Exam 3 Flashcards

Question

Lecture Canine Pregnancy, Parturition, and Neonatal Management

Answer 1

Abdominal palpation -28-35 days "String of pearls" -Difficult after 35 days Radiographs -Safe after day 40 -Best done in the final week for fetal count (calcification) -Pre-Whelping radiographs: Number of fetuses (aids in management decisions), know when labor is complete, know when dystocia is present, measure fetal head and maternal pelvic canal Ultrasound -Day 24-28 start as early as day 21 -Inaccurate on count -Fetal viability information -Uterus: best in dorsal recumbency -Ovaries: best in lateral recumbency, 2cm off caudal pole of kidney -Difficult to find anything during anestrus -HR 2x maternal HR -<150 bpm an emergency (fetal stress) Relaxin -Canine only - comes from placenta -Measurable in serum after day 21-28

Answer 2

Initiation of Parturition -Progesterone falls <2 ng/ml -Transient drop in body temp BID -Milk evident in glands 1-7 days prior (unreliable ) -Nesting behavior 12-24 hours prepartum First Stage of Parturition -Begins after progesterone drops -Removal of "progesterone block" -Myometrial activity begins -Increase in oxytocin receptor sites -Nesting, anxiety, anorexia, vomiting Second Stage -Active contractions: fetus in pelvic canal stimulates "urge to push" -Fergusons reflex: oxytocin release and abdominal contractions **Amnion appears first** occasionally chorioallantois first -Greatest effort to deliver head -Caudo-longitudinal presentations are normal -Total time averages 6-12 hours -Greenish-black discharge: Uteroverdin from placental marginal hematomas -Average interval 30-60 minutes -Dam eats placentas Third Stage of Parturition -Passage of placental -Retention is rare, most passed 5-15 min following fetus delivery -Two or three pups may be born before passage of their placentas -Oxytocin is not necessary if suckling pups are present -Zonary endotheliochorial placenta: endometrium of the uterine vessels lies adjacent to the fetal chorion 1. Body temp drops ~ 24 hours prior to whelping -Indicates dron in progesterone -Usually <98F -Take temp twice daily starting 5 days prior 2. Tocodynamometry and/or fetal heart rate monitoring (Whelpwise) -Start 1-2 weeks prior to due date to establish baseline -Detects stage 1 labor and allows monitoring of fetal distress 3. Progesterone and Prediction of Whelping date -10 ng/ml suggests 36 hours to whelping -4 ng/ml 18 hours prepartum -2 ng/ml 9 hours prepartum **Safe and ready for C-section if <2 ng/ml**

Answer 3

Prolonged Gestation -Problem with singleton pregnancies -Primary uterine inertia: progesterone <2 ng/ml. No labor -Ultrasound: fetal viability and stress -C-section if needed Uterine Torsion -Uncommon -Acute abdominal distress, pain, asymptomatic until dystocia -Dx: exploratory laparotomy Abnormal Vaginal Discharge -Occasional mucus ok -Hemorrhagic: may be normal, evaluate cytology, vaginoscopy, ultrasound. May be sign of impending abortion -Purulent: PYOMETRA or DEAD FETUS -Choice of antibiotics when necessary: Clavamox, Cephalosporins, Quinolones, Ampicillin Fetal Wastage -Ultrasonography to confirm -Trauma, heat stress, luteal insufficiency, viral, bacterial, cystic endometrial, hyperplasia (CEH), protozoa -Treatment: evacuation of uterine contents, if all puppies dead PGF2Alpha Abortion -Collect normal fetus for necropsy and culture -Collect placenta -Paired serum for neospora, leptospirosis, herpes, brucella and toxoplasmosis: 2 weeks apart -Monitor next pregnancy closely

Answer 4

PPP -Presentation: Cranial or caudal -Position: dorsosacral -Posture: extended limbs 60% born in cranial longitudinal with front limbs extended 40% born in caudal longitudinal with hind limbs extended Fetal factors -Fetal monsters, anasarca (water pups), multiple limbs, single pup, hydrocephalus, schistosomes reflexus Maternal Factors -Primary uterine inertia: hypocalcemia may be a cause -Secondary uterine inertia: uterus tires out, pup obstruction -Breed: broad head an narrow pelvis -Others: obesity, diaphragmatic rupture, neoplasia, etc. Dystocia Intervention -Weak contractions >4 hours before 1st pup -Active contractions >30 min with no pup -Rest period between pups > 2 hours -Painting, restlessness, inappetence >12 hours (first stage of labor) -Black thick discharge without a pup -Purulent or hemorrhagic discharge -Temperature dropped more than 24 hours previously without pups

