L21: Dystocia, C-section, Post Partum Problems (Kelleman) Flashcards
physical signs 1-2 weeks before parturition in bitches
- small amt. of vulvar discharge
- anorexia and panting
- +/- mammary development
- nesting behavior
methods of predicting parturition
- body temp/progesterone drop 12-48 hrs prior to part.
- rads
- progressive ossification
- US
- organ development
- GI layering (58-60d; hypoechoic lumen and muscular layer)
- GI peristalsis (62-64d post LH)**
3 stages of parturition
preparation
fetal expulsion
placental passage
breed dispostions to dystocia
Boston Terrier Bulldogs Border terrier Chihuahua Cocker Spaniel Mastiff, etc. etc.
rules of dystocia
- prolonged gestation
- stage I labor >12 hrs
- stage 2 labor >4 hrs w/ no pup produced
- stage 2 labor with hard contractions >30min
- > 2 hrs since pup born
- bitch systemically ill
- frank vulvar hemorrhage
- green vulvar d/c before pups (sign placenta is separating)
- obvious abnormal presentation
uterine inertia
inability for uterine muscle to contract even with oxytocin
- primary: dam fails to expel normal pups through vagina (as with Hypocalcemia, Singleton litter)
- secondary: obstructive dystocia**
maternal causes for dystocia
- inadequate size of birth canal
- uterine torsion/rupture (“acute abdomen”)
fetal causes for dystocia
- Fetal oversize (Singleton litters, Hydrocephalus/anasarca)
- Abnormalities of presentation or posture (transverse, breech, deviation of head/neck or limbs)
Medical management of dystocia**
- Oxytocin: should NOT be used with obstruction!
- Hypocalcemia: Calcium gluconate (give IV slowly, helps efficacy of oxytocin)
- Hypoglycemia: karo or glucose
Assisted vaginal delivery
- must be in correct position and posture
- clean perineum
- lubricant
- head or pelvis (not limbs)
what should fetal HR be in dogs?
2-2.5x that of dam’s
which drugs should be avoided in C-section?
ketamine
Methoxyflurane
Xylazine
Acepromazine
steps post-C section
- oxytocin after uterine closure for contraction
- lavage abdomen and uterine incision with warm saline
- routine closure
methods of timing elective Cesarean
-at least 63d from LH surge, but no later than 65d
-monitor P4 daily and cut when drops below 2
+/- monitor fetal HR and cut when HR < 180 bpm
corticosteroids may be carefully used to induce final fetal maturation
T
Neonate Resuscitation Elements
- vigorous rubbing to stim. breathing
- airway: suction
- supplement oxygen
- drugs: dextrose, doxapram, epinephrine
- keep dry and warm
Neonatal exam
check for cleft palate, limbs/toes, functional anus, umbilical hernia, gender, etc.
normal uterine involution
- complete at 3 mo. post partum
- normal to have lochia 4-6wks
Agalactia
inadequate milk production or let-down
- If nutrion-caused, needs 2.5-4x maintenance
- if nervous-caused, give acepromazine
- oxytocin, domperidone, acupuncture can help
Elements of PE for postpartum bitch
- temperature (to 103.5 ok)
- abdominal palpation
- mammary glands
- vulvar d/c quality
mastitis dx/tx
Dx: culture/cytology (E. coli, staph, strep);
Tx: Abx (cephalexin, clavamox), anti-inflammatory, local therapy
appearance of normal mammary glands
supple, soft, non-painful, not discolored
dx/tx of metritis (“acute puerperal metritis”)
Dx: -abdominal assessment** -CBC/Chem -Culture/cytology Tx: abx, supportive care, sx?
Hypocalcemia/Eclampsia incidence/CS/Tx
-small breed
-multiple puppies
-1-4 wks post partum
CS: CNS signs of nervousness, trembling, inc. TPR, death
Tx: slow IV Ga gluconate; supplement or remove pups
SIPS
Sub-involution of placental sites
- causes prolonged hemorrhagic vulvar d/c
- may cause anemia
- can ignore or perform OVH
Feline Dystocia
- rare
- more common in Devon rex, short/long headed/nosed breeds
Feline post partum problems
(similar as in bitch) metritis mastitis postparturient hypocalcemia agalactia SIPS postpartum uterine prolapse (can amputate or replace)
