Pregnancy Flashcards
1
Q
Four ways to diagnose pregnancy?
A
- Palpation
- Ultrasonography
- Radiography
- Relaxin hormone testing
2
Q
Palpation diagnose of pregnancy - benefits?
A
- Inexpensive and readily performed
3
Q
Drawbacks of palpation
A
- can be inconclusive
- Doesn’t really give you specifics
4
Q
How long after conception can you palpate chorionic vesicles?
A
- 25-40 days
- GENTLE PALPATION
5
Q
What will you palpate on a female dog pregnant from 40 days to term?
A
- General caudal abdominal distension
- Fetuses coalesce and don’t have distinct vesicles, making them harder to feel
6
Q
What can you palpate from 50 days to term depending on conformation?
A
- Fetuses
7
Q
When to diagnose with ultrasound?
A
- After day 25 (but closer to 30 I think?)
- Assess fetal viability by heart beat after day 25
- Monitor problem pregnancy and embryonic or fetal loss
8
Q
What is one thing you can only do on ultrasound?
A
- Assess fetal viability with heart rate
9
Q
What is difficult to do on ultrasound?
A
- Assess gestational age
- There are some measurements that you can take that suggest gestational age, but they are formulated based on breed size so have limited use
10
Q
When can you use radiography to determine pregnancy?
A
- Day 45 to term
- Day 45 is mineralization of the skull and spine
- requires skeletal mineralization
11
Q
How is radiography useful?
A
- can count number of fetuses more accurately
- Less useful for determining fetal viability
12
Q
Hormones during pregnancy
A
- Progesterone
- Estrogen
- relaxin
- Prolactin
- Growth hormone
13
Q
Progesterone in pregnancy
A
- Elevated for duration of gestation
- Maintains endometrial integrity and glandular function
- Maintains attachment of placenta
- Suppresses uterine contraction
14
Q
Estrogen during pregnancy
A
- Rises 10-15 days after LH surge
- Supports progesterone secretion and progesterone receptors
15
Q
Relaxin during pregnancy
A
- Produced only by the placenta
- Earliest detection around 21 days post LH surge, but if you’re going to use it to detect pregnancy, do it around 30 days
16
Q
Prolactin during pregnancy
A
- Supports corpora lutea function in conjunction with estradiol
17
Q
Growth hormone during pregnancy
A
- can lead to mammary development, but does lead to insulin resistance
18
Q
Canine placentation
A
- Zonary
- Endotheliochorial
- Chorioallantoic placenta after week 4
19
Q
Normal physiologic changes during pregnancy
A
- Normocytic, normochromic anemia
- 35% PCV 20 days post-LH surge due to volume expansion
- Mild neutrophilia
- Hypoalbuminemia
- Hypercholesterolemia
- Decreased serum protein
- Decreased BUN/creatinine (dilution)
- Insulin resistance
- Decreased serum calcium
20
Q
What body score has highest chance of conception?
A
- BCS slightly below normal or at ideal weight and gaining
- Overweight females have increased problems (diabetes) and increased incidence of dystocia
21
Q
When is energy demand greatest during gestation?
A
- Last 3 weeks of gestation
22
Q
What to feed?
A
- NRC and AAFCO for all life stages
- Carbs, protein, and fat in proper proportion
- Vitamins, minerals, and AAs in line with energy content
- DO NOT SUPPLEMENT calcium
23
Q
How much to feed a pregnant female dog?
A
- Base on the energy requirements of the female
- ME = 130 x body weight x 0.75
- The 130 is a coefficient that varies depending on the activity of the dog
- ME requirement can be determined from what has been fed to keep female at the ideal body weight
24
Q
When is fetal growth rate greatest?
A
- During last 3 weeks of 9 week pregnancy
- female will gain 25% body weight during last 3 weeks of pregnancy
25
What should change about food, quantity, or frequency for first 6 weeks of gestation?
- No change in requirement for food, quantity, or frequency for first 6 weeks of gestation
- Some bitches may have normally reduced appetite during mid to late gestation
26
Feeding during last three weeks of pregnancy
- Increase ME gradually over weeks 7, 8, and 9 to 50% above pre-breeding amount
27
How much to increase Me fed by third week of lactation?