Answer 5

-Should be considered early -Ultrasound is helpful to determine fetal viability and stress -Radiographs to determine presence of additional fetuses -Oxytocin if no obstruction present -Ca++ if deemed necessary Indications -Fetal HR <150 bpm -Not responsive to medications -Can't deliver with gentle traction -Pups too large ->4 pup still in utero when dystocia occurs -Repeated oxytocin may lead to placental separation fetuses die -Ionized calcium <1.1mmol/L straight to C-section ->1.1 mmil/L give Ca++, wait 30-45 min, give oxytocin q 30 min up to 3 doses, if no pup then C-section Calcium Glucocante -10% at 1ml/30lbs IV give very slowly

Answer 6

-Decreases overtime: mostly fluid/cellular material expelled first 2 weeks -Changes in color: red to brown -Changes in consistency: watery to Mucoid -No odor: if there is odor then there is a problem -Brownish mucoid loch can be normal for 4-6 weeks postpartum Management of Dam -Monitor mammary glands and vulvar discharges daily -Unlimited food and water -Start weaning at 3-4 weeks -Reduce food to dam at weaning -Pressure in glands signal to quit milking

Answer 7

-Need colostrum and daily milk intake -22 ml/kg -Eat, sleep, and dream -Dam stimulates urination/defecation -Crying indicates a problem -Poikilothermic for first 2-3 weeks: can't maintain their body temperature: assume ambient temperature Temp -1-7 days 85F -8-28 days 80F -29 days 70-75F -"Pig Piles" = cold babies -Provide heat lamps Daily weight gain -10% of birth weight Hypothermia: most important Hypoglycemia: inadequate caloric intake Hypovolemia: dehydration

Answer 8

-Regular exercise -Weight control -Last trimester increase calories intake by 50% -Fish oil - omega 3 -Avoid all other supplements

Answer 9

-Post partum disease -Inflammation of the endometrium and myometrium **Caused by ascending infection, abortion, fetal infection, dystocia, or retained placenta** C/S -Systemic illness -Fever, discharge, anorexia, neglect of pups, -Foul smelling/purulent vulvar discharge Dx -Leukocytosis with left shift -Vaginal cytology and culture -Ultrasound or radiographs to diagnose retained placenta or feti Tx -Prostaglandin F2 alpha: to evacuate uterus and lyse any luteal tissue -Oxytocin: may be less effective > 24 hours post whelping **If uterine wall <1-2mm thick, avoid ecbolics due to risk of rupture** -Supportive therapy: fluids, antibiotics. Broadspectrum - gram negative common **Ampicillin** -Pups can nurse as long as there is no toxemia

Answer 10

Pyometra -Diestral disease: during progesterone phase of cycle -60-90 days post-estrus in bitch, anytime in queen -Medical reason for saying females not intended for breeding -Often associated with cystic endometrial hyperplasia Tx -Ovariohysterectomy treatment of choice Cystic Endometrial Hyperplasia - Pyometra Complex -Acute or chronic post-estrual disease with variable clinical signs and pathologic findings: incidence increase with age Pathogenesis In the normal Bitch: -Estrogen: promotes growth, increased vascularity, edema in endometrium. Cervical relaxation and dilation. Increased numbers of progesterone receptors. Estrogen receptors down-regulate due to increasing in progesterone -Progesterone: stimulates proliferation and secretion of endometrial glands. Inhibits myometrial activity. Closure of cervix. Progestin effect is enhanced by priming of estrogens In CEH dogs -Normal down-regulation of estrogen receptors due to increasing progesterone may be defective -So, they get prolonged effects of estrogen on ednometrium and then are exposed to progesterone resulting in DIESTRUS --- Progesteron effects --- CEH -Pyometra occurs when they have CEH with ascending infection

