Testing non-antibiotic procedures to treat clinical endometritis in dairy cows

Nuria García

Clinical endometritis is defined as purulent or mucopurulent uterine discharge present in the vagina after 21 days postpartum, and it is associated with tissue damage, delayed uterine involution, disruption of endometrial function, and perturbation of ovarian cycles.

The main bacteria associated with clinical endometritis are Escherichia coli, Trueperella pyogenes, Fusobacterium necrophorum, and Prevotella species. Traditionally, intrauterine broad-spectrum antibiotics such as oxytetracycline have been used for treating clinical endometritis. However, this practice increases the risk of antibiotic residue presence in milk after intrauterine infusion, and the emergence of multidrug resistance bacteria.

A recent study published in Reproduction in Domestic Animal evaluated the efficacy of traditional and alternatives treatments for clinical endometritis in a large commercial dairy herd in Iran. Between 28 and 35 days in milk (DIM), the researchers Rahim Ahmadi et al. (2019) evaluated 3,819 lactating Holstein cows for clinical endometritis, and scored their vaginal discharge on a 0–3 scale as follow:

  • 0 = normal uterine discharge.
  • 1 = flakes of purulent exudates in the uterine discharge.
  • 2 = >50% of the uterine discharge is made up of purulent exudates.
  • 3 = hemorrhagic uterine discharge mixed with purulent exudates.

Cows were housed in free stall barns and their average milk production was 50 kg.

The incidence of clinical endometritis was 41.5% (score 1-3) and the affected cows were assigned to one out of the four following treatments:

  1. Intrauterine infusion of 5 g/cow of 10% oxytetracycline using a disposable transcervical pipette.
  2. Intrauterine infusion of 200 ml of a 50% dextrose solution.
  3. Intrauterine injection with 100 ml of liquid paraffin.
  4. Intramuscular injection of prostaglandin F2-alpha (500 mg of cloprostenol sodium).

After 50 days postpartum, all cows received a synchronization program such as G6G, heatsynch and ovsynch. In the oxytetracycline treatment group, the odds ratio for conception at first insemination and pregnancy rate at ≤ 100 DIM were close to healthy cows. However, cows treated using alternative procedures had a lower reproductive performance than untreated cows (score 0). Compared to healthy cows, cows treated with dextrose and liquid paraffine had a lower likelihood of pregnancy at first insemination (odds ratio: 0.70 and 0.60, respectively) and a lower pregnancy rate at ≤ 100 DIM (odds ratio: 0.79 and 0.50, respectively). Cows treated with prostaglandin F2-alpha; however, had a similar odds ratio for conception at first breeding but the odds ratio for pregnancy rate at ≤ 100 DIM was lower (0.80) than in healthy cows.

In conclusion, according to the results from this work, the use of non‐antibiotic procedures of intrauterine infusion of dextrose 50% or liquid paraffin or injection of prostaglandin F2-alpha is not effective for treating high-producing dairy cows with clinical endometritis.


Mohammad Rahim Ahmadi, Meysam Makki, Abdolah Mirzaei, and Hamid Reza Gheisari. 2019. Effects of hypertonic dextrose and paraffin solution as nonantibiotic treatments of clinical endometritis on reproductive performance of high producing dairy cows. Reprod Dom Anim. 54:762–771.

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