post-partum abnormalities Flashcards
What are the key factors of examination of the bitch after parturition?
what is the biggest problem with the bitch post-partum?
- Becomes settled after birth of last pup
- Red/green/brown discharge normal
- Frank haemorrhage is abnormal - bright red, clotting
- Check for presence of milk
- Passage of placenta may not be immediate
most significant challenge is poor mothering behaviour
- Bitch wont settle; picks up and carries pups, doesn’t let them suck, is aggressive to owner or visitors, is aggressive to pups
- Where the litter is larger then the number of teats, 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 of the pups.
what are the key steps of hand feeding pups?
- When required use appropriate teat size, with one or two small holes (milk should drip not pour out)
- Correct concentration of milk
- Ensure fed warm not hot or cold
- Feed in normal position with neck extended
- Feed 6 times per day
- Check hydration status (urine colour / skin tent) at each feed
- Check weight gain daily
how long does uterine involution take in the bitch and queen?
how long is there discharge for?
Normal involution takes 12 weeks in the bitch
Normal involution takes 6 weeks in the queen
There is a normal vulval discharge for 3-4 weeks
Not odorous, not associated with illness, but may be coloured
what are the post-partum diseases in bitches, state them in order of occurence:
- Suspected retained fetal membranes
- Post partum metritis
- Inadequate milk
- Hypocalcaemia
- Sub-involution of placental sites
- Haemorrhage
when is the placenta passed in the bitch?
what are the sigsn of retained placenta?
what is the diagnosis for retained placenta?
what is the treatment?
what often occurs after retainted placenta?
- Placenta usually passed within 20 minutes of each pup
- Retention suspected if green/black discharge persists after parturition
- May be associated with retained pup and placenta
- Diagnosis requires ultrasound (radiographic not diagnostic) examination: palpation is unreliable
- In suspected cases oxytocin and antibiotic should be given
- Remember few oxytocin receptors after 36 hours therefore consider low dose prostaglandin (which PG would you use?)
- Metritis is a common sequelae
what are the causes of metritis in bitches?
what are the clinical signs?
how is it differnt from pyometra?
what is the management?
- Bacterial infection following on from:
- Difficult or prolonged birth
- Placental retention
- Abortion
- Clinical signs
- Depression, pyrexia, anorexia
- Purulent vulval discharge
- Neutrophilia with left shift
- Uterine enlargement
- Remember there is no underlying hormonal issue unlike pyometra (here progesterone is low)
- This is a contamination / infection of the uterus
- Conservative management is feasible
- Broad spectrum antimicrobial drugs
- Fluid therapy
- Ecbolic agents
- Prostaglandins (synthetic naturally occurring)
what are the two conditions that cause inadequate milk?
what are the reasons for each of them?
what are the treatments?
Agalactia (no milk production)
* First litter
* Possibly in premature birth
* Early caesarean
* Dopamine antagonists are prolactin agonists = metoclopramide
* 0.1-0.2 mg/kg/SC every 6 hours; takes about 3 days for effect
Lack of milk let-down
* Less common
* Anxiety, pain, stress, cold
* Treatment is oxytocin administration
(If there is no milk it cannot be let-down)
when does hypocalcaemia affect bitches?
what are the clinical signs?
what is the treatment?
- Most common in small breeds
- Commonly in early lactation (rarely in late pregnancy)
- Clinical signs: nervousness, panting, whining, hypersalivation, stiff gait, tetany
- Frequently there is marked pyrexia
- Treatment is calcium borogluconate slowly by IV infusion, followed by same dose SC
- Feed pups artificially for 24 hours
- 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
NB also termed ‘eclampsia’ which causes confusion with different human condition called ‘pre-eclampsia’
what is seen with sub-involution of placental sites?
- Haemorrhagic vulval discharge for longer than the normal 4 to 6 week duration post-partum
- Often found in young bitches that are otherwise normal
- Palpation or ultrasound may reveal an area of the uterus that has not involuted
- Signs often persist until after the next oestrus
- No significant impact of most treatments
- If blood loss is significant regular observation and haematology is warranted –> ovariohysterectomy may be needed
what are the causes of post-partum haemorrhage?
what is the treatment?
Due to physical injuries of the birth canal
Or, lack of involution of the uterus
Or, following on from a caesarean
Treatment
* Use of vaginal tampon
* Ecbolic agents
* If uterine origin and severe may need OVX
* Also if severe in specific breeds may consider a coagulopathy