Answer 11

**Primary pathology is CEH with secondary pyometra possible** -If pyometra is present the most common organism is E. coli Most common signalment -5-6 yo or older -Hx of being in heat 1-12 weeks prior to presentation -Currently anorexic -Depressed -PU/PD -Abdominal distension +/- purulent vaginal discharge -Can have vomiting, diarrhea, and septic shock in disease C/S Pyometra Open Pyometra -Less severely ill -Copious red-brown to yellow-green foul smelling vulvar discharge Closed Pyometra -No discharge -Abdominal swelling -Systemically ill Dx -Uterine enlargement without pregnancy (diestrual disease), abdominal palpation, radiograph, **Ultrasound** -Immature neutrophilia -Increased WBCs -May have increased BUN and increased total globulins Tx -Ovariohysterectomy -Need to stabilize the bitch first -Start Ampicillin TID until culture results are back Medical Tx Only with open cervix pyometra -Considerations: open cervix, valuable breeder, <6 yo, not azotemic. -Prostaglandin F2 alpha (Dinoprost or Cloprostenol): contraction for uterine evacuation. Continue until progesterone is baseline. Multiple small injection will lyse CL (corpora lutea) -PGE (Misoprostol): PO every other day to help dilate cervix -Side effects: panting, salivation, vomiting, defecation, vocalization (queens) -30-40 minutes duration -Recommendations: breed and spay after next estrus

Answer 12

Uterine Prolapse -Rare -Increased in dystocia C/S -Firm tubular mass protruding from vulva. -Occurs during or following parturition Dx -PE Tx -Ovariohysterectomy Vaginal Prolapse -When estrogen is high (Proestrus and Estrus) -No Breed predisposition reported Dx -Type 1: floor of vagina; may not be visible externally -Type 2: floor and walls of vagina through vulva (looks like a pear) -Type 3: Entire vaginal circumference (lookalike a donut) Tx -Should regress after ovulation (estrogen decreases) -Induce ovulation: GnRH or hCG -Keep it clean and moist -E-collar -Surgical: OHE -Purse string suture does not have great success

Answer 13

Perineal Masses -Tumor -Abscess -Hematoma -Seroma -Vaginal Leiomyoma -Transmissible venereal tumor 1. Vaginal Neoplasia: Older dogs. Mass that does not vary with cycle is more likely neoplasia 2. Vaginal Hyperplasia: Younger dogs, mass varies with cycle 3. Vestibular mass (Abscess) 4. Intersex Condition (enlarged clitoris)

Answer 14

C/S -Enlarged, hot, painful glands usually during first week of lactation -Fever, neglect of pups -CBC shows immature neutrophilia -Coliforms, Streptococcus, Staphylococcus. -Hot pack and strip abnormal milk Tx -Warm cooked cabbage leaves on swollen gland, anti-inflammatory -NSAIDs (carprofen - little gets in milk) -Antibiotics: Clavamox or Chloramphenicol -Reverse syringe to suck milk out and decrease bacterial number Surgical -Remove dead or gangrenous gland

Answer 15

Pseudopregnancy and Galactorrhea -Spontaneous development of mammary glands -Spontaneous flow of milk Tx -Can use Cabergoline or Bromocriptine to dry up secretions. Decreases likelihood of mammary tumors in the future Mammary Neoplasia -Most common type of tumor in the bitch -50% malignant mixed with benign fibroadenomas -50% malignant adenocarcinomas -Presence of benign tumor increases changes of developing malignant tumor -No breed predisposition -Mean 10 yo -Malignant 93% of all tumors metastases lungs and lymph nodes -Intact bitches 7x more at risk than spayed -Spayed before 1st cycle = 0.5% chance of tumor -Spayed after 1st cycle = 8% -Spayed after 2nd cycle 26% chance of tumor Dx -Surgical excision -Staging is done by pathologist at a lab Tx -Surgery -Malignant tumors often recur -OHE may or may not increase survival time -Chemo, radiotherapy, immunotherapy consult oncologist Prognosis -Poor if >2-3 cm tumor malignant and metastasis

Answer 16

First Three: Cranial Thoracic Mammary glands and Cranial Abdominal -Drain into the Axillary LN Caudal Two: Caudal Abdominal and Inguinal -Drain into the Inguinal LNs

