Disorders and complications of pregnancy and neonatal conditions

Question 1

Physiological pregnancy length in dogs

Answer 1

61-63d from the time of ovulation

56-58d from the onset of cytological dioestrus

58-72d from the first breeding

Any confirmed pregnancy >65d with no signs of parturition warrants investigation, but not panic

Question 2

Prediction of due date in cats

Answer 2

induced ovulation and numerous matings make prediction of the parturition day far more difficult (52-74d from the 1st mating or 65-66d from the last mating

Question 3

Warning signs of dystocia in dogs and cats

Answer 3

○ Prolonged gestation when ovulation is known
○ Pregnant bitch >72 days breeding
○ Pregnant queen >71 days post breeding

Question 4

Alarm bells for dystocia in dogs and cats

Answer 4

Bitch strains for 1hr continuously before the delivery of any puppy

Green or black vaginal discharge prior to delivery of first puppy

The bitch rests 3 or more hours between puppies

The delivery of stillborn puppies

The dam is ill or distressed

Question 5

Foetal factors in dystocia of dogs and cats

Answer 5

Malpresentation

Malformation

Foetal oversize

Foetal death

Question 6

Maternal factors in dystocia of dogs and cats

Answer 6

Uterine inertia (primary or secondary)

Anatomical changes of birth canal (often fractures in queens, or intrapelvic masses)

Uterine torsion

Hydrallantois

Vaginal septae and bands

Vaginal stricture

Question 7

Predisposing factors to dystocia in dogs and cats

Answer 7

Size of the litter, smaller more likely to cause uterine inertia

Breed, brachycephalics or miniature breeds bred at 1st heat

Question 8

Management of primary uterine inertia

Answer 8

Establish the condition of the dam, number and viability of pups/kittens and when labour started

Small litter size and early onset:
- administration of oxytocin may have some effect and may be combined with calcium gluconate

Numerous pups and exhausted dam: unlikely that the parturition will be completed even if initial uterine contractions can be stimulated. C-section recommended.

Dead foetuses -> c-section.

Question 9

Oxytocin in support of labour

Answer 9

Currently recommended doses are 0.5-2iu to increase the frequency and quality of uterine contractions

Initial dose - 0.1-0.25iu/kg recommended

The dosage may be repeated in 30 mins

Repeated administration or excessive dose can lead to uterine spasm and tetanic contractions which further compromise the foetuses

Absolutely contraindicated in cases of obstructive dystocia

Question 10

Calcium in support of labour

Answer 10

Usually given before oxytocin to improve the contractions strength before increasing the frequency

Calcium gluconate is available as several salts and is administered as 10% calcium gluconate at 0.2 mL/kg IV or 22mg/kg per dog SC (give it slowly and keep an eye on the heart rate!)

If S/C you must dilute the volume with 1:1 saline, as calcium salts may be irritating

Do not give more frequently than every 4-6 hours

More commonly used in dogs

In cats, reports of very strong uterine contractions induced by calcium administration discourage most vets

Question 11

Management of obstructive dystocia in cats and dogs

Answer 11

Determine if there is a realistic chance for manual correction
§ Cause of obstruction
§ Number of foetuses ‘waiting’ and their viability
§ How much space do you have ‘inside’?

Will resolution of this particular obstacle give high chances for timely and safe completion of parturition?
§ If no or not sure then caesarean section

Be delicate and protect the birth canal

Always use as much lubricant as possible

Act in line with the uterine contractions not against them, retract between contractions, pull during them

In small and slim females, you can fix the uterus with the obstructing foetus using a hand applied to lower abdomen

Remember - the best way to reposition/rearrange the foetus is to first push it back a bit to gain space in the birth canal

Once the foetus is in the vagina pull downwards not upwards

Question 12

Caesarean section in dogs and cats

Answer 12

Usually the easiest and safest way to solve difficult parturition in dogs and cats

Additionally - if the pregnancy was unplanned and the female is not/no longer intended for breeding, ovariohysterectomy can be done at the same time

Plan the anaesthesia for the operated dam carefully, bearing in mind the possible influence on foetuses

Ensure that resuscitation tools and medication are in place if the neonates are expected to be alive

Important surgical aspects:
○ Gravid uterus is heavy and delicate so care should be taken when lifting from the abdominal cavity to avoid ruptures
○ It is helpful to make initial incision in the uterine wall with a scalpel and then widen it with scissors to avoid injury to the foetuses
○ While pulling out foetuses with their foetal membranes some fluid may escape and should be sucked away
○ Move along the whole uterus until you have reached both ovaries and the cervix and are sure all foetuses are removed

Question 13

Post partum complications in dogs and cats

Answer 13

Placental retention

Sub-involution of placental sites (SIPS)

Eclampsia/puerperal tetany in bitches

Question 14

Placental retention in dogs and cats

Answer 14

Far less frequent than in livestock

<24h pp -> oxytocin

<48h pp -> pretty serious -> surgery

Question 15

Sun-involution of placental sites (SIPS)

Answer 15

Specific to dogs

Persistence of sanguineous vulval discharge beyond 16 weeks pp.

Mild cases - spontaneous resolution.

Severe cases - Ovariohysterectomy.