Exam 1 (Small Animal)

Question 1

Proestrogen Assay; Progesetrone Levels & Cycle Stages

Answer 1

 LH surge 1.5-2.0 ng/mL
 Ovulation = 4-10 ng/mL
 Fertilization period = 12-16 ng/mL
 Cervix close = 20

Question 2

Cell Types Present on Vaginal Cytology

Answer 2

 Anuclear – no nucleus
 Superficial – very dark cell w/ tiny nucleus
 Intermediate – nucleated cell w/ some pointy edges
 Parabasal – round w/ large nucleus
 Neutrophils
 RBCs

Question 3

Guidlines for Timing Insemination in Bitch

Answer 3

o Evaluate bitch 4-5 day after the beginning of proestrus ->
o Vaginal cytology reaches 60% of cornification (anuclear cells) ->
o blood drawn for progesterone assay every 3-5 days until LH surge or ovulation
o Fresh/chilled semen - inseminate 2 days and 4 days post-ovulation
o Frozen thawed semen - inseminate 3 to 5 days post-ovulation

Question 4

Insemination w/ Chilled Vs Frozen Semen

Answer 4

Chilled Semen
o Collecting and shipping semen over weekends and holidays can be problematic
o Pregnancy rates with intravaginal insemination range from 60 to 95%

Frozen Semen
o Intrauterine insemination required
o Thawed spermatozoa capable of fertilization for only 24 hours
o Transcervical insemination vs surgical insemination

Question 5

Semen Evaluation

Answer 5

o Evaluate total number of sperm, Motility, & Morphology
o need 200 million sperm

First fraction
 0.5 to 7+ mL
 clear fluid

Second fraction
 sperm rich
 0.5 to 2 mL
 white opaque fluid

Third fraction
 primarily prostatic
 5 to 30 mL
 clear fluid

Question 6

Causes of Infertility in the bitch

Answer 6

o Failure to have an estrous cycle
o Prolonged inter-estrus interval
o Short inter-estrus interval
o Prolonged proestrus/estrus
o Failure to conceive/early reabsorption
o Failure to breed

Question 7

Primary Vs Secondary Anestrus

Answer 7

Primary Anestrus
 Congenital ovarian aplasia
 Congenital disorder sex development
 Silent heat
 Inadequate estrus detection
 Can induce estrus

Secondary Anestrus
 Hormones: Progestogens Mibolerone
 Luteal cysts
 Hypothyroidism
 Cushing’s

Question 8

How to induce estrus in dogs

Answer 8

Dopamine agonist (prolactin antagonist)
o Cabergoline or Bromocriptine
o needs to be given for a long time
o can cause vomiting & coat color change

Question 9

Reasons for Prolonged inter-estrus interval (>10 months), Short inter-estrus interval (<4 months), Prolonged/persistent proestrus or estrus

Answer 9

Prolonged inter-estrus interval (>10 months)
o Basenji & basenji hybrids more prone
o Can be due to ovarian neoplasia, underlying illness or ovarian cysts

Short inter-estrus interval (<4 months)
o Normal follicular development + failure to progress to ovulation
o Heat comes back in 1-10wks
o 2nd cycle usually fertile

Prolonged/persistent proestrus or estrus
o Follicular cysts
o Granulosa theca cell tumor
o Exogenous estrogens

Question 10

Pregnancy Failure due to Early Resorption; Most common cause & other causes

Answer 10

Most common cause
 Uterine infections due to normal female flora mycoplasma in the vagina and uterus.
 Pasteurella multocida, Beta hemolytic streptococci, E. Coli and mycoplasma
 Brucella canis only bacteria proven to cause infertility

Other
 Hypoluteoidism
 Reproductive tract occlusion
 Systemic illness

Question 11

Neutering/Spaying Pros & Cons

Answer 11

o Decrease chance of cranial cruciate rupture in large breeds by waiting until 2yo
o Decrease mammary tumors & prostatic hyperplasia when done earlier

Question 12

Results of Ovary Sparing Hysterectomy

Answer 12

o Routine estrous cycles
o Enlarged vulva with no vaginal bleeding
o Estrous behaviors
o Presumably at a greater risk for developing mammary tumor

