Periparturient Conditions Flashcards by Kendra Broadfoot

normal mothering behaviour (5)

-attentiveness
-helping pups nurse
-stimulating urination and defecation
-grooming
-protecting and retrieving pups

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three possible causes of abnormal mothering

-stress
-pain
-excessive human interference

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what is mastitis

inflammation of mammary glands

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normally, a bitch should have mammary glands that are: (4)

Non painful
Symmetrical
Either firm or softer
Should be warm; NOT hot or cold

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when does mastitis commonly occur /when is it less likely to occur

-Commonly occurs post-partum. Usually occurs at 6-10 days post-
whelping or at early weaning

-Less likely to occur in pseudopregnancy or prior to whelping

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does mastitis affect every mammary gland

Can affect 1 or more glands or 1 or
more sections of a mammary
gland

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is mastitis life threatening

Can be life threatening and bitch
can be systemically ill

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clinical signs of mastitis in early disease process/mild cases

Mammary may just feel firm, bitch
may be uncomfortable, but without
fever

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clinical signs of mastitis as condition progresses/moderate-severe cases (5)

Bitch is febrile
Can see hot, painful, hard, discolored mammary gland (red, bruised, black)
Milk can look normal, purulent, brown/red to green in color
Bitch can appear quite sick → lethargic, not eating, not being a good mom, anxious, painful
Can be septic if abscessed or gangrenous

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4 diagnostics for mastitis

-Bloodwork
o CBC → leukocytosis with left shift
o Can be septic with gangrenous
mastitis

-Cytology of milk sample
o Degenerative neutrophils, bacteria
engulfed by neutrophils,
macrophages

-Culture and sensitivity of
aseptically attained milk sample

+/- Ultrasound of the mammary
gland

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treatment for mastitis (8)

-Analgesia (Tramadol, Opioids, Anti-inflammatory (NSAIDs) but Not recommended (pups))

-Hot packing/cold packing

-Cabbage leaf bandages

-Surgical debridement of necrotic tissue & honey bandages (Abscessed, Gangrenous)

-Antibiotics based on culture and sensitivity

-Fluid therapy if required

-Manual milking

-Need to consider if pups will still be nursing from mom → some drugs are passed through the milk & are toxic to neonates
–> Should not nurse if gangrenous /abscessed
–>Need to consider pup age if removal of pups from mom is necessary

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what is agalactia and when is it suspected

-Absence of milk in a female that should be lactating

-Suspected if pups are not gaining weight

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causes of agalactia (7)

-Asynchrony between delivery and milk production (eg. elective csection)
-Inadequate nutrition
-Stress
-Premature whelping
-Mastitis
-Metritis
-Endotoxemia/systemic illness

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treatment of agalactia

-Need to supplement pups
-Try to treat cause eg. stress
-Dopamine receptor antagonists (Dopamine inhibits prolactin → if we block dopamine → prolactin inc. )

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what is galactostasis

◦ Excessive accumulation of milk but with lack of milk let down

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what is required for lactation

prolactin!

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what do you expect to see with normal PP discharge (5)

-No odor
-Reddish brown to green color
-Present for up to to 3 weeks post partum
-Should decrease gradually with time
-Can have slightly elevated temperature for several days post partum but should not exceed 39C

metritis occurs following what

◦ Most commonly occurs following a dystocia, retained fetal membranes or fetus, prolonged delivery, contaminated obstetrical manipulations

when does metritis usually occur

1 week PP

what is metritis

infection of the uterus (endometrium and myometrium)

clinical signs of metritis (7)

-Poor mothering
-Lethargy
-Inappetance
-Fever
-Decreased milk production →decreased weight gain in puppies

-Vulvar discharge: thick, creamy to reddish brown & malodorous, sometimes copious

-Can present in shock

diagnostics for metritis (5)

CBC → leukocytosis with left shift

Ultrasound → uterine dilation; potentially presence of retained fetal membranes or fetal structures?

Radiographs → distended soft tissue
structure in caudal abdomen; presence of retained fetus?

Cytology of fluid → degenerative
neutrophils, engulfed bacteria by
neutrophils, RBCs

Culture & sensitivity of fluid

what is the most common pathogen cultured in metritis cases

E coli

dose of lutalyse

0.01 to 0.05 mg/kg subcutaneously
every 12hrs of lutalyse, as needed =
microdosing

treatment of metritis (6)

-May need to remove pups from mom if bitch is too sick -Fluid therapy -Antibiotics (Still need to consider if pups nursing) -Prostaglandins (Contraindicated if at risk of uterine rupture, Side effects → monitor in clinic. Monitor response to PGF2a → ultrasound examinations) -Oxytocin likely won’t work -May need to spay in severe cases (If fetus/fetal parts present, need to be surgically removed)

are RFM usually a concern in bitches

preventin of RFM

oxytocin in the first 24hr PP

what breeds are RFM more common in

toy breeds

what does green/black discharge for more than 12 hours possibly indicate

metritis

hypocalcemia is more likely in: (5)

-Young bitches (1st litter) -Large litter -Small or medium breed -Bitch fed inappropriate diet during gestation; supplemented with Ca2+ -At 2-4 weeks post-partum → maximum milk production

clinical signs of hypocalcemia (14)

-Restlessness, anxious behavior (pacing, whining) -Weakness -Being a bad mom – not tending to her pups -Tremors -Panting -Staggering -Facial pruritus -Dilated pupils -Change in behavior -Tachycardia -Hyperthermia - fever -Muscle twitching Hypersalivation -Collapse → convulsions

diagnosis of hypocalcemia

◦ History, clinical signs, physical exam ◦ Low ionized calcium ◦ Total calcium can also be low ◦ Check other abnormalities (hypoglycemia, hypomagnesemia, hypophosphatemia) ◦ Check acid-base status, protein levels

why is it important to treat hypocalcemia quickly

Can be life-threatening & is a rapidly progressive disease important to treat quickly!!

what form of calcium is being measured in supplements

elemental calcium

treatment of hypocalcemia

Slow IV administration of calcium → improvement is often rapid ~~10% calcium gluconate (0.5-1.5mL/kg) slow IV – monitor for bradycardia/arrhythmias during tx ~~Can follow up with subQ calcium after – diluted 50% saline q6-8hrs until stable Oral calcium ~~25-50mg/kg/day of elemental calcium – calcium carbonate (eg. Tums; 500mg tums = 200mg of elemental calcium) +/- remove pups to allow mom to recover & slowly re-introduce if too young to wean +/- supplement with milk replacer +/- cool down bitch if very hyperthermic +/- diazepam if convulsions

prevention of hypocalcemia (4)

-Feed well-balanced diet; especially with appropriate calcium/phosphate ratio (Avoid diets high in legumes) -DO NOT SUPPLEMENT WITH CALCIUM DURING PREGNANCY -Could reoccur with subsequent litters → plan to supplement feeding if necessary -Start supplementing calcium of next litters during the whelp

what is SIPS and when does it occur/should it be considered

SIPS = subinvolution of placental sites ◦ Occurs when involution is delayed ◦ Should be considered anytime there’s serosanguineous vaginal discharge > 6 weeks post partum

when does normal uterine involution take place by

by 12 weeks PP

diagnosis of SIPS

* Vaginal cytology: * Trophoblast cells (polynucleated and heavily vacuolated) * CBC if bleeding heavily * Anemia * Ultrasound/radiographs

treatment of SIPS

* Usually supportive and resolves on its own * If severe → spay