Complete bladder eversion in periparturient Nellore cow - case report

ABSTRACT Partial or complete bladder eversion is a rare condition of poor prognosis in cows, commonly associated with intense tenesmus observed in the peripartum period. A 14-year-old obese Nellore cow at 280 days of gestation was referred with 24-hour bladder prolapse. The bladder was complete eversion through the vulvar vestibule showing a thick congested wall and small residual urine volume. After clinical examination, the cow received scopolamine butylbromide and intercoccygeal epidural anesthesia, and the externalized bladder segment was partially reduced, remaining only 10 cm externalized. The cow was maintained with an intravesical human gastric tube number 16 and constant monitoring. The eversion was fully reduced after 12 hours of local treatment, and as the cow presented subclinical ketosis, hypocalcemia and cystitis, antibiotic, glucose, calcium and propylene glycol therapy were performed. We opted for induction of parturition, and after 24 hours, a healthy 52kg calf was born and the placenta was delivered 16 hours after calving. The cow and calf were discharged on the sixth day of hospitalization, with no recurrences or secondary complications after treatment.摘要：奶牛部分或完全性膀胱外翻（bladder eversion）是一类预后不良的罕见病症，常与围产期（peripartum period）出现的剧烈里急后重（tenesmus）相关。本次病例为1头妊娠280天的14岁肥胖内洛尔牛（Nellore），因膀胱脱垂持续24小时被转诊。患牛的膀胱经外阴前庭完全外翻，可见膀胱壁增厚且充血，残余尿量较少。经临床检查后，该牛接受了丁溴东莨菪碱（scopolamine butylbromide）与尾间硬膜外麻醉（intercoccygeal epidural anesthesia）治疗，外露的膀胱段得到部分还纳，仅残留10cm于体外。随后为该牛留置16号医用胃管进行膀胱内引流，并实施持续监护。经12小时局部治疗后，膀胱外翻完全还纳；因该牛并发亚临床酮病（subclinical ketosis）、低钙血症（hypocalcemia）与膀胱炎（cystitis），遂给予抗生素、葡萄糖、钙剂及丙二醇（propylene glycol）进行治疗。我们选择对其实施诱导分娩（induction of parturition），24小时后产下1头健康的52kg犊牛，犊牛出生16小时后胎盘顺利娩出。住院第6天时，母牛与犊牛均康复出院，后续未出现复发或继发并发症。