Question 13

Steroid Hormones for Contraception

Answer 13

Estrogens:
 Especially diethylstilbestrol
 Not recommended due to Bone marrow suppression and aplastic anemia

Progestins:
 Megestrol acetate,
 medroxyprogesterone acetate,
 proligestone

Question 14

Megestrol Acetate; Basics & Side Effects

Answer 14

o Antiandrogenic and antiestrogenic effects but also cortisol agonist
o Prevents follicular development and LH surge:
o Return to estrus variable
o litter size normal after treatment

Side effects
 Weight gain, lethargy, restlessness, and mammary development.
 Contraindicated w/ history of mammary neoplasia, diabetes mellitus, liver, or uterine diseases
 can cause masculinization of female fetuses

Question 15

Medroxyprogesterone Acetate Contraceptive; Basics & Side Effects

Answer 15

o Used only in anestrus
o Minimum doses 2mg/kg IM every 3-4 months
o Return to estrus variable

Side effects
 The most androgenic and immunosuppressive
 Not FDA approved

Question 16

Androgens For Contraception

Answer 16

In male dogs:
 Alter spermatogenesis by suppressing LH
 stimulate libido and prostatic growth

female dogs:
 Mibolerone used for fertility control for periods up to 5 years.
 Can cause clitoral hypertrophy, vaginal discharge, vaginitis, and male-type behavior

cats:
 Not approved for use in cats but mibolerone and other androgens can be effective in preventing reproduction

Question 17

GnRH Agonists as Contraceptive

Answer 17

Deslorelin
 Male dog contraceptive
 Not available in US

Nafarelin
 Female dog & cat contraceptive
 Not available in US

Question 18

Immunocontraceptive

Answer 18

o Vaccine developed for wildlife
o Short life span
o None for dogs or cats

Question 19

Gene Silencing

Answer 19

o Identify a gene w/in the hypothalamic-hypophyseal-gonadal axis that is required for fertility
o Choose a method that can selectively silence the gene of interest with minimal off-target effects
o Devise a minimally invasive method of silencing
o Utilizing a delivery vehicle that allows this silencing effect to be maintained for the life span of the animal
o Not currently available

Question 20

Estrogens for Pregnancy Termination; Drugs, Side Effects

Answer 20

Drugs
 Estrodial benzoate
 Estrodial cypionate (administer in estrus/diestrus)
 Tamoxifen citrate (compounded with estrogen activity)

Side Effects
 Bone marrow suppression and aplastic anemia
 Leucopenia and thrombocytopenia
 Endometritis, cystic endometrial hyperplasia, and or pyometra.
 Not approved for pregnancy termination

Question 21

Prostaglandins for Pregnancy Termination; How do they work, Side Effects

Answer 21

o PGF2α lyses CL -> contraction of uterus
o Progesterone must be < 2mg/ml for at least 48 hrs to terminate pregnancy
o Monitor w/ ultrasound and serum progesterone throughout treatment

Side Effects
 Prior to 35-40 days after breeding - resorption with few clinical signs
 After 40 days - overt vaginal discharge and abortions
 vomiting, diarrhea and depression
 Cloprostenol fewer side effects than Dinoprost.

Question 22

Prolactin Inhibitors for Pregnancy Termination; How do they work, When do you give them, Drugs, Side Effects

Answer 22

o Dopamine agonist -> Decrease Prolactin secretion from pituitary gland -> luteolysis.
o Only from 35 days in gestation

Drugs
 Bromocriptine
 Cabergoline

Side effects
 Bromocriptine is unstable when crushed and must be protected from light and heat.
 Vomiting, anorexia
 Side effects can be minimized with chlorpromazine or PGF2a

Question 23

Aglepristone for Pregnancy Termination; How does it work, Side Effects

Answer 23

o Synthetic steroid w/ antiprogestin property
o Competes w/ uterine progesterone-receptors with 3 times stronger affinity than progesterone in the dog and 9 times stronger affinity in the cat.
o VERY effective

Side Effects
 Can induce a localized inflammatory response.
 Divide large doses no more than 5 ml per site and massage the sites after injection
 No FDA Approved in USA. Only Europe and Australia

