cows in field

Calving: Seek help if you suspect a uterine torsion

By Roy Lewis, DVM

Perhaps because a uterine torsion is a very rare type of malpresentation it is often difficult for producers to recognize. If we can recognize them, and quickly get help, the majority of these calves can be saved. It’s important that you don’t make the mistake of attempting to pull these calves yourself.

I have never seen an actual percentage of torsions listed because they are often not documented but my guess is there is one every couple thousand births so larger producers may experience one every few years. The practice I was in saw lots of cow-calf operations and I would say we would see upwards of 10 a year.

I always had the producer feel in the vaginal canal when we did diagnose one so they would recognize it the next time. I do the same thing with new vets or students. Once you examine one it is hard to miss it a second time.

A torsion describes a condition where the free portion of the uterus (where the calf is) twists over on itself. The vagina is anchored by soft tissue in the pelvis so really it is much like putting a golf ball in a sock holding the open end stationary and giving the sock a 180- or 360-degree twist. It’s so tight you can’t reach in and pull the golf ball out. This is exactly what happens in a torsed uterus.

The initial complaint is very similar to a full breech (coming tail first) where the cow or heifer looks like they should have calved hours ago but nothing happened. The cow is bagged up and nesting yet no water bag or heavy straining has started. I always tell experienced cattlemen, if they suspect something is wrong they are probably right. This is especially true if they know the cows’ past history and they have calved normally.

A cow that is nesting, belloring or looking uneasy usually means either a breech, other malpresentation or a torsion so it’s best to vaginally examine the cow. When examining a torsion you will usually be able to reach the calf. Initially you will feel bands of tissue running this way and that and it is like running your hand down a corkscrew. When you finally reach the calf your hand may be upside down and the calf may even be upside down. The degree of the torsion will determine how tight the opening is. Generally the cow’s contractions line up the calf to be presented normally so if it’s upside down or sideways and you feel these bands of tissue it is very likely a torsion.

When one examines a cow that isn’t ready to calve you go straight in the vagina and run into a closed cervix that feels like a round doughnut with a hole so tight you may be able to get in only one or two fingers. A torsion feels much different with an uneven opening that you can wiggle your arm through and the cervix will be open enough to get your arm through, touch the calf, and the water bag will not be broken.

With almost all torsions, once identified, veterinary intervention becomes imperative. Veterinarians have several methods they can use to detorse the uterus. If done successfully the calf can be delivered alive out the back end provided it was alive to start with. A veterinarian must first determine which way the uterus is torsed as it can be either clockwise or counterclockwise, and so one must twist it the opposite way to get it detorsed.

Some very experienced veterinarians can detorse them by hand by getting the uterus rocking and skillfully flipping it back over. The cervix will then continue to dilate and the uterus will now dump out lots of fluid and the cow will start straining again.

Other methods involve using a detorsion rod or detorsion fork to facilitate untwisting the uterus by applying these apparatuses to the calf’s leg. With the use of this instrument an experienced practitioner can help the process along when some additional force is necessary.

Another method is to cast the cow on her side. The veterinarian holds the calf while the cow is rolled to untwist the torsion. Again it is critical to know which way the uterus is twisted. I would say that in my experience a higher percentage untwist by moving the calf clockwise meaning they are counterclockwise torsions.

If attempts by any method fail, the veterinarian can rely on getting the calf out by caesarian section. In some cases the calf may be detorsed internally through a C-section incision and then pulled out the back especially if the calf is dead. If the calf is twisted and on the far side of the abdomen often the calf must be taken by C-section first and then the uterus detorsed and sewn up.

As you can see there are many things to consider when we find a uterine torsion but I am proud to say many times we can get a live calf and the cow makes an uneventful recovery. Early detection on your part is the absolute key component.

I have seen backwards calves torsed and twins torsed.

Just like a prolapsed uterus, torsions are an absolute fluke. There is no reason the cow would do it again, so as long as she breeds back there is no reason to cull her.

Heifers have the same odds as cows when it comes to torsing. I have never seen one torse prior to calving, but I know of one in a horse at seven or so month’s gestation. The mare had slight colicky symptoms and the owner and vet were quick to detect the problem and correct it with surgery, flipping the uterus to the left, back to normal. The mare went on to deliver a normal foal.

Quite a remarkable story. The message is never give up. If you detect a uterine torsion seek experienced help immediately. The outcome will often surprise you.

Have a great calving season, but if you experience a rare torsion you now know what to do.

Originally published in Canadian Cattleman, February 3, 2016. Reprinted with permission from the author.

Roy Lewis is an Alberta-based veterinarian specializing in large-animal practice. He is also a part-time technical services vet for Merck Animal Health.