Question

I have a maiden heifer with a white discharge from the womb and from time to time I also notice some cows with a similar discharge. It can be thick and slimy. The maiden heifer never had a calf and some cows could have it even three months after calving. Is it an infection that needs to be examined by a vet and treated with antibiotics or will it resolve itself of its own accord? Also could it be caused by a mineral deficiency?.

Answer

This is a bacterial infection of the uterine tract called endometritis. If you perform a vaginal examination on any cow >14 days after calving and you discover a cervix that is closed down to one or two fingers in diameter, together with the presence of a predominantly white discharge with some mucus through it, then that cow has endometritis. It occurs when there is a failure to clear all the remnants of the afterbirth and associated fluid and debris from the uterus (womb) after calving. It is very common and can be caused by a number of different factors. I cannot tell if you are a dairy or a suckler farmer but my answer should cover both eventualities.
In terms of the heifer, she must, most probably, have been in-calf and aborted with subsequent failure to clean properly. The only other possibility would be that she picked up a venereal disease and I will mention this later. In terms of the cows the most common causes of a high incidence of endometritis (>5%) are:

i) Immunosuppression in the periparturient period (period around calving) leading to retained placenta – it has been recently discovered that the reason a cow retains her placenta is due to a failure of her immune system to recognise the afterbirth as foreign material that needs to be expelled. Therefore, cows that are suffering from a profound immunosuppression at calving due to:

(a) poor nutritional management (too fat or too thin),

(b) concurrent disease (mastitis, ketosis, subclinical hypocalcaemia or even clinical hypocalcaemia, i.e. milk fever),

(c) a stressful calving (dystocia, i.e. hard calving, calving in inclement weather conditions, calving on cold concrete) or

(d) a heavy parasite burden (Fluke and Worms) are all more likely to develop retained placenta, metritis and subsequent endometritis.

ii) Cows are more likely to develop endometritis if they have also developed metritis after calving. Metritis is a severe, systemic infection originating in the uterus in freshly calved cows(up to 10 days post-calving), involving the presence of large amounts of retained placenta, foul-smelling fluid and debris within the lumen of the uterus. The infection also involves the walls of the uterus and can spread into the bloodstream leading to septicaemia. Metritis always warrants veterinary intervention and treatment by way of injectable antibiotics, anti-inflammatories, fluids if necessary and wash-outs. Most cows will respond to treatment very well but may not completely clear the uterine tract of bacteria until some months after calving. By 2 weeks post-calving the uterus will have reduced in size and most of the infection will be gone leaving the cow with the white discharge of endometritis. It must be noted that most cows that develop endometritis did not have metritis first but had a weakened immune system leading to failure to completely clean properly and to combat any residual bacterial infection within the uterus.

iii)Negative Energy Balance (NEB) – all cows are in some degree of NEB post-calving until peak feed intakes are reached by about 6-8 weeks after calving. However, cows that are in severe NEB at calving and post-calving will inevitably suffer from a much higher incidence of metabolic diseases in the periparturient period, including milk fever, displaced abomasum, ketosis, mastitis, metritis, retained placenta and endometritis. NEB leads to a depression of the immune system as mentioned previously and therefore will impair complete afterbirth expulsion and the subsequent ability of the uterine immune system to combat the bacterial load that is present. Therefore, it is vital to prevent NEB as much as possible by body condition scoring cows during the dry period so that they calve down at BCS of 3.0, i.e. “Fit Not Fat”. Transition cow feeding is also crucial to maximise feed intake in the postparturient period.

iv) Hypocalcaemia (low blood calcium) – calcium is needed for muscle contraction throughout the body, including the abdominal muscles and the uterus. If a cow is low in calcium (even if it is not low enough to induce full milk fever) she will not have the ability to contract the uterus and strain with her abdominal muscles enough to expel the placenta. As I have already alluded to, anything that leads to retained placenta will increase the chances of endometritis. Also these cow will have reduced forestomach motility which will lead to reduced feed intake, exacerbating any potential NEB problems, with knock-on effects as mentioned previously.

v) Infectious disease – leptospirosis can lead to early embryonic death as well as abortion and therefore could contribute indirectly to an endometritis problem. BVD leads to immunosuppression and again this could exacerbate a problem of endometritis. Campylobacter infection is a venereal infection spread by bulls that will certainly lead to an infectious discharge as described in your heifer and cows. if you have recently purchased a bull and noticed a drop in fertility, this must be considered as a potential possibility.

vi) Mineral deficiencies – mineral deficiencies are not one of the major causes of endometritis but can play a part in some herds. If there is a severe deficiency in either selenium, iodine or copper deficiency this may directly or more usually indirectly (via immunosuppression) lead to an increased incidence of endometritis.

Overall it is clear that there are many potential causes for this endometritis problem. As I mentioned it is quite a common problem and it is acceptable to have a low incidence within herds. However, this bacterial infection will certainly stop the cow or heifer going in calf. A good proportion of affected cows will eventually clear themselves. However, the longer it takes to get the cow back in-calf the more money it will cost you as the farmer – it costs approximately €5 for every day that a cow runs over the desired 365 day calving interval, i.e. if she take a month longer to go back in-calf this can cost up to €150. Therefore, it is strongly recommended that you get all of the cows and the heifer examined by your vet so that treatment can be initiated immediately. Also, the vet can then carry out an investigation into the likely herd health problem behind the endometritis with a view to preventing it in the future.

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