Mismating Management, Contraception, and Ovarian Remnant Syndrome Flashcards
What are questions to ask during the initial consult?
Is she in heat?
Was a “tie” observed?
If not, how long was the bitch missing?
Are puppies wanted in the future and why?
Is this bitch a valuable breeding animal?
Will you let me spay her?
What should be performed on all mismated bitches?
Vaginal cytology
What should you look for on cytology?
Sperm heads
What are the options for pregnancy termination?
OHE Prostaglandins Estrogens Prolcatin inhibitors Corticosteroids Progesterone antagonists
What is the mode of action of prostaglandins?
Direct luteolytic action with multiple doses Removes source of P4 Causes myometrial contractions Dilates the cervix Pregnancy is expelled
What are the side effects of prostaglandins?
Panting Excessive salivation Vomiting Diarrhea Begine within 5 minutes and can last 20-30 minutes Bitch may return to estrus sooner
What happens with repeated use of prostaglandins?
Side effects subside
How can you minimize the side effects of prostaglandins?
Give on empty stomach Start with lower doses and increase Dilute with saline Walk immediately after injections Atropine 0.1 mg/kg SQ
What is the dosing of prostaglandins?
Lutalyse: 50 μg/kg SQ TID for 2 days, then increase to 200 μg/kg SQ TID until abortion is complete
Cloprostenol: 2.505 μg/kg SQ every 24-48 hours for at least 2 doses
What is the problem with cloprostenol if used at the dose rate of lutalyse?
It could be fatal
When can estrogens be used?
Only during estrus
This is the only product that can be used at the time of mating
Can estrogens be used in the valuable breeding bitch?
No
What is the mode of action of estrogens?
Tightens the utero-tubular junction
“Kink” formed in the oviducts
Delays tubular transport of embryos
Alters estrogen:progesterone ratio leading to implantation failure
Direct embryotoxic effect
Collectively this leads to failure of pregnancy maintenance
What are the side effects of estrogens?
Pyometra
Bone marrow suppression
Prolonged estrus
Infertility at subsequent cycles
What are the estrogens that can be used?
Estradiol cypionate: 44 μg/kg IM once during estrus
Estradiol benzoate: 10 μg/kg IM twice at 48 hour intervals 2-3 days after mating
Diethylbesterol is not an effective mismating agent
What is the mode of action of corticosteroids?
High cortisol levels cause fetal production of prostaglandins leading to abortion
May have direct luteolytic actions
What are the side effect of corticosteroids?
Anorexia
PU/PD
When do you start corticosteroids?
Start after day 30 of gestation
What is the mode of action of prolactin inhibitors?
Increases dopamine release
Dopamine inhibits prolactin release
Prolactin is the primary luteotropin in the bitch
What do low prolacitn levels lead to?
Low P4 levels which causes abortion/pregnancy loss
What are the side effects of PRL inhibitors?
Nausea, vomiting
Anorexia
Diarrhea
What PRL inhibitor are side effects more common with?
Bromocriptine
When should you start using PRL inhibitors?
After day 30 of gestation
What drugs require you to confirm pregnancy loss at the end of treatment?
Corticosteroids
PRL inhibitors
What are examples of progesterone antagonists?
Mifeprostone
Agleprostone
Both are unavailable in the US
What assures luteolysis has occurred?
Progesterone levels of <1 ng/ml at completion
What are contraception options?
Intratesticular injection of sclerosing agents
GnRH vaccines
GnRH agonists
GnRH antagonists
What are examples of intratesticular injection of sclerosing agents ?
Neutersol/esterilsol
What are examples of GnRH vaccines?
Gonacon
What are examples of GnRH agonists?
Gonazon
Suprelorin
What are examples of GnRH antagonists?
Acyline
What does Neutersol/Zeuterin/Esterilsol result in?
Sterility due to destruction of sperm production
What is an ovariectomy?
Uterus is left but ovaries are removed
What is an ovarian sparing spay?
Ovaries remain
Why must the cervix be removed in an ovarian sparing spay?
Pyometra is possible
What are the cons to ovarian-sparing spay?
Still show signs of estrus, mammary tumors
What are pros to ovarian-sparing spay?
Decreased spay incontinence
Bone development and orthopedic problems
What is a vesectomy?
Only renders male sterile but still will have testosterone present
What are alternatives to vasectomies?
Castrate and prosthesis
What is a flank spay in cats often used in cases of?
Mammary hyperplasia
What is ovarian remnant syndrome a complication of?
OHE
Is ORS more common in cats or dogs?
Cats
When does ORS occur?
When a piece of retained ovary becomes functional
What is the biggest indication of ORS?
Spayed female exhibiting signs of proestrus or estrus
Vulvar swelling
Mucoid to serosanguinous discharge
What can be seen following “heat” in an animal with ORS?
Pseudocyesis
What are DDx in animals with ORS?
Conditions that cause bloody vaginal discharge in spayed females: vaginitis, vaginal neoplasia, stump pyometra, trauma, foreign body, exogenous estrogen exposure
What is the average interval from OHE to estrus?
Over 15 months
What is used to diagnose ORS?
Vaginal cytology
Vaginoscopy
Raciographs/US are usually not helpful
What are will you see on vaginal cytology from an animal with ORS?
Consistent with proestrus or estrus in the absence of exogenous estrogen exposure
Predominant cornified/superficial cells
What are will you see on vaginoscopy from an animal with ORS?
Vaginal edema typical of proestrus/estrus
What is the exception for using US with ORS?
May be helpful on large breed dogs with large follicles or cysts present
What is the hormone profile of ORS females?
Elevated anti-mullarian hormone levels
Confirm rising P4 2 weeks later
High E2
LH concentration low on 2 separate tests
How do you treat ORS?
Remove offending tissue surgically
Lifelong medical management if unable to remove surgically
What is used for medical management of ORS?
GnRH analogue/GnRH antagonist
Megesterol acetate (Ovaban)
Mibolerone (Cheque)
Why is medical management not recommended for ORS?
Side effects: Mammary gland tumors Acromegaly Clitoral enlargement Adrenocortical suppression
