ovarian cysts in the cow - orbi: home ovarian cys… · prof. ch. hanzen–ovarian cysts in the cow...

Prof. Ch. Hanzen – Ovarian cysts in the cow -Salamanca 8th may 2008 1

Ovarian cysts in the cow

Professor Ch. Hanzen

University of Liège

Faculty of Veterinary Medicine

Department of Pathology of Reproduction

B42 Sart Tilman, 4000 Liège

E-mail : [email protected]

Web site : www.fmv.ulg.ac.be/oga


Contents

● Definition

● Frequency

● Diagnosis

● Etio-pathogeny

● Treatment

● Conclusions


Definition


mm

2

8

10

12

14

16

1818

44

66

Recruitment phase :

prepuberty, postpartum

Growth phase :

puberty, pregnancy, postpartum

Preovulatory phase

Post-partum

Reproduction period

Puberty

Reproduction

periods and

anovulation


11 22 33 44 55 66 77 88 99 1010 1111 1212 1313 1414 1515 1616 1717 1818 1919 2020 2121 2222

mmmm

00

22

44

66

88

1010

1212

1414

1616

1818

Follicular reserve

1st group : recruted follicles

4rd group :

Preovulatory follicle

3rd group :

dominant follicle

Ovulation

Follicular

cyst

Luteinized

follicular

cyst

Cyst = abnormal follicular growth

2nd group : selected follicles

Three evolutions :

- Atresia

- Ovulation

- Cyst


So, the cyst is an abnormal ovarian structure …

� In 30 to 40 % of cases : cyst coexists with a CL

1. Absence of corpus luteum

� Duration of dominance : 5 to 6 days

2. More than 1 week

� In the cow, ovulation between 13 to 19 mm

3. Diameter more than 20 to 24 mm


Frequency


Frequency of ovarian cysts amongst different studies (1974 to 1994)

0 2 4 6 8 10 12 14 16 18

**

**


Frequency of ovarian cysts

● Fourichon et al., 2000 : meta-analysis (20.000 cows in 196

dairy herds) : 12 % (3 to 29 %)

● Lubbers 1998 (Holland) : 12.626 lactations during 10 years in

39 herds 7,2 % (1,9 to 11,3 % amongst herds)

● Erb et Martin, 1980 and Kinsel et Etherington, 1998

(Canada) 24.356 lactations : 9,3 %

More than 10 % : herd problem


Evolution with timeLopez-Gatius et al. Is fertility declining in dairy cattle ? A retrospective study in northeastern

Spain Theriogenology, 2003, 60, 89-99.

4 dairy farms

0

1

2

3

4

5

6

7

8

9

1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 Tot


Diagnosis

- Manual palpation

- Ultrasonography

- Hormones

- Ethology


Manual / US diagnosis

Follicular cyst

Luteinized cyst

Diameter : 31 ± 4 mm to 33 ± 7 mm

(if > 24 mm : Hanzen and Bascon 2007)

Easily depressed

Thin wall (< 3 mm)

Cavity anechogenous

Ovary

Cavity less large (24 to 49 mm)

and anechogenous

Diameter : 35 ± 7 mm to 39 ± 9 mm

(if > 24 mm : Hanzen and Bascon 2007

Thick wall (3 to 9 mm)

Less easily depressed


Caracteristics of cysts


Caracteristics of cysts (ultrasonography)

20 mm20 mm


Luteinized cyst an corpus luteum with cavity

20 mm


Diagnosis (hormones)

