Endometritis in Dairy Cows: Causes, Symptoms, Treatment and Prevention

Endometritis — inflammation of the uterine lining (endometrium) — is one of the most common reproductive diseases in dairy cattle and a direct drain on farm profitability. Affected cows take longer to conceive, extend their lactation cycle unnecessarily, and in severe cases never become pregnant again. Globally, 20–30% of dairy cows develop endometritis after calving (Journal of Dairy Science, 2021). In Uzbekistan, that figure may be higher, because systematic postpartum monitoring, proper obstetric assistance, and structured calving management are still absent on many small farms. Early diagnosis and correct treatment allow full reproductive recovery.

1. What Is Endometritis?

Latin name: Endometritis uteri

The uterus has a protective lining (endometrium) that normally cleans itself after calving. When bacteria colonize this lining before the uterus can clear them, inflammation develops. Depending on severity and timing, the condition takes different clinical forms.

2. Causes

Endometritis is almost always connected to events surrounding calving.

Primary causes

• Dystocia (difficult birth): Birth trauma and stress suppress immune function
• Retained placenta: If the placenta is not expelled within 12–24 hours, the risk of endometritis rises sharply — to 50–70%
• Abortion: The uterus is not fully cleared of fetal and placental material
• Non-sterile obstetric assistance: Unclean hands or instruments introduce bacteria directly into the uterus
• Postpartum ketosis and hypocalcaemia: Both depress immunity and slow uterine clearance

Risk factors

3. Clinical Signs: How to Detect Endometritis

Clinical endometritis (most common form)

Suspect endometritis if any of the following are present more than three weeks after calving:

• Vaginal discharge: Yellow-green or brownish purulent material visible on the tail, rear legs, or bedding
• Foul odor: Occasionally a very strong, putrid smell from the discharge
• Discharge strings in the morning: Seen on the tail head or floor at first check of the day
• Repeated breeding failure: Cow fails to conceive after 2–3 insemination attempts
• No visible estrus: No heat signs observed by 40–60 days into lactation

Subclinical endometritis

This form cannot be detected by observation alone — it requires uterine cytology (endometrial swab examination). On farms where the first-service conception rate falls below 40%, subclinical endometritis should be considered a likely contributing factor.

Pyometra

• Uterus palpably enlarged but no estrus signs
• Corpus luteum persists, sealing pus inside the uterus
• The cow appears "permanently pregnant" — but is actually accumulating pus
• Impossible to diagnose without rectal palpation by a veterinarian

4. Specific Risks in Uzbekistan

Calving hygiene gaps: On many small farms, proper disinfection of the calving area, hands, and instruments is not practiced consistently. This multiplies bacterial contamination during delivery and obstetric assistance.

Retained placenta mismanagement: A common mistake is trying to manually pull a retained placenta. This injures the uterus further and dramatically increases endometritis risk. The correct action is always to call a veterinarian.

Nutritional deficiencies: Energy shortfalls around calving — especially during summer hay shortages — increase the risk of ketosis, which directly slows uterine clearance.

Delayed treatment: Many farmers dismiss early postpartum discharge as normal and do not seek veterinary help. By the time infertility becomes obvious — often 2–3 months later — the condition has become much harder to treat.

5. Diagnosis

Field examination

• Character and color of discharge around the vulva and tail head
• Rectal palpation by a veterinarian — assesses uterine size and tone

Laboratory

• Cytology: Definitive method for subclinical endometritis — counts inflammatory cells in the uterine lining
• Bacterial culture and sensitivity: Identifies the specific pathogen and determines which antibiotic will be effective

6. Treatment

Step one: Call a veterinarian

Endometritis treatment is a veterinary task. Deciding which preparation to use, how to administer it, and at what dose requires professional judgment. Attempting to flush or manually treat the uterus without veterinary supervision can cause permanent infertility.

Treatment options (prescribed by a veterinarian)

Intrauterine antibiotic therapy

Antibiotic placed directly into the uterus. Before selecting a preparation, bacterial culture is recommended to identify the causative organism and confirm sensitivity.

Commonly used preparations:

• Oxytetracycline (intrauterine)
• Chloramphenicol-based intrauterine preparations
• Cefapirin intrauterine (e.g., Metricure and similar products)

Prostaglandin F2α (PGF2α)

• Causes regression of the corpus luteum
• Stimulates uterine contractions, helping expel pus and inflammatory material
• First-line treatment for pyometra
• Used from 14+ days postpartum

Oxytocin

• Stimulates uterine contractions
• Most effective in the first 1–2 days after calving
• Loses effectiveness when used weeks after the initial infection

Systemic antibiotics

• Indicated in severe clinical cases or when systemic signs of infection (fever, depression, reduced milk production) are present
• Dosage and duration decided by the veterinarian

Retained placenta management

• Do not attempt to pull the placenta manually — this injures the uterus and sharply raises endometritis risk
• Call a veterinarian
• In many cases the placenta will separate on its own within 5–7 days; veterinary monitoring during this period is essential
• Preventive oxytocin or antibiotics may be considered by the veterinarian based on individual assessment

7. Impact on Reproductive Performance

Untreated or late-treated endometritis causes measurable losses at every reproductive benchmark.

