Effects of teat cistern mural biopsy and teatoscopy stab versus longitudinal incision with or without tube implant on incisional healing in lactating dairy cattle
Department of Clinical Studies, New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square 19348. American Journal of Veterinary Research
(Impact Factor: 1.34).
Effects of teat cistern mural biopsy and full-thickness stab and longitudinal incisional healing were evaluated experimentally on clinically normal teats in 12 lactating dairy cattle. Each teat on each cow was assigned by Latin-square design to 1 of 4 surgical interventions: (I) teatoscopy only; (II) teatoscopy, stab incision, and mural biopsy; (III) longitudinal incision and mural biopsy; and (IV) longitudinal incision, mural biopsy, and tube implantation. Teatoscopy was done with a 4-mm OD arthroscope introduced through the teat canal and attached to a television camera. Teatoscopy was quicker to perform and provided a more detailed videotaped examination of the teat and gland cistern, compared with gross inspection through a longitudinal incision. In intervention-II cows, the Ferris-Smith biopsy instrument jaws introduced through a longitudinal 1-cm midteat stab incision were easy to visualize and manipulate accurately. Stab incisions closed with only 1 or 2 skin sutures healed without complications in all 12 teats. On palpation, stab incisions were significantly (P less than 0.01) less thick than longitudinal incisions at 8 weeks and were microscopically indistinguishable from the normal tissue. However, in 24 teatoscopically examined teats, 9 (38%) had microscopic evidence of teat canal injury and 12 (50%) of the quarters developed mastitis. This was attributed to trauma resulting from introduction of the arthroscope through the teat canal. Intervention III yielded satisfactory results with the least complications. All 12 longitudinal incisions healed by primary intention, and all teats remained patent. Mastitis developed in 4 (33%) quarters. Intervention IV caused considerable complications associated with the tube implant and no improvement in biopsy site healing, compared with interventions II and III. Eleven longitudinal incisions healed by primary intention. One incision dehisced, 2 (17%) tube implants dislodged, 2 (17%) became obstructed proximally, and irritations of the mucous membrane developed in 2 teats proximally and in 6 teats distally. Mastitis developed in 6 (50%) quarters. Longitudinal incisions healed with moderate submucosal fibrosis. All sutured incisions had multifocal microgranulomata in which suture material was in various stages of degradation. At 8 weeks, localized teat wall thickening could be detected at incisional and biopsy sites, but did not obstruct milk flow. Excessive granulation tissue was at the biopsy sites (72 total) at 2 weeks, and at this time, the sites were partially covered by metaplastic squamous epithelium. However, by 8 weeks, 71 (98%) of the areas were replaced by fibrous tissue with minimal protrusion into the teat cistern.
Available from: Wim Van den Broeck
- "Postinvasive complications, however, were multiple, such as blood clots in milk, fistula formation, and mastitis . Therefore, an endoscopic approach through the ductus papillaris may be a more suitable alternative for the collection of fresh biopsies of the lower parts (i.e., lactiferous cistern) of the mammary gland (Tulleners and Hamir, 1990; Persson et al., 1992; Shakespeare, 1998). Using an endoscopic technique, follow up of macroscopic lesions occurring during experimentally induced mastitis could be of interest. "
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ABSTRACT: The aim of this study was to evaluate the application of an endoscopic technique to investigate the teat and udder cisterns of the bovine mammary gland, and to biopsy tissues within the cisterns. An anesthetic protocol for application in standing animals was designed, using a combination of general and local anesthesia. Individual quarter milk production (QMP), quarter somatic cell count (SCC), and occurrence of new intramammary infection were assessed after application of the technique, and possible applications for biopsies collected were investigated. Bovine teat and gland cistern lining could be visualized and small biopsy samples could be collected. The collected biopsy samples were successfully used in histological-histopathological examination and PCR analysis. To study the impact of endoscopy on QMP, milk SCC, and bacteriology, endoscopic examination of 12 low SCC (<200,000 cells/ mL) quarters was performed in 8 different first- and second-lactation cows. Immediately following endoscopy, 8 quarters received antibiotic treatment, whereas 4 quarters remained untreated. During a 15-d follow-up, no new intramammary infection could be observed in the endoscopically treated quarters. For QMP, no significant interaction between time and treatment could be observed throughout the 15-d follow-up period. Quarter SCC did not differ among treatments (control, endoscopy with antibiotics, and endoscopy without antibiotics). In conclusion, the endoscopic technique is suitable for examination and tissue biopsy collection of the bovine mammary gland cisterns without major interference with QMP and quarter SCC.
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ABSTRACT: To evaluate use of a reinforced polytetrafluoroethylene vascular graft for treatment of an artificial defect of mucosa of the teat cistern in lactating cows.
9 clinically normal lactating dairy cows.
A 20-mm wide circumferential area of mucosa was sharply excised from the cistern of 1 teat on each cow 10 days after spontaneous calving, and the lesion was covered by a graft. After 14 days of passive milk drainage, routine milking was resumed. Follow-up examinations were performed during the next 2 lactation periods and included evaluation of wound healing, location and sonographic appearance of the implant, milk flow and yield, and somatic cell counts. Cows were slaughtered, and teats and mammary glands were examined microscopically.
Implants had partially to totally collapsed within 30 to 90 days. Milk flow was significantly increased by day 15 of the first lactation, but decreased significantly by day 300 of lactation 1. At the end of lactation 1, milk flow had ceased in 3 out of 7 quarters. Only 3 of 9 quarters drained through grafted teats were milkable at the end of the study. Somatic cell counts of these quarters were significantly increased in the first lactation period. At necropsy, 2 grafts were in the teat cistern, but only 1 was incorporated into the mucosa by connective tissue. The mucosa was thickened in all teats with grafts, and there was epithelial metaplasia and granulation tissue proliferation.
Use of a polytetrafluoroethylene graft can preserve patency in the first lactation period. However, the graft may not be sufficiently incorporated into the mucosa if routine machine milking is resumed 2 weeks after implantation. )
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ABSTRACT: A method for endoscopic resection of obstructing tissue in the area of the teat canal opening into the teat sinus, using a triangulation technique, was developed. Benefits of this approach, compared with existing methods, include excellent observation of obstructing tissue, ease of manipulation of tissue flaps by use of a probe introduced through the teat canal, and precise excision of obstructing tissue by use of a pair of scissors introduced through an instrument portal. Outcomes for 12 cows treated with this technique were determined 2 weeks and 3 months after surgery. Three or more months after surgery, outcome was excellent in 10 of 12 cows, and 11 owners would opt for use of the procedure for other valuable cows in their herds.
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