Dog and Cat 1 Flashcards

1
Q

what type of breeders are dogs, when puberty and interoestrus interval

A
  • Non-seasonal breeders
  • Spontaneous ovulation
  • Puberty at time of first oestrous cycle
    ○ 3.5 to 24 months (breed dependent) - average 10-12 months
    ○ Generally small breeds experience their first oestrus earlier and large breeds later
  • Interoestrus interval (IEI)
    ○ Average: 7 months
    ○ Normal range: 5 to 12 months
    ○ Dormitory effect
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2
Q

Prooestrus of dogs average duration, what occurs in terms of hormones

A
  • Average duration of 9 days
  • This is when bleeding occurs -> not shedding internal lining but due to hyperaemia
  • Maximum oestrogen levels - different from others
  • Progesterone is starting to rise
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3
Q

Placental take over of production of progesterone what species never has this take over

A

Pigs, cats, dog
- Never placental take over for the production of progesterone
○ Some progestagens produced by the placenta but not complete take over

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4
Q

What are the 3 important series of events with dog breeding and what occurs/how you know when occur

A

Day 0 (d0) = day of the LH surge (most important)
- First day serum progesterone doubles/rises > 2ng/ml
Days 1-7 = -6 days of oestrus
- In relation to LH surge
D1 = first day of dioestrus
- Based on cytology (decrease of keratinised cells to <50%)
○ Also get neutrophils -> normal in dioestrus, anoestrus BUT NOT OESTRUS
§ Not in oestrus because of the keratinised epithelium of uterus
§ Once get dioestrus sloughing of keratinised epithelium and neutrophils leave

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5
Q

What are 4 important features of a pre-breeding exam

A
  • Signalment, history
  • General exam, esp. hereditary diseases
  • Special reproduction exam
    ○ Digital palpation of vulva and vagina - in large breed dogs as can have strictures
    ○ Vaginoscopy
    ○ Cytology
    ○ Microbiology??? - waste of time and money
  • B. canis test - important in north america
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6
Q

oocyte maturation what days are important

A
  • d0
  • d2 -D3 ovulation
  • d4 - D6 oocytes
  • d6 - cervix closes
    D1 = d8 = first day of dioestrus
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7
Q

Maximum fertility of occyte and insemination times for fresh, chilled and frozen semen

A

Maximum fertility
- From days 4-8 possible fertility
- All oocytes are fertile day 5-6 or day 5
Insemination times
- Fresh semen: 6 days -> inseminate on day 3 and 5 OR day 4 and 6
- Chilled semen: 2 days -> inseminate on day 3 and 5 OR day 4 and 6
- Frozen semen: 24h -> inseminate on day 4 or 5 OR 5 and 6, if only one dose: day 5

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8
Q

What are 4 important tests to determine when breeding is to occur

A

1) Breeding reflexes - starts in prooestrus and progresses through oestrus
2) Vaginal exam- speculum
3) Exfoliative cytology - prooestrus see non and cornified cells, 100% cornified is oestrous but not necessary LH surge
○ If have 100% cornification but also neutrophils -> INFECTION (endometritis) - not as common as horses
4) Serum progesterone levels - should do with cytology

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9
Q

In terms of breeding reflexes what are important things to look for

A
  • “flagging”: lateral deviation of the tail
  • “winking”: upward tipping of the vulva
  • “lordosis”: standing firmly and arching her back
  • Note vaginal discharge
    ○ Proestrus - bloody
    ○ Oestrus - less bloody
    ○ Dioestrus - puss
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10
Q

Vaginoscopy for breeding management what use and what do you see in different stages of oestrus

A
  • Use (plexi) glass speculum and light source
  • Note vaginal wall and folds
    ○ Pro-oestrus: pink, swollen, rounded folds, moist
    ○ Oestrus: pale-pink, shrunken/angular (crenulated), dry
    ○ Dioestrus: hyperaemic areas, rounded folds
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11
Q

Vaginal cytology what does it reflect, excellent to determine, good and not useful

A
  • Reflects endogenous oestrogen levels
  • Excellent to determine dioestrus (D1)
  • Good to determine
    ○ Early prooestrus vs late prooestrus/oestus
    ○ Prooestus/oestrus vs dioestrus/anoestrus
  • Not useful to determine ovulation or ideal time of breeding
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12
Q

What are the 2 main types of cells in the reproductive tract and cells within

A
  • Non-cornified cells
    ○ Parabasal cells: small, round - oval, “fried egg” appearance
    ○ Intermediate cells: larger than parabasal cells, higher cytoplasm: nuclear ratio
  • Cornified cells
    ○ Superficial cells: pyknotic nuclei, angular shape to the cytoplasm
    ○ Anuclear squamous cells: anuclear largest of vaginal epithelial cells, resemble cornflakes
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13
Q

In terms of vaginal cytology what is present in anoestrus

A

○ Non-cornified epithelial cells
§ Mainly small, round parabasal cells and intermediate cells
○ Neutrophils can be present
○ Bacteria can be present

