RECTAL EXAMINATION IN BOVINES

At present, the most cost-effective and accurate method of examination of the reproductive tract is per rectal palpation of the cervix, uterus, ovaries and supporting structures.

Rectal examination involves -
Examination for pregnancy 
Examination for non pregnancy

RECTAL EXAMINATION IN BOVINES
Rectal examination in bovines


EXAMINATION FOR PREGNANCY

Pregnancy diagnosis is based on detection of the physiological changes of the genital organs associated with pregnancy.
The uterus is the organ mainly involved and the positive signs of pregnancy include-
Palpation of amniotic vesicle
Palpation of fetal membrane slip
Palpation of placentomes
Palpation of fetus 


NORMAL NON-PREGNANT REPRODUCTIVE TRACT

The size, muscular tone and contents of the uterus should be assessed.
This can be done simultaneously with the “membrane slip” for pregnancy determination.

Commonly used terms for characterizing uterine tone include the following: 

Estrus tone: a turgid, contracted uterus that is often curled into a rather tight configuration
 
Diestrus (“normal”): a relaxed muscular uterus
 
Edematous: a somewhat turgid uterus but without muscular contraction; may be palpable for a few days after estrus
 
Flaccid: a limp, soft, usually thin-walled uterus that does not contract in response to palpation
 
Thickened (“doughy”): a pathologic description, indicating thickening of the endometrium and possibly the myometrium as well 

Fluctuant: uterus in which there is intra luminal fluid


Post Parturient Involution

Pregnancy and involution represent the only two clinically appreciable physiological alterations of size. In pregnancy, the size progressively increases while during the involution period, the size of the uterus regresses and returns to the non pregnant state.

During routine post partum examinations in cases in which pregnancy diagnosis is negative or in examination of “problem cows,” the reproductive tract should be examined for palpable abnormalities. The essential questions for the examiner to answer are the following: 

Is the uterus symmetrical and approximately the size and tone of the non gravid tract? 

Is there a corpus luteum or an ovarian follicle associated with corpus luteum or an ovarian follicle associated with increased uterine tone that is indicative of cyclicity? 

Are there any palpable lesions of the reproductive tract?

Uterine Inflammation -
It is generally possible to diagnose moderate to severe endometritis, acute metritis or pyometra by rectal examination.

Adhesions -
 On rectal examination it would be possible to detect the presence of uterine or utero-ovarian adhesions that would interfere with normal retraction of some part of the tract. 

-Commonly, the uterus will adhere to the rumen, the omentum or the ovarian bursae. 
-Prognosis depends on the severity of adhesions and the degree of involvement of the oviducts and fimbriae

Abscesses -
 Uterine abscesses can occur  following dystocia ,  as a sequel to the improper use of an intrauterine pipette. 
 Location and size of the abscess varies depending on the degree of mechanical insult in the former and the degree of endometrial/ myometrial insult in the latter. 
 
Abscess is most often located in the area of the uterine body and is approximately the size of a golf ball and in either case the abscess is firm and raised and may cause discomfort when palpated.
 Adhesions of the abscessed portion of the uterus to other abdominal or pelvic organs are common.

Tumors -
 Tumors of the bovine uterus are not common but when seen occur predominantly in older cows. Uterine lymphosarcoma, leiomyoma and rarely carcinoma have been diagnosed. 
 Lymphosarcoma may be detectable as multiple smooth nodular enlargements of the uterine wall, often with concurrent enlargement of the deep inguinal and iliac lymph nodes.

Fetal Remnants 
 Occasionally, a fragment of an autolyzed term fetus may remain in the uterine lumen following parturition 
 Can be detected as a moveable firm mass in the lumen of an involuting uterus. A foul vaginal discharge will often be noted. 
 Cows or heifers that do not calve at the expected time following a positive pregnancy diagnosis may have either a mummified or macerated fetus. 
 In cases of fetal maceration, a distended uterus with palpably crepitant fetal bones can be felt. An ipsilateral CL may be present, as well as a fetid vaginal discharge. 
 The prognosis for future fertility of such cows is grave due to severe damage to the endometrium .

Freemartinism -
 In Freemartinism the cervix is rudimentary while the uterus is underdeveloped and characterized by the presence of two thin walled, very narrow tubes occupying the sites of the normal horns, suspended in ligamentous sheets resembling the broad ligaments 
 Lateral exploration along the edge of the broad ligaments leads to location of barely perceptible thickening indicating the rudimentary ovary 
 Failure to locate the normal cervix during the course of rectal examination should always be followed by a thorough exploration for signs of freemartins.

White Heifer Disease-
 Also known as segmental aplasia of the Mullerian duct 
 The extent of aplasia and the number of the missing segments is variable  

Secretion of the normal segments becomes entrapped between the missing segments or anterior to the missing part, resulting in marked distension of the normal segment associated with thinning of the wall. Persistence of the “hymen,” one of the forms of white heifer disease, results in accumulation of secretion in the anterior part of the vagina, with consequent dilation which elicits tenesmus. 

Uterus Unicornis -
This relatively rare abnormality has been found in practically all breeds. 
 The horn that is present is functionally normal and conception is possible only during an estrus when the follicle develops and ovulates occurs in the ovary on the side of the normal horn 
 Reduced fertility can be anticipated. 

Cervix Duplex or Double Cervix-
 This also is a rare abnormality. The presence of two cervices, resulting in two single tube genital tracts anterior to the vagina, might cause temporary confusion in the examiner’s mind. Diagnosis, however, is easy . 
Fertility of the affected animal does not have to be impaired if natural breeding is employed.
Artificial insemination might result in failure to conceive unless the ovary carrying the follicle ready to ovulate is detected and the semen is deposited in the cervix of the same side. 
 Bilateral insemination in the double cervices might also be recommended.