Canine Pregancy And Postpartum Flashcards
What do you call the time during one or more offspring develops in the uterus?
Gravidity/gestation
Why should we do pregnancy diagnosis?
Schedule holidays to coincide with arrival of pup
Decide whether they should mate additional bitches
Curiosity/expectancy
Implement veterinary care
What pre-breeding veterinary care should animals receive?
Brucellosis screening
Vaccination — core
Anthelmintics
Flea control
Heart-worm preventative
OFA — list of breed specific testing (eg hip dysplasia)
CERF (canine eye registration foundation)
At how many days can pregnancy be detected by abdominal palpation?
21-35 days
“String of pearls”
When is it safe to do rads for pregnancy diagnosis?
After 42 Days
-organogenesis /calcification complete
At how many days of pregnancy can US be used to determine fetal viability ?
22-25days
When is relaxin measurable in serum?
After 21-28 days
Where can you palpate to diagnose pregnancy in the dog?
Flank and lower abdomen
Feel gestational sacs (6-30mm diameter)
-> 87% accuracy
By how much should you increase nutrition to mama doggo in the last trimester?
By 50%
Multiple small meals — growth formulation with 28-30% protein
Fish oil with omega 3 helpful
What is the gestation length post ovulation for the dog?
63days
What is the gestation length after onset of diestrus?
56-57 days
What is the average length of feline pregnancy?
63days
What are signs that whelping is going to occur ?
Body temp drops usually below 98F (indicates drop in progesterone becaus it is thermogenic)
Nesting behaviour 12-24hrs before parturition
Milk glands evident 1-7days prior to parturition
What does a whelpwise machine detect?
Fetal heart rate
Detects labor and monitors fetal distress
How does progesterone change prior to parturition ?
10ng/ml at 36hrs prior to whelping
4ng/ml at 18hr prior
2ng/ml at 9hr prior
What is the best method for determining number of fetuses?
Radiographs — 1 week prior to due date is best
How should clients set up a whelping area at home?/
Out of traffic area Whelping box with “pig rails” Acclimatize one week prior to due date Washable breeding Need good footing
Purulent discharge during pregnancy indicates?
Pyometra or dead fetus
What does hemorrhagic discharge indicate during pregnancy?
Can be normal
Can indicate impending abortion
Evaluate with cytology and vaginoscopy
What are the choice antibiotics in the pregnant bitch?
Clavamox, cephalosporins, Quinolones, ampicillin
What is the best method to determine fetal wastage?
Ultrasonography
Causes of fetal wastage?
Trauma, heat stress Luteal insufficiency Viral Bacterial Cystic endometrial hyperplasia Protozoa
Treatment for fetal wastage?
Evacuate uterine contents if all puppies/kittens are dead (PGF2a)
In what cases do you more commonly see prolonged gestation?
Singleton pregnancy
Medium to large breed dogs
How can you confirm you have a primary uterine interna?
If P4 <2ng/ml
No labour/prolonged gestation
Clinical presentation of uterine torsion?
Acute abdomen — pain, distress
May be asymptomatic until dystocia
Dx- exploratory laparotomy
What occurs in the first stage of parturition?
Begins after progesterone drops
Removal of “progesterone block” from uterus - myometrial activity begins
Increase in oxytocin receptor sites
Nesting, anxiety, anorexia, vomiting
What occurs in the second stage of parturition?
Active contractions — fetus in pelvic canal stimulates “urge to push”
Ferguson reflex — oxytocin release and abdominal contractions
Amnion appears first
Greatest effort do deliver head
Caudal presentation is normal
Greenish-black discharge “uteroverdin” (from placental marginal hematoma— accumulation of maternal blood that suppplies fetus with iron supplementation through pregnancy)
When should you intervene during parturition?
Active contractions >1hr
Rest period > 4 hrs
Black thick discharge without a fetus
60% of fetuses are born with what presentation?
Cranial longitudinal with front legs extended
About 40% of fetuses are born in what presentation?
Caudal longitudinal with hindlimbs extended
What breed is predisposed to primary uterine inertia and what is often the cause?
Terriers
Hypocalcemia
What is secondary uterine inertia? What are causes of this?
When pup obstructs and the uterus tires
Often in bulldogs and boston terriers-> broad head and narrow pelvis
Poor conformation of pelvis (eg fracture or persistent hymen’s)
Strictures
Diaphragmatic rupture
Obesity
Neoplasia
What intervention would you do if you determine the pups cannot be delivered naturally?
C section (consider early)
Oxytocin if no obstruction present
Ca++ if necessary
What are the steps for intervention?
No intrapelvic obstruction (diagnose by digital exam, US, rads) —> give 1-2IU of oxytocin
If pup within 30mins —> give oxytocin about q30mins until all delivered
No pup—> give Ca 10% @ 1cc/30lbs IV with glucose) then oxytocin
No pup in 30mins —> C-section
What is the third stage of parturition?
Passage of placenta — most passed within 15mins following fetus
2-3pups maybe born before passage of their placenta
Retention is rare — consider if purulent discharge occurs postpartum
Now many layers are there and what type of placenta does the dog have?
Zonary endotheliochorial placenta
5 layers
How many repeat C-sections are possible in an animal over their lifetime?
3-4 procedures if there are no complications
How does incision heal, adhesions, serosoal inclusion cysts?
Anesthesia ?
Body wall healing?