- Up to 3 times the pre-breeding amount
28
When does eclampsia or puerperal tetany occur?
- Usually at highest lactation, but can see anytime from pre-partum to 4 weeks post-partum
29
Pathophysiology of eclampsia
- Loss of membrane bound calcium allows easier depolarization of muscle fibers
30
Clinical signs of eclampsia
- Uterine inertia, panting, whining, muscle fasciculations, seizures, hyperthermia
31
Calcium levels for puerperal tetany/eclampsia/hypocalcemia
- Total serum calcium <9 mg/dL
32
What is appropriate dietary Ca:P ratoi?
- 1.2:1
- Homemade diets may vary considerably!!!
- If you give too much external calcium, that can mess up the stores of calcium
33
Treatment for puerperal tetany?
- Acute crisis administer calcium by slow IV
- Carefully monitor HR by auscultation
- Stop injection with any dysrhythmia or change in heart rate
- Dose based on type of calcium
- 10% calcium gluconate
- Oral supplementation with calcium carbonate and vitamin D
- MAY give cabergoline to stop lactation
34
Which breeds get hypoglycemia?
Very small breeds
35
Clinical signs of hypoglycemia?
- Similar to puerperal tetany
36
How to diagnose an animal showing signs of puerperal eclampsia?
- Run serum calcium as well as glucose
- If serum tests not readily available, check urine glucose with dipstick to ensure patient does not have insulin resistant diabetes mellitus
- If the urine glucose is normal, you can give oral glucose while continuing to pursue diagnosis and definitive treatment
37
How to treat hypoglycemia?
- Treat with IV dextrose
38
How common is pregnancy toxemia in dogs?
- Uncommon compared to other species
39
What can lead to pregnancy toxemia?
- Large litter size and inadequate nutrition (usually in form of inadequate carbohydrates) leads to ketosis
- Anorexia during last 2-3 weeks of pregnancy
40
How do you differentiate diabetes mellitus from pregnancy toxemia?
- Urine ketones in absence of urine glucose is pregnancy toxemia
41
Treatment of pregnancy toxemia
- May respond to increased energy in the diet
| - May require termination of pregnancy
42
Gestational diabetes mellitus
- Progesterone stimulates growth hormone and leads to insulin resistance during late pregnancy
- May see in diabetic keto-acidotic crisis
43
How to diagnose gestational diabetes mellitus?
- High serum glucose or high urine glucose and urine ketones
44
Treatment for gestational diabetes mellitus?
- If diagnosed early, insulin therapy may help
| - Termination of pregnancy often necessary
45
Drugs during pregnancy
- Avoid at all possible
46
What changes during pregnancy impact drug distribution?
- Serum albumin
- Renal clearance
- Cardiac output
47
Is there a reliable placental barrier to any drug?
- NO
48
Class A drugs
- Specific studies have proven safety in species during pregnancy
49
Class B drugs
- Lab animal studies show some risk, but likely safe if used cautiously
50
Class C drugs
- Studies have shown potential risks and should be used only as a last resort
51
Class D drugs
- Contraindicated during pregnancy
52
Examples of class A drugs
- Amoxicillin, Cephalosporin, Clavamox, Clindamycin,
- Miconazole
- Fenbendazole, Pyrantel
- Lidocaine, naloxone
- Antacids, sucralfate
53
Examples of drugs Class B
- Sulfonamides, TMS
- Ketoconazole
- Acepromazine, Fentanyl, isoflurane, morphine, butorphanol
- Antiemetics, Metoclopramide
- DOpamine, heparin, theophylline
54
Examples of class C drugs
- Chloramphenicol, gentamycin, metronidazole
- Amitraz
- Diazepam, halothane, thiopental, corticosteroids
55
Examples of Class D drugs
- ciprofloxacin, enrofloxacin, tetracycline, streptomycin
- Pentobarbital
- Diethylstilbestrol, estradiol, stanozolol, testosterone
