title: A novel diagnostic technique to determine uterine health of Holstein cows at 35 days postpartum.
abstract: The objectives were (1) to evaluate the association of uterine lavage sample optical density (ULSOD) with uterine health, and (2) to estimate and evaluate a threshold value that will maximize the accuracy of ULSOD as a diagnostic tool for clinical endometritis. The study enrolled 1,742 cows from 3 dairy farms located near Ithaca, New York. The samples were collected at 35 ± 3 d in milk (DIM) by using low-volume uterine lavage. Cows with a purulent or mucopurulent secretion in the sample were diagnosed with clinical endometritis, whereas a subgroup of all studied cows was examined for cytological evidence of inflammation by endometrial cytology. Data for ULSOD measured at different wavelengths (200, 352, 620, 790, 860, and 960 nm) were available for 554 cows; all 1,742 cows had data for ULSOD measured at 620 nm (ULSOD(620)). Incidences of clinical endometritis, metritis, and retained placenta were 10, 15.2, and 5.6%, respectively. The ULSOD(620) was associated with clinical endometritis. Receiver operating characteristic (ROC) analysis of the accuracy of optical density in the detection of clinical endometritis was conducted for ULSOD measured at different wavelengths; ULSOD(620) was selected for further analysis because it presented the best ROC curve to detect clinical endometritis. The recommended threshold for ULSOD(620) ROC was 0.058, where the sensitivity and specificity were 76.3 and 78.3%, respectively. The ROC analysis of the accuracy of optical density in the detection of endometritis defined as a percentage of neutrophils in the uterine lavage samples higher than 18% was conducted for ULSOD(620). The recommended threshold was 0.059, where the sensitivity and specificity were 100 and 82.2%, respectively. Cows with ULSOD(620) ≤ 0.058 were 1.21 times more likely to conceive than cows with ULSOD(620) >0.058; moreover, the median calving-to-conception interval for cows that had ULSOD(620) ≤ 0.058 was 122 d compared with 148 d for cows that had ULSOD(620) >0.058. Cows that were positive for Arcanobacterium pyogenes, diagnosed with metritis, or had retained placenta had 4.0, 1.4, and 1.7 times higher odds of having ULSOD(620) >0.058, respectively. Cows with ULSOD(620) >0.058 had a higher percentage of neutrophils in the uterine lavage samples than cows with ULSOD(620) ≤ 0.058. Uterine lavage sample optical density measured at 620 nm can be used as an objective indicator of uterine health in dairy cows, principally for clinical endometritis.
authors.affiliation: Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA.
authors.forename: V S
authors.initials: VS
authors.lastname: Machado
authors.forename: W A
authors.initials: WA
authors.lastname: Knauer
authors.forename: M L S
authors.initials: ML
authors.lastname: Bicalho
authors.forename: G
authors.initials: G
authors.lastname: Oikonomou
authors.forename: R O
authors.initials: RO
authors.lastname: Gilbert
authors.forename: R C
authors.initials: RC
authors.lastname: Bicalho
mesh_terms: D000818:Animals; D002417:Cattle; D004716:Endometritis / Q000175:diagnosis / Q000503:physiopathology / Q000662:veterinary*; D005260:Female; D007774:Lactation / Q000502:physiology; D049590:Postpartum Period / Q000502:physiology*; D014599:Uterus / Q000166:cytology / Q000502:physiology*