Answer 17

C/S -Serum calcium falls to 4-7 mg/dl (normal 9-11) -Can be hereditary in some lines -Primarily small breeds during 2-4 weeks of lactation -Panting, pacing, muscle tremors, ataxia -Hyperthermia 106-108F -Tonic-clonic convulsions -Death Tx -IV Calcium gluconate to effect -Follow up with SQ -Oral calcium for maintenance 1-3 g PO QD -Can remove pups for 12-24 hours -Wean pups if old enough

Answer 18

-Young bitches after first litter most common -Persistent uterine bleeding, usually still after weaning (normal 3 weeks) -Gross lesions: erosions in endometrium with nodular protrusions -Nodules made up of eosinophilic tissue -Necrosis -Hemmorrhage **Failure of normal thrombosis and occlusion of endometrial blood vessels** Tx -Usually self limiting -OHE -PGF2alpaha and transfusions Not related to postpartum metritis, nor future infertility

Answer 19

Estrus Suppression 1. Ovariohysterectomy 2. Progesterones Megestrol Acetate: progestin (not in queens due to diabetes mellitus) -Daily dosing required -Proestrus: Start in first 3 days of proestrus to be effective -Anestrus: For 32 days **Should not be used on first cycle or more than 2 consecutive cycles** Medroxyprogesterone Acetate: other injectable progesterones Side effects -Predisposes to cystic endometrial hyperplasia (CEH) and Pyometra 3. Androgens Mibolerone -Androgenic compound -Prevents LH release by negative feedback -Contraindicated in cats due to liver toxicity -Not approved for use in breeding bitches -Daily dosing required (PO) -Start 30 days prior to next anticipated cycle -Available through compounding pharmacies Side effects -Clitoral hypertrophy -Vaginitis, etc. -Safety/efficacy issues -Short inter-estrus intervals (IEI) may lead to infertility, embryonic death, or small litter size -Make sure bitch is not pregnant using baseline progesterone testing Testosterone Enanthate -Racing greyhounds to suppress estrus -Side effects are minimal 4. Gonadotropin releasing hormone (GnRH) analog Deslorelin (US for ferrets) -GnRH analog -Long acting implants NOT in US -Down regulates the pituitary-gonadal axis -Totally safe -Totally reversible -Treatment for antisocial behavior and prostatic enlargement -Reduces testosterone levels

Answer 20

Progesterone Supplementation -When <3 ng/ml or lower -Wait until after 45 days of gestation to prevent masculinization of female pups -Remove 2-3 days prior to due date to allow cervis relaxation 1. Micronized progesterone (Prometrium) -Taper dose as due date approaches -Easy to create progesterone profile and modulate it 2. Altrenogest (Regumate) -Allows measurement of endogenous progesterone to see if hypoluteoidism is real or not 3. Progesterone in oil for quick blood concentration -Then switch to oral for maintenance

Answer 21

**Only 38% of dogs become pregnant from one mating** -Termination attempts should be delayed until ultrasound verification of pregnancy (21-30 days gestation) -Prior to day 40 = absorption -After day 40 = expulsion -After day 55 pups may be alive and require euthanasia (not viable) Methods 1. Ovariohysterectomy 2. Estrogen Drugs: Estradiol Cypionate, Estrone -"Mismating" shots of estrogen -Within 72 hours of breeding -While still in estrus -Take vaginal cytology to confirm estrus/sperm present in vagina -Causes tubular blockage and disrupts/alters uterine environment Side Effects **25% incidence of pyometra** -Neoplastic anemia possible -Bone marrow suppression in dogs and ferrets. Lethal and irreversible -Client need to sign release 3. Prostaglandin: +/- prolactin inhibitors Drugs: Prostaglandin F2 alpha Dinoprost tromethamine -Multiple small injections will lyse the corpora lutea of the bitch or queen -Treatment for pyometra, retained placenta, mismating, collection of males -Best done during second trimester, after pregnancy diagnosis Side effects **Should be done in hospital** -Smooth muscle contractions -Drop in blood pressure -Vomiting, diarrhea, salivation, and panting **Luteolytic dose is only 5 fold fro LD50** 4. Prolactin inhibitors Drugs: Bromocriptine, Cabergoline, Prolactin is luteotropic. -Prolactin is leutotropic in the bitch and queen during the second trimester. -Corpora lutea lyse in response to lowered prolactin levels. -Progesterone <2 ng/ml for 48 hours induces whelping/abortion **Prostaglandin F2 alpha and Prolactin inhibitors induce abortion** -Before mid gestation prolactin is not luetotropic, so just use PGF2 alpha. -After mid gestation use both Prostaglandin F2 alpha Drugs: Dinoprost tromethamine (Lutalyse) -Takes 10-12 doses (3-4) days apart before abortion is complete -Recheck with ultrasound to ensure abortion is complete 5. Glucocorticoids Drugs: Dexamethasone -Fetal death within 5-13 days -Make sure use 10 days full treatment -Should abort completely within 14 days -If not complete treatment fetus may be born alive but not viable, die quickly Side Effects -PU/PD disappears after cessation of treatment -Very cheap compared to PGF2a 6. "Anti-Progestins" Drugs: Aglepristone in Europe -Bind to progesterone receptors (no effect on progesterone) -Works very well with no side effects -Can be used for early mismating treatment

