Canine: Pregnancy, Post-partum, drugs Flashcards
Given the following P4 values, when did the LH peak occur?
Mon 1.6
Tue 1.1
Wed 1.4
Thurs 1.9
Fri 2.1
Sat 2.3
Friday
T/F: Relaxin is pregnant specific and can be used to diagnose pregnancy.
True
Metritis is a conditon that occurs in ______ while pyometra occurs during ______.
(Stage of cycle)
Anestrus After whelping
Diestrus
When is the earliest pregnancy can be diagnosed via US?
24 days
Why is radiology counterindicated before day 42 of pregnancy?
Teratogenic
When (range of days) is organogenesis complete?
42-45
When can a relaxin assay be used to confirm pregnancy?
28-30+ days
Can try after 20 days
If you can feel a “string of pearls” on abdominal palpation, how old are the fetuses?
21-28 days (up to 35 days)
Difficult after 35 days
What is the source of relaxin in a pregnant bitch or queen?
Placenta
What heart rate indicates fetal stress?
a. >200bpm
b. 190bpm
c. <180bpm
c. <180bpm
T/F: Calcium should be supplemented during pregnancy, especially after 40 days when fetal skeleton calcification occurs.
False (all of it is)
What occurs before whelping when progesterone drops?
Decrease in body temperature
- ~24 hours prior to whelping*
- P4 is thermogenic*
Why should temperature be monitored twice daily when trying to predict whelping? What temperature usually indicates whelping is upcoming?
BID or TID and look at values 12 hours appart due to transient drop
<98F
Whelping occurs the day after the temperature drops
What progesterone value indicates 36 hours to whelping? 18 hours? 9 hours?
10 ng/mL
4 ng/mL
2 ng/mL
Which of these IS NOT an appropriate antibiotic for a pregnant bitch?
a. Clavamox
b. Enrofloxacin
c. Cephalexin
d. Tetracycline
E. Ceftizoxime
d. Tetracycline
* Remember: Cephalosporins (e.g. Ceftizoxime, cephalexin)* and Quinolones (e.g. Enrofloxacin) are ok
What should you administer if you have confirmed absolute fetal death (i.e. all pups are dead) in a bitch?
PGF2a
ASAP
_______ falls rapidly to initiate parturition. The level will be <___ ng/mL.
Progesterone
2
T/F: Milk is evident in glands 1-7 days prior to parturition, this is a reliable predictor of parturition.
False, time is correct but this is not a reliable indicator
Removal of the “progesterone block” from the uterus allows ________ activity to begin. Receptor sites for _____ also increase at stage one of partution.
Myometrial
Oxytocin
T/F: Vomiting during the first stage of parturition can be normal.
True
What appears first during parturiton?
a. Amnion
b. Placenta
c. Head of pup
d. Confetti
a. Amnion
What is uteroverdin?
Accumulation of maternal blood that supplies the fetuses with iron throughout the pregnancy and is expelled as greenish-black discharge
What are the 3 criteria for intervention during stage 2 of parturition?
Active contactions > 1 hour
Rest period > 4 hours
Black thick discharge without fetus
T/F: Caudal and cranial longitudinal are both normal presentations for pups being born.
True
What is the default treatment for dystocia?
C-section
What must you ensure before giving oxytocin to a bitch with dystocia?
That there is no obstruction present
What can you cause if you administer too much oxytocin to a bitch wiith dystocia?
Tetany
What is the 2nd treatment given to a bitch if oxytocin did not resolve the dystocia?
Calcium
IV with glucose, followed by more oxytocin
Why is placental retention rare in dogs?
Because they have a zonary placenta
Zonary endotheliochorial placenta
What effect may a c-section have on subsequent litters?
Reduce in litter size of 1-2 pups
T/F: Brownish mucoid iochia can be normal for 4-6 months postpartum.
False, weeks
How many layers are there in a bitch placenta?
5
When should weaning begin? When should it be complete?
3-4 weeks offer gruel
5-8 weeks
What 2 things can it indicate if a bitch is neglecting one of her pups?
Bitch is sick
Pup is failing to thrive
T/F: Pups require 1 full day of colostrum and then need daily milk intake.
False, milk and colostrum daily
For how long are pups poikilothermic?
2-3 weeks
What should the ambient temperature for pups be in the first week of life? The following 4 weeks? After that?
85-90F To limit viral replication
80F
70-75F
How much weight should pups gain daily?
10% of birth weight
T/F: Post-partum metritis presents as systemic illness including fever, deression, and purulent vulvar discharge.
True
Should you give PGF2a to a bitch with post-partum metritis if on ultrasound the uterine wall in 3-4mm thick?
