Postpartum Dz

Question 1

What layers of the uterus are inflamed with metritis?

Answer 1

Endometrium & myometrium

Question 2

What promotes pyometra?

Answer 2

Hi P4 env’t following a hi E2 env’t…

hi E2 primes endometrium of bitch that doesn’t become pregnant
into a state where it is both proliferative & secretive

Question 3

• Acute or chronic post-estrual disease
  w. variable clinical signs/pathological findings…
• Incidence increases w.age -*

Answer 3

CEHMP
Cystic Endometrial Hyperplasia - Metritis Pyometra complex

Question 4

What effects does estrogen {E2} exert normally in the bitch?

Answer 4

• Promotes growth
• inc. vascularity & edema of endometrium
• cervical relaxation/dilation
• E2 Receptors down-regulated by increasing P4

Question 5

What effects does progesterone {P4} exert normally in the bitch?

Answer 5

• stimulates proliferation & secretion of endometrial glands
• inhibit myometrial activity
• closure of cervix
• ​progestin effect is enhanced by priming of estrogens

Question 6

Briefly describe the pathogenesis of CEH in terms of hormones (e2, p4) & receptors (R)?
{3-4 main events}

Answer 6

The normal down-regulation of e2Rs may be defective…

→ prolonged effects of e2 on endometrium
→ increase in p4Rs
→ enter into diestrus → p4 effects…

Question 7

What’s the difference b/t an open vs. a closed pyometra?

Answer 7

Open​

• ​​​less severely ill
• copious red-brown/yellow-green foul-smelling vulvar discharge

Closed​​

• *no discharge*
• abdominal swelling
• systemically ill

Question 8

What is the treatment of choice for open vs closed pyometra?

Answer 8

OHE!
For both!!

Question 9

If we have a bitch w.pyometra and her owner wants to breed her again,

how do we treat?

Answer 9

medical therapy

• PGF2-alpha aka Lutalyse® or Estrumate
  {0.05mg/kg TID}
• Misoprotol
  {0.01mg/kg QID}
• *only w.open cervix pyometra*
  {may rupture uterus w.closed cervix}
• causes sm.muscle {myometrial} contractions for uterine evacuation;
  multiple small injections will lyse CL; continue until P4 is baseline

Question 10

What’s the difference b/t treating {inducing ovulation} in bitches vs cows?

Answer 10

Bitches: GnRH or hCG

Cows: PGF2-alpha {lyse CL & cows come back into estrus}
^can’t do this in the bitch bc we don’t have a CL at this stage^

Question 11

What’s the term for…
spontaneous flow of milk from mammary gland unassociated w.pregnancy ?

Answer 11

Galactorrhea

Question 12

What can we use to treat false pregnancy?
{may need 10-day Tx}

Answer 12

Cabergoline

Question 13

If spayed before the first estrous cycle, what is the risk of malignant mammary tumors?

Answer 13

0.5%

Question 14

If spayed after first estrous, what’s the risk for malignant mammory tumor?

Answer 14

8%

Question 15

If spayed after 2nd estrous cycle, what’s the risk for malignant mammory tumor?

Answer 15

26%

Question 16

What are the progressive clinical signs of hypocalcemia {aka Eclampsia} ?

Answer 16

• Panting
• pacing
• muscle tremors/trembling
• ataxia
• hyperthermia {106–108F}
  tonic-colonic convulsions
• death

Question 17

How do we treat Eclampsia?

Answer 17

IV calcium gluconate - to effect

Question 18

A definitive diagnosis for pregnancy in bitches is based on…?

Answer 18

Measurement of Relaxin 28 days after fertilization