“…The incidence of metritis, including retained placenta, was 21% in a survey of 97,318 Holstein cows in the USA [32]; and, the incidence of endometritis was 19% in 19,870 Holstein cows in Germany [33]. Metritis is also important in purebred and crossbred Bos indicus dairy cows and buffalo; the incidence of metritis was 10.3%, 22.6%, and 9.7% in 1,609 Sahiwal lactations, 2,549 crossbred Holstein x Tharparkar lactations, and 1,604 Murrah buffalo lactations, respectively [34]. The greatest impact of uterine disease, is that there is reduced fertility even after successful treatment.…”