Yes, do not give is <1-2mm because risk rupture
Which is a more effetive ecbolic >24 hours post-whelpingg, PGF2a or Oxytocin?
PGF2a
Oxytocin not as effective >24h post-whelping
Which condition is seen 60-90 days post-estrus in the bitch and any time in the queen, usually affecting older animals?
Pyometra
T/F: Cystic Endometrial Hyperplasia-Metritis Pyometra complex (CEHMP) can present as a chronic or acute post-estrual disease.
True
What is defective in a bitch who has developed CEHMP?
Down-regulation of estrogen receptors due to increaseing P4 levels
Secondary bacterial invasion may occur in a bitch with CEHMP. What is the most common organism?
E. coli
What is the treatment of choice for a closed pyometra? Open pyometra?
OVH for both after stabilization
What is the term for spontaneous flow of milk from a mammary gland unassociated with pregnancy?
Galactorrhea
What drug can you use to try to resolve an open cervix pyometra? How does it work?
PGF2a (Lutalyse, Estrumate)
Multiple small doses lyse the CL bringing down the [P4] to baseline
Treat to effect and monitor with US until uterine contents gone
What side effects should you warn a bitch owner after administering PGF2a? What should you also include in this list when your patient is a queen?
Panting
Salivation
Vomiting
Defecation
(all 30-40 min duration)
Queens: Vocalization
T/F: Oxytocin is involved in vaginal prolapse.
False, estrogen
How can you treat vaginal prolapse?
Induce ovulation with GnRH or hCG
+/- OVH or OVX
Which of the following is not a DDx for tissue protruding from the vulva?
a. Vaginal hyperplasia
b. Enlarged clitoris of an intersex
c. Subinvoluted placental sites
d. Transmittable veneral disease
c. Subinvoluted placental sites
When talking to an owner about removing a vaginal leiomyoma, what must you make sure they are aware of?
Surgery can cause lifelong incontinence
Which of the following is not a treatment for mastitis?
a. Carprofen
b. Clavamox
c. PGF2a
d. Warm cooked cabbage leaves topically
c. PGF2a
T/F: It is advisable to restrict access to water for a bitch with galactorrhea.
True
What is the most common benign mammary tumor?
Benign Mixed Mammary Tumor
T/F: The presence of a benign mammary tumor increases the chances of developing a malignant mass.
True
What % risk does a bitch spayed before her first estrous cycle have of developing mammary neoplasia? What if she is spayed after the 1st estrous? After the 2nd estrous?
0.5%
8%
26%
Infact have 7 x the risk if developing mammary tumors than OVH
What main 2 locations do malignant mammary tumors metastasize to?
Lungs
Lymph nodes
Which potentially hereditary post-partum condition occurs primarily in small nervous breeds leads to tonic-clonic convulsions? What is the treatment?
Hypocalcemia / Eclampsia
Tx: IV Calcium gluconate to effect then PO calcium for maintenance
What post-partum condition do you suspect if you note persistent uterine bleeding and multinuclear giant (trophoblast) cells on histology?
Subinvolution of Placental Sites (SIPS)
A definitive diagnosis for pregnancy in bitches is based on:
a. Measurement of P4 21 days after mating
b. Measurement of Estrone Sulphate 35 days after fertilization
c. Measurement of Relaxin 28 days after fertilization
d. Measurement of LH 19 days into diestrus
c. Measurement of Relaxin 28 days after fertilization
Why is Progestin counterindicated in cats?
It can cause Diabetes mellitus
What does giving Megesterol acetate starting 3 days into proestrus SID for 8 days cause?
Early onset of NEXT estrus (4-6 weeks early)
Stops ovulation/estrus + no pseudopregnancy
Why should you wait until after 45 days of pregancy, or at least the first trimester, to supplement progesterone?
It masculinizes the female pups and can induce cryptorchidism in male pups
What is Mibolerone used for? Why is it counterindicated in cats?
To prolong the interestrus interval (short IEI can cause infertility, EED, or small litter sizes)
Hepatotoxic in cats
Generally not recommended as contraceptive due to safety/efficacy issues
What can be used to treat pyometra, retained placenta, and mismating?
Prostaglandin (PGF2a)
How do Cabergoline and Bromocryptine decrease Prolactin (which leads to CL lysis)?
Caber= serotonin antagonist
Bromo= dopamine agonist
What is the downside to indusing estrus with cabergoline?
Conception is not as high if estrus is induced
T/F: Pseudopregnancy is normal after every estrus in bitches.
True
What can be given to treat unwanted uterine contractions?
Terbutaline (B-2 agonist)
+ Progesterone (if Terbutaline not cutting it)
What are 3 possible causes of unwanted uterine contractions?
Infection
Inflammation
Dead pup
What is Domperidone used for?
To increase milk production