Answer 22

Cabergoline -Prolactin inhibition may shorten anestrus -70% will induce within 14 days -Make sure progesterone is low -Look for bleeding and vulvar edema to start -Cytology, vaginal speculum, until proestrus -May get coat color changes, especially with treatment beyond 3 weeks but will go away in the next shed Canine Pseudopregnancy -Mammary development -Galactorrhea Tx -Cabergoline or Bromocriptine -Time (self limiting) -Testosterone, Mibolerone

Answer 23

Terbutaline -Decreases uterine contractions -Beta2 agonist -4 times per day -Avoid high doses, may cause cardiac effects Progesterone -Decreases uterine contractions -May be used if terbutaline is nor totally effective

Answer 24

Domperidone -Used for bitch that whelps with little to no milk -Comes as a 3% gel or 11% for horses

Answer 25

-A complication of ovariohysterectomy -More common in cats -Recurrent estrus after OHE -Can show up months or years later -Cycle normally: swollen vulva, serosanguinous discharge, etc. Dx -Vaginal cytology indicates proestrus/estrus -Hormonal testing -Estradiol 20 pg/ml -Progesterone >2 mg/ml Tx -GnRH and check progesterone 1-2 weeks -Anti-Mullerian Hormone: single blood test to detect when ovaries are present or absent -Laparotomy to remove ovary

Answer 26

Recessed Vulva -Estrogen therapy -Drug: Diethylstilbestrol -Delayed spay until after first estrus Estrogen-Responsive Urinary Incontinence -Can occur in spayed bitches Tx -Estriol tablets: increases number and sensitivity of alpha receptors -Phenylpropanolamine: directly stimulates alpha receptors Hooded Vulva -Puppy vaginitis -Adult vaginitis -Perivulvar Dermatitis Tx -Episioplasty: removal of excess skin folds -Allows freer voiding of urine Puppy Vaginitis -Small amount of clear to cloudy (+/- purulent) discharge in pre-pubertal bitch Tx -Best option for treatment is benign neglect -Rule out cystitis -Postpone OHE until resolved -Goes away with first estrus -Douche -Try probiotic for 2 months (Fortiflora Purina) Adult Vaginitis -Primarily seen in ovariectomized bitches: spayed before first estrus -Rule out: skin disease, perivulvar dermatitis, anatomic, inverted juvenile vulva, urinary tract infection, foreign body, tumor Tx -DES to thicken vaginal epithelium and improve urinary incontinence -Estrogen cream -Premarin tabs (conjugated estrogens) -Continue until >70% enucleated superficial cells, then for about 10 days

Answer 27

-Contagious through mucous membranes -Abortion due to placentitis -Orchitis/Epididymitis -Erythritol in placenta and epididymides: may stimulate growth of Brucella **Essentially non-treatable for breeding stock** Screening -Test all dogs with enlarged testis/epididymis -Culture semen -Ejaculation may be too painful -Ultrasound to differentiate from other issues (neoplasia etc) Dx -Culture of organism Gram (-) coccibacillus -RSAT (rapid slide agglutination test) excellent screening test. Very sensitive but not specific (SPIN, SNOUT) -Tube Agglutination test (TAT) -Agar Gel Immunodiffusion (AGID) -Immunofluorescent Antibody test (IFA) detects antibodies or immune complexes -PCR becoming more available

