Dystocia

Question 1

If a patient presents for a dystocia, you should feather the dorsal/ventral (choose one) vaginal wall with finger to see if she initiates a Ferguson’s reflex.

Answer 1

Dorsal

Question 2

How do we perform gestational aging in early gestation?

Answer 2

Inner chorionic cavity diameter (ICCD) - this is the most accurate for gestational aging

Question 3

How do we perform gestational aging in late gestation?

Answer 3

Biparietal diameter (BPD)

Question 4

When performing a c-section, you can only administer Oxytocin & Buprenorphine to the dam before/after (choose one) the puppies have been removed.

Answer 4

After

Question 5

When is medical management of a dystocia appropriate?

Answer 5

• When there is no obstruction
• Cervix is fully dilated
• No more than 2 fetuses remaining in utero
• Fetal heart rates > 190-200bpm (no fetal distress)

Question 6

Describe the medical management of dystocia.

Answer 6

• Supportive care (IV catheter, LRS)
• Lubrication of birth canal
• Give oxytocin IM/SC (if no response, repeat 20-30 minutes later, maximum of 1-2x for the same puppy); can also put born puppies on dam to nurse to stimulate oxytocin release from posterior pituitary
• 10% calcium gluconate if hypocalcemic (may also help if Ca levels normal & given 15 min. prior to oxytocin)
• Glucose if hypoglycemic

Question 7

T/F: Medical dystocia management can still be used even if a Ferguson’s reflex is absent

Answer 7

F; need to perform C-section

Question 8

What are the 2 common types of dystocia in the bitch? (Generally speaking)

Answer 8

Obstruction or uterine inertia (insufficient or absent uterine contractions)

Question 9

What are the 2 most common causes of obstructive dystocia in the bitch?

Answer 9

1. Abnormal fetal presentation/position/posture or size
2. Abnormal birth canal in the bitch

Question 10

What are the treatment recommendations for the causes of obstructive dystocia?

Answer 10

• Abnormal fetal presentation/position/posture/size -> manual correction & vaginal delivery OR c-section if manual correction not possible
• If bitch has an abnormal birth canal, recommend c-section

Question 11

Describe primary uterine inertia.

Answer 11

• She either doesn’t have any contractions or she has them but they aren’t strong enough to expel puppies
• NO puppies born yet
• No obstruction, normal birth canal

Question 12

What is the treatment recommendation for a bitch with primary uterine inertia?

Answer 12

C-section

Question 13

Describe secondary uterine inertia with obstruction

Answer 13

Prolonged contractions due to obstruction, followed by uterine fatigue & cessation of contractions.

Question 14

What is the treatment recommendation for a bitch with secondary uterine inertia that is obstructive?

Answer 14

Manual correction & vaginal delivery OR C-section

Question 15

Describe secondary uterine inertia without obstruction.

Answer 15

No obstruction & fetuses already delivered, but contractions stop due to uterine fatigue (i.e. large litter)

Question 16

What is the treatment recommendation for a bitch with secondary uterine inertia that doesn’t have an obstruction.

Answer 16

Medical management or c-section

Question 17

Green vaginal discharge in the bitch and reddish-brown discharge in the queen prior to delivery of the first puppy/kitten indicates what?

Answer 17

Indicates the beginning of placental separation; this is indicative of dystocia during stage 1 of labor

Question 18

T/F: Indicators of dystocia before the birth of the first puppy include persistent abdominal straining for more than 30 minutes without delivery of a puppy & intermittent abdominal straining for more than 4 hours without deliver of a puppy.

Answer 18

T

Question 19

After the birth of the first puppy, if more than ______ hours passes before the birth of the next puppy, then that would be indicative of a dystocia.

Answer 19

2 hours