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14
Q

In terms of vaginal cytology what is present in prooestrus

A

○ Shift from parabasal and intermediate cells to superficial cells
○ Numerous red blood cells
○ Neutrophils commonly observed
○ Bacteria commonly observed

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15
Q

In terms of vaginal cytology what is present in oestrus

A

○ >90% cornified cells marks beginning of “cytological oestrus”; superficial and anuclear squamous cells (Dead)
§ Oestrogen leads to hyperplasia or the wall
○ Bacteria can be present
○ BUT no neutrophils present (as above)

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16
Q

In terms of vaginal cytology what is present on dioestrus

A

○ 1st day with <50% keratinized epithelial cells marks D1
○ Increase in parabasal and intermediate cells
○ Many neutrophils observed - progesterone leading to sloughing of epithelial cells
○ Metoestral cells: neutrophils found in cytoplasm
○ Copious amount of vaginal discharge sometimes observed -> “dioestral dumping” of neutrophils

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17
Q

In terms of breeding management what are important practices

A
  • Sampling every 2 to 3 days (M,W,F)
  • Start in prooestrus
  • Breeding reflexes, vaginoscopy and cytology should be done until D1
  • Serum progesterone levels should be assessed q 2d until LH surge; blood should also be taken at time of breeding and on D1 (serum can be frozen in case of negative preg check)
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18
Q

Serum progesterone concentrations what concetrations occur at LH surge, time of ovulation, fertile period and after this range. what aiming for with breeding

A
  • 2 ng/ml at time of LH surge (or doubling of previous level)
  • 5 ng/ml at time of ovulation
  • 10-25 ng/ml at time of fertile period (variable) - day 5-6
  • VERY variable thereafter
  • Aim for one breeding between 15-20 ng/ml
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19
Q

Vaginal semen deposition natural vs artifical insemination in terms of what day to breed and pros and cons

A
  1. Natural mating - day 5: allow natural mating
    ○ Pros: largest litter size (same as surgical and endoscope)
    ○ Cons: no semen assessment
  2. Artifical insemination (AI) with catheter (eg. Flexible horse catheter) - day 3 collect semen, assess and then inseminate
    ○ Pros: easy to do
    Cons: smaller litter size, not suitable for frozen semen
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20
Q

Intrauterine semen deposition what are the 2 types how to do and pros and cons

A
  1. Transcervical
    ○ Endoscope - most common but specialised
    § Pros: certain, good success rate
    § Cons: expensive equipment
    ○ Norwegian catheter
    § Pros: cheap
    § Cons: difficult to learn, risk of perforation
  2. Surgical
    ○ Greyhounds with frozen semen have to have this
    ○ Pros: certain
    ○ Cons: surgical complications, ethical issues (highly invasive)
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21
Q

Where do you deposit the semen in bitch reproductive tract and how do you achieve for fresh and frozen semen

A
  • Fresh semen: Location Vagina Technique catheter (can use endoscope as better outcome but more expensive)
  • Frozen semen: Location Uterus Technique Transcervical endoscope
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22
Q

what is the best way to determine the first day of dioestrus and what results from oestrogenisation

A

What is the best way to determine the first day of dioestrus
- Vaginal cytology smear -> presence of neutrophils, clumping cornified and presence of increasing non-cornified
Oestrogenisation
- High levels of oestrogen results in cornification cells within the vagina
- Results in either tumor or ovarian remnant syndrome

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23
Q

What are 2 main reasons a desexed dog has discharge and how to differentiate

A
  1. Pyometra or vaginitis -> non-cornified cells found on vaginal smear
  2. Ovarian remnant syndrome - cornified cells found on vaginal smear
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24
Q

What are 4 main pregnancy diagnosis techniques, at what days post LH surge and how common AND what shouldn’t you use

A

1) Ultrasonography: > 20 days post LH surge
○ If don’t see anything may need to come back in a week as too early
2) Abdominal palpation: > 25 days post LH surge
○ Not necessarily pregnancy, may be pyometra
3) Relaxin test: > 28 days post LH surge
○ Not often, generally just use ultrasound
4) Radiography: > 44 days post LH surge
Beware: serum progesterone levels are NEVER to be used as an indicator of pregnancy in the bitch

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25
Q

What are the 2 main treatments for termination of pregnancy

A
1) #1 treatment: ovariohysterectomy!
○ Do you want to breed her in the future??
2) In breeding bitch: confirm pregnancy at appropriate time 
- If pregnant:
○ PGF2alpha
○ Dopamine agonists 
○ Aglepristone 
○ Corticosteroids - Dexamethasone 
Or a combination of the above
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26
Q

What is important to remember when using Aglepristone (Alizin) and what main uses

A

1) Abortion
registered in Australia for induction of abortion in the bitch from 0 – 45 days after mating
○ Before about 45 days, foetus is resorbed
§ Should wait till off heat as if given then mate again 2-3 days later
○ After 45 days, they deliver the foetus -> not nice, want it to be done before this
○ 2 injections 24 hours apart
○ MUST be given by a vet
2) induction of parturition
- Off-label use of Alizin
- Evidence it’s safe from day 58-59
- Takes >24h