« high » : 1,08 et 10,4 ng/ml low : 0,13 et 2,1 ng/ml Progestérone

Oestradiol low or high low

Anoestrus or nymphomania

LC FC

> 0,5 or 1 ng/ml


Courtesy Prof Badinand ENV Lyon


Etio-pathogeny


Risks factors of ovarian cysts and their interrelationships in the cow

Negative energy balance Nutrition

Follicular

wallEnvironmentHypothalamo-

hypophysis

complex

Animal

Low

progesteronemia

Modification

of – FB of oestradiol

on cyclic LH

Lack of tonic LH

inhibitionModification of oestradiol

receptors

Abnormal production

of growth factors

Abnormal production of

proteines by cellular matrix

Number of lactation

Milk production

Stage of postpartum

Puerperal diseases

Genetic

Decrease of leptine IGF1 decreaseHypoglycemiaHypoinsulinemia

GnRH decrease

Increase of NEFA and

cetones

GnRH inhibition by

neuropeptide Y

Increase of LH inhibition

by alpha MSH and

endorphines

Decrease of LH/FSH

Cortisol

LH

inhibition

Season

Stress


Hormonal pathogeny

of ovarian cyst in the

cow

Tonic

LH

Hypothalamus

Progesterone

(0.1 à 1 ng) Growth

stimulationH

ypophysis

Wave 1

Oestradiol

Inhibine

1

2

3

4

Cyclic

LH

5

Impaired

ovulation

6

Cyst9

FSH

7

8New wave


Frequency (%) of cysts according to stage of postpartum (days)

(Whitmore et al. 1974, Wiltbank et al. 1953, Whitmore et al. 1979, Erb et White 1981, Kirk et al. 1982)

0

5

10

15

20

25

30

0-15 16-30 31-45 46-60 61-75 76-90 91-105 106-120 121-135 136-150 >150


Treatments

- To treat or not to treat ?

- Preventive treatments

- Non hormonal curative treatments

- Hormonal curative treatments

- individual approach

- hormonal associations


To treat or not to treat : that’ the question

● Stage of the postpartum period

� Lenght of the waiting period decided

� Diagnosis during the reproduction period

● Spontaneous regression of cysts

� 28 to 80 % before d60 of postpartum

● Accuracy level of the diagnosis : follicular vs luteinized

● Efficacy of the treatment : different parameters

� Interval treatment-pregnancy

� Fertility index after treatment

● Cost of the treatment

● Preventive or curative treatment


Preventive treatments

● Association of GnRH and PGF2a (10d apart) at d15

postcalving

● Decrease the frequence of placental retention, endometritis,

lameness

● Regular control of the BCS to prevent a NEB

● Genetic selection ?


Non hormonal curative treatments : manual ruptureLopez-Gatius personal communication

Effect of manual rupture of

a cyst on the oestrus return

rate in the 14 days after

treatment (388 dairy cows)

0

5

10

15

20

25

30

35

40

GnRH and

MP

PGF2a and

MP

MP


Non hormonal curative treatments : manual rupture

Lopez-Gatius personnal communication

● Effect of manual rupture

of a cyst on the

pregnancy rate at first

AI after treatment

(10.634 lactations)

● Oestrus observed 6,8

days after treatment in

36 % of cows

20

22

24

26

28

30

32

34

PGF2a and MP MP


Hormonal curative treatments : general objective

To obtain as soon as possible a new follicular

growth with expulsion of a mature oocyte


Hormonal curative treatments : three steps

to obtain

a P4 phase

to assume ovulation

of the dominant

follicle

to stop the P4 phase

and assume

the final follicular

growth

hCG

GnRH

PRID

CIDR

PGF2a Remote of

PRID

CIDR

hCG

GnRH

1 2 3


Hormonal treatment steps of a follicular cyst

Endogenous synthesis of P4

hCG or GnRH

CL

3 ?

2

1

LH effect

Luteinization

if receptors

Ov

Ov PGF2a

7 to 14 d

Oestrus

GnRH

Increase of P4

7 to 20 days

70 to 90 % of cases

2 to 5 d


Hormonal treatment steps of a follicular cyst

Effect of an exogenous administration of P4

Progesterone treatment (7-12 days)

6 to 24 h

1

Oest R HPTH

- GnRH

+

LH

+

New wave

and DF ?

