Equis ISSN 2398-2977

Metritis-laminitis-septicemia complex

Contributor(s): Carla Sommardahl

Introduction

  • Cause:
    • Sequelae to retained placenta or any gross contamination of the uterus during foaling.
    • Severe bacterial infection in the myometrium   →   systemic bacterial +/- toxin absorption, septicemia and peripheral vascular changes   →   laminitis.
    • Parturition abnormality, including retained placenta, especially in draft breeds.
  • Signs: increased vulval discharge, severe systemic illness and toxemia, laminitis, occasionally death.
  • Treatment: includes therapy for retained placenta   Placenta: retained  , uterine lavage, systemic antibiotics, NSAIDs, IV fluid therapy and acute laminitis treatment   Foot: laminitis  .
  • Prognosis: guarded.

Pathogenesis

Etiology

  • Delayed involution.
  • Severe bacterial infection including anaerobes, egBacteroides fragilis Bacteroides fragilis.

Predisposing factors

General

Specific

Pathophysiology

  • Sequele to retained placenta or any gross contamination of the uterus during foaling, eg dystocia   Reproduction: dystocia  .
  • Infection of endometrial, myometrial and occasionally serosal layers   →   septicemia and possible secondary consequences, eg laminitis   Foot: laminitis  .
  • Gross contamination of the uterus at foaling +/or retained placenta   →   delayed uterine involution, increased autolysis of the placenta and severe bacterial infection.
  • The uterine wall becomes thin and friable   →   disruption of the endometrial barrier   →   allows myometrial +/- serosal infection.
  • The toxic metritis allows absorption of bacteria and bacterial toxins   →   subsequent septicemia/toxemia + peripheral vascular changes   →   laminitis.
  • Death can occur in severe fulminating cases.

Timecourse

  • 12-24 h onwards.

Diagnosis

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Treatment

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Prevention

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Outcomes

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Further Reading

Publications

Refereed papers


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