What should you expect normally in the postpartum period?
Most of fluid and cellular material is expelled in the first 2 weeks
Changes in color- red —> brown
No odor
Brownish mucoid lochia can be normal for 4-6weeks postpartum
When should pups be weaning ?
Start process at 3-4weeks
Complete by 5-8weeks
How do you treat newborns that are lacking colostrum?
Pooled serum SQ in pups — 22ml/kg
What is the normal temperature for pups in the first 2-3weeks?
Poikilothermic — ambient temp
How should you manage temperature for newborn pups?
1-7 days keep temp at 85-90F
8-28 days keep temp at 80F
29+ days 70-75F
If babies are cold —> piles
How much weight should puppies gain a day? What factors can impact this??
10% of brith weight / day
Hypothermia ***
Hypoglycemia (starvation)
Hypovolemia (dehydration)
What do you call inflammation of the uterus?
Metritis (endometrium and myometrium)
T/F: you see systemic illness in cases of metritis
True
—> fever and depression with purulent vulvar discharge
How can you diagnose metritis ?
CBC
Vaginal cytology
Culture
US
How would you treat metritis?
PGF2a to evacuate the uterus
Oxytocin is less effective >24hrs post whelping
What phase of the cycle does pyometra occur?
Diestrus (progesterone phase)
What is the pathogenesis of cystitis endometrial hyperplasia?
Estrogens
—promote growth inc. vascularity, edema of endometrium
—cervical relaxation and dilation
—increased P4 receptors
Progesterone
—stimulates proliferation and secretion of endometrial glands
— inhibit myometrial activity
—closure of cervix
In CEH —> normal down regulation of estrogen receptors with increasing P4 is defective —> prolonged estrogen effects on endometrium and high P4 receptors
Most common organism to cause secondary infection in CEH?
E.coli
What is the difference between an open and closed pyometra?
Open — less severely ill , copious red- brown, yellowish-green foul smelling vulvar discharge
Closed — no discharge, abdominal swelling, systemically ill
What usually causes the depression and PU/PD seen in cases of pyometra?
Endotoxemia
Treatment of pyometra ?
OHE
Medical
—PGF2q: lutalyse or estrumate (causes smooth muscle contractions for uterine evacuation)
— antimicrobial therapy based on C/S
T/F: medical therapy iwth PGF2a can only be used in closed pyometra
FALSE
Only open pyometra
Can cause uterine rupture in a closed pyometra
Side effcts of PGF2a?
Panting, salivation, vomiting, defecation, vocalization (queens)
How can you reduce risk for pyometra in breeding bitches?
Breed starting early
Don’t miss a cycle
Spay when you have obtained all litters desired
*pregnancy seems protective of uterine pathology
What is this?
Firm tubular mass protruding from the vulva
Occurs during for following parturition
Rx OHE
When does vaginal prolapse usually occur?
When there is high estrogen
Proestrus and estrus
Type this prolapse
Floor and walls of vagina are visible through vulva
Type 2
Type this prolapse
Entire vaginal circumference protrudes out of the vulva like a doughnut
Type 3
Treatment for vaginal prolapse?
Should regress after ovulation
Induce ovulation — GnRH or hCG
Keep clean and moist
E collar
Surgical — purse string suture / OHE
DDX for tissue protruding from vulva?
Prolapse Neoplasia Vaginal hyperplasia Vestibular mass (abscess) Intersex (enlarged clitoris)
DDX for perineal masses?
Tumor Abscess Hematoma Seroma Vaginal leiomyoma
What do you call enlarged, hot, painful glands
Fever and leukocytosis also present?
Mastitis
Common bacteria causing mastitis?
Coliform
Staph
Strep
Treatment for mastitis?
Hot pack and strip abnormal milk (warm cooked cabbage -> anti inflammatory)
NSAIDS (carprofen — little goes into milk)
Pups on yogurt/probiotics
Surgically removed dead/gangrenous gland
What is galactorrhea ?
Spontaneous flow of milk from mammary gland unassociated with pregnancy
When does galactorrhea usually occur?
In response to decreasing P4 stimulation
— 2-3months after estrus
— 3-4 after diestrus OHE
This is a normal phenomenon of intact bitch as P falls and E2 and prolactin rise
Clinical signs of false pregnancy?
Spontaneous development of mammary gland — usually clear, no milk
Treatment for false pregnancy?
Usually resolves on its own
May last up to 6 weeks
R/O pregnancy — relaxin
Cabergoline -10day treatment
What is the 2nd most common tumor type in dog?
Mammary neoplasia
1st are skin tumors
If spayed before the first estrus cycle, the risk for mammary tumors in dogs is ___%, after the first cycle, risk is at __%
0.5; 8
T/F: metastasis is common in canine mammary tumors
True
Treatment for canine mammary tumors?
ALWAYS recommend surgery
— wide margins
—only 50% are completely removed
OHE may or may not increase survivialtime
Chemotherapy adjunct
Clinical signs of eclampsia?
Panting Pacing Muscle tremors — trembling Ataxia Hyperthermia Tonic-clonic convulsions Death
Treatment of hypocalcemia?
IV Ca gluconate to effect
Oral supplements for maintenance
Weaning — if pups old enough
Clinical signs of subinvolution of placental sites ?
Persistent uterine bleeding
Gross lesions or erosions in endometrium
Histologically — mutlinuclear giant cells
