abundance of Firmicutes, Bacteroides, Lactobacillus and Lactococcus, and the decreasing relative abundance of Cupriavidus and Proteobacteria. 133 and 130 metabolites were found to be potential biomarkers in serum and uterine tissue respectively. In serum and tissues, dehydroepiandrosterone (DHEA) and catechol were significantly increased in the BGD treatment versus the inflammation group. Results of combined omics analyses demonstrated that DHEA was positively correlated with changes in microbiota. Results of pathological model demonstrated that DHEA could cure endometritis effectively associated with the decreasing infiltration of inflammatory cells and expression of inflammatory factors in the uterus. In summary, our results demonstrated that BGD could cure endometritis in mice by modulating the structure of the uterine microbiota and its metabolites, in which DHEA may be one of the main components of the therapeutic effect of BGD.     

Exosome-derived uterine miR-218 isolated from cows with endometritis regulates the release of cytokines and chemokines

As an inflammation of the endometrium, endometritis can affect fertility and lead to serious economic losses in the dairy industry. Widely found in various tissues and body fluids, exosomes and exosome micro (mi)RNAs have been shown to play an important regulatory role in the immune responses. As one of differentially expressed exosome miRNAs, miR-218 is involved in the pathogenesis of bovine endometritis. The mechanisms of miR-218 in regulating the release of cytokines and chemokines in endometritis, however, are poorly understood. Exosomes were isolated from bovine uterine cavity fluid and verified by transmission electron microscopy. An in vitro lipopolysaccharide-treated cell model for bovine endometritis was then established to evaluate the correlation between exosome-derived miR-218 and the immune responses. We demonstrated that exosomes could be used to deliver miR-218 from endometrial epithelial cells (EECs) into the uterine microenvironment and adjacent recipient cells to modulate local immune responses. miR-218 packaged in the exosomes secreted from EECs acts as an inhibitor by blocking immune factors such as interleukin (IL)-6, IL-1β, tumour necrosis factor-α, the chemokines macrophage inflammatory genes (MIP)-1α and MIP-1β to maintain the immune balance in the uterus. However, uterine inflammation altered the immunoregulatory mechanism of exosome miR-218. MiR-218 is a potential biomarker for the detection of endometritis. Our findings also revealed a new mechanism for the development of endometritis in cows.     

Interaction between equine semen and the endometrium: the inflammatory response to semen.

Insemination of mares with bacteria-free equine spermatozoa results in an influx of polymorphonuclear neutrophils (PMNs) into the uterine lumen. In vitro studies have demonstrated that equine spermatozoa activate complement, resulting in cleavage of factors C5a and C3b. Since uterine secretion is rich in complement, it is likely that an interaction between spermatozoa and uterine secretion results in C5a-mediated chemotaxis and migration of PMNs into the uterine lumen. Once in the uterine lumen, the PMNs phagocytize bacteria and spermatozoa, which is an important part of sperm elimination from the reproductive tract. It is not clear how the spermatozoa are opsonized, or if phagocytosis of equine spermatozoa is a selective or non-selective process. Breeding-induced endometritis appears to be both up and down regulated by seminal components. A modulatory role on the inflammation has been suggested for equine seminal plasma. Seminal plasma suppressed complement activation, PMN-chemotaxis and phagocytosis in vitro. Preliminary in vivo experiments also support a suppressive role of seminal plasma in breeding-induced endometritis. The duration but not the magnitude of the PMN-influx into the uterine lumen was shortened when seminal plasma was included in an insemination dose. The presence of PMNs in the uterus affects the motion characteristics of spermatozoa in vitro. Both progressive motility and mean path velocity were impaired when spermatozoa were incubated in uterine secretion from mares with ongoing breeding-induced endometritis. The binding of spermatozoa to PMNs was prominent in all samples collected from mares with an ongoing endometritis. The motility remained impaired, but the binding of the spermatozoa to PMNs was reduced when the spermatozoa were incubated in uterine secretion in the presence of seminal plasma. Preliminary characterization of the immune-suppressive component in seminal plasma suggests that it is one or more molecule(s) with a molecular weight between 50 and 100 kDa, partially inactivated by charcoal stripping and partially heat-inactivated at 95 degrees C for 45 min.     

