Disorders of the Pregnant and Post-Partum Dog Flashcards
are there any external signs of a pregnancy loss prior to 40d gestation?
nah; usually resorb fluids and tissue
describe signs of pregnancy loss between 40-65d gestation
- hemorrhagic vulvar discharge
- expulsion of fetuses
- +/- signs of maternal illness
what is always important to consider when dealing with an aborting dog?
BIOSECURITY!!!!!
CHV1, brucellosis, lepto
- wear gloves when handling tissues, dams, pups
- isolate aborting dam
- clean and disinfect areas dog contacts
- change shoes and clothing after handling the dam
- test other dogs and people once agent ID
list infectious causes of pregnancy
- CHV-1
- brucella
- campylobacter
- salmonella
- toxo
- lepto
- E. coli
anything that causes severe systemic illness
describe canine brucellosis
many strains!
-brucella canis, B. abortus (cows in other countries), B. suis (wild boars)
transmission: oral, conjunctiva, venereal, transplacental
secreted in aborted material, vulvar discharge, milk, urine, semen
-can shed high loads for 1-4 weeks post infection, but can shed for years (64 months) after infection
describe brucellosis clinical signs
- can be asymptomatic
- reproductive:
-infertility
-vulvar discharge
-embryonic death
-abortion
-neonatal death
-testicular atrophy
-epididymitis
-scrotal dermatitis - non-repro
-disco
-anterior uveitis
-lymphadenitis
-glomerulonephritis
-meningoencephalitis
describe testing for brucella
- takes 4-12 weeks for antibodies to be detected in serum
-acute infections can be hard to detect - antibodies remain elevated 3-9 months after abacteremic
- bacteremia can recur in chronic infections when dog is in heat, pregnant, or aborting (most reliable times to test)
- brucella card test
-detects antibodies to cell wall antigens of brucella canis
-used as screening test (highly sensitive)
-false positive common (cross reacts with other bacterial antigens)
-can increase specificity by adding 2-mercaptoethanol (inactivates IgM)
-if STILL positive, submit for AGID (uses cytoplasmic antigens) +/- confirm with blood culture
describe brucella treatment
- ZOONOTIC and persists in tissues and puppies!!!
- euthanasia: most common in food animal
- sterilization: still may shed in urine
- tetracycline + genatmicin, or enrofloxacin LONG TERM
-even though control bacteremia, often don’t eliminate bacteria from intracellular location
-can/will relapse
-repeat blood culture after 6 months
describe brucella prevention and control
- test new kennel dogs twice, 30d apart
- only use brucella-negative males
- screen all dogs every 3-6 months in breeding kennels
- remove positive animals
-quarantine and test all dogs monthly, must have THREE consecutive negative tests
describe CHV-1: transmission, shedding, and clinical signs
transmission: transplacental, oronasal, venereal
shed in:
-nasal discharge
-vulvar discharge
-aborted tissues
clinical signs:
-macerated or mummified fetuses
-stillbirths
-neonatal death
describe CHV-1 in adult dogs
- mild respiratory, ocular, or genital infections
-can see self-limiting papulovesicular vaginitis in bitches - self-limiting after developing immunity
-most repro problems if infected for 1st time during pregnancy
-protective colostral antibodies - latency/recrudescence: avoid stress during pregnancy!
- naive pregnant dogs
-isolate during last 3 weeks gestation: most susceptible period
-maintain good biosecurity with pregnant dogs in your clinic!
-there is a vaccine but not effective and not available here
describe CHV-1 in neonates
- disease/death if infected in utero or <3 weeks of life
- replication at low temps (<100F, 44-55% humidity)
- diagnosis:
-virus isolation (nasal or vaginal swabs) or IHC (aborted tissue)
-histopathology (necrosis and viral inclusion bodies) in aborted tissues - treatment:
-antibodies in colostrum of immune bitches; can supplement with colostrum or serum from immune
-infection usually fatal: puppies will cry nonstop, acute hemorrhagic septicemia, thrombocytopenia, interstitial pneumonia, encephalitis, cerebellar and retinal dysplasia segmental renal necrosis
-antivirals like acyclovir rarely helpful
describe uterine torsion
- rare in the bitch but does occur
-often see uterine rupture at time of surgery
-oxytocin CONTRAINDICATED
-usually when only one horn gravid (singleton) - resolution:
-C section +/- OVH
-urethral obstruction rare sequela to dystocia or obstruction
describe pregnancy toxemia
- relatively rare in the dog
-associated with inadequate carbohydrate intake, large litter size, and poor body condition
-ketonuria in absence of glucosuria
-can be life threatening to both dam and fetuses - treatment:
-nutritional support as long as possible
-C section when no longer able to stabilize
-best to intervene early (when bitch anorectic >24 hr)
describe nutrition and monitoring of the post-partum dog
nutrition:
-growth/lactation formula ad libitum
-need 2-3 times normal food intake
monitoring:
-daily rectal temp for 2 weeks
-mammary glands: color, size, secretions
-lochia (vulvar discharge): greenish-black to tan for up to 3 weeks
what can cause vulvar discharge >3 weeks post partum?
