Pregnancy in the Bitch

Question 1

Diagnosing pregnancy.

Answer 1

Abdominal palpation.
- day 28 in the bitch.
Ultrasound scan.
- from day 20.
Blood samples.
- acute phase proteins or the hormone relaxin from day 21.
X-rays.
- from day 42 when skeletons start to ossify.
Behavioural/other changes.
- less reliable – bitches have progesterone dominated phase whether mated or not.
–> mammary development, abdominal thickening, nest making.

Question 2

1. Duration of gestation from time of service.
2. Duration of ovulation from ovulation.
3. Litter size + breed size and duration of gestation relationship.
4. What is ‘single pup syndrome’?

Answer 2

1. Very variable - 56-72 days.
2. More exact - 63 days (or fertilisation 61 days).
3. Large litters shorter gestation.
   Small breed shorter gestation.
4. No stimulus provided for onset of labour so long gestation.

Question 3

When does fertilisation happen?

Answer 3

In oestrus after LH surge.
Ovulation occurs over a period of 24-96hrs, primary oocytes 24-48hrs for capacitation, then individual eggs are fertile for 12-24hrs, which is the fertilisation period.

Question 4

Termination of pregnancy.

Answer 4

Surgical.
Medical.
- Antiprogestin (aglepristone).
– can be used from day 1-45 post mating, efficacy greater before day 22.
- Antiprolactin (cabergoline) – only licensed for pseudocyesis but will be partially luteolytic after day 35 of pregnancy.
- Prostaglandins?

Question 5

Management of the ‘overdue’ bitch.

Answer 5

• Remember ‘window of conception’.
• Check service date and gestation length.
• Assess mammary glands – lactation established?
• Abdominal ultrasound to confirm pregnancy and assess foetal HR (150bpm) and movement.
• Plasma progesterone – abrupt decrease signals parturition.
• Monitor daily.
• 70 day limit regardless.

Question 6

How to predict parturition.

Answer 6

• Behavioural changes.
• Changes in appearance of perineum (subtle) – effects of relaxin.
• Body temperature – sudden drop in rectal temperature 10-14hrs prior to whelping.
• Diagnostic imaging.
  – Ultrasound –> foetal size, head diameter.
  – Radiography –> ossification times for different areas.

Question 7

1. Physiologically, what happens in stage 1 parturition.
2. Physiologically, what happens in stage 2 parturition.
3. Physiologically, what happens in stage 3 parturition.

Answer 7

1. Uterine contractions, cervix dilation.
2. Abdominal contractions, foetal fluids and rectal temperature.
3. Expulsion of foetal membranes.

Question 8

1. Signs associated w/ stage 1 labour and duration.
2. Signs associated w/ stages 2 and 3 labour and duration.

Answer 8

1. Restlessness, nest making, shivering, inappetance, hiding/seeking reassurance, panting, occasional vomiting. Lasts up to 24hrs.
2. Active and visible contractions of the abdomen, recumbency or standing. Lasts 10-30 mins from onset of active straining to birth, time between puppies up to 4hrs.

Question 9

Recognising dystocia.

Answer 9

• Rectal temperature drop and return to normal w/ no evidence of labour.
• Gestation longer than 70 days.
• Green vaginal discharge (placental separation) but no other signs of labour.
• Strong contractions (second stage labour) for longer than 30mins w/ no pup produced.
• Weak contractions (2nd stage) for more than 4hrs w/ no pup produced.
• More than a 4 hour gap between pups.
• Parturition has lasted 24hrs.
• Systemic illness in the bitch.
• Bitch in severe discomfort.

Question 10

1. Maternal causes of dystocia.
2. Foetal causes of dystocia.
3. Other cause of dystocia.
4. % success of manipulation and medication.

Answer 10

1. • Uterine inertia.
     - Pelvic canal abnormalities.
     - Intrapartum compromise e.g. hypoglycaemia, hypocalcaemia, sepsis, shock.
2. • Oversize.
     - Malposition and malposture.
     - Anatomical abnormalities.
     - Malpresentation.
3. Combination of both.
4. 30%.

