Disorders of post-parturitient bitch Flashcards
When does uterine involution occur in dogs?
nonpreg takes 4 months from onset of proestrus
preg bitch takes 90 days from postpartum (5mo?)
What are the clinical signs of retained placenta?
green-bblack discharge persists >12-24hr systemic signs (anorexia, vomiting etc) 2-4d pp hungry restless pups
When might retained placenta occur?
after dystocia, inappropriate intervention in labour, maternal dz (ecclasmpsia etc)
What are consequences of prolonged retained placenta?
- necrosis of uterine wall
- toxemia
- uterine distention
- metritis
- death
How do you diagnose retained placenta?
count the placenta
palpation, U/S, xray, CBC–systemic inflam
(U/S early probably best–can be hard if there is not a lot of fluid)
What is the treatment for retained placenta?
- oxytocin and uterine massage
- digital manipulation
- prostaglandins
- antibiotics, fluids, NSAIDs if required
- ovariohysterectomy
What are features of subinvolution of the uterus?
usually both uterine horns, may be focal or segmental
incomplete ineffective uterine contracations
difficult to observe, may be palpable
fetal fluids, debris retained
What is toxic milk syndrome?
subinvolution of the uterus causes breakdown products to be excreted in milk and pups are restless, crying, bloated, may have edematous rectum
What is treatment for subinvolution of the uterus?
- empty uterus, prevent endometritis, metritis
- restore tone
- oxytocin
- PGF2alpha
- Ca gluconate–hypocalcemic may be reason for subinvolution
- remove pups 24hr, feed 10% dextrose to decrease bloating
What are the features of acute metritis?
2-3 days post-partum, rarely after estrus, AI or natural mating
E. coli, staph, strep
What are the clinical signs of acute metritis?
depression, fever, anroexia
agalactia, neglect of pups
red fetid vaginal discharge, or green to black
+/- abdominal pain, vomiting, diarrhea
How do you diagnose acute metritis?
- palpation
- +/- ultrasound, xray
- vaginal cytology, degenerate WBC, bacteria, RBC
What is the treatment for acute metritis?
- remove pups
- supportive tx, fluids, dextrose
- antibiotics 10-14d systemic broad spectrum
- PGF2alpha
- oxytocin if shortly after parturition
- ergonovine oral adjunct–promotes uterine contractility, can be given ORALLY that is the advantage
- OHE if unsuccessful
What is subinvolution of placental sites? who gets it?
placental sites do not involute properly (the fetal cells that are not degenerating normally, different from subinvolution of uterus)
trophoblastic cells do not degenerate, continue to invade deep into endometrium, myometrium
usually first litter bitches
What are clinical signs of subinvolution of placental sites
persistent hemorrhagic discharge (weeks to month), rarely anemia but usually the animal is systemically normal
How do you diagnose subinvolution of placental sites?
- pallpation, U/S, discrete enlargements of uterus
- vaginal cytology, RBCs, occasional snycytiotrophoblasts, normally not many WBC at all
- rarely secondary infection (rare!)
- signalment/history is important in this case
What is treatment for Subinvolution of placental sites?
- none monitory PCV
- PGF2alpha
- progestin
- OHE if desirable or anemic bitch
Why might you not want to breed animals that get subinvolution of placental sites? What would you do if you still wanted to breed them?
it can reoccur in subsequent litters
could give oxytocin post partum or ergonovine but that preventative therapy may not be that helpful
How common is uterine prolapse in the dog?
rare!
When might uterine prolapse occur in the dog?
tenesmus post RP dead fetus trauma metritis ==>impaired contractility post partum and excessive straining
What is the appearance of uterine prolpase?
large fleshy structure coming from vagina
may be to different degrees (only cervix vs both horns)
What is the treatment for uterine prolapse?
- examine closely for necrosis, self-mutilation, rupture
- rinse and replace
- may use dextrose or elevation and wrap to reduce swelling
- follow with oxytocin
- antibiotics 7-10d
- may have to perform OHE
often friable
How common is agalactia?
rare
What is the cause of agalactia?
