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SA DX & TX I > Exam 3 - Postpartum Disease > Flashcards

Exam 3 - Postpartum Disease Flashcards

1
Q

what are some increased risks associated with causing maternal hypocalcemia?

A

increased risk with large litters & if calcium is supplemented during pregnancy

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2
Q

T/F: maternal hypocalcemia is rare in cats

A

true

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3
Q

what are the causes of maternal hypocalcemia?

A

increased calcium demands from fetal skeleton mineralization & milk production postpartum

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4
Q

what are the clinical signs of eclampsia?

A

stiff gait, tremors, anxiety, panting, fever

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5
Q

when does eclampsia usually occur?

A

usually 3 weeks postpartum but can occur in late gestation

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6
Q

T/F: fever/agitation day 1 after parturition is more often hypocalcemia than metritis

A

true

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7
Q

what is the treatment for eclampsia?

A

1-20 ml of calcium gluconate IV to effect over 30 minutes SLOWLY (0.5-1.5 ml/kg)

monitor EKG for bradycardiac or PVC - d/c calcium if noted

oral calcium 25-50 mg/day - continue until puppies are weaned

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8
Q

when should puppies be weaned?

A

after 3 weeks of age

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9
Q

what drug can be used to stop lactation?

A

cabergoline - anti-prolactinic

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10
Q

how is eclampsia diagnosed?

A

serum chemistry - low serum calcium

EKG - tachycardia & prolonged q-t interval

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11
Q

what is metritis?

A

acute, serious postpartum infection of the uterus

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12
Q

what are some causes of metritis?

A

bacterial invasion of the uterus via open cervix

retained fetuses or abortion

prolonged delivery or dystocia

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13
Q

what are the clinical signs associated with metritis?

A

foul smelling vulvar discharge generally 1 week postpartum

fever

+/- anorexia

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14
Q

how is metritis diagnosed?

A

vaginal cytology - neutrophils & bacterial

vaginal culture

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15
Q

what is the treatment for metritis?

A

antibiotics - penicillins, cephalosporins, fluoroquinolones if puppies are < 4 weeks old (pick based on culture)

nursing pups stimulate oxytocin which will help in uterine clearance

acupuncture to stimulate uterine clearance - CV1, SP6, BL67

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16
Q

what is subinvolution of placental sites?

A

delayed uterine involution post-whelping where fetal trophoblastic cells persist that is non-infectious & usually resolves on its own

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17
Q

what are the clinical signs of subinvolution of placental sites?

A

sanguineous/serosanguinous vulvar discharge for > 6-12 weeks - monitor for anemia/hypoproteinemia in severe cases

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18
Q

why not use ergonovine in a bitch with subinvolution of placental sites?

A

stimulates uterine contraction but puts mom at risk for uterine rupture

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19
Q

why does progesterone carry risk for a bitch with subinvolution of placental sites?

A

it sloughs the trophoblastic cells but puts mom at risk for pyometra

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20
Q

what therapy can be done if subinvolution of placental sites persists or is severe?

A

OHE

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21
Q

what is mastitis?

A

inflammation of glands with or without bacterial infection that ranges from mild/sub-clinical to life-threatening gangrenous

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22
Q

what are some causes of mastitis?

A

environmental - unsanitary, trauma from untrimmed puppy nails, & rubbing whelping box as they enter/exit

galactostasis

hematogenous spread from neonatal death

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23
Q

if you see gas near the mammary glands on rads for a mastitis patient, what do you suspect?

A

gangrenous mastitis - worry about septic shock

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24
Q

what are the subclinical signs of mastitis?

A

neonatal failure because mom won’t let puppies nurse

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25
Q

what are the clinical signs associated with mastitis?

A

one or more glands affected

heat, redness, abnormal milk color/texture, can see bruising/ulceration

gas = gangrenous

can progress to septic shock

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26
Q

how is mastitis diagnosed?

A

cbc- neutrophilia & thrombocytopenia if severe

milk cytology - neutrophils & bacteria

milk culture

xray - check for gas!!!

ultrasound - check for pockets on fluid

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27
Q

T/F: gangrenous mastitis has a grave prognosis

A

true

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28
Q

why does gangrenous mastitis have a grave prognosis?

A

quick progression of mastitis over hours - need ICU care for sepsis

may have better prognosis with quick surgical intervention

29
Q

what is the treatment used for mastitis?

A

broad spectrum antibiotics - based on culture, penicillins, cephalosporins, fluoroquinolones if < 4 week old puppies

warm compress & gentle drainage - don’t drain/milk if pseudocyesis because it encourages more milk production

cabbage - decrease swelling

neonates can continue to nurse

surgical drainage of abscesses may be necessary but ulcerations can heal with wound care

30
Q

what is uterine torsion?

A

rare - rotation of one or both horns that can occur anytime but most commonly postpartum

31
Q

what are the clinical signs of uterine torsion?

A

vaginal discharge, abdominal pain, lethargy, anorexia, vomiting

32
Q

what is seen on xray & ultrasound that supports a diagnosis of uterine torsion?