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27
Q

What are the 3 main ways to estimate whelping date

A

1) 57 +/- 1 day post D1 of dioestrus
2) 65 +/- day post LH surge
3) BUT: 65 +/- 8 days post breeding
§ If have breeding date -> Could be breed in prooestrus or last day of heat oestrus
□ If want to know when whelp more accurate -> ultrasound (on day 20) - gestational age

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28
Q

What are the 3 stages in whelping, how long does it take and what occurs

A

Stage I (6 to 12 hours; up to 24h)
- Nesting behaviour, off food, restlessness, vomiting, anorexia shivering —-> cervical dilation, vaginal relaxation, uterine contractions
Stage II (3 to 12 hours)
- Water breaks, Expulsion of first pup can last up to 4 hours, usually 30 min to 2 hours in between pups; may take break
○ Large issue if there are contractions without a puppy
Stage III (variable)
- Expulsion of allantochorionic foetal membranes
○ Occurs at the same time as stage II -> Randomally dispersed between pups

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29
Q

What are 6 signs of dystocia in bitches

A
  1. Whelping not observed after temperature drop
    ○ Progesterone taken away (thermogenic) will result in temperature drop
    ○ Should take temperature regularly for a few days prior to know when the drop is
  2. Active labour > 4 hours and non pup produced
  3. Green-coloured or malodorous vaginal discharge in first stage labour
    ○ Detachment of the placenta -> normal in stage III
  4. Interval between pups > 30 min (with myometrial contractions)
  5. Interval between pups >2 hours (without myometrial contractions)
  6. Signs of pain or diffuse vaginal bleeding
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30
Q

what occurs if it is an obstructive dystocia and what are the 2 things you should do

A
  • EMERGENCY
  • But take time to examine the bitch and reach a diagnosis
  • Should still do two procedures
    1. Vaginal exam - feel for puppy, and should contract if not - hypocalcaemia
    2. Ultrasonography - foetal viability and heart rate
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31
Q

Elective caesarean section what do you need to know, signs and what should you do beforehand

A
  • Important to know dO and D1
  • Progesterone drops 24 to 48 hours praepartum
  • Rectal temperature drops 8 to 24 hours
  • Check foetal heart rates in last couple of days (especially in singleton pregnancy)
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32
Q

Uterine inertia how assess, treatment and what is important

A
  • Assess hypocalcaemia clinically
  • Blood Ca levels (even ionised) can be normal in clinically hypocalcaemia bitch
  • Give 10%- Ca solution INTRAVENOUSLY
  • ALWAYS listen to heart while administering calcium
    ○ Heart rate will slow, then increase so do again
  • Give calcium TO EFFECT
  • Oxytocin may be helpful but often not necessary (no one has diagnosed hypooxytocinaemia)
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33
Q

List the 3 main postpartum diseases

A

1) Eclampsia
2) metritis
3) subinvolution of placental sites

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34
Q

Eclampsia when most common, clinical signs, treatment and prevention

A

○ Observed mainly in toy breeds with large litters (3 + puppies) < 28 days post partum
○ Clinical signs: tremors, nervousness, salivation; late stage: opisthotonus
○ Treatment: calcium IV to effect, oral calcium supplementation, wean puppies if >4 weeks
○ Prevention: adequate Ca:P ratio per partum
§ Recommend off the shelf pregnancy feed

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35
Q

Metritis when does it generally occur in dogs, clinical signs, diagnosis and treatment

A

○ Acute puerperal metritis occurs 0 to 7 days pp due to retained foetal membranes/fetuses, dystocia etc. and secondary infection
○ Clinical signs: fever, anorexia, vaginal discharge, doughy enlarged uterus
○ Diagnosis: cytology: neutrophils, bacteria (phagocytosed), membrane parts, WBC: leukogram can be normal initially
○ Treatment: treat shock, antibiotics (broad-spectrum), evacuate uterus

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36
Q

Subinvolution of placental sites what occurs, what age common, clinical signs and treatment

A
  • Delayed involution of placental sites
    ○ More often in bitches <3 years of age
    ○ Clinical signs: sanguineous vaginal discharge > 6 weeks post-partum
    ○ Treatment: often self-limiting, OHE if necessary
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37
Q

False pregnancy what are the clinical signs, pathogenesis and treatment

A
- Clinical signs
○ Mammary development and galactorrhea 
○ Nesting and "mothering" behaviour 
○ Abdominal distention/uterine enlargement 
- Pathogenesis 
○ Low Progesterone  -> so spaying doesn't help 
○ High Prolactin 
- Treatment 
Prolactin antagonist (Cabergoline)
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38
Q

Hypoluteinism what occurs and treatment

A
  • Often diagnosed but never proven
  • Progesterone supplementation in the dogs needs clear indication - not recommended
  • Side effects are substantial -> risk of pyometra and uterine enlargement
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39
Q