Question 24

Trisomy (XXY)

Answer 24

 Males w/ hypoplastic testes, epididymides & vas differentia.
 External genitalia vary from normal to hypoplastic.
 Complete male phenotype is explained by the presence of testes capable of producing MIS
 Presence of two “X” chromosome prevents normal spermatogenesis
 Calico males

Question 25

o Monosomy (XO)

Answer 25

 Normal or small stature  Externally female phenotype  Infantile female internal genitalia  Gonadal dysgenesis (streak gonads)

Question 26

Chimerism; XX/XY w/ testes

Answer 26

* Ambiguous genitalia: Cranially displaced vulva, enlarged clitoris or small prepuce * Dysuria and urine scalding may be present * Hypoplastic penis * Hypoplastic abdominal testis * Hypoplastic uterus

Question 27

Chimerism; XX/XY w/ freemartinism

Answer 27

* Female born co-twin to a male * Common in cattle * Ovaries of the freemartin do not develop normally and remain very small. * External vulvar region can range from normal looking female to a male-like appearance

Question 28

Sex Reversal

Answer 28

 The gonadal sex does not agree with the chromosomal sex  XX true hermaphrodites (ovotestes)  XX males (bilateral testes)  Inherited as an autosomal recessive trait in American Cocker Spaniel & German shorthaired pointer  degree of masculinization depends on the degree of gonadal function  related to polled trait in goats

Question 29

Female Pseudohermaphroditism

Answer 29

 XX karyotype w/ ovaries  masculinized internal or external genitalia  Results from in utero androgen exposure

Question 30

Male Pseudohermaphroditism

Answer 30

 XY karyotype, testes but the internal and/or external genitalia present variable degrees of feminization  Failure of regression of Müllerian ducts or defects in androgen dependent masculinization

Question 31

Persistent Müllerian duct syndrome; what is it? treatment

Answer 31

 autosomal recessive trait in the miniature schnauzer  XY w/ cryptorchid testicles, uterus, oviducts, cervix and cranial vagina Treatment * Castration and removal Mullerian ducts

Question 32

Cryptorchidism

Answer 32

 Associated with XX DSD  Considered cryptorchid if testes are not descended by 6mo

Question 33

Hypospadia

Answer 33

 In males  abnormal location of the urinary orifice  occurs when there is incomplete masculinization of the urogenital sinus (closure of the urethra)  May have a familial basis in Boston terriers

Question 34

When does parturition Occur in Relation to Hormones

Answer 34

o 64-66 d after LH surge o 63 days after ovulation o 57 days after cytological diestrus

Question 35

Other Methods for Diagnosing Pregnancy in Dogs

Answer 35

Abdominal palpation  21-30 days post LH surge Prolactin  35+ days post LH surge  More difficult than relaxin

Question 36

Methods for Diagnosing Pregnancy in Cats

Answer 36

Ultrasound  17-30 days gestation Prolactin  20+ days post breeding  More difficult than relaxin Abdominal palpation  21-25 days post breeding Relaxin blood test  25+ days post breeding X-ray  38-40 days gestation

Question 37

Ultrasound for Determining Pregnancy in Dogs

Answer 37

 17-30 days gestation o Assessment of fetal viability o determine number of fetuses o Gestational aging o Heartbeat visualized 23-25 d post-LH surge o Fetal movement visualized 34-36 d post-LH surge

Question 38

X-rays for Determining Pregnancy in Dogs

Answer 38

 42-45 days gestation o Fetal skeletal calcification of the spine and skull begins 42-46 days post-LH surge o Fetal teeth radiopaque at 58-63 days post-LH surge o Staging advanced pregnancies

Question 39

Relaxin for Determining Pregnancy in Dogs

Answer 39

 25-40 days post LH surge o Hormone produced primarily by the canine placenta o Serum levels rise 20-30 days o In-house assay o (-) results in early gestation -> repeat testing 7-10 days later

