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Oxytocin verus carbetocin administered to cows after uncomplicated calvings and subsequent fertility

Clinical Scenario

During a visit to one of your dairy farms, the owner Mr Simons asks for your advice about managing his cows post-calving. He currently gives all of his cows an injection of oxytocin after calving to promote uterine involution, and feels it helps get the cows back into calf more quickly. One of his neighbours has recently switched to using carbetocin instead, and he asks whether you think he should do the same. You wonder whether there is any evidence that switching to carbetocin might have a positive impact on fertility in Mr Simons' herd...

3-Part Question (PICO)

In [post-parturient cows] does [exogenous oxytocin compared with carbetocin] improve [subsequent fertility]?

Search Strategy and Summary of Evidence

Search Strategy

MEDLINE(R) In-Process & Other Non-Indexed Citations and MEDLINE(R) 1946 to Present using the OVID interface

(cow.mp. OR cows.mp. OR cattle.mp. OR bovine.mp. OR bovines.mp. OR bos.mp. OR exp Cattle/)

AND

(partum.mp. OR postpartum.mp. OR postparturient.mp. OR parturient.mp. OR calving.mp. OR parturition.mp. OR obstetrics.mp. OR calve.mp. OR calvings.mp. OR calves.mp. OR calved.mp. OR birth.mp. OR birthing.mp. OR labour.mp. OR labor.mp. OR exp postpartum period/)

AND

(oxytocin.mp. OR carbetocin.mp. OR reprocine.mp. OR oxytocic.mp. OR oxytocics.mp. OR exp Oxytocin/ OR exp Oxytocics/)

CAB Abstracts 1910 to Present using the OVID interface

(cow.mp. OR cows.mp. OR cattle.mp. OR bovine.mp. OR bovines.mp. OR bos.mp. OR exp cattle/ OR exp cows/)

AND

(post partum.mp. OR postpartum.mp. OR postparturient.mp. OR post parturient.mp. OR calving.mp. OR parturition.mp. OR obstetrics.mp. OR calve.mp. OR calvings.mp. OR calves.mp. OR exp postpartum period/ OR exp obstetrics/ OR exp calves/ OR exp parturition/)

AND

(oxytocin.mp. OR carbetocin.mp. OR reprocine.mp. OR oxytocic.mp. OR oxytocics.mp. OR exp oxytocin/)

Search Outcome

MEDLINE

  • 377 papers found in MEDLINE search
  • 376 papers excluded as they don't meet the PICO question
  • 0 papers excluded as they are in a foreign language
  • 0 papers excluded as they are review articles/in vitro research/conference proceedings
  • 1 total relevant papers from MEDLINE

CAB Abstracts

  • 493 papers found in CAB search
  • 489 papers excluded as they don't meet the PICO question
  • 3 papers excluded as they are in a foreign language
  • 0 papers excluded as they are review articles/in vitro research/conference proceedings
  • 1 total relevant papers from CAB

Total relevant papers

1 relevant papers from both MEDLINE and CAB Abstracts

Comments

An additional paper (Bajcsy et al. 2006) was identified which compared oxytocin and carbetocin, however it focused on measuring outcomes related to uterine contractility. As this outcome is not of direct relevance to our PICO question, the paper was excluded.

Summary of Evidence

Barrett et al. (2009) Assumed UK

Title:

Effects of the administration of oxytocin or carbetocin to dairy cows at parturition on their subsequent fertility.

Patient group:

501 Holstein-Friesian dairy cows on five farms. Cows were allocated into three groups, and for groups receiving a treatment, this was administered within six hours of parturition. Group 1 received 25 iu oxytocin, Group 2 received 0.35mg carbetocin and Group 3 received no treatment.

 

Study Type:

Randomised Controlled Trial

Outcomes:
  • Occurrence of periparturient hypocalcaemia and retention of foetal membranes beyond 12 hours post calving.
  • Endometritis score between 28 and 42 days after calving.
  • Reproductive performance (median calving to first insemination interval, first insemination pregnancy rate, median calving to pregnancy interval, inseminations per pregnancy).
Key Results:
  • Median calving to first insemination interval was similar between cows receiving oxytocin versus carbetocin
  • First insemination pregnancy rate was similar between cows receiving oxytocin versus carbetocin
  • Median calving to pregnancy interval was similar between cows receiving oxytocin versus carbetocin
  • Inseminations per pregnancy were similar between cows receiving oxytocin versus carbetocin
Study Weaknesses:
  • Treatments were not allocated truly randomly but sequentially in chronological order which may introduce some selection bias
  • There was limited detail in the methods section about how the farms were recruited
  • Some basic data were missing, particularly in terms of comparability between groups in relation to age, parity and reasons for drop-out
  • While assessment of endometritis score was blinded, there did not appear to be any other blinding at administration of treatment or assessment of outcome
  • Sample size was not justified and so the study may have been underpowered
  • While the methods stated that statistical analyses were conducted to compare the three groups in terms of reproductive performance, p values were not stated for these analyses
  • Authors did not state whether ethical approval had been obtained
Attachment:
Evidence appraisalEvidence appraisal

Comments

Given that only one study was identified, and that there were various limitations to this study, an adequately powered and randomised controlled trial would need to be conducted to answer this question with greater certainty. However, given that few differences were found between the groups in this study, it may be beneficial to explore the literature examining the use of oxytocin compared with no treatment, or carbetocin compared with no treatment.

Bottom line

The current evidence suggests that there is no difference between oxytocin or carbetocin given post-calving in relation to subsequent fertility.

Disclaimer

The BETs on this website are a summary of the evidence found on a topic and are not clinical guidelines. It is the responsibility of the individual veterinary surgeon to ensure appropriate decisions are made based on the specific circumstances of patients under their care, taking into account other factors such as local licensing regulations. Read small print

References

Bajcsy AC, Szenci O, Weijden GC, van der Doornenbal A, Massen F, Bartyik J, Taverne MAM (2006) The effect of a single oxytocin or carbetocin treatment on uterine contractility in early postpartum dairy cows. Theriogenology 65: 400-414

Barrett AJ, Murray RD, Christley RM, Dobson H, Smith RF (2009) Effects of the administration of oxytocin or carbetocin to dairy cows at parturition on their subsequent fertility. Veterinary Record 165: 623-626

About this BET

First author:
Natalie Robinson
Second author:
Marnie Brennan
Institution:

CEVM, University of Nottingham

Search last performed:
2016-03-23 15:07:28
Original publication date:
2016-03-31 15:07:28
Last updated:
2016-03-31 15:07:28
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