|
Table of metritis score definitions and examples of present usage in practice. |
|||
| Scores |
Clinical signs - vaginal examination |
Cases |
|
|
|
|||
| Practical scoring |
Decision making on treatment |
||
|
|
|||
| 0 |
None or very small amount of clean mucous discharge - no odour |
L elaborates on the use of score 0: "Well, some should maybe have been 1 or 2. The score 1 I have never used." L scores all cows with a normal puerperal discharge 0. |
|
|
|
|
||
| 1 |
A very small amount of bloody mucous discharge - no odour |
||
|
|
|
||
| 2 |
Small amount of bloody mucous/grey discharge - no odour |
||
|
|
|
||
| 3 |
Large amounts of bloody seromucous/grey-yellow discharge - scabs on tail - no odour |
J: "I use 2 - which means I will not treat, but I would like to see the cow again for control [...] I could use 3-4. But I just use 2, and the farmer knows what it means". J uses 0 for cows that are immediately characterized as non metritic. |
|
|
|
|||
| 4 |
Large amounts of grey/yellow seromucous discharge - no abnormal odour |
K: "My metritis score 4. It is when there is plenty of discharge, that smells and there is no temperature". J: "I can not differentiate as sharp as it is suggested by the system, so I only use 5-7-9". |
A uses 4 and rectal temperature as a minimum threshold for metritis treatment. |
|
|
|
||
| 5 |
Little to medium amounts of purulent discharge - difference in consistency and colour - smell abnormal |
L uses the combination of score 4 and a flaccid uterus by rectal examination to initiate treatment with prostaglandin. |
|
|
|
|
||
| 6 |
Medium amounts of discharge - difference in texture and colour - smell abnormal |
K, I, E, J & B are explicitly using 5 as a minimum threshold for treatment. |
|
|
|
|||
| 7 |
Medium to large amounts of discharge - beginning to look red-brownish - stinks |
I: "I have never given a cow score 9 if she was not very ill. We saw a cow I gave 8 [...]If she had had sunken eyes I had probably given her 9 with the same vaginal findings" |
D, C, L, & H using a variable threshold for treatment and makes individual decision on individual cows based on multiple clinical criteria (incl. metritis score). |
|
|
|
||
| 8 |
Large amounts of greyish discharge - stinks |
K's scoring is influenced by rectal temperature: the higher temperature, the higher metritis score. |
H attempts to exclude score 8-9 from the scale: "If they have a cow there is as sick as 8-9 they should call in advance. " |
|
|
|
||
| 9 |
Large amounts of brown-yellow/brown discharge- typically a retained placenta - "smells like h...!" |
||
|
The table explains the metritis scores with definitions. Cases from the interviews are given to demonstrate how the scores are used in a practice context, and how they are used during decision making for determining treatment threshold for metritis. Capital letters refer to specific veterinarians. | |||
Lastein et al. Acta Veterinaria Scandinavica 2009 51:36 doi:10.1186/1751-0147-51-36 |
|||