Metritis is one of the most common fresh cow diseases. Approximately 12-20% of dairy cattle are affected by this disease in the first part of their lactation. Commonly seen about 10-14 days after calving, a foul-smelling, brown-to-red discharge from the vulva frequently diagnoses metritis. Other symptoms include fever, lower milk production, and decreased reproductive performance. While the uterus is usually a sterile environment, calving can introduce bacteria, which can lead to metritis. Dystocia and twins can increase the likelihood of bacteria entering the uterus. Many cows are only infected with a low level of bacteria, and their immune systems can rapidly clear any contamination. Some cows may have complicating factors such as a retained placenta, metabolic disease, or weakened immune system, which leads to them developing metritis that they cannot clear on their own. Generally, E. coli is the inciting cause of the disease, with certain strains well adapted to the uterine environment. Other bacteria often involved include  fusobacterium and trueperella.

Treatment of metritis usually includes a systemic antibiotic and supportive care. Antibiotics most commonly used are tetracyclines and ceftiofurs. Supportive care often involves fluid therapy and anti-inflammatories. Prostaglandins are also used to help clean out the uterus as it induces estrus and some uterine contractions. Prostaglandins can also help the cow cycle again after clearing the infection. Previously, uterine infusions were used to treat the infection at the source. Now it has been shown that these infusions can introduce more bacteria and prolong the disease.

While treatment is often necessary, prevention should be the primary focus regarding metritis. Most farms can take many simple steps to reduce the incidence of metritis. Keeping a clean calving pen is probably the most important prevention step. Ensure calving pens are not overcrowded, they are cleaned, and new bedding is provided frequently so that the pen stays dry. Prevention can also be started long before calving time. Cows that are in good body condition and not over-conditioned will be less likely to develop metabolic diseases contributing to metritis. Management of the close-up dry cow pen is also very important. Ensure it is not overcrowded and cows have adequate bunk space of at least 30 inches per animal. Good ventilation and air movement are also important in reducing stress. Working with a nutritionist can ensure that your cows receive the proper nutrients to reduce hypocalcemia and ketosis, which can complicate metritis. It is also important that the fresh pen has adequate bunk and lying space and that the nutrition supports a high-producing animal. Vaccines may also be developed in the future to reduce the risk of metritis.

Metritis can be a costly and frustrating disease. However, through appropriate treatment and prevention efforts, cattle can overcome metritis and continue to be productive members of the herd. Work closely with your veterinarian to develop prevention, diagnostic, and treatment strategies to ensure success in fighting metritis.