Question 11

Medical management of dystocia.
– What do these do?

Answer 11

• Oxytocin – increases frequency of contractions.
• Calcium gluconate – increases strength of contractions.
• Dextrose infusion – for exhaustion and hypoglycaemia.
• Manipulation.

Question 12

Indications for caesarean.

Answer 12

• Failure to respond to medical management or manipulation.
• Pelvic abnormality evident.
• Foetal distress evident:
  – HR –> <150/min = stress, <130/min = poor foetal survival if not delivered w/in 2-3hrs, <100/min = immediate intervention required.

Question 13

Post-parturient care.

Answer 13

• Gentle body stimulation (rubbing) if does not respond quickly to bitch licking or bitch disinterested.
• Clear airway.
• Clamp and cut umbilicus.
• Maintain body temperature.
• Encourage suckling.

Question 14

1. How common is retained foetus or placenta?
2. When would metritis typically occur?
3. What is seen w/ acute metritis?
4. Bacteria typically associated w/ metritis.
5. Metritis treatment.

Answer 14

1. Uncommon.
2. W/in 1 week.
3. Foul smelling vaginal discharge, green/black discharge if placental retention. Systemically unwell – depression, anorexia, pyrexia, dehydration. Restless puppies.
4. E. coli.
5. Oxytocin if <24hrs from end of parturition. IVFT, antibiotics (amoxy-clav first line). Ovariohysterectomy may be required.

Question 15

1. How common is uterine prolapse or rupture?
2. Cause of uterine prolapse post partum?
3. Treatment of post partum uterine prolapse?
4. Cause of post partum uterine rupture?
5. Treatment of post partum uterine rupture.

Answer 15

1. Uncommon.
2. Excessive traction or straining.
3. Manual replacement or laparotomy and ovariohysterectomy.
4. Large litters, multiparous dam, excessive oxytocin use.
5. Laparotomy and ovariohysterectomy.

Question 16

1. Severity of eclampsia (puerperal tetany)?
2. When does eclampsia typically occur?
3. Bitches most at risk?
4. Predisposing factors?

Answer 16

1. Potentially life threatening.
2. Typically post-partum due to lactation demands causing hypocalcaemia.
3. Small breed and primiparous bitches.
4. Inappropriate Ca supplementation in pregnancy, hypoglycaemia, hypothermia during parturition.

Question 17

Signs of eclampsia.

Answer 17

• Restlessness.
• Salivation.
• Facial pruritis.
  Progresses to…
• Stiffness/ataxia.
• Recumbency / leg rigidity.
• Tachypnoea and tachycardia.
• Hyperthermia.

Question 18

Treatment of eclampsia.

Answer 18

• Slow IV calcium (5-20ml of 10% calcium gluconate) given to effect.
• Response should be evident w/in 15mins.
• Oral supplementation then required.
• Pups should be removed for 24hrs and fed artificially, then supplemented.

Question 19

1. What is agalactia?
2. Primary agalactia?
3. Secondary agalactia?
4. Associated w/?
5. Signs?
6. Treatment?

Answer 19

1. Absence of milk.
2. Failure of mammary gland development.
3. Failure of milk let down.
4. Presence of metritis/retained membranes, other maternal illness, primiparous dams, post-caesarean, extreme stress.
5. Restless vocal puppies.
6. Oxytocin parentally, supplement feed puppies.

Question 20

1. Cause of mastitis?
2. Bacteria associated w/ mastitis?
3. Signs of mastitis?
4. Treatment of mastitis.

Answer 20

1. Ascending infection.
2. E. coli, staphylococcus, streptococcus.
3. Pyrexia, anorexia, dehydration, painful firm mammary glands, watery/blood stained/purulent secretions.
4. • Warm compresses, stripping, massage, allow pups to suckle (but also supplement).
     - ABX – amoxycillin clavulanate or trimethoprim/sulfadiazine empirically.
     - Pain relief – paracetamol.
     - If need to stop lactation – cabergoline.