Answer 28

-Contagious through mucous membranes -Abortion due to placentitis -Orchitis/Epididymitis -Erythritol in placenta and epididymides: may stimulate growth of Brucella

Answer 29

Dx -Culture of organism Gram (-) coccibacillus -RSAT (rapid slide agglutination test) excellent screening test. Very sensitive but not specific (SPIN, SNOUT) -Tube Agglutination test (TAT) -Agar Gel Immunodiffusion (AGID) -Immunofluorescent Antibody test (IFA) detects antibodies or immune complexes -PCR becoming more available Interpretation of Results False Negatives -Early in disease process -Can detect dogs 12 weeks after infection False Positives -Lack of specificity of test -Cross-reactivity with other antigens -Retest positives with confirmatory test If positive in routine screening -AGID to rule out false positive If positive with clinical signs -Blood or discharge cultures If negative on routine test -No other testing needed If negative with clinical signs -3 monthly negatives tests are required to rule out false positives Prevention -Test all new additions 3 times -Test annually all breeding animals -Test females prior to breeding -Use AI to decrease risk

Answer 30

-Temperature sensitive virus -Replicates in oronasal pharynx -No illness in animals over 3 weeks of age -Neonatal deaths primarily Critical time -Niave bitch -Last three weeks of pregnancy and -First three weeks of neonatal life No problem -Poikilothermic period: 2-3 weeks exposure postpartum -Exposed during breeding C/S -Fetal greenish stool, abdominal pain, crying, high mortality Dx -Positive titer -PCR -Necropsy: petechial hemorrhages in kidney, lung, liver, spleen (pathognomonic) -INIB on histopath Management -If already in kennel -Expose naive bitch prior to breeding -Vaccine in Europe not US

Answer 31

-Normal inhabitant in female repro tract -Low conception rate -High rate of fetal resorption Tx -Doxycycline

Answer 32

Testicular Descent -Testis should be in scrotum by 10 days post partum -Both by 16 weeks of age should be descended into scrotum

Answer 33

-Considered cryptorchidism if they are in the inguinal canal at 6 months of age -Hereditary, some breeds predisposed Dx -Similar to ovarian remnant syndrome in bitch -Human Chorionic Gonadotropin Hormone (hCG) -Baseline testosterone, 4 hours and 8 hours post hCG check -Testosterone should be >2x baseline level if testis are present -AMH: blood test can detect when testicles are present. Somewhat Inconclusive

Answer 34

**Lack of pain on palpation, ultrasound, and biopsy** -All tumors cause testicular enlargement -Sertoli = atrophy of opposite testis -Multiple tumors may occur in one testis -Sertoli tumors bilateral in 45% of cases. Associated with feminization caused by estrogen secretion. Alopecia, pancytopenia, anemia, bilateral symmetrical alopecia, hyperpigmentation of inguinal area, gynecomastia, prostatic, pendulous prepuce, bone marrow hypoplasia

Answer 35

-All tumors cause testicular enlargement -Sertoli = atrophy of opposite testis -Multiple tumors may occur in one testis -Cryptorchidism increases incidence of tumor by 13.6 times and 23 times for Sertoli tumors -Sertoli tumors bilateral in 45% of cases. Associated with feminization caused by estrogen secretion. Alopecia, pancytopenia, anemia, bilateral symmetrical alopecia, hyperpigmentation of inguinal area, gynecomastia, prostatic, pendulous prepuce, bone marrow hypoplasia

Answer 36

Azoospermia is the ejaculation of seminal fluid that does not contain spermatozoa Causes -Retrograde ejaculation -Incomplete ejaculation -Hypopituitarism -Hypothyroidism -Inguinal/scrotal hernia -Endogenous or exogenous glucocorticoid excess -Intersex animals -Germinal cell aplasia -Bilateral cryptorchidism -Autoimmune orchitis -Testicular injury -Testicular neoplasia -Etc. Dx Testicular causes -ALP in seminal plasma >5000 U/L Pre and Post testicular causes -ALP <5000 U/L -Testicular biopsy -PE, ultrasound, testicular ultrasound

Answer 37

-Penis, prepuce, vagina, mucous membranes (nose) -Different number of chromosomes Dog: 78, TVT 59 +/-5

