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2007, Vol 2 No 2, Article 17


Management of Toxic Puerperal Metritis

in Dairy Cows using Oxytetracycline along with

PGF2α Therapy

H. K. Bhattacharyya and M. R. Fazili

Teaching Veterinary Clinical Complex,
Faculty of Veterinary Sciences & Animal Husbandry,
Shuhama, Alustang, Srinagar-190006 (J&K)

(email: drhiranyabh@yahoo.co.in)



Successful treatment of toxic puerperal metritis in cattle with intrauterine infusion of oxytetracycline and parenteral administration of PGF2α is reported and discussed.


Toxic puerperal metritis (TPP), Oxytetracycline, PGF2α


Toxic puerperal metritis (TPP) is a reproductive disorder affecting dairy cattle. It results in heavy economic loss due to decreased milk yield, reduced fertility and high treatment cost. Incidence of the disease varies from 2.2 to 37% (Kelton et al., 1998). Various agents have been used to treat this condition from time to time which includes oxytetracycline, penicillin, sulfonamide, β-lactams (Whitacre, 1992; Oslon et al., 1986), ceftiofur (Smith et al., 1998), hepatoglobins, cytokines (Alsemgeest et. al., 1994), prostaglandin F2α (Melendez et al., 2004) etc. The purpose of this communication is to put on record the efficacy of oxytetracycline along with PGF2α in 8 cows suffering from TPM.


A total of 8 cows in 2nd to 5th lactation were presented within 10-14 days post-calving with the history of anorexia, depression, mild dehydration, reduced milk yield and watery foetid vulvar discharge. All the cows were feverish (103-104.50F) and their per rectal examination revealed flaccid, non-retractable uterus that were located in the abdomen along with cervical enlargement. Cervical diameter (>75mm) was assessed following the criteria fixed by Zemjanis (1970). In 4 cows caruncles were not involuted (1-2 cm in diameter) with very big middle uterine artery (m.u.a.) that gave characteristic fremitus like pulsation resembling with the cases of superfoetation. Five cows had suffered from retained foetal membrane that was removed manually by local veterinarian. Two more cows developed milk fever on 2nd day post-calving. Uterine discharge was collected aseptically and subjected to sensitivity testing.


Cows were treated with intrauterine infusion of oxytetracycline (Liquid Terramycin* 60 ml daily for 5 days) and PGF2α (Lutalyse** 5 ml i/m) on the first day of oxytetracycline administration. No other treatment was provided.

(* 50 mg/ml, Pfizer Animal Health Division, Mumbai – 400 021
** 5 mg/ml, Novartis India Limited, Animal Health Sector, Mumbai – 400 020)


The treatment resulted in expelling of discharges amounting to 10 to 15 liters from all the cows within 3 days. Uterine involution had progressed to around 50% on day 3 and 70% on day 5. Caruncles were involuted completely on day 5. Rectal temperature reduced to normal values and m.u.a. returned to non-gravid state. All the animals resumed feeding.
Toxic puerperal metritis is a disease characterized by fever, anorexia, depression, dehydration, reduced milk yield and foetid watery uterine discharge (Oslon et. al., 1986; Smith et. al., 1998). Similar findings were recorded in the present study. However, status of m.u.a. and caruncles in cases of TPM was not mentioned in the earlier studies. In the present study incomplete involution of m.u.a. and caruncles was observed in 50% cases. Therefore, in future TPM may be defined on the basis of all criteria including status of m.u.a., caruncles and dehydration in addition to the other previously fixed criteria.
The disease developed within 10-14 days post-calving i.e. early in the post-partum period. This finding simulates with the earlier finding of Gilbert and Schwark (1992) who reported that the disease occurred within 1st week post-partum. The TPM is observed as acute condition due to involvement of highly pathogenic organism and other predisposing factors like poor resistance of the cow.
In the present study 5 out of 8 cows (62.5%) had suffered from retained foetal membrane and 2 cows (25%) suffered from milk fever. Association of retained foetal membrane and metritis was also reported earlier (Smith et al., 1998). Retained foetal membrane and hypocalcemia may act as a contributing factor for metritis by decreasing required uterine motility which is caused by reduction in plasma Calcium level.
It is very difficult to determine the exact cause of TPM because of fastidious nature of the organisms and due to involvement of both pathogenic and non pathogenic organisms. However, most researchers reported involvement of both gram positive and gram negative bacteria and hence systemic and/ or intrauterine infusion of antibiotic is must to kill the involved organisms. In the present study oxytetracycline was used to which all fluid samples showed high sensitivity. Oxytetracycline for the treatment of acute metritis was also advocated earlier by several workers (Gustafson, 1986; Whitacre, 1992).
Normal myometrial activity of the uterus is greater at calving and decreases drastically around 7 to 9 days post-partum (Gajewski et al., 1999). Although inflamed uterus (metritis) produces additional prostaglandin, the uterine musculature does not respond to this endogenous prostaglandin and involution process is delayed (Kindahl et al., 1999). Calcium is a key mediator for muscle contraction (Nelson and Cox, 2000). Cows that develop hypocalcaemia within few days post-partum have prolonged intervals to complete uterine and cervical involution than normocalcaemic cows (Kamgarpour et al., 1999). In such cows uterotonic compounds like PGF2α might be less effective in triggering uterine motility and tonacity (Melendez et al., 2004). In the present study exogenous administration of PGF2α by day 10-14 played a vital role in clearing debris from the uterus by increasing myometrial activity and uterine contractility (Patil et al., 1980; Gajewski et al., 1999). From the study it is concluded that intrauterine administration of oxytetracycline along with parenteral PGF2α is highly useful in treating TPM in dairy cows.


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