Pyometra workshop Flashcards
what drugs should we avoid if the animal is compromised
NSAIDs
alpha 2 agonists
acepromazine
What pre-med should we probably use when pre-med a pyometra
methadone- IM or slow IV
what drugs do we use in co-induction- why do it
Propofol or alfaxalone then benzodiazepine then more propofol or alfaxalone
co-induction, theory is it might reduce total dose of propofol or alfaxalon
what 2 questions should you ask yourself if SPO2% is dropping
Is respiratory system ok?
Is oxygen supply and delivery ok ?
List 4 things that capnography can inform us of
ventilation
metabolism
cardiac output
equipment/ airway
Define hypotension
BP values of systolic <80–90 mm Hg, mean <60–70 mm Hg, and diastolic <40 mm Hg
Describe how to manage hypotension during anaesthesia
Switch down the volatile agent and consider PIVA – see if this works
Try an IV bolus of crystalloid (5-20ml/Kg) occasionally colloids are used – see if this works
If the animal is bradycardic too? Administer anticholinergic (atropine/glycopyrrolate)
What does a slowly a dropping CO2 on a capnograph suggest
Dropping cardiac output
What breeds are predisposed to pyometra
Labrador
Poodle
Doberman
What are the clinical signs of a pyometra
open cervix –> mucopurulent vaginal discharge
closed cervix–> abdominal distention
what is the most common bacteria involved in pyometras
E coli phylogroup B2
What factors can increase the risk of pyometras
Diet containing E coli
Transmission of E coli from another dog
Administration of steroid hormones e.g. oestrogen
Hormonal effects amplified throughout life => higher risk in older dogs
Some dogs with a pyometra present with PU/PD. What is the mechanism for this clinical sign?
Escherichia Coli endotoxin interfere with sodium reabsorption and damage ADH receptors and may result in an immune-complex glomerulonephritis and this causes the PU/PD
A cockerpoo is admitted following suspicion of a pyometra by your colleagues in a branch practice and on presentation is in hypovolaemic shock. The dog weighs 12kg and you decide that it needs a bolus of fluids. You decide to give it a 10mL/kg bolus over 10 minutes. The giving set delivers 20 drops/mL.
What would the drip rate be?
4 drops a second
How much methadone (10mg/ml) does the 12kg cockerpoo require if you choose a dose of 0.3mg/kg
0.36ml
How much maropitant would you like to administer to a 12kg dog? Dose is 1mg/kg and the formulation is 10mg/ml
1.2 ml
Consider the difference between cystic endometrial hyperplasia (CEH) and pyometra and decide which of the following statements is correct
Cystic endometrial hyperplasia is a thickening of the uterine tissue which then makes for an ideal environment for a pyometra to occur.
If during anaesthesia a patients bradycardia is persistent, and the MAP is now also reducing, and the pulse oximeter reading is reducing from 98% to 92%. What do you do?
Administer atropine
A patient is undergoing an OHE for a closed pyometra. The patient is ASA IV(E) What perioperative antibiotics, if any, would you prescribe?
Amoxicillin and clavulanic acid
Cefuroxime (Zinacef)