Pyometra how common, and how occurs

A
  • Affects 24% of intact bitches before 10 years of age
  • Due to not being able to get rid of bacteria before the cervix closes
  • 75-93% of affected bitches show clinical signs within 12 weeks of their last heat
    1) E. coli is isolated from the uterus in up to 96% of clinical cases
    2) Progesterone -> stays high even when not pregnant within dioestrus
  • Stimulates proliferation and secretion of endometrial glands (uterine milk)
  • Keeps cervix functionally closed
  • Inhibits myometrial contractions
    Reduced immune response to pathogens
    3) These effects are exacerbated if the uterus is previously primed with oestrogen
  • Therefore multiple oestrus cycles without pregnancy will have a “cumulative effect”
    ○ CEH (cystic endometrial hyperplasia) -> all with pyometra will have this, can be secondary
    4) RESULT: the perfect environment for bacteria
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40
Q

In terms of pyometra what is the classic and atypical patient

A
The "classic" patient 
- Middle aged to old 
- Intact, in dioestrus 
- Has not been pregnancy 
- THERE ARE EXCEPTIONS 
The "atypical" patient 
- Breed predisposition: 
○ Increased risk: goldern retriever, cavalier king Charles, miniature schnauzer 
○ Lower risk: Pekingese, boxer, poodle, fox terrier, dachshund, German shepherd 
- Anecdotal familial clustering
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41
Q

What are the 2 types of pyometra and clinical signs

A
  1. Open pyometra - more obvious as discharge but generally not as systemically sick
  2. Closed pyometra - generally more systemically sick
    Clinical signs
    - Not definitive
    - Pyometra should be suspected in any intact bitch presenting
    ○ 4 to 12 weeks after having been in heat
    With vaginal discharge, depression, PU/PD, vomiting, and/or pyrexia
42
Q

What are the 3 main ways to diagnose pyometra and 3 different differential diagnosis

A
  • History
  • Whole blood count (neutrophilia with left shift)
  • Ultrasonography - always recommended
  • Differential diagnosis
    ○ Mucometra
    ○ Hydrometra
    Haemometra
43
Q

What are the 4 main treatment options for pyometra

A

1) #1 treatment - OVARIOHYSTERECTOMY
2) If in breeding animal -> evacuate the uterus
○ Low dose prostaglandinF2alpha - low dosage in the beginning
○ Can be used in combination with Aglepristone (helps with luteolysis without giving contractions - don’t want contractions when closed - given 24 hours prior to PGF2alpha)
3) Treat bacterial infection
○ Broad spectrum antibiotic based on E. Coli
4) Treat systemic signs if indicated

44
Q

pyometra prognosis for future fertility

A
  • Dependent on age, parity, degree of CEH change, and response to treatment
  • Reported pregnancy rates: 50-75%
  • Reported recurrence rate: 10-80%
  • If no response to treatment within 5 days
    ○ Poor prognosis in regard to future fertility
    ○ Increased risk of recurrence of disease
  • Prolonging anoestrus with androgen (mibolerone) recommended
45
Q

What is the chance of pregnancy in a mating, therefore chance of bitch not falling pregnant and percentage for bitch missing twice in two consecutive cycle

A
  • If a fertile male and a fertile female mate at appropriate time of cycle have a 75% chance of producing a litter
    ○ Therefore the bitch has 25% chance NOT to fall pregnancy per cycle
    ○ BUT only 6% of bitches miss twice in two consecutive cycles
46
Q

When is fertility exam justified,, when done and the 3 main components

A
  • Fertility exam justified after two empty consecutive cycles
    ○ Ideally first exam done in anoestrus (few months before next expected heat)
    1) History
    2) Generally physical exam and blood work
    3) special reproductive exam
47
Q

What history is important for a fertility exam in the dog

A
§ Signalment, esp breed and age 
§ Environment - other dogs 
§ Vaccination history, brucella canis tst 
§ Complete medical history 
§ Reproductive history 
□ Determine if she has: 
® Normal oestrus cycle 
® Irregular oestrus cycle 
◊ Prolonged prooestrus/oestrus 
◊ Shortened prooestrus/oestrus 
◊ Shortened IEI (<4 months) 
® Fails to cycle
48
Q

What is important to consider with general physical exam and blood work in fertility exam of the dog

A

§ Acquired disease
§ Inherited diseases –> discourage from breeding if present
§ Baseline laboratory data
□ CBC/blood chemistry to exclude CUSHING’s
□ Urinalysis if sign of urinary tract infection
□ B.canis test
□ Supplementary
® TSH stimulation test if indication of hypothyroidism (no research that correlates this with infertility)
® Adrenal stimulation test if indicated
® Karyotyping if suspicious (ambiguous genitalia, primary anoestrus) - if had puppies then no
® Gonadotropin concentration if suspicious of hypogonadism
§ Follow-up exam might be necessary

49
Q

What are important factors of special reproductive exams in assessing bitch fertiity

A
§ Abdominal palpation of uterus 
§ Digital palpation of vulva and vagina when possible 
§ Rectal palpation of vagina and bony pelvis 
§ If applicable 
□ Ultrasonography 
□ Vaginoscopy 
□ Endoscopy 
□ Laparoscopy (with good indication)
50
Q

