Diseases of the female Flashcards
What are the most common bacteria isolated in pyometra?
E.coli most
few staph/ strep/ pseudomonas/ proteus
What medical management of pyometra is there?
Contraindicated for medical management
Antibiotics with aglepristone (progesterone receptor blocker)
high recurrence rate
cervical relaxation within 48 hours
Can also use prostaglandins but they have higher severe s/e rate
What are some predictive markers for the outcome of pyometra cases?
leukopenia has been associated with both presence of peritonitis and increased postoperative hospitalization in surgically treated bitches with pyometra
Band neutrophil concentrations, lymphopenia and monocytosis, blood urea nitrogen greater than 30 mg/dL, and creatinine concentrations greater than 1.5 mg/dL have been associated with death
In queens, white blood cell counts, neutrophils, band neutrophils, monocytes, and the
percentage band neutrophils were positively, and albumin concentrations negatively,
associated with postoperative hospitalization
What is agalactia?
Primary - anatomic or physiological abnormality
Secondary agalactia results from low milk production or decreased let down of milk into the teat canal. Often the lack of milk supply is identified within 2 to 3 days postpartum when the neonates fail to gain 5% to 10% of body weight daily
How is milk production controlled hormonally?
During late gestation when progesterone is decreasing, prolactin increases and subsequently increases again when the neonates start to suckle.
Prolactin production receives both inhibitory
and stimulatory signals. Dopamine is a main inhibitory factor of prolactin and the relationship is important for modulating milk production with drug therapy
What can cause secondary agalactia?
Concurrent medical conditions: malnutrition, systemic illness, premature parturition, progesterone therapy, mastitis, metritis, endotoxemia, stress, and pain from
a cesarean delivery.
The dam is highly nervous and anxious and the production of adrenalin blocks the release of oxytocin from the pituitary.
The dam has a large litter with high lactational demands.
The dam has poor appetite and is unwilling to consume adequate nutrition
How can agalactia be treated?
Tx underyling disease - may need fluids etc
Oxytocin - can help mild let down
Metoclop - dopamine antagonist
ACP - can reduce anxiety
Add water to meals and provide an energy-dense diet approved for reproduction and lactation, consisting of 30% protein, 20% fat, and 20% to 30% carbohydrate
on dry matter basis.
House the dam in a quiet and traffic-free room.
Use a dog-appeasing pheromone plug-in diffuser, spray, or collar (ADAPTIL, Ceva
Sante Animale, Libourne, France), which provides a synthetic equivalent of the
calming pheromone produced by dams when they are reassuring their pups
When does galactostasis occur (can appear similar to septic mastitis but the pet shouldn’t be ‘ill’
s shortly after parturition or after a dam has weaned from pups or lost a litter. It can also be associated with a dam nursing a small litter that has produced a large amount of milk or when neonates are weak or not rotating to nurse all glands
How do you treat galactostasis?
Treatment for Dams Nursing Neonates:
Confirm neonates’ ability to effectively suckle and dam’s acceptance to nursing
the litter.
Cool compress hard and engorged glands and alternate with warm compresses to gently soften. Massage the glands frequently, relieving pressure and eliciting milk ejection. Neonates nursing immediately after the application of warm compresses will maximize the emptying of glands.
When glands soften and milk ejection occurs, assist nurse neonates to further stimulate milk let down.
Treatment for Dams Weaned from Neonates
Reduce food intake and physically separate the dam from the pups.
Apply cool compresses 10 minutes 3 times per day to engorged glands.
Give nonsteroidal analgesics for pain relief.
If necessary, the dopamine agonist cabergoline reduces prolactin secretion and milk production: give 2.5 to 5 mg/kg/d for 4 to 6 days
How can you diagnose mastitis?
Bloods may show inflammatory changes
Can submit milk for culture, cytology of milk will show degenerate neutrophils/ ontracellular bacteria
US can be used to look for abscesses
What would be appropriate ABs for mastitis?
Co-amox or cephalexin
7-14d course
What other tx apart from ABs should be given for mastitis?
Pain releif
Moist hot packing of gland(s) softens mammary tissue and allows the expression of infected milk. Frequency depends on inflammation, but initially every 4 to
6 hours is ideal.
Apply rinsed, cool cabbage leaves to engorged glands after hot packing. Cabbage contains antibiotic and anti-irritant properties.
if painful, apply a bandage or loose fitting shirt on the dam to protect gland from trauma and prevent nursing of the affected gland.
When necessary for the dam’s comfort, separate the dam from litter during initial healing and only allow nursing with supervision.
The dam may continue to nurse neonates, even on the infected glands, unless the infected glands become too painful, abscessed, or gangrenous, or the
dam is receiving medication that neonates should not consume in milk.
Debridement of tissue may be needed
What is metritis?
Metritis is an acute infection involving the endometrium and the myometrium of the uterus and typically occurs 1 to 7 days after whelping
How do you tx metritis?
ABs
frequent walks and baths
consider prostaglandin treatment
INI will require surgery to remove anything stuck within the uterus or OVH
Which patients are likely to get eclampsia?
Eclampsia typically occurs during the first 4 weeks of lactation ; however, symptoms may arise prenatally on rare occasions.
small breed dams with large litters are typical, but any size and breed of dog may develop the condition.
Calcium supplementation or ingesting calcium containing foods during gestation inhibits parathyroid hormone secretion, predisposing the dam to eclampsia during lactation.
A dam with heavy lactational demands or one that is reluctant to maintain adequate nutrition is also at risk.
What are the signs of ecampsia?
Restlessness Poor mothering Facial pruritis Hyperthermia Hypersalivation Panting Anxiousness/whining Muscle fasciculation Stiffness Staggering Dilated pupils Tachycardia Opisthotonos Collapse/lateral recumbency Involuntary tremors/twitching Seizures