Answer 38

Ddx -Squamous cell carcinoma

Answer 39

Prolapse - Urethral -Genetic predilection in English Bulldogs -Pathognomonic "red pea" appearance a the tip of penis Tx -Surgical removal of prolapsed tissue - Urethropexy Priapism -Unnatural penile tumescence -Erection that won't go away -Rare -Usually associated with back issue, neurological problem Retained frenulum

Answer 40

Bening Prostatic Hyperplasia -The most commonly diagnosed prostatic disease in dogs C/S -Rectal tenesmus -May be asymptomatic -May produce constipation -Infertility -Caudal abdominal pain -Serous or serosanguinous urethral discharge -95% of intact stud dogs >9yo -Nearly 100% of intact dogs 10-12 yo Dx -Digital trans-rectal palpation -Older dogs normally have larger prostates located over the pelvic brim falling cranially into the abdomen -Younger dogs located on the pelvic floor close to the pelvic brim -After 12yo the prostate is completely abdominal. Need to elevate abdomen with outside hand and finger of the other hand in the colon -Normal: no bumps, no lumps, smooth, bilobed, symmetrical, and non-painful to palpation. Homogenous consistency. Firm, not fluctuant or fluid-filled. -CBC, culture of seminal fluid and urine, prostatic wash -Ultrasound guided needle aspirate -Biopsy -Radiographs Prostatic Wash -BHP - uniform cells -Neoplasia - variable cells -Septic - inflammatory cells Tx -Castration is the treatment of choice -Hormonal therapy (estrogens, progestins, anti-androgens, etc) Ddx -Acute bacterial protatitis: fever, depression, pain on rectal palpation, neutrophilia, etc. E. coli most common cause -Chronic bacterial prostatitis: recurrent lower urinary tract infection. Concurrently with benign prostate hyperplasia -Prostatic adenocarcinoma: poor appetite, weight loss, hind limb weakness, dysuria, hematuria, dyschezia. **Carcinoma cells may be seen in urine sediment** -Prostatic and paraprostatic cysts: palpable abdominal cysts masses filled yellow orange fluid

Answer 41

5a-reductase inhibitors - **Finasteride** -Block action of testosterone and or dihydrotestosterone -Need 3-4 mts treatment -Monitor liver values **DES** -May also be used for prostate hypertrophy **Castration is the treatment of choice** -Sexual behavior can take months to years to disappear

Answer 42

BPH -Symmetrical, mild enlargement, slightly mottled, small cysts IN parenchyma Acute Prostatitis -Symmetrical to asymmetrical, poorly marginated, multifocal mixed echogenicity, areas of mineralization Prostatic Neoplasia -Asymmetrical, mottled parenchyma -Areas of mineralization Prostatic Abscess -Asymmetrical, mottled parenchyma Prostatic Cysts -Located next to prostate not into it, look like a second bladder, usually thin walled, fluid echogenicity

Answer 43

-Alopecia -Comodones -Hyperpigmentation -Pendulous prepuce Testicular atrophy -Prostatic cyst -Gynecomastia

Answer 44

-Varies due to seasonality and body weight 4-12 months (~9 months) Early season -Will reach puberty when they are 1 year old Late season -Puberty as young as 4 months old Body weight -2.3-2.5 kg

Answer 45

Seasonal breeder -Long daylight hours necessary for cycle to occur Induced ovulators Seasonally polyestrus February through November Inside queens exposed to light may cycle year round Proestrus -Not as defined as bitches, rarely observed Estrus -Acceptance of mating Post-Estrus (interestrus) -No ovulation has occurred, queen not mated Diestrus -When ovulation has occurred Anestrus

Answer 46

Proestrus -Increased activity, vocalization, increased affection towards people, rubbing against things -Vaginal cytology undergoing similar changes -Estrogens levels rising Estrus -Vocalization, rolling behavior, assuming breeding position, treading with hind legs -3-16 days in length -Estrogen is high -4 or more breedings: 100% ovulation Post-Estrus -Period between successive estrus periods if ovulation does not occur -No luteal phase on ovary, no progesterone -No sexual receptivity -Inter-estrus period 8-10 days until next receptivity Diestrus -Only occurs when ovulation has been induced by breeding or other means. Hormonal or mechanical -Pregnancy: luteal phase 65 days -Pseudopregnancy: luteal phase 40-45 days. Non-fertility mating. Spontaneous ovulation occasionally occurs Anestrus -No cycling activity -October - November through January