- metritis
- SIPS
- coagulopathy
- brucellosis
- trauma
- neoplasia
describe SIPS
subinvolution of placental sites
- hemorrhagic vulvar discharge >3 weeks post partum
- occurs when fetal trophoblastic cells do not degenerate
- trophoblasts continue to invade endometrium and myometrium, resulting in
-damage to blood vessels
-endometrial ulceration
-uterine perforation (rare) - diagnosis:
-radiographs or ultrasound: uterine swelling
-vaginal cytology: trophoblast-like cells (multinucleate and vacuolated) - treatment:
-spontaneous resolution
-transfusions if severe
-OVH
-antibiotics if concurrent infection (usually not necessary)
describe clinical signs and causes of postpartum metritis
clinical signs:
-malodorous red to brown vulvar discharge
-fever, dehydration, depression, endotoxemia
-can turn into toxic/septic metritis, septicemia, shock
causes:
-retained fetal membranes
-macerated or decomposed pups
-dystocia and uterine compromise
describe metritis diagnostics
- clinical signs
- clinical pathology
- vaginal cytology:
-degenerate or toxic PMNs
-endometrial cells
-muscle fibers (of pups) - bacterial culture:
-vaginal or uterine
-aerobic and anaerobic - ultrasound/radiographs!
-enlarged/fluid filled uterus
describe metritis treatment
- stabilize the dog
-IV fluids - control bacterial growth (systemic broad-spectrum antibiotics)
- evacuate uterine contents
-surgical removal of pups, membranes, devitalized tissues
-careful with ebolics (oxytocin and prostaglandin) because uterus prone to rupture
-uterine lavage: risk of rupture?
describe mastitis
- usually in first 2 weeks of lactation (rarely with pseudopregnancy; if see with pseudopreg = reason to treat pseudopreg)
- acute:
-fever, depression anorexia
-can be life threatening
-hot, painful mammary glands - chronic:
-asymptomatic
-puppy failure to thrive - mammary gand secretions
-macroscopic exam: normal, purulent, or reddish brown
-cytology!: degenerate neutrophils, bacteria
-culture: >10^4 bacteria/ml; usually E. coli, staphylococcus, or streptococcus - antibiotic selection:
-based on culture and sensitivity
-must penetrate milk: blood barrier
-must be safe for nursing pups
-NO FLUOROQUINOLONES FOR YOUNG PUPPIES
describe puerperal tetany
- also called eclampsia, post-parturient hypocalcemia
- common in small breeds in the 1st 4 weeks of lactation
-common in dogs with small body weight:litter weight ratio (small dog large litter) - decreased extracellular ionized calcium
-increased membrane permeability
-spontaneous muscle depolarization - clinical signs:
-hyperthermia: temp can be >105 without infection!
-restlessness
-poor mothering
-panting, tremors
-stiffness
-seizures, death - diagnosis:
-clinical signs
-total blood calcium <7mg/100ml; ionized calcium <0.8mmol/L
describe treatment of puerperal tetany
- 10% calcium gluconate SLOWLY IV
-to effect until signs resolve
-slowly to avoid cardiac side effects - often benefit from 1 dose dextrose too
- remove pups from nursing for at least 24 hrs
- supplement oral calcium and vitamin D until weaning
- large litters: supplement puppies with milk replacer until weaning
- can occur in subsequent pregnancies so maintain optimal Ca:P ratio of 2:1; maintain diet adequately during gestation!!
-use oral calcium: TUMS tablets postpartum only!!!
what are reasons for postpartum panting?
- temperature: room and in whelping box; ensure there is a cool place for bitch to access
- anxiety: no other dogs/pets/people intruding!
-give quiet environment and maybe cover whelping box or dim lights - ionized calcium levels +/- tums trial (subclinically hypocalcemic)
- pain meds if post op
- sometimes associated with oxytocin release at time of nursing
