Torsion Final

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Uterine torsion in bovines
Uterine torsion is defined as the revolution or twisting of the uterus on its long
axis, it is frequent cause of dystocia in cattle,specially in dairy cattle confined
for long period in the stable, occasionally observed as a cause for dystocia in
sheep, mares,dogs and cats. Torsion of uterus is uncommon in mare due to
dorsally attached broad ligaments that tend to prevent torsion.
• In cow, sheep, goat, the gravid horn is in the arc shape or "U" shape loop
with vagina and ovary at the respective end of the arc.
• In unipara, because of the strong intercornual ligament and the distension of
the uterine horn and body with placenta and fluid, both gravid and non gravid
horns are involved in torsion.
•The lesser curvature of the uterus in advanced pregnancy is supported by
broad ligament dorso-laterally.
• The greater curvature lies free in the abdominal cavity resting on the
abdominal floor and supported by the rumen, viscera and the abdominal wall.
•Incidence is about 7.3 %.
•The ovarian end of the gravid horn of the bovine uterus is a relatively
small or narrow base upon which the uterus rests.
• If the non-gravid horn is small or non-functional, the instability of the
uterus is increased.
•This anatomical arrangement, together with the manner in which the
cow lies down, with the fore quarters going down first and rises by
elevating the rear quarters first so that each time the cow lies down or
rises the gravid uterus is suspended in the abdominal cavity.
• Sudden slip or fall in the either lying down or rising could cause the
torsion.
• Lack of fetal fluid during advanced pregnancy causes torsion.
•Confinement in stables for long time favours torsion in cow.
• More common in pluriparous than premiparous.
• Lack of tone of pregnant uterus.
•Twins in the ruminants tend to prevent torsion by making a broader
base for the uterus to rest upon and filling abdominal cavity.
•In few cases strong movements of the fetus can cause uterine torsion.
• Uterine torsion is observed most commonly in advanced pregnancy.
•Cases have been observed from 70 days to term.
• Torsions occurring before 7 months of pregnancy in the cow are
unusual.
• Most torsions occurred during the early part of the first stage of
parturition.
• Uterine torsion of cattle of 180° may be present for days or weeks
without clinical symptoms until labour begins and dystocia results.
• In these cases no evidence of circulatory interference of the blood
supply to the uterus was present.
•During pregnancy 45° to 90° torsion or rotations of the uterus are
frequently found on rectal examination, these are usually corrected at
the time of parturition automatically.
• In unusual instances, torsions may involve 180° to 360° rotation
of the uterus.
• In torsions greater than 180º the birth canal at parturition is
usually tightly closed.
• Cervix and fetus are not palpable through vagina.
• These severe torsions causes obstructions to the blood supply of
the uterus, with resulting congestion, edema, shock, death of the
fetus.
• In neglected cases, rupture of the uterus may occur.
• In rare cases, uterine vessels may also rupture, followed by
severe haemorrhage into the abdominal cavity.
• In uniparous animals, torsions may be either to the right side
(clockwise) or to the left side (counter clockwise).
• Right torsions are more common, probably rumen occupying the
left side of the abdominal cavity tend to prevent left torsion.
Symptoms
•Symptoms of torsion are completely lacking before parturition if
it is mild i.e.45°-90°.
•When the torsion is 180º or more, definite signs of abdominal
pain may be noted, anorexia, constipation, lack of
rumination,slow rumen contractions, rapid pulse rate,
restlessness or colicky symptoms.
•These symptoms may be confused with traumatic gastritis,
indigestion, pyelonephritis or intussusception.
• These can be ruled out by per rectal or per vaginal examination.
• In right torsion, the right broad ligament is pulled strongly
downward and under the twisted uterine body or vagina, and the
left broad ligament is pulled tightly across over the top of the
cervix, the body of the uterus and the vagina towards right side.
•In counter clockwise or left uterine torsion the right broad
crossing over the top of the twisted portion of the birth canal.
•Middle uterine artery is also tightly stretched
•The amount of tension on the broad ligaments and arteries will indicate
the severity of the torsion.
• The fetus is often difficult to palpate but position of the fetus in the
uterus in advanced pregnancy may help indicate the degree of torsion.
• A dorso-pubic position of the fetus usually occurs when the torsion is
180º.
• In severe cases of torsion occurring in late pregnancy the blood supply
to and from the uterus is restricted or cut off.
• In these cases marked symptoms of complete anorexia, constipation,
fetid diarrhea, complete lack of rumination, very rapid and weak pulse,
rapid respiration, expiratory grunt, sub normal temperature, cold
extremities, shock and death.
• In other cases, fetus may die, become emphysematous and macerate
or become mummified and cow develops only slight or mild symptoms.
•Prognosis in torsion depends on the degree of torsion, severity of the
symptom and length of time it has existed.
Treatment
1. Rolling of dam.
2. Schaffer's method.
3. Laparotomy
4. Caesarean operation.
Rolling of dam
• Rolling is one of the oldest and simplest of the various methods

used to relieve torsion of the uterus.
• It requires assistance of 3-6 persons depending on size of animals.
• If dam is furious, tranquilizer should be given 20 minutes prior to
rolling.
• After the direction has been determined, the cow is laid down in
lateral recumbency on the same side as the direction of the torsion.
• The two hind legs of the cow are fastened together and the two
front legs are tied together, leaving 8-10 feet end on each side of
rope.
• The cow's head is held extended.
•The front and hind feet should not be tied together because it
compresses the abdominal cavity and tend to make the gravid
uterus rotate with the cow.
•The animal should be rapidly rotated in the same direction as
the torsion by strong coordinated pulling on the ropes attached
to the forelegs and hind legs
.• After the cow has been rolled 180°, her body must be then
either rolled back slowly to the original position or be pushed
slowly on the same side as the direction of torsion so as to be
rapidly turned over again.
• After each two or three rapid rotations of the cow's body the
birth canal should be examined to determine if torsion is
corrected.
•Occasionally, there may be rush of fetal fluid from the uterus as
the torsion is relieved.
• If torsion is not relieved, this procedure should be repeated 4-5
times.
Casting &Rolling of Dam
Schaffer's Method
• This method requires less assistance because the cow
with torsion is rolled slowly instead of rapidly.
• The cow is casted on the same side of torsion and tied in a
manner similar to that has been described for rolling.
• A plank of 9-12 feet long and 8-12 inches wide is placed on
the cow's abdomen with lower end of the plank on the
ground.
• An assistant stands on the plank and the cow is slowly
rolled in the same direction of torsion by pulling the ropes
around the front and hind feet.
• This creates pressure first on the upper abdominal wall,
then floor the opposite side of the abdomen resulting in a
correction of the tor be determined by examining the
genital tract.

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• Rolling is one of the oldest and simplest of the various methods

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