Answer 47

-Copulation necessary for ovulation unless GnRH or hCG given -Multiple breedings ensure copulation -Peak concentration and duration of LH is important -After day 3 of estrus

Answer 48

-Gestation 65 days (63-65) Hormones -Progesterone: 30-40 ng/ml -Placenta contributes starting day 28-32 -Relaxin: detectable on day 25. Excellent for pregnancy diagnosis -Queens may show estrus behavior during pregnancy Pregnancy diagnosis -Abdominal palpation: day 16-30, best day 21 "String of pearls" -Ultrasound day 14-15, Heart beat day 20-25 -Radiographs day 43

Answer 49

Infectious -Feline Herpes Virus: abortion, maceration, placental necrosis, congenital fetal infection, not many C/S at abortion. -FIV: In utero infection, arrested development, stillbirth, viable infected kittens. Postnatal milk. 71% kittens born with the virus -FeLV: Resorption and abortion. 80% kittens death, 20% carriers -Feline panleukopenia virus: Cerebellar hyperplasia, abortion, stillbirth. -Bacterial: mycoplasma, Strep, Salmonella, Brucella, E. coli. -Protozoal: toxoplasma gondii - rare -FIP: kitten mortality complex, endometritis, abortions, stillbirths, poor reproductive performance. Common in catteries. Non-infectious -Ovulation failure -Early embryonic death -Taurine deficiency -Fetal chromosomal aberration -Stress on queen -Dilated cardiomyopahty

Answer 50

-No pre partum drop in rectal temperature -Takes several hours, 4 hours first kitten, 2 hours between kittens -Pedigree litters have higher risk of dystocia. Siamese, Persian, Devon Rex -Most common cause of dystocia is uterine inertia -May come into estrus 7-8 days post partum -No lactational anestrus Uterine Prolapse -Manual reduction + OHE Retained Placenta -Uncommon -Oxytocin Metritis -Increased incidence with dystocia, RP -Depressed, vulvar discharges malodorous -Antibiotics, ecbolics, OHE Mastitis -8 glands -Pyrexia, anorexia Tx: antibiotics, cabbage, hot/cold, compression

Answer 51

Ovaries -Cysts: Tx- OHE, hCG or GnRH -Ovarian remnant syndrome: Dx - estrogen levels, cytology, AMH test. Tx - hCG or GnRH, surgical removal. -Neoplasia: low incidence in cats. Uterus -CEH: spontaneous ovulation occurs occasionally. Middle age cats. E. coli common cause. C/S vulvar discharge, anorexia, abdominal pain distention. Tx - OHE + antibiotics, PGF2a if wanting to breed again -Pyometra -Neoplasia -Congenital abnormalities Vagina/vulva -Disorders are rare, secondary vaginitis Mammary glands -Mammary hypertrophy: Fibroadenomatous Hyperplasia (FAH) Usually young queens, pregnant or not pregnant, under the influence of luteal phase progesterone. May regress after luteolysis. Tx: Aglepristone: progesterone receptor blocker OHE not always result in resolution -Mammary neoplasia: 3rd most common tumor in cats Usually malignant carcinomas. Metastasis common Prognosis: better survival if tumor <2cm single most important prognostic factor

Answer 52

Puberty at 9 months 3.5 kg -Testosterone production leads to the formation of the spines on the penis (cornified papillae) after 6-7 mts of age Ejaculate -Electroejaculation under anesthesia -Artificial vagina or urethral collection -Normal motility: 40-80% -Morphologically: 50-70% Medetomidine Urethral Collection -Medetomidine with ketamine -Meloxicam for post op -Urinary catheter inserted 9cm into urethra Infertility in the Tom -Testicular hypoplasia: XXY chromosome male Calico cat -Cryptorchidism -Orchitis: rare -Testicular neoplasia -Testicular degeneration atrophy: nutrition related 1. Failure to show sexual interest 2.Failure to breed successfully: dental or penile problems: bad teeth, hair rings on penis. Too much size difference between male and female 3. Failure to impregnate the queen: Azoospermia. Test breeding and see if sperm present