Endometritis how diagnose,, best time to diagnose and treatment

A
  • Controversial - does it exists
  • History (>2 open cycles) together with positive intrauterine culture AND cytology are diagnostic
  • Best time to diagnose: in dioestrus BUT luteolysis has to be initiated - give
  • Appropriate antibiotics based on sensitivity
51
Q

Oestrus induction what are 4 main indications and protocols

A
- Indications 
○ Silent heat 
○ Missed cycle 
○ Limited male availability 
○ Prolonged anoestrus 
- Various protocols available 
○ Deslorelin (GnRH agonist) works well if given as implant or long acting injection
52
Q

Follicular cysts how diagnose, confirmation and treatment

A
  • Diagnosis based on history and u/s
  • Need to confirm that the cycle is prolonged —> cytology
  • Ultrasonography: follicles fail to luteinise; > 8mm diameter
  • Treatment: GnRH or hcG
    Always think of ovarian NEOPLASIA as a differential diagnosis
53
Q

Vaginitis what are the 2 types, clinical signs and treatment

A
  • Puppy vaginitis: Prior to first oestrus -> once goes away can spay
  • Adult vaginitis: AFTER first oestrus and in spayed females
  • Clinical signs: discharge, may attract male dogs
  • Treatment: puppy vaginitis often resolves spontaneously after first oestrous cycle
  • check for brucellosis
  • Phenylpropanolamine recommended for adult vaginitis
54
Q

Split heat what age common, what occurs and treatment

A
  • Common phenomenon in young bitches during first heat
  • Physiological and behavioural signs of prooestrus occur without progression to oestrus
    ○ Discharge -> so pyometra is a differential however that generally older this younger animals
  • After 4 weeks “normal oestrous cycle” with ovulation occurs
  • Generally only occurs once and after that get normal oestrus
55
Q

shortened IEI interval what leads to, cause and treatment

A
  • IEI < 4 moths, subsequent infertility
  • Can be breed related; especially German Shepherds affected
    Treatment: delay oestrus with androgens (mibolerone)
56
Q

Exogenous steroid hormones how common, what is banned and others used

A
  • Have been used extensively in small animal reproduction
  • Especially oestradiol and progestagens (delaying oestrus)
  • BUT side effects make most uses OBSOLETE - BANNED
    Androgens
  • Mibolerone
    ○ Not registered for breeding bitches but it is the recommended drug to delay onset of oestrus; start at least 1 month before onset of next oestrus
  • Testosterone propionate
    ○ Commonly used in racing greyhounds
    Androgens are contraindicated in praepuberal bitches and dog with renal or hepatic disease
57
Q

Ovarian remnant syndrome what occurs, clinical signs, diagnosis

A

important

  • Piece of ovarian tissue left behind at the time of spaying
  • Bitches present with signs of prooestrus (+/- bleeding)
  • Can do hcG/GnRH stimulation test
  • Laparoscopy during oestrus or luteal phase
58
Q

List 3 ways can determine whether dog is spayed

A

1) Tattoo in ear
2) Incision midline - could be other things
3) FSH/LH test -> will be high -> no negative feedback from ovaries
Snap-test

59
Q

what is the prostate and function

A
  • Major accessory sex gland in the dog
    ○ Prostatic fluid is transport and support medium for sperm during ejaculation
    ○ Prostatic fluid reflux -> fluid produced leaks into bladder or out of penis
60
Q

what are the 3 phases in prostatic development

A

I - embryonic and juvenile development
II - hyperplasia and hypertrophy in dogs 2.5 to 12 years
- Increases in weight
- Dependent on continuous androgen secretion
○ 5-alpha-dihydrotestosterone (DHT) is active androgen at intracellular level
III - senile involution in dogs >12 years

61
Q

What is are the 3 main prostatic diseases and 3 that come secondary commonly

A

1) Neoplasia - more common in castrated dogs, malignant adenocarcinoma most common - grave prognosis
2) prostatomegaly
3) Benign prostatic hypertrophy/plasia (BPH)
- 90% of intact male dogs will have
- Increase in intraprostatic oestrogen: androgen ratio
- Easy to fix - CASTRATION
SECONDARY
- Often secondary to BPH therefore CASTRATION CURATIVE
1. Prostatitis - acute or chronic ->
2. Prostatic abscesses - often secondary to prostatitis
3. Prostatic cysts

62
Q

prostatomegaly main clinical signs

A
  • Dripping blood from penis
  • Haematuria
  • Haemospermia
  • Tenesmus
  • Dysuria
  • Poor semen quality/infertility
  • In acute prostatis: fever, anorexia, lethargy
63
Q

Prostatomegaly diagnosis and treatment

A

Diagnosis
- Rectal palpation: size, symmetry, surface, pain
- Radiography
- Cytology and culture of prostatic fluid - Retrograde cysturethrography
- Urinalysis
- Ultrasonographically guided fine needle aspirate and/or biopsy)
Treatment
- CASTRATION
- If breeding animal
○ Finasteride (5 alpha reductase inhibitor) or progesterone until breeding “career” is over
○ Consider freezing semen