Question 40

Blood Indicators that Rise During Pregnancy but are Not Used for Diagnosis

Answer 40

o Estrogen o Fibrinogen o C-reactive protein

Question 41

Fetal Heartrate

Answer 41

o 2-3 times the mother o > 190 bpm - Normal o < 190 bpm - Stress o large breed <180 - fine o small breed <180 - distressed o <160 bpm – emergency C-section o 20 days from parturition starts to decrease

Question 42

Development of Fetus

Answer 42

20-30d  Heart rate  Jaw mineralization 30-40d  Ribs  Thoracic, lumbar, & cervical spine  Head 40-50d  Kidneys  Lungs  Liver 50-60d  Stomach  Bladder  Gallbladder  GI

Question 43

Gestational Aging w/ Ultrasound

Answer 43

Inner chorionic cavity & crown rump length  21-37d Biparietal Diameter & body diameter  >37d ( biparietal most accurate in large breeds)

Question 44

Gestational Aging w/ X-ray

Answer 44

Spherical Swelling  Dog – 31-38d Ovoid Swelling  Dog – 38-44d Spine Mineralization  Dog – 45d Teeth  Dog – 61d

Question 45

Are the puppies ready to be delivered?

Answer 45

o If you can see the dark and light of the separation of the cortex & medulla on ultrasound o Intestinal motility

Question 46

How Much Weight Should a Female Gain During Pregnancy

Answer 46

o 15-25% of body weight increase o Last 3-4wks o Mostly last week

Question 47

Consequences of Inadequate Nutrition

Answer 47

Ketosis  inadequate nutrition or not enough carbs Eclampsia:  Toy-small breeds  due to calcium supplementation during gestation  Ataxia, muscular tetany and convulsive seizures. Cleft palate:  folic acid deficiency Gestational diabetes mellitus:  Due to inadequate endogenous insulin supply. Poor milk quality and puppies' growth

Question 48

Nutrition During Lactation

Answer 48

o 1-1.5 maintenance in 1st week o 2x maintenance in 2nd week o 2.5-3x maintenance in 3rd & 4th week

Question 49

Parturition Initiation & General Rules About Gestation Length

Answer 49

o Small litters = prolonged gestation o Large size litters: may shorter gestation o Older bitches prolonged gestation (0.11 days per year of age) Parturition Initiation  Fetal adrenal glands produce cortisol ->  12-24hrs later prolactin increases ->  Progesterone declines ->  Relaxin produced by fetuses ->  relaxation of pelvic ligaments and vaginal tissue ->  parturition

Question 50

Stage 1 of Labor

Answer 50

o estradiol and prostaglandin -> o myometrial contractions -> o oxytocin -> o More myometrial contractions o Panting, nervous, restless, nesting, vomiting o 4 to 12 hours

Question 51

Stage 2 of Labor & Abnormalities to watch for

Answer 51

o Abdominal straining o Green or clear fetal fluids expelled o Amniotic sac may be visible o First puppy delivered within 4 hours o Once fetus visible at pelvic canal it should be delivered w/in 20 minutes o Litter fully delivered within 12 hours Abnormalities  Most common in stage 2  Large amount of bright red or dark red/brown fluid  Labor should not be allowed to continue beyond 24 hours

Question 52

Stage 3 of Labor

Answer 52

o Pass placenta o Shortening of uterus o Rest period of 1-2hrs

Question 53

Phases of Uterine Involution

Answer 53

1st week postpartum:  uterine horns dilated and edematous  Placental sites prominent and covered with mucous/blood clots Up to 8wks postpartum  Normal lochia (dark red to brown) 9 weeks podtpartum:  uterine horns uniform in shape and contracted with a narrow lumen  Trophoblast-like cells not observed at the placental sites  Regeneration and replacement of the endometrial lining is not complete 12-16wks postpartum  Uterine involution complete

Question 54

Reasons for Vet Evaluation During Parturition

Answer 54

o Prolonged gestation for >65d from ovulation or >72d from breeding o No signs of labor 24-36 h after temp. drop o More than 4 h between rupture fetal membranes and delivery of 1st puppy o Active uterine contractions >30 min without expulsion of fetus o More than 2 hours between births o Abnormal vaginal discharge o Bitch has delivered stillborn puppies o Bitch has been in 2nd stage labor for more than 12 hours.

