Management of uterine torsions in dairy cows: Insights from a practitioner after attending 59 cases in WA dairies

By Caio Figueiredo, Veterinary Medicine Extension and Dr. Craig Johnson, Bovine Herd Health

Uterine torsions represent a major issue in calving management, as the condition can be life-threatening to the dam and calf and usually requires extensive labor for its correction. During a previous Extension meeting, Dr. Johnson brought to my attention some interesting data and insights generated from 2012 – 2023 based on his experience managing 59 uterine torsion cases on 10 WA dairy herds.

Of the 59 uterine torsion cases, 12 (20%) were corrected vaginally, 36 (61%) were corrected by rolling the cows, and 11 (19%) required either cesarean section or euthanasia/culling. An average of 2 rolls were required to correct uterine torsions; however, the number of rolls that resulted in torsion corrections ranged from 1 to 6. A total of 29 cases corrected by rolling the cow were followed up to assess spontaneous calving, and all cases (29) required some level of assistance to deliver the calf (the remaining 7 cases corrected by rolling the cow were not followed up by the attending veterinarian). A decision tree developed by Dr. Johnson (Figure 1), highlights the most important factors that determine which clinical approach should be used in uterine torsion cases. Considering the decision tree, the degree of uterine torsion is a deterministic factor for a vaginal correction vs a rolling approach. Calf viability (alive, dead, and time after death) and cervical dilation are deterministic factors for electing spontaneous calving, assisted calving, cesarian section, or euthanasia approaches.

Johnson’s Decision Tree for Uterine Torsion

Conduct vaginal exam (without caudal epidural) to determine direction of uterine torsion, and degree and viability of calf (alive, dead for < 8 hours, dead 8 hours, dead emphysematous)




Figure 1. Decision tree for the management of uterine torsion.