4 Diagnosis and Treatment

Transcript

The next one is lesson 4.

In the 3rd lesson already, we discussed the Signs and Symptoms of the luteal cyst, Diagnosis, History and Clinical signs, Rectal examination, Ultrasound examination, Serum progesterone concentration, and Prognosis of the Cystic Ovarian Degeneration.

Here we are going to discuss Treatment and Diagnosis.

So as far as Treatment is concerned, in the olden days onwards, the manual rupture was followed. It is the earliest Treatment, just introduce your hand and place your fingers on the cyst and just pinch of the cyst and the rupture of the cyst we have to do, in that case, the single cyst is there it is possible to do, but repeated manual rupture is required for most of the times. Again, suppose the remnants of cystic cells are there, tissues are there, the accumulation of fluid again is possible, so repeated manual rupture is highly essential between 6-10 days interval. Most of the time the thick-walled follicles are there, we may not be able to do manual rupture, it is not possible also.

What are the Disadvantages? This means most of the time haemorrhage occurs, due to that haemorrhage, Ovaria-bursal adhesions are also possible, so it may have sterility also, it may lead to sterility. So, it is not popularised, this treatment was not popularised.

Specific Treatment for Luteal Cyst: That is, the first one is PGF2 Alpha.

Two types of PGF2 Alpha are available in the market: One is Synthetic, another one is Natural. Natural: Dinoprost Tromethamine, for example, Lutalyse, 25 milligrams, intramuscularly we have to administer, that is the total dose not based on per KG body weight.

Synthetic: Cloprostenol Sodium, for example, Pragma is available in the market, the dose is about 500-750 micrograms intramuscularly.

Sometimes the cyst is not responsive for PGF2 Alpha, in those cases, you have to go for GnRH+PGF2 Alpha Treatment. On day 0, GnRH administration will be done, or LH administration may be adopted, GnRH receptor that is the example it comprises of Busarelin acetate 20 mcg is administered, LH means Chorulon that comprises of HCG (Human chorionic Gonadotropin, 3000IU (international units) may be administered.

After that, on Day 7 or 10, again Dinoprost Tromethamine may be administered, or Cloprostenol Sodium may be administered. If you go for GnRH, once the GnRH will act on the anterior pituitary, and then LH release will be there, complete luteinization of the follicle is possible or sometimes ovulation may also be possible. In the case of LH, it will act directly on the ovaries and directly act on the persistent follicle or cystic follicle and luteinization of the follicle occurs or ovulation occurs.

Nowadays, researchers are telling that GnRH is more effective than LH. And after Day 10, just go for insemination also, at 72 hours after PGF2 Alpha, that is Dinoprost Tromethamine, the second insemination will be adopted 96 hours post-administration of PGF2 Alpha.

The next one is the Specific Treatment for Follicular Cyst: In the case of the Follicular cyst, if you go for Dinoprost Tromethamine directly no effect will be there, hence you have to go for GnRH or HCG on Day 0 and then on Days 7 and 10, Dinoprost Tromethamine is administered, then after administration of prostaglandin 72 hours and 96 hours of insemination may be carried out, that is called Fixed Timed Insemination, which will be carried out.

The next one is most of the bedding veterinarians, even experienced veterinarians were not able to differentiate that follicle or cyst and luteal cyst. So, in those cases, just go for this type of therapy, combined therapy, the general treatment for follicular cyst and luteal cyst. You have to go for GnRH and its analogues with PGF2 Alpha and its analogues. If you go for GnRH, after administration of GnRH, that will cause an immediate release of LH that LH will act on that follicle, that is a cyst, complete luteinization of cyst occurs or even sometimes ovulation of anovulatory follicles also occurs.

So finally, the cyst that is luteinized follicle or ovulated that is the formed corpus luteum is highly responsible for PGF2 Alpha. The progesterone secretion level, secretary ability are increased and it is highly responsive to PGF2 Alpha. The responsiveness of the Hypothalamus to the positive feedback effect of estrogen is also possible, so it leads to LH surge and normal ovulation may take place, animal return to normal ovarian cyclicity. So based on this, this treatment protocol is adopted Day 0, Busarelin acetate 20 mcg or HCG 3000 IU (International units) administered intramuscularly and Day 7 Cloprostenol Sodium 500 mcg is administered, at the time of administration, you can visualize the presence of follicle, that follicle after administration of Busarelin acetate, that follicle may get luteinization that is called completely luteinized follicle, in this(showing picture) follicle is not an ovulated one and then Day 9 again, Busarelin acetate is injected with Fixed Time Artificial insemination after 72 hours of Cloprostenol injection, Here lysis of CL or luteinized follicle occurs, new emergence of the follicle is observed here and then at the time of Day 9 injection of Busarelin acetate cause hastening of ovulation also that is the synchronization of ovulation with artificial insemination and then on Day 10, second Fixed Time Artificial Insemination is done. On day 45 pregnancy Diagnosis is made with Ultrasound.

So far, we have discussed various Treatments like:

• Manual rupture like cystic follicles,
• Specific treatment for luteal cyst, follicular cyst, and
• GnRH and its analogues with PGF 2A and its analogues for the treatment of either Follicular cyst or Luteal cyst.

Next class, we will discuss the remaining Treatment portion and Prevention and Control.

Thank you!