64
Q

cats what is needed for mating and what is special about oriental breeds

A

Need to mate MULTIPLE times in order to ovulate
- Postcoital yowl - is characteristic of cat breeding
- Tomcat’s penis - has a band of 120 to 150 androgen-dependent spikes
○ If no spikes than castrated, if cryptorchid then can still have spikes
- Oriental breeds -> sometimes are spontaneous ovulators and therefore have a higher risk of pyometra

65
Q

what occurs with cats if mated

A
  • If mated then will get LH surge and increase in progesterone and ovulation
    § If mated and ovulate and do fall pregnant will stay on heat until parturition
    § If mated and ovulate and don’t fall pregnant can have pseudo-pregnancy so progesterone levels remain high but not as long as they do in dogs
66
Q

what occurs with cats if not mated

A
  • If not mated within the heat of the week will go into post-oestrus for a week (not on heat), oestrogen and progesterone levels are low
    § Then New follicular wave will occur increase oestrogen and then will go through week of heat, if not mated repeat cycle
67
Q

What are the 2 main differentials for a mammary growth in a cat

A
- Fibroadenomatous hyperplasia 
○ Involved the whole mammary gland and generally symmetrical unlike mammary neoplasia 
○ If spay should go down 
- Mammary neoplasia 
○ Most commonly malignant unlike dogs
68
Q

what is the neonatal and pediatric period and what are the 2 important considerations with anaesthesia

A

○ Neonatal period extends for the first 6 weeks of life
○ Paediatric period for the first 12 weeks
1) Limited organ reserve
2) Exaggerated or prolonged effects of anaesthetics

69
Q

List the 4 main major physiological differences affecting organ function with neonates

A

1) cardiovascular system
2) sympathetic nervous system not fully developed
3) respiratory system
4) thermoregulation

70
Q

In terms of cardiovascular system what is different with neonates

A

○ Low myocardial contractile mass - thinner myocardium
○ Low ventricular compliance
○ Stroke volume and cardiac reserve are limited -> cannot increase contractility so drugs that do this are useless
§ Cardiac output is heart-rate dependent
○ Persistence of the foetal circulation in foal for up to 3 days (right-to-left shunt)

71
Q

In terms of sympathetic nervous system and thermoregulation what is different with neonates

A

Sympathetic nervous system not fully developed
○ Minimal increase in heart rate and myocardial contractility → further impairing ability to increase cardiac output
§ May not be able to increase the CO to suitable level
§ Can still use atropine
○ Poor vasomotor control and inadequate response to blood loss -> more hypovolaemic than others
Thermoregulation
○ Immature thermoregulatory system
○ High body surface to mass ratio -> very important to keep warm during procedures
→ Prone to hypothermia

72
Q

In terms of respiratory system what is different with neonates

A

○ Pulmonary reserve is minimal
○ More compliant chest → greater work of breathing (when create negative pressure air moves in as well as ribs (decreasing the pressure gradient) therefore not as efficient - will need to increase respiratory rate)
○ High minute volume as more dead space -> more breaths but gas exchange not as efficient so need the higher minute volume (how much volume inspire per minute)

73
Q

List 6 main major physiological different affecting pharmacological properties of anaesthetic and what properties does this affect

A
  1. Hypoalbuminemia → more free drugs as most drugs are more than 90% protein bound (except morphine 50% bound)
  2. Increase permeability of the blood brain barrier → more drugs getting to the brain
  3. Low body fat percentage → less drug redistribution in adipose tissue - especially for drugs such as thiopentone
  4. Mature hepatic metabolism → increase duration of action -> ketamine is metabolised in liver
  5. Immature glomerular filtration rate (neonate) → increase duration of action
  6. Higher metabolic rate → increase oxygen consumption and carbon dioxide production
74
Q

What are the 4 main things needed for adequate anesthetic protocols

A
  1. Sedative
    1. Muscle relaxant
    2. Analgesia
    3. Hypnotic
75
Q

What are 6 important components of adequate anaesthetic protocol when neutering

A

1) fasting (limited in paediatric patients)
2) intra-muscular anaesthetic premedication
3) intravenous anaesthetic induction
4) anaesthetic maintenance
5) loco-regional analgesia
6) post-operative analgesia

76
Q

in terms of intra-muscular anaesthetic premedication and intravenous anaesthetic induction for YOUNG ADULTS NEUTERING what are 3 different protocoals for each

A

Intra-muscular anaesthetic premedication
1. Medetomidine (NOT IN PAEDIATRIC PATIENT) & methadone (dogs and cats)
2. Or acepromazine (not good sedative in cats) methadone (dogs)
3. Or ketamine (when use HAVE to combine with muscle relaxation) & midazolam (good absorption via IM) & methadone (cats)
Intravenous anaesthetic induction
1. Propofol +/- diazepam
2. Or alfaxalone +/- diazepam (IV cannot be given IM)
3. Or diazepam & ketamine

77
Q

What is involved with anaesthetic maintenance, loco-regional anaglesia and post-operative anaglesia for NEUTERING YOUNG ADULTS

