Normal canine pregnancy and parturition

Question 1

Maternal recognition is defined as…?

Maternal recog. factors in the bitch and queen?

Answer 1

the events by which the conceptus initially signals its presence to the dam and thereby enables pregnancy to continuous.

Maternal recognition factors have not been identified in the bitch and queen. For the continuation of the pregnancy, the luteal phase must be maintained.

Question 2

Progesterone source in pregnancy for the queen.

Answer 2

TAfter day 45 of pregnancy the CL is not producing progesterone to maintain pregnancy, probably the placenta takes over but this hasn’t been confirmed.

Question 3

After fertilization, the cleavage of the zygote begins, becomes a →

Answer 3

a morula →
a blastocyst →
reaches the uterus at day 5-8, to become a hatched blastocyst, and until implantation the embryo is fed by uterine milk from the uterine glands.

Question 4

The implantation is… the union of the trophoblast to the maternal tissue in the
uterus.

When does it occur in dogs and cats?

Answer 4

The implantation is the union of the trophoblast to the maternal tissue in the uterus.

Day 15-18 in dogs and cats

Type of placenta: zonary, endotheliochorial and deciduat.

Question 5

What is a deciduate placenta?

Answer 5

Deciduate placenta is where there is a significant attachment between the maternal tissue (uterus) and the fetal tissue (placenta). This close attachment results in some maternal tissue being shed during childbirth along with the placenta. The term “deciduate” comes from the Latin word deciduus, meaning “falling off,” reflecting this shedding process.

Question 6

What species have a
epitheliochorial placenta?
And endotheliochorial?
And hemochorial?

Answer 6

epitheliochorial placenta in horse, cow, pig sheep

endotheliochorial in dog, cat

hemochorial in man and rodents

Question 7

Canine pregnancy lasts for
? from the LH-Surge
? from ovulation

Answer 7

• 65 +/- 1 days from the LH-Surge (NO mating)
• 63+/-1days from ovulation

Estimation of due date from breeding dates is very inaccurate due to the length of the time that sperm may be viable (2-10 days).

Question 8

Premature puppies are born on what day of gestation?

Answer 8

before day 58

they will likely die if born too premature

Question 9

3 hormones that are super important in the bitch during pregnancy

Answer 9

progesterone

prolactin (luteotropic & from anterior pituitary)

relaxin

Question 10

Progesterone in pregnancy is produced from

Answer 10

the thecal cells of the CL and a little from the placenta

Question 11

P4 increases to what range after ovulation?

Bitch will abort if it drops to how low?

Answer 11

Increases the first weeks after ovulation to between 15-90 ng/ml.

Reaches the highest level around day 30, stays on a plateau level until 2-3 weeks before term where it slowly declines.

No precise values during pregnancy but the bitch will abort if progesterone drops below 2ng/ml (you’d need to supplement).

Question 12

Dam temp before parturition

Answer 12

P4 drops fast below 2 ng/ml short before the delivery → drop in body temperature
8 hours after, to under 36.7’C.

Question 13

Why can’t you use progesterone for pregnancy diagnosis in the dog?

Answer 13

The luteal phase has the same lifespan for the pregnant than for the non-pregnant female.

diff:
gradual P4 drop off in the non-pregnant, distinct luteolysis in the pregnant bitch

Question 14

Relaxin is produced by

Answer 14

the placenta and is the only pregnancy specific hormone in the bitch.

Relaxin promotes relaxation of the pelvic ligaments and support the formation
of prolactin.

Question 15

Placenta produces relaxin in increasing amounts after day

Answer 15

19 post-ovulation.

Low concentrations in the blood from day 19, measurable up till 3 weeks post
partum.

Question 16

Clinical symptoms during pregnancy in bitches. (8)

Answer 16

 White, non-smelly vaginal discharge the first 14 days.

 Reddish enlarged teats 3-4 weeks of pregnancy.

 Mammary development 14-2 days before the delivery.

 Swelling and relaxation of the vulva before term.

 Increased abdominal girth, depending on numbers of puppies, breed and number of
pregnancies

 Mucilaginous clear vaginal discharge is often seen the last 14 days of pregnancy).