Spontaneous recovery or persistence of postpartum endometritis and risk factors for its persistence in Holstein cows

It has been stated that postpartum endometritis in dairy cows has a tendency to cure without intervention. The objectives of this field study, therefore, were to determine the proportions of cows with spontaneous clinical recovery or persistence of postpartum endometritis and to determine some risk factors for its persistency in dairy cows (Bos taurus). Holstein-Friesian cows (n = 441 lactations) from seven dairy herds were examined monthly by vaginoscopy and transrectal palpation. A cow was considered to have “postpartum endometritis” if it had pus in the cervico-vaginal discharge at the first postpartum examination during Days 15 to 60 (Day 0 = day of calving); this was classified as mild, mucopurulent, or purulent endometritis, or endometritis with fluid in uterus. Furthermore, a cow with evidence of endometritis at least once during Days 61 to 150 was considered to have “persistence (or recurrence) of endometritis.” A total of 104 (23.6%) lactations had postpartum endometritis, of which 25.3% had persistence or recurrence of clinical endometritis. Cows with persistence or recurrence of endometritis became pregnant at a slower rate (hazard ratio [HR] = 0.28; P < 0.001) than those with no endometritis until Day 150. Calving in summer (odds ratio [OR] = 7.00; P = 0.04), early postpartum complications (OR = 6.58; P = 0.05), moderate (OR = 4.03; P = 0.08) and severe (OR = 30.99; P = 004) degrees of urovagina, and mucopurulent (OR = 9.54; P = 0.02) and purulent (OR = 5.70; P = 0.04) endometritis were risk factors for the persistence or recurrence of endometritis. Furthermore, 10.6% of cows that had not shown signs of postpartum endometritis had a new diagnosis of endometritis during Days 61 to 150. Some risk factors for the new diagnosis of endometritis beyond Day 60 were early postpartum complications (OR = 2.82; P = 0.03) and moderate (OR = 5.00; P = 0.001) or severe (OR = 12.63; P < 0.001) degrees of urovagina. In conclusion, approximately one quarter of cows with postpartum endometritis had persistence of endometritis until or beyond the breeding period. Risk factors for the persistence of clinical endometritis were summer calving, early postpartum complications, clinically relevant urovagina, and clinically relevant endometritis within 2 mo postpartum.     

Phenotyping of leukocytes and granulocyte and monocyte phagocytic activity in the peripheral blood and uterus of cows with endometritis

This study was a comparative evaluation of selected immunological parameters in peripheral blood and uterine wash samples from cows with a normal postpartum period compared with cows with endometritis. We aimed to determine the usefulness of these parameters in monitoring the puerperium. In total, 40 cows were included in the study: 20 had endometritis (experimental group), and 20 did not have uterine inflammation (control group). Animals were chosen on the basis of cytological and bacteriological test results. The tests were conducted 5, 22, and 40 days postpartum. In both groups, flow cytometric analysis of the surface molecules CD4, CD8, CD21, CD25, and CD14 in the peripheral blood and uterine washings was performed. Granulocyte and monocyte phagocytic activity was determined using a commercial Phagotest kit that was adapted for flow cytometry. The percentage of phagocytic granulocytes and monocytes in both the peripheral blood and the uterine washings was significantly lower for cows in the experimental group compared with the control group (P < 0.01). A significant decrease (P < 0.01) in the percentage of CD4+, CD25+, CD14+, and CD4 + CD25^high leukocyte subpopulations was also observed in the peripheral blood of cows with endometritis. A significant decrease (P < 0.01) in CD21+ lymphocytes and an increase in CD8+ lymphocytes was detected in uterine washings. The results of this work indicate that cell immunity dysfunction may be the main factor causing advanced inflammation of the uterus in endometritis. Knowledge of the immunological mechanisms observed in cows with endometritis might aid in choosing the correct immunomodulating agent–based adjuvant therapy.     

The effect of a single administration of cephapirin or cloprostenol on the reproductive performance of dairy cows with subclinical endometritis

This study examined the effect of a single administration of cephapirin iu or cloprostenol im on the reproductive performance of dairy cows with subclinical endometritis. Cows (n = 228) at 20-33 days in milk (DIM) from two commercial dairy farms, determined to be normal for clinical endometritis (based on absence of abnormal uterine discharge on vaginoscopic examination) were enrolled. At enrollment, a thorough reproductive examination was performed, including rectal palpation, ultrasonography (US) and endometrial cytology (EC). The case definition for subclinical endometritis was the presence of >18% neutrophils on EC examination or fluid in uterus (FIU) on US examination. All cows were randomly assigned to receive one of three treatments: 500 mg benzathine cephapirin iu, 500 microg cloprostenol im, or control (no treatment). Reproductive performance was monitored for a minimum of 8 months after treatment. Cows with subclinical endometritis treated with cephapirin or cloprostenol had a significantly increased relative pregnancy rate compared to control [hazard ratios 1.89 (P = 0.01) and 1.70 (P = 0.05), respectively]. In conclusion, a single treatment with cephapirin or cloprostenol at 20-33 DIM significantly improved the reproductive performance of cows with subclinical endometritis.