Canine Postpartum Reproductive Diseases Flashcards
What are 4 reasons for veterinary involvement in obstetrics?
- Timely intervention
- To increase live birth (minimize still births)
- To minimize morbidity and mortality in the dam
- To promote increased survival of neonates during the first week of life
Placental sites from previous pregnancies can be seen in what species?
Dog
Inflammation of the entire uterus is known as what?
Metritis
Metritis includes what layers of the uterus?
- Endometrium
- Myometrium
What are 3 clinical signs of systemic illness that can be seen with metritis?
- Fever
- Depression
- Purulent vulvar discharge
What are 4 diagnostic methods that can be used to diagnose metritis?
- CBC
- Vaginal cytology
- Culture
- US
What do you treat metritis with?
PGF2a
If the uterine wall is less than 1-2 mm thick, what should be avoided due to the risk of rupturing the uterus?
Ecbolics
What are 2 forms of supportive therapy that can be used with metritis?
- Fluids
- Antibiotics
Pyometra is considered what type of disease?
Diestral disease
Pyometra occurs during what phase?
Progesterone phase
When is pyometra usually seen in the bitch?
In the queen?
- 60-90 days post-estrus
- Anytime in the queen
Is pyometra more commonly seen in younger or older females?
Older
What is a common media reason for spaying females not intended for breeding?
Pyometra
Pyometra may be associated with what condition?
Cystic endometrial hyperplasia
What does CEHMP stand for?
Cystic Endometrial Hyperplasia - Metrisi Pyometra complex
Estrogen receptors are normally down-regulated by what?
Increasing P4 in diestrus
What does progesterone stimulate?
Proliferation and secretion of endometrial glands
What is usually defective in a dog with cystic endometrial hyperplasia?
Normal down-regulation of estrogen receptors due to increasing P4 may be defective.
Dogs with cystic endometrial hyperplasia get prolonged effects of what?
What does this do?
- Prolonged effects of E2 on endometrium
- Increases number of P4 receptors entering the female into diestrus
Which organism is most commonly involved with cystic endometrial hyperplasia?
E. coli
Which type of pyometra is less severely ill, open or closed?
Open
With which type of pyometra do you see copious red-brown to yellow-green foul smelling vulvar discharge, open or closed?
Open
With which type of pyometra do you see abdominal swelling, open or closed?
Closed
Depression with pyometra is most often seen with what?
Toxemia
What can lead to PU/PD with pyometra?
Endotoxins from E. coli
What are 3 diagnostic techniques for pyometra?
- Abdominal palpation
- Radiography
- US
What is the treatment of choice for both open and closed pyometra?
What needs to be done first?
- OHE
- Need to stabilize first
What is a medical therapy option for pyometra?
This can only be used with which type of pyometra?
- PGF2a (Lutalyse or Estrumate)
- Open
What does PGF2a cause when used for pyometra?
Causes smooth muscles contraction for uterine evacuation.
How long should PGF2a injections be used when treating for pyometra?
Continue until progesterone is baseline and uterine contents are gone as seen on US.
What are 5 possible side effects that can be seen with PGF2a use?
- Panting
- Salivation
- Vomiting
- Defecation
- Vocalization (queens)
When should a culture be done with a pyometra?
Once cervix is open and discharging.
What are 3 recommendations for a breeding bitch?
- Breed starting early
- Don’t miss a cycle
- Spay when done breeding
The incidence of uterine prolapse is increased with what?
Dystocia
How does a uterine prolapse clinically present?
Firm tubular mass protruding form the vulva.
When does a uterine prolapse typically occur in a dog?
During or following parturition
What is the treatment for a uterine prolapse?
OHE
A vaginal prolapse where you may see the floor of the vagina or may not see it at all is what type?
Type 1
A vaginal prolapse where you see the floor and walls through the vulva, which looks pear-shaped, is what type?
Type 2
A vaginal prolapse where you see the entire vaginal circumference, which looks like a doughnut), is what type?
Type 3
A vaginal prolapse in a bitch should regress after what occurs?
What can be given to include this?
- Ovulation
- GnRH or hCG
What needs to be done with a vaginal prolapse while waiting for it to regress?
Keep it clean and moist
What are 2 surgical options for treating a vaginal prolapse?
- Purse-string suture
- OHE or ovariectomy (remove hormone source)
What hormone are vaginal prolapsed associated with?