Question 55

Uterine Inertia; Basics & Causes

Answer 55

o Most common reason for dystocia o Inability of the uterus to contract o Usually need C-section Causes  Sepsis  Illness  Age-related  Genetic inability of the myometrium to contract  Primary inertia when there are only few fetuses

Question 56

Complete Primary Vs Partial Primary Vs Secondary Inertia

Answer 56

Complete Primary  Normal birth canal  No fetuses delivered  Uterine dysfunction Partial Primary  Normal birth canal  Some fetuses born  Uterus becomes fatigued Secondary  Uterus is exhausted due to obstruction to passage of fetus

Question 57

Dystocia; Signalment, Symptoms

Answer 57

Signalment for Dystocia o Primiparous bitches < 2 yo o Toy and small brachycephalic breeds o Very large or very small litters (SUPERFECUNDATION – many males) o Not as common in cats Symptoms of dystocia o Vocalization o Biting/chewing at vulvar region o Abnormal vulvar discharge o Fetus protruding from vulva o fever, weakness, tremors

Question 58

Treating Hypocalcemia and Hypoglycemia during Parturition

Answer 58

o Ca Gluconate 10% o 50-150 mg/kg IV over 10-15 mins

Question 59

Using Oxytocin During Parturition

Answer 59

o Can be given to further along labor o Must treat hypoglycemia and calcemia first o Don’t use during dystocia o Only 3 doses before C-section

Question 60

Meds During C-section

Answer 60

o Pre-med: Fentanyl o Induction: Propofol o Epidural: Morphine & lidocaine o Sevoflurane inhaled o Intra-op: Fentanyl o Post-op: methadone or opioid

Question 61

Meds to Prepare Dog for C-section

Answer 61

Corticosteroid (betamethasone)  2-12 h before  Starting at day 57 to stimulate surfactant PGF2a  induce luteolysis and increase prolactin Intranasal oxytocin  When waking from Sx to accept the puppies

Question 62

Vaginitis; Basics, Clinical Signs, Treatment

Answer 62

o Mostly dogs o Usually bacterial infection, secondary to conformational abnormalities o Also caused by Viral infection (canine herpesvirus), foreign bodies, neoplasia, hyperplasia, androgenic steroids, intersex conditions Clinical signs  Vulvar discharge  Licking of the vulva  Attraction of males  Frequent micturition  NO systemic illness  Normal hemogram and biochemical profile Treatment  Give probiotics first  Give antibiotics as last resort

Question 63

Brucella canis; Epidemiology, Clinical Signs

Answer 63

o Gram (-) o Intracellular o Zoonotic & reportable o Transmitted horizontally & through placenta/milk o VERY important to test for during breeding soundness exam Clinical Signs  Fever uncommon  Subfertility,  early embryonic death  abortion  teratozoospermia  orchitis  prostatitis  Discospondylitis  Lymphadenomegaly  lameness

Question 64

Brucella canis; Signs in Puppies, Signs in Male dogs, Treatment

Answer 64

Puppies  may die shortly after birth  may seem healthy, but are infected  Shed B. canis for several months  Can become clinically affected after puberty Specific Signs in Male Dogs  Licking of the scrotum  Scrotal edema  Scrotal asymmetry  Abscess formation and necrosis of testicles  Sperm agglutination 3-4 months post infection Treatment  NONE  Should euthanize or quarantine

Question 65

Canine Herpesvirus 1; Symptoms, Diagnosis, Control

Answer 65

Symptoms  Symptoms worse in young dogs  Respiratory signs  Low litter size  Embryo resorption-infertility  Abortion (2-3 weeks after exposure)  Neonatal death (3-4 weeks old)  Stillbirth  Genital lesions  Multifocal hemorrhage of all organs on necropsy Diagnosis  Intranuclear inclusion body liver spleen kidney  Necrotic areas of the placenta.  Paired titer serology  Virus isolation  PCR  Do two test to confirm Control  Prevent stress  Reduce contact w/ novel dogs  Vaccine available outside of US

