In the first two parts of this series, we discussed the possible causes of uterine torsions, presenting clinical signs, and potential complications associated with this condition. We also discussed why it is critical to call your vet right away to increase the chances for a positive outcome. In this article, I would like to discuss some of the ways veterinarians can correct this problem.
The first step is to determine the direction of the torsion, clockwise or counterclockwise, and degree of rotation: 180, 270, or 360. If the cervix is closed off and the calf cannot be felt, then two options are to do a Cesarean Section, or to literally roll the cow to untwist the uterus. To correct the torsion nonsurgically, the veterinarian will place the cow down on her side and roll the cow the opposite direction of the twist. Usually a plank will be placed on the side of the cow’s flank, and someone will sit on the plank as the cow is rolled over. The purpose of the plank is to hold the uterus in place while the cow is being rolled. The calf in the uterus will bump against the pressed in flank and be held in place while the cow is rolled. If rolling the cow fails to correct the problem, then surgery is the only option left.
If the torsion has not pinched off the uterus and the calf can be felt through the cervix, then the veterinarian has several options for correction. C-section and rolling are still viable options for correction, and will depend on the size of calf and cow, duration of the problem, and preference of the vet. The other option is to flip the calf and uterus inside the cow. In this procedure, the calf is rolled in the same direction as the twist, catching up to the twist. This can be done by directly holding a calf’s leg or putting a hand against the side of the calf, rocking the uterus, and then flipping it as momentum carries it. If only the calf’s legs are accessible and a good grip is not possible, a detorsion bar can be used. Chains are placed on the calf’s legs and then wrapped on the bar. The bar is rotated back and forth to get the calf rocking and then flip over. To help make the whole process easier, the patient will often be given an epidural and something to relax the uterus to aid in the process.
One the uterus is detorsed, the cervix is evaluated to see if the calf can be delivered. If not the vet may now choose to perform a C-section, or if the calf is alive, may wait a couple of hours to see if the calf will dilate the cervix and be born vaginally. After delivery the veterinarian will evaluate the cow for complications and treat her as needed.