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Endometritis and the Vulval Discharge Syndrome
(215) Since 1985 there has been a gradual reduction in farrowing rates in many herds associated with increased repeats in sows. A survey carried out at that time (Fig.6-9) indicated that up to 24% of herds may have had previously unrecognised problems with this disease.A discharge from the vulva post-service does not automatically mean there has been a pregnancy failure, but it will in most cases indicate infection. Fig.6-10 shows the anatomy of the reproductive tract and the potential areas from which discharges could arise. These include the rectum, the vulva, the vagina, the cervix and the uterus. Discharges can also arise from infection of the kidneys (pyelonephritis) or the bladder (cystitis) with pus being passed in the urine.
It is important to record the time when discharges are first seen, their colour and composition and effects on the sow. Use the farrowing rate loss sheet as shown in chapter 5 to record the observations.

Clinical signs
The time in the reproductive cycle when the discharge is seen is important particularly between 14-21 days post-service. The lips of the vulva of each sow should be parted daily and any tackiness or small discharge noted. The sow should be marked and if she repeats a problem may be developing. Note also the periods when it is quite normal for the sow to show evidence of a slight discharge. (Fig.6-11). Remember discharging sows may be pregnant and always pregnancy test before culling. The types of discharge are shown in Fig.6-12.
Fig.6-13 shows the reproductive performance of 42 sows in a herd that had a discharge problem and this highlights the fact that only 28% of the sows farrowed, and 62% of them repeated. Most of the animals had 5 or more litters. It is important therefore to cull such animals because farrowing rates of only 50-60% are achieved to matings. The response to treatments is poor.
Records
Diagnosis
An initial diagnosis is made from observations of vulval discharges commencing 10 days post-service and associated with a loss of pregnancy. Leptospirosis caused by Leptospira bratislava/muenchen, particularly in gilts, can cause discharges post-service, particularly if there is early embryo loss (14-25 days) and absorption. Brucellosis also causes vaginal discharges following absorption.
Examination of records can help in differentiating between infectious and non-infectious causes of infertility as shown in Fig.6-16.
Post mortem examinations on sows with heavy discharges are not particularly helpful. Post mortem examination of 47 discharging sows within seven days of the event showed only 12 with an infection actually in the womb. (Fig.6-17). This is because by the time sows can be slaughtered and the wombs examined they have come into oestrus which has the effect of resolving and removing the pus from the womb. In spite of this most sows still remain infertile
During the period of oestrus and whilst oestrogen levels are high it is difficult to infect the womb. However, as oestrogen levels drop and the levels of progesterone rise the womb becomes susceptible to infection.
It is likely that over a period of time in problem herds, certain opportunist bacteria gradually predominate in the preputial sac of the boar, the vagina and the environment.
If matings take place towards the end of the heat period with high levels of infection persisting at the cervix, the risk of ascending infection becomes high.
The major predisposing factors leading to the development of a vulval discharge problem include:
Treatment
Treatment of the boar
Discuss these methods of treatment as outlined in Fig.6-19 and Fig.6-20 with your veterinarian.
Treatment of the sow
Discuss these methods of treatment as outlined in Fig.6-19 and Fig.6-20 with your veterinarian.
Management control and prevention
Vulval discharges are common within 3-4 days of farrowing when a thick viscous material may be excreted. If the sow is healthy, the udder is normal and there is no mastitis, ignore it. It is common practice to inject such sows, but his is not necessary under these circumstances. Always be mindful that with a heavy smelling bloody discharge there may be a retained piglet or afterbirth.

The changes that take place are shown in Fig.6-14 and highlight increases in repeat matings, sows not in-pig and discharges, but a proportion of sows will discharge and remain in-pig. In these cases infection arises from either the vagina or the bladder. Doubtful or negative pregnancy tests at 30 and 40 days increase, but levels of abortions, litter size and sow health remain normal.

The bacteria causing reproductive tract infections are shown in Fig.6-15. The main organisms associated with endometritis and vulval discharges are opportunist invaders. In some herds no specific organism can be identified, although bacteriological tests may show one or more bacteria predominating either in the prepuce or vagina. A precise diagnosis can be difficult.

Field studies have identified the following factors that do not appear to be associated with post-mating vulval discharges and infertility and these include:
Artificial insemination does not appear to be a major part of the complex because its use in problem herds does not necessarily solve the problem. Bladder/kidney infections do not cause pregnancy loss, unless the sow is ill, when abortion or death may occur. Generally, there is no relationship between discharges seen in lactation and those seen post-service with loss of pregnancy. Likewise, assistance at farrowing does not appear to affect a post-service problem.
Management control is carried out by changing and improving the factors considered important on the farm.
This is carried out in three phases:

You are advised to discuss aspects of treatment with your veterinarian but there are three methods, antibiotics installed into the prepuce, by injection into muscle or by mouth. (Fig.6-19). The latter can be best carried out using in-feed premixes and placing a small amount on the food daily for ten days. The boar could be injected with long-acting antibiotic preparations, but this should be avoided if possible because he can become needle-shy. If leptospirosis is suspected as an initiating factor injections of streptomycin should be given daily for 3 days and this repeated monthly for 5 occasions. Streptomycin is not available in some countries.

The most effective method is to insert an antibiotic into the anterior vagina up to the cervix (but not actually into it). A 3ml dose of most injectable antibiotics can be used the selection being dependent upon the bacteriological examinations and sensitivities. A disposable AI catheter of small diameter, or a cattle AI catheter can be used. Shorten it by approximately 150mm. Attach a syringe with an adapter. Fill the catheter and syringe completely with the antibiotic. The catheter should then be gently inserted as far as the cervix but not into it and the antibiotic can then be deposited easily. This can be carried out 6-24 hours after the last mating. It is important however, when adopting this procedure to always monitor the results for any adverse effects over the first three weeks in respect of both discharges and return rates. An alternative method of medication is to top dress the feed of the sow from weaning to 21 days post-service. In herds with major problems it may be necessary to medicate all breeding females for a period of ten days with in-feed medication using the appropriate antibiotic.





