I n my last article we looked at the typical presentation for a uterine torsion and some of the risk factors associated with this problem. This month I will discuss how the problem is diagnosed and how it can be treated.
There are two locations for the “twist” or site of the torsion. One is pre-cervical, which means the twist is before the cervix and can be felt vaginally. If you have performed vaginal exams before, the vaginal vault is an open chamber and the cervix can be felt on the far wall. With a pre-cervical torsion, this area is twisted off and will feel like a narrow passage or a cone. If you let your hand run along the wall of the vagina, you may even feel bands that rotate as you go in. The second location is post-cervical which, cannot be felt vaginally and a rectal examination is needed to diagnose. A veterinarian is usually needed to diagnose this type of torsion.
If a cow fails to come into labor and a torsion is suspected, call your veterinarian immediately due to the complications that can result. With the uterus twisted, the blood supply can be impaired, which can cause damage to the uterus and can stress or kill the calf. Blood clots can form in the vessels from the impaired flow and can break free after the uterus is de-torsed, leading to organ damage or death.
Another possible complication can be damage to the uterine arteries. Once the uterus is corrected, the patient can bleed internally if the arteries are torn. Unfortunately, due to the location of these vessels, it is very difficult, if not impossible, to go in and clamp them off in time.
The other possible complication that can occur is that the calf may put a leg through the uterine wall, rupturing the uterus internally. The calf’s exit is closed due to the twist and the uterus is damaged from the decreased blood flow, so during contractions, the calf is shoved into the uterine wall where a hoof can easily be pushed through. The most frustrating part of this scenario is that the veterinarian may not know there is a hole in the uterus until after the calf is delivered.
The uterine torsion is a high risk condition and can be tricky to correct successfully. It is extremely important to know the severity and direction of the twist before you try to fix it, which is why I recommend that you always call your veterinarian if you suspect this condition. The earlier these are caught and treated, the better chance of a good outcome. In the next article, we will discuss some of the techniques that your veterinarian may use to correct the torsion.
Editor’s note: Stephen Foulke, DVM, DABVP (Dairy) is a board certified specialist in dairy practice with Agricultural Veterinary Associates in Lititz, Pa. He can be reached at 717-625-4212.