Block 2 More Flashcards
What is most common cause of sub fertility?
Endometritis
What are the 3 anatomical barrier to protect against endometritis?
Vulva
v-v sphincter
Cervix
how is endometritis diagnosed?
Uterine cytology via double guarded swab and brush
On diagnosis of endometritis, what must you order?
Both culture AND cytology
When do you treat endometritis?
Treat during estrus or induce estrus (PGF) at start of treatment
What are the 3 approaches to treating endometritis?
Correction of anatomical defects
Avoid reinfection
Mechanical removal of microorganisms
What type of antibiotics do you give to treat endometritis?
Systemic
What antibiotic do you use to treat fungal endometritis (they’re worse)
Fluconazole
What percent of intact females develop pyometra by 10?
23%
What are the 3 criteria that ensures its the uterus, not the ureters?
Blood supply is parallel to tube
Does it bifurcate at body of uterus
Does it have an ovary
IS there an increase in risk doing an ovariectomy for pyos as compared to ovariohisterectomies?
NO!!
What is a complete hysterectomy?
Removal of uterine horn and cervix but leaves ovaries.
Saves hormones
Still risk of stump pyo and mammary tumors
Disadvantages of complete hysterectomy
Continued heat cycles
False pregnancies
Ovary tumors
What 4 things increase the risk for RFM?
Abnormal deliveries
Infectious diseases
Twins
Induced parturition
When is a placenta considered retained in a cow?
8-12 hours
This is a long one but:
What is the sequelae of RFM?
Delayed uterine involution
>Prolonged time to 1st service
>Decreased pregnancy rates
>Increased services per conception
>Increased days open
When is considered RFM in a horse?
3 hours
Clinical signs in < 8
What is a large sequelae of equine RFM?
Endotoxemia leading to laminitis
How many units of oxytocin should a horse be give?
2-5 units
What systemic therapies can be given to a horse? (4)
Antibiotics
NSAIDs
Laminitis prevention
Uterine lavage (2x/day)
When do sheep and goat most commonly have RFM?
With brucella infection
What is endometritis?
Inflammation of lining of uterus (prepartum)
What is metritis?
Inflammation in all layers of uterus (post partum)
What is pyometra
Pus filled uterus
What are the 3 bacteria of toxic metritis?
Trueperella pyogenes
Fusobacterium
Bacteroides
What is the treatment for toxic metritis?
Systemic antibiotics
What are 3 hallmark signs of metritis in small animals?
Red
Watery
Rank
What is SIPS
Subinvolution of placental sites
What occurs in SIPs?
Vulvar discharge in postpartum bitch 6-12 weeks after calving (not smelly)
Is SIPS ok?
Yeah, just annoying
What may be seen in SIPS?
Trophoblastic cells
What percentage of body weight is blood volume?
8%
What are the normal physiological compensation mechanisms to hypovolemia?
Increased HR
How much oxygen is extracted from each hemoglobin in a horse at rest?
3%
What biomarkers fall with whole blood loss? Which one increases?
Decreased proteins
Increased lactate
What percent of blood loss is concerning?
30%
What do you do before 30% blood loss?
Give shock dose of crystalloid @ 20mL/kg
What are the 2 treatments fr lepto?
Penicillin and doxycycline
Which antibiotic does not eliminate the carrier state?
Penicillin (ampicillin)
Which antibiotics do eliminate the carrier state?
Doxy and erythromycin
How long should treatment continue?
4 weeks
What type of bacteria is pyelonephritis usually caused by?
Gram-negative
How long should treatment continue continue with pyelonephritis?
4-6 weeks
(Urine taken 3-7 days after stopping treatment)
What antibiotic is contraindicated in puppies ad why?
Doxy for turning teeth yellow
What can be given if there is gastric reflux?
Proton pump antagonists
What is a common secondary disease associated with AKI?
Pancreatitis
What is really important in managing AKI?
Feeding (enteral feeding may be necessary)
When should hypertension associated with AKI be treated?
Above 180
What is a good drug to reduce the hypertension?
Amlodipine
What type of drugs are avoided during AKI due to decreased renal perfusion?
ACE and ARB
Hyperkalemia can occur with AKI but usually when oliguric or anuric
What is mild hyperkalemia?
6.5-7
What is moderate hyperkalemia?
7-8
What is severe hyperkalemia?
> 8
Action potentials are ____ to generate with hypokalemia
Harder
_____ affects resting potential
Potassium
______ affects threshold
Calcium
After treatment for hyperkalemia, what is it that needs to be done to return potassium to normal levels (not just intracellular/extracellular levels)
Urine production
Even a small amount will get it within normal limits
What can severe azotemia cause to the mucous membranes?
xerostomia
What should you do if you suspect over hydration?
Furosemide
How much is lost in respiratory losses?
22 mL/kg/day
How much fluid is lost in urine?
1-2mL /kg/hr
How do you calculate fluid based on % dehydration?
% dehydration x kg
How fast should you rehydrate something?
Over 6-12 hours
What is the maintanece fluid therapy?
66 mL/kg/day
OR
Dog: 140 x kg^0.75
Cat: 80 x kg^0.75
How do you make a fluid plan?
Correct the dehydration + Provide maintenance + replace on-going losses (V, D, polyuria)
DONT FORGET TO DIVIDE BY 24 FOR THE HOURS IN THE DAY!!
What does a cat with pyuria, bacteruria, and azotemia have?
Pyelonephritis
What vomit center is activated with AKI?
Central
Why is it centrally mediated?
Uremic toxins!
What does c/d diet stand for?
Cystitis diet
What does k/d diet stand for?
Kidney diet (phosphate and protein restricted. Increased Omega 3)
What does mertazepine do in dogs and cats?
Appetite stimulant
