Post-partum abnormalities Flashcards
Immediate examination of the bitch
- becomes settled after birth of last pup
- red/green/brown discharge normal
- frank haemorrhage is abnormal
- check for presence of milk
- passage of placenta may not be immediate
Poor mothering behaviour - what are the behaviours? Causes? Prevention?
Probably the most significant challenge is poor mothering behaviour
- bitch won’t settle
- picks up and carries pups
- doesn’t let them suck
- is aggressive to O or visitors
- is aggressive to pups
Causes
- often inexperienced bitch/O
- poor whelping environment (too much disturbance)
Prevention
- preparation & familiarisation within the whelping area
- restricting visitors
- keeping a calm environment
Fostering or hand-rearing may be necessary
What to do when the litter is too large
Supplementary feeding (rotation of pups) or fostering may be required
Hand rearing is the least preferred method as it may be associated with poor behaviour development to fate pups
- when required use appropriate teat size, with 1 or 2 small holes (milk should drip not pour out)
- correct [] of milk
- ensure fed warm, not hold or cold
- feed in normal position with neck extended
- feed 6x/day
- check hydration status (urine colour / skin tent) at each feed
- check weight gain daily
The puerperium
- normal involution takes 12w in the bitch
- normal involution takes 6w in the queen
- there is normal vulval discharge for 3-4w
– not odorous, not associated with illness, but may be coloured
Post-partum dz (in order of how common)
- suspected RFM
- post partum metritis
- inadequate milk
- hypocalcaemia
- sub-involution of placental sites
- haemorrhage
Suspected RFM - when should the placenta be passed?
- usually within 20 mins of each pup
Suspected RFM - CS
- green/black discharge persists after parturition
Suspected RFM - what can it be associated with?
- retained pup and placenta
Suspected RFM - diagnosis
- requires US
- radiograph not diagnostic
- palpation is unreliable
Suspected RFM - tx
Oxytocin and antibiotic should be given
- oxytocin receptors regress after parturition, so following parturition treating with oxytocin doesn’t cause issues
- few oxytocin receptors after 36h therefore consider low does prostaglandin
– Dinoprost: stimulates natural, luteolytic and spasmogenic, but can cause things like colic
– Estrumate: much more luteolytic, much less spamogenic, useful in horses for luteolysis, not useful in dogs as require smooth muscle contractions
Suspected RFM - what is a common sequelae?
- metritis
Post-partum metritis - what is it? what causes it?
Bacterial infection following on from
- difficult or prolonged birth
- placental retention
- abortion
There is no underlying hormonal issue - it is a contamination / infection of the uterus
Post-partum metritis - CS
- depression
- pyrexia
- anorexia
- purulent vulval discharge
- neutrophilic with left shift
- uterine enlargement
Post-partum metritis - tx
Conservative management is feasible
- broad spec antimicrobials
- fluid therapy
- ecbolic agents: encourage uterine contractions/expulsion of material
– prostaglandins
Inadequate milk - what 2 conditions are seen?
- agalactia
- lack of milk let-down
Agalactia - what is it?
- no milk production
Agalactia - when is it seen?
- 1st litle
- possibly in premature birth
- early c-section
Agalactia - tx
Dopamine antagonists are prolactin agonists = metoclopramide
- 0.1-0.2mg/kg SC q6h
- takes about 3d for effect
Lack of milk let-down - when is it seen?
- less common
- anxiety, pain, stress, cold
- if there is no milk it can’t be let down
Lack of milk let-down - tx
- oxytocin
Hypocalcaemia - when is it seen?
- most common in small breeds
- commonly in early lactation (rarely in late pregnancy)
Hypocalcaemia - CS
- nervousness
- panting
- whining
- hypersalivation
- stiff gait
- tetany
- frequently there is marked pyrexia
Hypocalcaemia - tx
Tx is calcium borogluconate slowly by IV infusion followed by same dose SC.
Calcium glutinate available as 20% solution
- 20% calcium gluconate diluted 1:7 (=2.5%)
- 1.0ml/kg SC of 2.5% solution
- (30kg Lab = 30ml divided into 2 sites)
- give IV 1st then same volume SC to provide a reserve
Feed pups artificially for 24h
May consider Cabergoline (Galastop)
- to stop lactation and wean pups if difficult to control
Oral calcium supplementation
- can be given using ‘Rennie’ but usually not as preventative as depresses PTH and may exacerbate hypocalcaemia if given before whelping
Hypocalcaemia - what is it also known as?
- eclampsia
- different to pre-eclampsia seen in humans
Sub-involution of placental sites - what is it? when is it seen?
- haemorrhagic vulval discharge for longer than the normal 4-6w duration post-partum
- often found in young bitches that are otherwise normal
- signs often persist until after the next oestrus
Sub-involution of placental sites - diagnosis
- palpation or US may reveal an area of the uterus that has not involuted
Sub-involution of placental sites - tx
No significant impact of most tx
- if blood loss is significant: regular observation and haematology is warranted
- OVH may be needed
Post-partum haemorrhage - cause
- due to physical injuries or the birth canal
- or lack of involution of the uterus
- or following on from a c-section
Post-partum haemorrhage - tx
- use of vaginal tampon
- ecbolic agents
- if uterine origin and severe may need OVH
- also if severe in specific breeds may consider a coagulopathy
Excessive milk at weaning - CS & tx
- large swollen mammary glands
- may become painful
- predisposes to mastitis if environment not clean
- may require tx with cabergoline (Galastop)
