Post Partum Dam

Question 1

what is NORMAL vulvar discharge (lochia) post-partum?

Answer 1

can occur normally 3-4 weeks post-partum

immediately after birth, it is green, but then it changes reddish-brown, then becomes watery-mucoid
it should never have an odor and the amount should decrease over time.

if you look on cytology, there can be some neutrophils, RBCs, and bacteria.

Question 2

what are NORMAL mammary glands post-partum?

Answer 2

engorged, not hard
swollen
colostrum is yellowish-white, mature milk is just white

Question 3

when is peak lactation?

Answer 3

3-4 weeks

Question 4

T/F: normal postpartum vulvar discharge in cats is scant and only visible for up to 4 days. It is reddish-mucoid, and does not have odor.

Answer 4

true

Question 5

what is the most common bacteria associated with metritis?

Answer 5

E. coli

Question 6

what are clinical signs of metritis?

Answer 6

malodorous, red-brown or purulent vulvar discharge
fever, lethargy, anorexia, vomiting, painful abdomen
decreased lactation, poor mothering, puppies not gaining weight

Question 7

how do you diagnose metritis?

Answer 7

vaginal cytology – degenerate PMNs, bacteria, and non-cornified vaginal epithelial cells.

ultrasound – intraluminal fluid, uterine wall thickening, hyperechogenic endometrium

CBC – leukocytosis with left shift

Question 8

how do you treat metritis?

Answer 8

1. evacuate the infected material from the uterus – PGF2a or oxytocin (if in 1st 24 hr PP), or surgical – OHE
2. antibiotics – based on c/s and safe for neonates (beta lactams, cephalosporins)
3. NSAIDs – carprofen
4. supportive care – famotidine (decrease gastric acid production) metoclopramide (increase milk production)

Question 9

why is the concern for using enrofloxacin to treat metritis LOWER if the neonates are <3 weeks of age?

Answer 9

because the neonates are non-weight bearing, so there is lower risk of impaired cartilage development.

Question 10

what is a good indirect measure of milk production?

Answer 10

puppy weight gain

Question 11

what is the difference between primary and secondary agalactia/hypogalactia?

Answer 11

primary = anatomical abnormality of gland or lack of response to physiological stimuli

secondary = mastitis, metritis, other systemic illnesses (hypocalcemia, stress, premature delivery, inadeq. nutrition)

Question 12

what drug do you treat hypogalactia/agalactia cases with?

Answer 12

metoclopramide (dopamine receptor antagonist) which will increase prolactin and increase milk production
OR
domperidone