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THE WESTERN PRODUCER | WWW.PRODUCER.COM | JANUARY 12, 2017
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TWISTED UTERUS
Successful births possible even with uterine torsions ANIMAL HEALTH
ROY LEWIS, DVM
U
terine torsions are rare compared to other calving difficulties, but if producers learn to recognize cases and act quickly, most calves can be saved. Producers must learn to avoid the mistake of attempting to pull calves in these situations. I have never seen an actual percentage of torsions because they are often not documented, but my guess is that it occurs once in every couple thousand births. Larger producers may experience one every few years. At a practice I worked at, which included many cow-calf operations, we saw upward of a dozen or more yearly. In practice, I always had the producer feel in the vaginal canal when we diagnosed a uterine torsion so they would learn to recognize the feeling. I do the same thing with new vets or student vets. Once you examine one, it is hard to miss it the second time. A torsion is really when the free portion of the uterus (where the calf is) twists over on itself. The vagina is anchored by soft tissue in the pelvis. A uterine torsion is similar to putting a golf ball in a sock and giving the ball a 180 or 360 degree twist while holding the open end of the sock stationary. Once that occurs, you cannot reach in and pull the golf ball out. In a uterine torsion situation, the initial birthing report from a producer might be similar to a full breech calf (coming tail first) where the cow or heifer looks like it should have calved hours ago, but nothing has happened. The cow is bagged up with heavy udders and has been nesting, yet no waterbag or heavy straining has started. I tell experienced producers that if they suspect something is wrong, they are probably right. This is especially true if they know the cow’s history and it has calved normally in the past. The cow’s nesting and bellowing behaviour, or an animal that looks uneasy for prolonged periods, points to potential birthing problems: a breech, other malpresentation, or a torsion. It is best to vaginally examine the cow in these cases. When examining a torsion, you will usually be able to reach the
calf. Initially, you will feel bands of tissue running this way and that, similar to running your hand down a corkscrew. When you reach the calf, your hand may be upside down and the calf may be upside down. The degree of the torsion will determine the tightness of the opening. Generally, the cow’s contractions line up the calf to be presented normally, so if it is upside down or sideways and you feel these bands of tissue, it is likely a torsion. When one examines a cow that isn’t ready to calve, you go straight in the vagina and run into a closed cer vix that feels like a round doughnut with a hole in which you may be able to get in one or two fingers.
A torsion feels much different. It has an uneven opening with the cervix generally open enough to get your arm through and touch the calf. The water bag will usually be unbroken. Once a torsion is identified, it is imperative to get veterinary intervention. Veterinarians have several methods to detorse the uterus and if done successfully, the calf can be delivered alive out the back end, provided it was alive to start with. A veterinarian must first determine which way the uterus is torsed — clockwise or anticlockwise — and twist it the opposite way to get it detorsed. Some experienced veterinarians can detorse by hand by getting the uterus rocking and skillfully flip-
ping it back over. The cervix will then continue to dilate and the uterus will dump out fluid and the cow will start straining again. Other methods involve using a detorsion rod or detorsion fork to help untwist the torsion by applying these to the calf’s leg. With help from these, an experienced practitioner may apply further force as necessary. Another method places the cow on its side. The veterinarian then holds the calf while the cow is rolled to untwist the torsion. It is critical to know which way the uterus is twisted. In my experience, untwisting has been achieved a higher percentage of time by moving the calf clockwise.
If attempts fail, the veterinarian can carry out a caesarean section. In some cases, the calf can be detorsed internally through a C-section incision and then pulled out the back, especially if the calf is dead. If the calf is tightly twisted, often the calf must be taken by C-section and then the uterus detorsed and sewn up. There are many things to consider when a uterine torsion is found, but many times a calf birth can be successful, while the cow makes an uneventful recovery. Early detection is the key component. Roy Lewis works as a technical services veterinarian part time with Merck Animal Health in Alberta.
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