 Behavioral changes

 Decreased appetite (normally after 4 weeks due to implantation and again just
before term).

Question 17

Define pseudocyesis.

Answer 17

technical term for phantom pregnancy

Question 18

Hematology in the pregnant bitch. (5)

Answer 18

• Significant reduction in the percentage of packed cell volume (PCV)
• Mild non-regenerative anemia in late pregnancy (due to increased blood volume)
• Increase in plasma fibrinogen and other acute phase proteins, like CRP (after day 25)
• Thrombocytosis (up to 40% increase)
• Mild leukocytosis (last 1/3 of pregnancy) with no left shift, monocytosis nor toxic neutrophils

Question 19

Pregnancy diagnosis by 4 main methods.

Answer 19

 Abdominal palpation
 Ultrasound
 Blood samples
 X-ray

Question 20

Describe Abdominal palpation for pregnancy diagnosis.

Answer 20

 Most accurate day 25-35

 Difficult in giant breeds, fat bitches, small litters.

Technique: the bitch on the examination table → the breeder talking to her → uterus is palpated from just caudally to the kidneys and all the way to the bladder: discrete gestational sacs feels like small
bubbles

Question 21

Describe U/S for pregnancy diagnosis in bitches.

Answer 21

Can be diagnosed from day 19 but better to wait until after day 24.

Even better at day 26-27, and why is that? → take a look at these pictures.

You can confirm pregnancy, assess fetal viability and do a basic assessment of embryonic numbers.

Question 22

Describe X-ray for pregnancy diagnosis.

Answer 22

Don’t use x-ray before the organogenesis is ended (day 35 of pregnancy).

May be used from day 45 of pregnancy.

Remember to increase kV of the x-ray machine by 6-8, because of the less
mineralization of the fetus compared to a grown-up dog.

If possible take both LAT and DV projection all the way to pelvic entrance to determine the number of puppies and whether a normal vaginal delivery is possible.

Question 23

What can be visualized on canine pregnancy x-ray:
 Day 31-38:
 Day 44-46:
 Day 46-51:
 Day 50-53:
 Day 53-59:
 Day 53-63:

Answer 23

 Day 31-38: uterine enlargement
 Day 44-46: mineralization of the cranium day 44-46
 Day 46-51: scapula, humerus and femur
 Day 50-53: radius, ulna, tibia
 Day 53-59: pelvis and all the costae
 Day 53-63: teeth

Question 24

Describe the Relaxin-test.

Answer 24

Indicated for pregnancy diagnosis in bitches.

Can be used from day 30 to term
(a lot of false negative results from day 19-30).

Question 25

Fibrinogen/CRP for use in pregnancy diagnosis.

Answer 25

Acute phase-protein (CRP) that increases during pregnancy (more than
250mg/dl day 21-30).

Due to an inflammation in the endometrium because of trophoblast invasion during implantation.

Levels > 300mg/dl after day 30 is indicative of pregnancy or other severe
inflammation → NB the test is not very specific to use as a pregnancy diagnosis.

Question 26

Implantation period: day?
The embryonic period: day?
The fetal period: day?

Answer 26

Implantation period: day 16-22
The embryonic period: day 22-44
The fetal period: day 45-63

Question 27

Nutrition during pregnancy.

Answer 27

Choose a commercial brand, e.g. Royal canin HT42/starter, P/D puppy for small dogs (when feeding the pregnant bitch despite her breed, its due to food composition), Virbac hpm babydog.

Don’t feed Barf during pregnancy and especially not after implantation → risk
of bacteriemia/toxoplasmosis → abortion.

Needed composition: Protein 25-30%, fat 20%, carbohydrates 30%, balanced content of omega 3/6, vitamins and minerals.

Avoid supplements, except fish oil 400-1000 mg/day and probiotica (enterococcus faecium).

No calcium supplements due to the risk of eclampsia post partum.

Question 28

When to feed puppy diet to pregnant dam and how often?

Answer 28

Pregnancy/puppy diet from the 4. week of pregnancy, depending on the breed and number of puppies, in late pregnancy feed 4-5 times a day.