Question 66

Pyometra; Cause, Symptoms, Clin Path, Signalment

Answer 66

Cause  Cystic Endometrial Hyperplasia  Exogenous estrogen therapy  Progesterone therapy Symptoms  Vaginal discharge  Decreased appetite  PU/PD  Vomiting  Ds  Nocturia  Abdominal enlargement  Sepsis Clin Path  Neutrophilia w/ left shift and toxic neutrophils  Mild normocytic, normochromic anemia  Azotemia  elevated protein and globulins  elevated ALT, ALP  electrolyte disturbances  degenerative polymorphonuclear cells & bacteria on cytology Signalment  Intact bitches  8-9 years old  Nulliparous  5 or 80 days after the end of estrus

Question 67

Pyometra; Treatment

Answer 67

Medical * Only if not systemically ill & <6YO * Antibiotics for 4-6wks * Prostaglandin (Dinoprost or cloprostenol) BETTER * Dopamine agonist (Cabergoline, Bromocriptine, Luteolyze) Surgical * OHE * Antibiotics

Question 68

Cryptorchidism; Basics

Answer 68

o Testes does not descend into the scrotum by 6 months of age o Prevalence 1-11% o Unilateral > bilateral o The testis can be retained in prescrotal subcutaneous area, inguinal area, or the abdomen o Heritable o More common in smaller breeds & smaller dogs of litter

Question 69

Cryptorchidism; Consequences, Diagnosis, Treatment

Answer 69

Consequences  abnormal thermoregulation -> neoplasms such as Sertoli cell tumors and seminomas -> Associated with feminization syndrome.  spermatic cord torsion  decreased / abnormal spermatogenesis Diagnosis  Palpation  Ultrasonography  AMH to differentiate castrated versus bilateral cryptorchid dogs Treatment  Castration  Laparoscopic cryptorchidectomy  NO orchipexy, GnRH, physical pulling

Question 70

Benign Prostatic Hyperplasia; Clinical SIgns Consequences

Answer 70

Clinical Signs  Often asymptomatic  Tenesmus/Constipation  Sanguineous prostatic fluid dripping from the prepuce  Hematospermia  Hematuria  Dysuria Consequences  Prostatitis  Prostatic abscess  Prostatic neoplasia

Question 71

Benign Prostatic Hyperplasia; Treatment

Answer 71

Finasteride * 5-alpha reductase 2 inhibitor * T2 is not inhibited * libido and spermatogenesis continues Osaterone acetate * T2 analog * Decreases T2 * Decrease libido & spermatogenesis

Question 72

Acute Prostatitis; Clinical Signs, Diagnosis, Treatment

Answer 72

Clinical Signs * Pain * depression, anorexia * vomiting * fever * stiff gait * Prostate painful on palpation * neutrophilia w/ left shift and toxic change * Mild to severe urinary tract infection Diagnosis * diffuse enlargement of the prostate on ultrasound Treatment * Finasteride to decrease prostate size during initial treatment * castration after infection is eliminated. * Antibiotics (enrofloxacin) 4-6wks * Once inflammation subsides the prostate-blood barrier will return and antibiotics must then be chosen with that in mind.

Question 73

Chronic Prostatitis; Clinical Signs, Diagnosis, Treatment

Answer 73

Clinical Signs * Asymptomatic / subclinical * persistent penile discharge * dysuria, hematuria * fever * anorexia * abdominal pain * rear limb lameness, stiff gait, and back pain * prostate may be normal size, shape, and consistency & non-painful Diagnosis * Single organism on culture of prostatic fluid * FNA * Mineralization of prostate on rads * mixed echogenicity of the prostate on ultrasound Treatment * Antibiotics (ENRO, Erythromycin, chloramphenicol) 4-6wks * Consider castration * Finasteride

Question 74

Azoospermia; Causes, Diagnosis, Treatment

Answer 74

Causes  Hypothalamus or pituitary issues  Cryptorchidism  Delayed puberty  Chemotherapy or radiation  Anabolic steroids administration  Toxin exposure  Obstruction Diagnosis o ALP levels in ejaculate o <2500 IU/L absence of sperm o 2500 – 5000 IU/L equivocal o >5000 IU/L confirmation of ejaculation Treatment o Phenylpropanolamine o increases urethral pressure and reduces the number of sperm voided into the bladder during ejaculation