Source: Journal of Dairy Science (2021)

8. Prevention

Calving management

• Disinfect the calving pen before each use — clean bedding, disinfected surfaces
• Wash and disinfect hands and instruments thoroughly before any obstetric intervention
• If delivery has not progressed after 30–60 minutes — call a veterinarian; do not apply excessive traction
• Maintain a clean, dry, low-stress calving environment

Postpartum monitoring

• Check daily that the placenta has been expelled after calving
• If placenta is retained beyond 12–24 hours — call a veterinarian
• Observe the vulva and tail head area for discharge for at least 3 weeks postpartum

Nutritional optimization

• Feed a transition diet (specifically formulated for the dry-off to fresh period) during the 3 weeks before and after calving
• Ensure adequate calcium, phosphorus, vitamin E, and selenium — all support immune function and uterine clearance
• Prevent ketosis and hypocalcaemia; both are primary drivers of prolonged uterine infections in Uzbekistan's production conditions

Vaccination

• BVD, IBR, and Leptospirosis vaccines reduce the incidence of reproductive disease
• Booster vaccination 3–4 weeks before calving

9. Economic Impact

Endometritis costs money through multiple channels simultaneously.

Quick Reference: What Should the Farmer Do?

Around calving:

1. Prepare the calving pen in advance — clean, dry, disinfected
2. If delivery exceeds 1 hour — call a veterinarian
3. If placenta is not expelled within 24 hours — call a veterinarian; do not pull it

Postpartum monitoring:

1. Check the vulva and tail head daily — is there discharge?
2. If purulent discharge is visible 3 weeks after calving — call a veterinarian
3. If no heat signs are observed by 50–60 days postpartum — call a veterinarian

Frequently Asked Questions (FAQ)

1. Can a cow with endometritis become pregnant?

In mild clinical cases, yes — after successful treatment. In severe or chronic cases, the prognosis is guarded and permanent infertility is possible.

2. How long is postpartum discharge considered normal?

Reddish-brown discharge during the first 1–2 weeks after calving is normal (lochia). Yellow-green purulent discharge visible after 3 weeks is a sign of endometritis.

3. Is it safe to manually remove a retained placenta?

No. Manual removal tears the placentomes, damages the uterine lining, and greatly increases infection risk. Always call a veterinarian instead.

4. How long does treatment take?

Endometritis caught early may respond in 1–2 treatment courses. Pyometra and chronic cases can require 1–2 months of management.

5. Is a cow that had endometritis at higher risk in subsequent pregnancies?

Yes. Prior endometritis is a recognized risk factor for recurrence. Cows with a history of endometritis should be monitored especially carefully after every calving.

6. Can subclinical endometritis be detected on a commercial farm?

It requires uterine cytology, which means a veterinary farm visit. If your herd first-service conception rate is consistently below 40%, a systematic cytology survey is worth the investment.

7. What role does nutrition play in prevention?

Good body condition at calving (BCS 3.0–3.5), adequate calcium and energy during the transition period, and prevention of ketosis all directly support faster uterine clearance and lower endometritis incidence.

Conclusion

Endometritis is one of the most economically damaging diseases on Uzbekistan's dairy farms — and one of the most frequently overlooked. The most powerful tools against it are proper calving hygiene, prompt response to retained placenta, and systematic postpartum monitoring. When caught early, the prognosis is good and the cow can return to full reproductive function. Tracking each cow's calving history, placenta expulsion time, and reproductive cycle in a platform like FarmOps makes early detection far more reliable.

Sources and References

1. Journal of Dairy Science (2021). Uterine Disease and Subsequent Fertility in Dairy Cows. Vol. 104, Issue 5.
2. Merck Veterinary Manual (2023). Metritis, Endometritis, and Pyometra in Cattle. merckvetmanual.com
3. Cornell University (2022). Postpartum Uterine Disease Management in Dairy Cows. dairy.cornell.edu
4. USDA NRCS (2021). Reproductive Management in Dairy Cattle. nrcs.usda.gov
5. FAO (2020). Reproductive Management in Dairy Cattle for Smallholders. fao.org