Anorexia not unusual 3-4 weeks post-ovulation and again during the last weeks of pregnancy

Question 29

Bitch increase in bodyweight during gestation.

Answer 29

Increase in bodyweight with 36% is a max, don’t let them be too fat → everything will become more difficult.

Question 30

What is 1-2 puppy-syndrome?

Answer 30

If you notice a small litter at ultrasound 3-4 weeks of pregnancy definitely take an X-ray later on!

The cortisol production from the adrenals of the few puppies can be too low to start
the delivery properly.

Puppy megaly can occur too, and decreased placentae function after day 66 can lead to dystocia, hypoxia and fetal death.

2 puppy-pregnancy in large breeds can also cause problems

Question 31

Resorption in pregnancy is…?

Abortion in pregnancy is…?

Answer 31

Resorption is the loss of pregnancy before day 45; often no clinical signs, maybe a little brownish vaginal discharge.

Up to 10% of all puppies are being resorbed → most of them before day 30.

Abortion occurs after day 45; the bitch will abort fetuses/part of fetus. The whole litter or only part of it, depending of the cause.

Question 32

Causes of resorption in pregnancy: (3)

Answer 32

• Defects
• Infections
• Premature drop in progesterone (primary hypoluteoidism/subclinical endometritis/ a lack of prolactin)

Question 33

Describe gestational Diabetes mellitus/ Ketosis in pregnancy.

Answer 33

Decreased insulin sensitivity in up to 43% in pregnant bitches → suppresses intracellular transport of glucose and increases circulating glucose concentrations.

+ Big litters, high energy requirement
+ Decreased appetite

The bitch will show PU/PD, weight loss, polyphagia, later lethargy, weakness → ketosis in severe cases.

Most bitches normalize spontaneously postpartum.

Question 34

How to monitor a problem-pregnancy?

Answer 34

The aim is to avoid delivery of immature puppies before day 58.

Ultrasound is a very important diagnostic tool. Pulse, placentae evaluation, maturity of the internal organs, signs of endometritis between the implantation spots.

Progesterone measurement if suspicion of premature drop in P4, measure 2x weekly, and do ultrasound at the same time if possible.

Progesterone: first 30 days > 15 ng/ml → slowly decrease to about 5 ng/ml until
the beginning of the delivery.

Question 35

Progesterone level during first 30 days of gestation

Answer 35

> 15 ng/ml → which slowly decreases to about 5 ng/ml until the beginning of the delivery.

Question 36

Describe Hypoluteoidism.

Answer 36

= insufficient secretion of progesterone by the corpora lutea during pregnancy.

Bitches that have been pregnant, but have resorbed/aborted, often giant breeds
and German Shepherds.

Ultrasound day 25 after ovulation (check for inflammation).

Quantitative progesterone measurement 2x weekly, therapy according to the type
of progesterone and the stage of pregnancy.

Do ultrasound several times during the last month of pregnancy (check pulse, placentae, interplacental sites, internal organs).

Closely monitoring of the bitch during the delivery and post partum.

Question 37

Drug Therapy options for tx of hypolutheodism. (2)

Answer 37

Synthetic progesterone: Regumate® (altrenogest) 0,088mg/kgx1. Advantage: the progesterone of the bitch can be monitored normally.

Natural progesterone: Luthinus® tabl 2-5 mg/kg 2-3 x daily, human progesterone, con: not possible to monitor the progesterone from the bitch.

Don’t start treatment until after day 35 (end of organogenesis) to avoid cryptochid male puppies and masculinization of female puppies.

Stop treatment at day 60 post ovulation.

Side effects: malformation of the genitals of the puppies, prolonged pregnancy,
decreased milk production and decreased dam-puppy bonds.

Question 38

What to do in the event of premature labor?

Answer 38

Causes: infections, placental abnormalities, hypoluteodism, malformations

Use ultrasound!

If necessary use tocolytic treatment (slows contractions), such as Terbutaline 0,03mg/kg TID to delay the delivery 1-2 days until the puppies are mature (the puppies have to be healthy, otherwise it’s better to lose the pregnancy).