2

Increase of oestradiol

and LH receptors

3

4

Oestrus

(0 to 66 %)

Ovu


Hormonal treatment steps of a luteinized cyst

PGF2a

Oestrus

GnRH

2 to 5 d


Hormonal associations

Justifications :

- difficulty to make a differential diagnosis between cysts ?

- decrease time between treatment and pregnancy ?


Some hormonal associations

1. hCG or GnRH (d0) – PGF2a (d7 or d14)

2. GnRH and PGF2a (d0) – PGF2a (d14)

3. hCG (d0) – PGF2a (d7 to d12) – GnRH (d9 to d14)

4. hCG or GnRH(d0) – Progesterone (d7 to d14 or d16) –

PGF2a (d14 or d16) – GnRH (d16 or d18)

5. Ovsynch : GnRH (d0) – PGF (d7) – GnRH (d9)


2 to 5 dOB

Oestrus

Hormonal association : Progesterone with OBZulu et al. J. Vet. Med. Sci., 2003, 65, 57.

Douthwaite et Dobson Vet Rec. 2000, 147, 355

Progesterone treatment (12 d)

PR : 18 to 23 %

PR : 14 to 28 %

AI OD

LH


GnRH

Oestrus

Hormonal association : GnRH-progesterone-PGF-GnRH

Bartolome et al. Theriogenology, 2005,63,1643-1658.

CIDR (7 days)

PGF2a d7 GnRH d9 PR : 38 %

PR : 27 %GnRH d9PGF2a d7

TAI 16 h


Hormonal association : GnRH-PGF-GnRH (Ovsynch)

16 – 24 h

AI

GnRH

0 7

PGF2a

9

GnRH


Bibliography : Ovsynch and treatment of ovarian cysts

1. Bartolome et al. Theriogenology, 2000 , 53, 815- 825

2. Lopez-Gatius et Lopez-Bejar. Theriogenology, 2002, 58, 1337-1348

3. Bartolome et al. Theriogenology, 2003, 59, 1991-1997

4. Bartolome et al. Theriogenology, 2005,63,1628-1642

5. Bartolome et al. Theriogenology, 2005,63,1643-1658

6. Crane et al. Theriogenology, 2006, 65, 1563-1574

7. Crane et al. Theriogenology, 2006, 66, 1243-1248

8. De Rensis et al. Theriogenology, 2008, 69: 481-484.


Ovsynch and treatment of ovarian cysts (8 studies and 792

cases of cysts between year 2000 and 2008)

0

5

10

15

20

25

30

1 2 3 4 5 6 7 8 Total

% of pregnancy rate


Comparison of hormonal treatments of cysts (Hanzen et al. 2008)

3089GnRH(J0)-Ovsynch(J8)

17791OVSYNCH

22 to 3665GnRH-PGF (J0)-PGF(J14)

8 to 1662GnRH (J0)-PGF(J14)

14 to 2863PRID (12d) + OB

PR (%)NTreatment


Comparison of hormonal treatments of cysts (Hanzen et al. 2008)

2711CIDR(J0-J7)-PGF(J7)-GnRH(J9)

23 (CR)82CIDR 7J-PGFJ7

17791OVSYNCH

22 to 3665GnRH-PGF (J0)-PGF(J14)

8 to 1662GnRH (J0)-PGF(J14)

14 to 2863PRID (12d) + OB

PR/CR (%)NTreatment


Conclusions : to take home

1. Accuracy of ultrasonography diagnosis (> 24 mm)

→ Importance of correct diagnosis for quantification

2. Herd problem if > 10 %

→ Importance of HHM system

3. Impact of NEB in dairy cows and postpartum diseases

→ Importance of preventive approach

4. Poor results of hormonal therapy

→ Importance of quality and time of diagnosis

ovarian cysts in the cow - orbi: home ovarian cys… · prof. ch. hanzen–ovarian cysts in the cow...

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