Estrogen
What are 4 differentials for tissue protruding from the vulva?
- Vaginal neoplasia
- Vaginal hyperplasia
- Vestibular mass (abscess)
- Intersex (enlarged clitoris)
What are 5 differentials for perineal masses?
- Tumors
- Abscess
- Hematomas
- Seromas
- Vaginal Leiomyoma
What is the usual treatment for a perineal mass?
Treat with surgical debridement then obliterate the space the mass was lying in.
The clinical signs of fever and leukocytosis along with enlarged, hot and painful glands is indicative of what?
Mastitis
What are 3 common causative agents of mastitis?
- Coliforms
- Strep
- Staph
What are 4 ways to supportive care/treatment methods for mastitis?
- Hot pack
- Strip abnormal milk
- NSAIDs (carprofen)
- Antibiotics (clavamox or chloramphenicol)
What should be done with a gangrenous gland?
Surgically remove dead or gangrenous gland
Spontaneous flow of milk from a mammary gland unassociated with pregnancy is known as what?
Galactorrhea
Galactorrhea occurs in response to what?
When can this be seen?
- Decreasing P4 stimulation
- 2-3 months after estrus and 3-4 days after diestrual OHE
What is a normal phenomenon that can be seen in an intact bitch?
Galactorrhea
Does galactorrhea predispose a bitch to disease of the reproductive tract?
No
Spontaneous development of the mammary gland with discharge that is clear with no milk is seen with what condition?
False pregnancy
Is treatment usually necessary with a false pregnancy in a dog?
No
How long can false pregnancies last?
May last up to 6 weeks
What can be used to dry up secretions seen with a false pregnancy in a dog?
Cabergoline
What is the second most common tumor type in a dog?
Mammary neoplasia
What are 3 brand categories of malignant tumors in dogs?
- Carcinomas
- Mixed malignant tumors
- Sarcomas
What is the most common benign tumor seen in a dog?
Benign mixed mammary tumor
The presence of a benign mammary tumor increases the chance of what?
Developing a malignant mass
Intact female dogs have what risk of developing mammary tumors compared to a spayed dog?
7 times greater risk
What is the risk of developing malignant tumors if the dog is spayed before her first estrous cycle?
0.5%
What is the risk of developing malignant tumors if the dog is spayed after her first estrous cycle?
8%
What is the risk of developing malignant tumors if the dog is spayed after her second estrous cycle?
26%
OHE is not an effective preventative method for development of malignant tumors in female dogs after what point?
- Greater than 2.5 years of age or has cycled more than twice
What are 2 common locations of metastasis seen with mammary neoplasia in dogs?
- Lungs
- Lymph nodes
How is diagnosis of mammary usually made?
Surgical excision then staging conducted at laboratory
What is the recommended treatment for mammary neoplasia in the dog?
Surgery
What can be used as an adjunctive therapy with surgery as a treatment form mammary neoplasia?
Chemotherapy
What is the prognosis for mammary neoplasia?
Good
Survival of mammary neoplasia 2 years after diagnosis is more common if what 4 factors are present?
- Benign
- Slow growth rate
- Small tumor size
- Lack of local infiltration
Eclampsia is seen with what?
Hypocalcemia
Hypocalcemia/eclampsia occurs primary in what type of dogs?
Small nervous breeds
Is hypocalcemia/eclampsia heritable?
Hereditary in some lines
What are 7 progressive clinical signs seen with hypocalcemia/eclampsia?
- Panting
- Pacing
- Muscle tremors
- Ataxia
- Hyperthermia (106-108F)
- Tonic-clonic convulsions
- Death
What are 3 aspects of treatment for hypocalcemia/eclampsia?
- IV calcium gluconate given to effect
- Oral calcium supplements for maintenance
- Wean the pups if possible
What does SIPS stand for?
Sub-involution of placental sites
Sub-involution of placental sites can lead to what clinical sign?
Persistent uterine bleeding
Where can erosions be seen with SIPS?
In endometrium
What can be seen histologically in the lesions seen with SIPS?
Multinuclear giant cells (trophoblast cells)
T/F: SIPS is usually self-limiting.
True
What can be used to try and treat SIPS?
PGF2a
SIPS is not related to what 2 conditions?
- Postpartum metritis
- Future infertility