A

Anaesthetic maintenance
○ Isoflurane in oxygen
○ Balanced Crystalloid solution (2.5 to 5 ml/kg/h)
Loco-regional analgesia
○ Line block with bupivacaine or ropivacaine - longer duration effect than lignocaine - CANNOT GIVE IV
○ Intra-testicular block with lignocaine (dogs)
Post-operative analgesia
○ NSAID (carprofen or meloxicam)
○ +/- Opioid

78
Q

in terms of intra-muscular anaesthetic premedication and intravenous anaesthetic induction for NEUTERING PAEDIATRIC PATIENTS what are 3 and 2 different protocoals

A

Intra-muscular anaesthetic premedication
○ Acepromazine (low dose) & methadone (dogs and cats)
○ Or Acepromazine & Hydromorphone (dogs)
○ Or ketamine (low dose) & midazolam & methadone (cats)
Intravenous anaesthetic induction
○ Propofol +/- diazepam
○ Or alfaxalone +/- diazepam

79
Q

What is involved with anaesthetic maintenance, loco-regional anaglesia and post-operative anaglesia for NEUTERING PAEDIATRICPATIENT

A

Anaesthetic maintenance
○ Isoflurane in oxygen
○ Balanced Crystalloid solution
○ +/- 5% dextrose solution at 2 to 5 mL/kg/hour
Loco-regional analgesia
○ caution to the total volume administered
○ Line block with bupivacaine or ropivacaine
○ Intra-testicular block with lignocaine (dogs)
Post-operative analgesia
○ NSAID (carprofen or meloxicam) - NOT IN NEONATES (don’t use until liver is matured)
○ +/- Opioid

80
Q

What are the 3 main cardiovascular affects induced by pregnancy

A

1) Estrogens decrease vascular resistance, combined with increased Cardiac Output
○ Blood pressure unchanged
○ HR and SV ↑
○ Less reserve in cardiovascular function -> problem when stressed
2) Blood volume ↑ up to 40%
○ Plasma > RBC’s (RBCs number stays the same) = Decreased PCV
○ Decreased PCV = Decreased [Hb]
3) Cardiovascular Changes during Labor
○ ↑ HR, CO, BP, and CVP (central venous pressure)
○ Oxytocin levels rise
Vasodilatio

81
Q

What are the 4 main respiratory affects induced by pregnancy

A

1) Progesterone increases CNS sensitivity to CO2
○ “Normal” PaCO2 decreased to ~30 mmHg
○ Increased minute ventilation due to increased respiratory rate
2) Increased tissue oxygen demands (VO2)
3) Decreased functional residual capacity (FRC)
○ Gravid uterus pushes up on diaphragm = less space for lungs
○ More sensitive to hypoxemia and hypercapnia
4) ↓ FRC + ↑ minute ventilation = Faster Induction with Inhalants

82
Q

What are the main gastrointesintal, hepatic/renal and uterine affects induced by pregnancy

A
Gastrointestinal
- Gravid uterus pushing on stomach
○ Decreases gastric motility
○ Decreases esophageal sphincter tone
-> Risk of regurgitation increased and aspiration pneumonia 
Hepatic and Renal
- Increased hepatic and renal blood flow
○ GFR increased by up to 60%
○ BUN and creatinine decreased
Uterine
- Uterine Blood Flow increases during pregnancy and labour
- Uterine contraction and oxytocin decrease uterine blood flow => decreased foetal viability, effect worsen by anaesthesia
83
Q

List 4 conditions that favour drugs crossing the placenta and what are these qualities good for

A
  • Poor ionization (in the dam)
  • Low molecular weight (<500 daltons)
  • Low protein binding
  • High lipid solubility
    All qualities of a Good anaesthetic drug BUT all Bad for the foetus!!!
84
Q

How does foetal pH affect drug distribution

A

Fetal pH is 0.1 units LESS than the dam!
- if drug is weak base (opioid and local anesthetics) then get higher concentration in fetus = ION TRAPPING!
○ Now cannot cross back to the maternal circulation -> accumulation of drugs within the foetus

85
Q

What are important considerations with caesarean section

A
  • drugs will accumulate within the foetus so want to stop this as much as possible
    ○ Be prepared and quick
    ○ Use smallest doses possible
    ○ Consider local anaesthetics
    ○ Avoid long acting drugs
    ○ Choose reversible drugs if possible - NOT ACE (vasodilation within cardiovascular immature animals and will last long)
  • Minimize inhalant concentration (reduced MAC in pregnancy) -> vaporiser setting lower
  • Dam is at increased risk for vomiting and regurgitation
86
Q

What equipment and drugs is needed for neonates during casearean

A

○ Equipment includes:
§ Warming devices, towels, OXYGEN, intubation kits, dry gauze to wipe secretions from mouth/nose
○ Emergency drugs: Reversal agents (for dam and puppies), Epinephrine, Atropine, Dextrose

87
Q

Casearean what premedications use and don’t use and what is importnat to remember

A
  • Opioids - controversial
    ○ Look for minimal respiratory effects versus analgesia
    ○ => low dose methadone or pethidine
  • Avoid acepromazine or alpha-2 agonists
    ○ If necessary, small dose of alpha-2 can be reversed after induction
    ○ Xylazine is an identified risk factor for neonatal mortality
  • This is one instance where I may “skip” the premed
  • Remember to pre-oxygenate the patient!
88
Q