Betamethasone can be used to mature the lungs 24-48 hours before delivery or c-section.

Often infections/sec. luteolysis: use antibiotics and progesterone.

Monitoring daily until after day 58 post-ovulation (ultrasound/progesterone
measuring).

Question 39

Euthocia =

Answer 39

normal birth

Question 40

Signs indicating the antepartum period. (4)

Answer 40

 Clear mucinous discharge coming from
cervix (normally the last 2 days before the delivery)

 The body temp decrease to about 36,5°C (normally 24 hours before the 1. part of parturition)

 The bitch stops eating the last 24 hours

 Milk in mammae

Question 41

Stage 1 of parturition - hormonal and fetal changes.

Answer 41

Increase in PGF2-alfa and (estradiol) →

myometrial contractions →

increase in intrauterine pressure →

fetal movements →

rotation into upper position and
extension of the limbs →

fetus is pressed towards the cervix →

production of oxytocin (ferguson reflex) and myometrial contractions increases →

fetus enters the cervix that undergoes remodeling.

Cervical relaxation occurs due to relaxin-synthesis stimulated by PGF2-alfa.

Question 42

Stage 1 of parturition - Clinical symptoms and duration. (3)

Answer 42

• The bitch is in pain, but no contractions
• Restlessness, hyperventilation, scraping/nesting
• Can last for 6-12 (18) hours

Question 43

Stage 2 of parturition, labor - hormonal and fetal changes.

Answer 43

The increased pressure on the fetal membranes causes their rupture →

first allantochorion, while the amnion in some cases will stay intact and protrude
from the vulva (waterbag) →

the fetus enters the pelvis and becomes hypoxic →

increases fetal movements →

increases myometrial contractions →

abdominal straining from the bitch→

expulsion of the fetus.

Question 44

Stage 2 of parturition, fetal expulsion - Clinical symptoms and duration. (4)

Answer 44

 Can last for 6-12 hours

 Max 30 min with good contractions

 Max 2 hours between puppies

 No green discharge before the first puppy

Question 45

Stage 3 of parturition, expulsion of fetal membranes.

Answer 45

Myometrial contractions remain active with a lower amplitude after expulsion of
the fetuses, the abdominal contractions cease →

changes in the structure of the placenta the last days of pregnancy cause the separation of the fetal membranes →

dehiscence and expulsion of the fetal membranes.

In dogs and cats the membranes are expelled together with the fetus or in
between two fetuses→ the 2. and 3 stage can’t be separated.

Always count the number of membranes and let the bitch eat a few but not all of
them.

Question 46

How to handle the neonatal after birth.

Answer 46

If possible let the bitch do the job!

If not, then possible 1 person per puppy. Small towels from the microwave to avoid hypothermia.

Suction equipment for the nose/mouth to
release mucus and amnion fluid. Free the airways – suction larynx and nares free of mucus. If necessary give mouth to mouth.

Keep the puppies’ head downward but never shake them (neck problems and concussions). Rub the neck and inguinal region until it screams - dont´ give up too early!

Don’t use Dopram® (cardiac damage if the
puppy is hypoxic). Ligature on umbilicus 1-1,5 cm from the abdominal wall (primary infection-route). Let the puppies have colostrum before sending them home.

Question 47

Incubator use for neonatal puppies.
Temp and humidity.

Answer 47

 30-32°C for first 3 days (later on 24-25’C)
 70% humidity to avoid dehydration

Question 48

Checklist for health check of the newborn puppy.

Answer 48

 Cleft palate
 Anus

 The back (check for e.g. scoliosis)
 The tail

 Reflexes
 Mucus membranes/ skin on the
abdomen/pads

 Genitals (intersexism, hypospadias etc.)
 Compare puppies between each other.

Question 49

Post-partum instructions for the breeder. (5)

Answer 49

 Monitor the lochia

 Keep the puppies warm and weigh them twice daily for the next 10 days.

 Mark the puppies to tell them apart

 Starter mousse food for the bitch for the first couple of days postpartum

 Keep the bitch in a calm and quiet environment.