- poor nutrition
- psychological impairment of milk let-down
- primary agalactia: lack of teh development of mammary tissue; not treatable
- secondary: due to other diseae conditions, remove underlying cause
What is a possible consequence of agalactia
pups may need to be hand raised
What is galactostasis
mammary land congestion, edema
What are the clinical signs of galactostasis?
- uncomfortable, anorectic, few days before to 3 days after whelping
- often on a high plane of nutrition, sometimes follows pseudopregnancy
- milk drops at end of nipple
- may be seen in 1-2 glands, usually abnormal nipple
What is the treatment for galactostasis?
didn’t write dwn
What are the two routes of infection of mammary glands?
ascending or hematogenous
WHat is the major pathogen of mastitis in dogs, what are two less common ones?
- e coli
2. staph, strep
What are clinical signs of mastitis?
- 1 or more mammary glands enlarged, painful, warm
- fever, anorexia, often present with cracked teats
- occasionally pointing abscess
- may progress to gangrenous mastitis
- cytology; copious degenerate neutrophils, bacteria, some RBCs
What is the treatment of mastitis?
massage and remove discharge
hotpacks if infection well established, hot water bottle
if acute cold packs may give relief
lance and drain if abscessation present
antibiotics, NSAIds, cabergoline if necessary
supervision and rotation among pups or may have to treat puppies as orphans
evaluate enironmental hyigene
What are features of chronic mastitis?
- difficult to diagnose
- puppies not doing well, not gaining weight
- culture milk
damaged mammary gland may not produce enough milk - supplement puppies
What is puerperal teatany (eclampsia)
hypocalcemia
loss of calcium through lactation and fetal skeletal mineralization
When does puerperal tetany occur? to who?
before or up to 3-4 weeks after parturition
mostly in smaller excitable breeds, first litters, large litter sizes
inadequate diet, thyroid…????missed that
What are clinical signs of puereral tetany?
restlessness, excessive panting, excitable
trembling ataic, seizures, opsithotonus, dilated pupils, foaming at mouth
hyperthermia–seizures
hypocalemia
What is the treatment for puerperal tetany?
10% calcium gluconate--give slowly!! monitor heart rate and rhythm ECG titrate treatment to clinical responnse give same amount subQ remove pups 24hr, feed by bottle wean early if pupps >3wks hand raise no corticosteroids may eperience relapses, reoccurrence
What is prevention of puerperal tetany (eclampsia)?
during gestation feed a good qualiy, balanced diet Ca: P ratio 1:1 or less
danger of oversupplementing with calciujm
avoid feeds with high amounts of wheat bran or soybean meal
Why should you monitor glucose in dogs with puerperal tetany?
may have concurrent hypoglycemia (may be secondary to ecclampsia anorexia)
monitor blood glucose
can give IV dextrose
can also give valium and phenobarb to reduce nervous systemi signs with ecclampsia?
How often does rupture of uterus or cranial vagina occur?
rarely
What are causes of rupture of uterus or cranial vagina?
- overszealous use of oxytocin
- improper use of obstrectic instruments
- spontaneous related to infection +/- bloody discharge
What does rupture of the uterus or cranial vagina require for treatment?
surgical repair or ovariohysterectomy
Who do perforating uterine ulcers occur in?
smaller breeds
What is a perforating uterine ulcer?
local necrotizing lesion in uterine wall perforates and creates sepsis and peritonitis
What can perforating uterine ulcer be related to?
retained placenta or retained pup
What does perofrating uterine ulcer present as?
acute abdomen
How is perforating uterine ulcer treated?
missed
What may cause abnormal maternal behavior?
hormonal balance, general health and environmental interaction (young aniamls, not familiar with whelping box)
How can you reduce abnormal maternal behavior?
familiar quiet, surroundings, and supervision in the presence of young, tranquilizers