What are the pros and cons of using opioids in casearean premedications

A

Pros
- Less anaesthetic
- Less cardiovascular side effects on dam and neonates
Cons
- Respiratory depression -> when get to foetus result in increased depression of respiratory system

89
Q

What is important for maintenance with caesearians

A
  • Propofol / Isoflurane or Sevoflurane
  • Likely to require IPPV (due to dorsal recumbency)
  • Consider additional analgesics after removal of puppies or kittens
  • Don’t forget local analgesia
  • Ephedrine maintains uterine blood flow while treating hypotension
90
Q

What is important with puppy or kitten and casearian resuscitation

A
  • Oxygen is the single most important thing you can provide!
  • Rub vigorously to stimulate breathing
  • Do NOT “sling” puppies!
  • Doxapram (stimulate breathing) controversial - under tongue if no spontaneous breathing after oxygen and rubbing
  • Provide warmth and continued high oxygen environment
  • Reversal of the drugs given to the dam that could have transferred to the puppies through the placenta
91
Q

What are 4 important things to do with recovery after caesearian

A

1) Get puppies or kittens nursing on dam as soon as possible
○ Try to avoid “over-sedation” of dam as she could suffocate newborn
2) Assign someone to watch dam with newborns
○ Dams (especially with first litter) may try to EAT the newborns!
3) NSAIDs (not high doses as can transfer into milk) +/- Tramadol for dam for post-op pain
4) Get dam and litters out of your hospital ASAP!!!

92
Q

What are the 5 important diagnosis techniques for skin disease and equipment needed

A
  • Tape prep - acetate tape
  • Skin scrapes (superficial and deep) - 22 scalpel + paraffin oil
  • Impressions smears - glass slides
  • Trichograms - mosquito haemostats
  • FNAs - 22g needle + 5ml syringe
93
Q

What are the 3 important aspects of diagnosis of skin disease and what is critical to diagnosis

A
  • Right test for the right lesion
  • How to collect the sample
  • How to interpret
    CYTOLOGY - must have oil immersion lens microscope - condenser down and iris closed
94
Q

Alopexia what are the 2 main reasons this occurs, reasons within and what diagnostic processes need to do

A
Process/causes
1. XS loss
2. Failure to grow
DDx
• XS loss
○ Self-trauma
○ Folliculitis - inflammation of follicle
§ Parasites, bacteria, fungal 
• Failure to grow
○ Endocrinopathy - Cushing's disease 
Diagnostic approach
• Signalment (age)
• History (self trauma)
- Diagnostics
○ Trichograms and skin Scrapes needed
95
Q

What is involved with trichograms

A

Grab the edge of the lesions, 20 hairs at the base
Will hurt
Parafin oil on the slide
Line up the hair - all tips down on end and top down the other
Look at the tips of the hair

96
Q

In terms of skin scraping what parasites except to diagnose in superficial and deep and technique

A
  1. Superficial
    a. Sarcoptes
    b. Cheyletiella
    c. D. canis (short body)
    d. Trombic ula
    e. Lynxacrus radovsky
    f. Dermanyssus gallinae
  2. Deep
    a. D. canis - Demodex canis
    b. Long bodied
    Technique
  3. Clip skin - large area
  4. Apply paraffin on scalpel blade, on slide
  5. Scrape wide area
97
Q

Tips for doing a skin scrap

A
  • Squeeze skin
  • Paraffin oil
  • Scrape until capillary oozing present -> scrap firmly
    ○ Should blunten the scapel blade
  • Mix additional mineral oil
  • Cover slip on
  • Condenser down
98
Q

Papules and crusts what are they, 3 main causes and how to diagnose

A
  • Papules - pruritic and scratching
  • Crust - pustule that has ruptured
    All time variations of the SAME lesion
    Causes
  • infection
  • immune mediated
  • Allergy
    Diagnosis
    1. Impression smear
    ○ Moist / greasy lesions of flat areas
    ○ After crust removed
    ○ After rupturing pustule or vesicle
    2. Scalpel blade cytology
    ○ Dry papules
    THEN - stained cytology
99
Q

Dry scaley or greasy skin what diagnostic techniques needed and how to conduct

A

sticky tape preparation and skin scraps
- Generally have a lot of infection
Sticky tape preparation
- Stained on glass slide
- Look at straight away under low power and scan for neutrophils
Either neutrophils for damage of skin OR infection

100
Q

Nodules what are important signalment, history and diagnostic techniques

A
- Signalment
○ Age (neoplasia risk)
○ Breed (neoplasia risk)
- History
○ Speed of lesion growth
○ Hunting/ activities
- Diagnostics
○ Fine needle aspirate 
§ Nodules, tumor's, cysts 
§ Not aspirating vs aspirating 
□ Not aspirating - mast cell tumour 
□ Aspirating - epithelial tumor 
- FNA give diagnosis and specific treatment OR logical next step (histopathology, biopsy and deep tissue culture/PCR)