A

rads - caudal abdominal soft tissue mass

ultrasound - fluid filled segment of uterus

33
Q

what is the prognosis of uterine torsion?

A

good prognosis with OHE

34
Q

what is uterine prolapse?

A

prolapse of the uterus through the cervix & into the vagina

35
Q

what causes uterine prolapse?

A

etiology unknown but excessive straining or forced fetal extraction can play a role

36
Q

how is uterine prolapse diagnosed?

A

physical/digital exam

exposed uterus can be necrotic

37
Q

what do you need to differentiate uterine prolapse from?

A

vaginal hyperplasia

38
Q

how is uterine prolapse treated?

A

manual replacement if tissue isn’t necrotic

OHE if tissue is necrotic

39
Q

T/F: mortality of puppies/kittens is the highest during the first week of life

A

true

40
Q

what is fading puppy/kitten syndrome?

A

disease or death of neonates from parturition to weaning

41
Q

what are some risks for neonates regarding fading puppy/kitten syndrome?

A

higher risk for neonates:
- born late in delivery or dystocia due to hypoxemia/trauma
- low birth weight, >25% below average for puppies & < 75g for kittens, they are more prone to dehydration, hypothermia, hypoglycemia, & sepsis

42
Q

before all else, how should you treat fading puppy/kitten syndrome?

A

treat hypoglycemia & hypothermia

43
Q

what are some maternal causes of fading puppy/kitten syndrome?

A

dystocia, neglect, malnutrition of dam, agalactia, trauma, cannibalism, & systemic disease

44
Q

what are some examples of systemic disease in the bitch that can cause fading puppy/kitten syndrome?

A

mastitis, parasitism, & maternal diabetes mellitus causing puppies to have low BG

45
Q

what are some congenital anomalies that attribute to mortality in fading puppy/kitten syndrome?

A

atresi ani, cleft palate, hydrocephalus, heart defects, & hernias

46
Q

fading puppy/kitten syndrome is responsible for up to ____% of neonatal deaths in puppies & ____% in neonatal kittens?

A

40% - puppies

20% - kittens

47
Q

what is the anomaly shown in this puppy?

A

cleft palate

48
Q

what are some treatment options for fading puppy/kitten syndrome?

A

warmth, fluids, correct hypoglycemia, nutritional support, O2 support, antimicrobials (amoxi clav, cephalosporins - reduce dose by 30-50% in neonates) & blood transfusions

49
Q

how does malnutrition play a role in fading puppy/kitten syndrome?

A

overeating causing discomfort

inadequate milk production of mom or inadequate nursing

50
Q

how do you improve malnutrition in fading puppy/kitten syndrome?

A

allow smaller pups to nurse first

encourage suckle with warm, clean pinky finger

dextrose on nipple to stimulate suckling

51
Q

when are puppies able to shiver?

A

7-9 days old

52
Q

what is a big common cause of fading puppy/kitten syndrome?

A

environmental causes - too cold & malnutrition

53
Q

how do environmental causes play a role in fading puppy/kitten syndrome?

A

whelping box is too hot or too cold & puppies can’t shiver until they are 7-9 days old

54
Q

what causes neonatal isoerythrolysis in kittens?

A

queen & kittens don’t share the same blood type - kitten RBC undergo immune-mediated destruction by maternal antibodies in colostrum

55
Q

if you know the queen’s blood type doesn’t match her kittens, what do you do?

A

must separate kittens & queen for a period after birth

56
Q

what blood type cats are often affected by neonatal isoerythrolysis?

A

type a or type ab kittens born to a type b queen

type b cats have high levels of antibodies against type a cats

type a cats have low levels of antibodies against type b cats

57
Q

when can parasites be considered as a cause of fading puppy/kitten syndrome?

A

after 2 weeks of age

58
Q

what viral causes attribute in causing fading kitten syndrome?

A

calicivirus, herpesvirus, panleukopenia, felv, & coronavirus

59
Q

what viral causes attribute in causing fading puppy syndrome?

A

herpesvirus - high mortality in first 3 weeks of life

parvo, coronavirus, distemper

60
Q

how does bacteria cause fading puppy/kitten syndrome?

A

acquired from birth canal, placenta, or uterus - common cause of disease in the first week

61
Q

what puts puppies/kittens at risk for developing a bacterial cause of fading puppy/kitten syndrome?

A

lack of colostrum!!! symptoms progress quickly over hours & die within a day

TREAT QUICKLY

62
Q

what are some general categories of infectious causes of fading puppy/kitten syndrome?

A

bacterial

viral

protozoal

parasitic

63
Q

what virus is responsible for high mortality in puppies in the first 3 weeks of age?

A

herpesvirus

64
Q

what is this?

A

uterine prolapse

65
Q

what is this?

A

uterine torsion

66
Q

what is this?

A

subinvolution of placental sites

67
Q

what is this?

A

metritis

68
Q

what is this?

A

mastitis

SA DX & TX I (59 decks)

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