Repro Flashcards
Which individual triggers the onset of parturition, Fetus or Mother?
fetus
Maturation of the HPA axis of the fetus needs to occur first to trigger parturition. This entails the hypothalamus secreting ___________, which goes to the anterior pituitary and stimulates _________ to be released. This hormones stimulates the adrenal cortex to produce __________. All of which allows the fetus to become “stressed.”
corticotropin releasing hormone (CRH) adrenocorticotropic hormone (ACTH) this hormone cortisol
The fetus must reach “capacity” to trigger parturition. What does this mean?
As the fetus grows, space within the uterus becomes limited. This is a stimulus for ACTH secretion by the fetal pituitary, and subsequent cortisol secretion.
the cumulation of HPA axis maturation and _____________ = FETAL STRESS
fetus reaching mature size
the fetal pituitary stimulates secretion of adrenal ________.
cortisol
Fetal cortisol causes a decrease in ________ and an increase in estrogen.
Estrogen causes increased secretions by repro tract, increased myometrial contractions, increased pressure, increased cervical stimulation, increased oxytocin.
progesterone
T/F: enzymes that convert cholesterol to progesterone are upregulated before parturition and enzymes that convert progesterone to estrogen are down regulated
FALSE – down regulated chol –> prog, upregulate prog –> estrogen
overall outcome = decrease prog, increase E2
T/F: in most species, testing progesterone is not very useful because it does not “drop” until right before parturition will occur.
true
what is the purpose of progesterone decreasing during initiation of parturition?
removes the block on uterine contractions
remember, progesterone prevents contractions so that the fetus stays within the uterus during gestation.
What is the purpose of increased estrogen during initiation of parturition?
uterus will become responsive to induction of contractions
oxytocin receptors will be induced
pelvic ligaments will relax
vulva swells/softens
Cortisol increases production of ________, which is important for lung maturation. This is critical for when the fetus takes its first breath in preventing the lungs from collapsing.
surfactant
Expansion of the birth canal is mediated by what 2 hormones?
estrogen and relaxin
maternal behavior is mediated by what hormone?
oxytocin
synthesis and ejection of milk is mediated by what 2 hormones?
prolactin (synthesis)
oxytocin (ejection/let down)
initiation of uterine contractions is mediated by what 2 hormones?
PGF and oxytocin
termination of pregnancy is ultimately determined by what hormone?
PGF
Mammary enlargement, colostrum production, enlargement + elongation of vulva, pelvic ligament relaxation and softening of perineum, as well as isolation and decreased appetite are all signs of …
impending parturition
these would be signs during stage I of parturition when estrogen is taking effect
Gestation of camelids and mares…
11-12 months
gestation for cattle
9 months
gestation for sheep and goats
5 months (150-152 days)
gestation for pigs
3 months, 3 weeks, and 3 days (114 days total)
What stage of parturition is described as:
1. relaxation/dilation of cervix
2. uterine contractions commence (oxytocin, PGF, E2)
3. fetus adopts birthing position
4. chorioallantois enters the vagina
first stage
What signs can be observed from the dam during the first stage of parturition?
- isolation
- decreased/non-existent appetite
- signs of colic (treading, looking at flank, restless, pawing ground)
- tail flagging/raising
- vaginal discharge
- milk/colostrum production
What is the term for when oxytocin is released from the pituitary and causes uterine contractions that lead to the fetus positioning itself within the birth canal and in doing so, the pressure triggers nerves that carry signals to the brain (PVN) to continue producing oxytocin. (positive feedback)
Ferguson reflex
What could occur if the Ferguson reflex fails and the fetus does not position itself correctly?
failure of cervical dilation and dystocia
What stage of parturition is described as:
1. cervix is completely dilated
2. uterine contractions continue
3. abdominal contractions begin
4. fetus enters birth canal which causes rupture of chorioallantois membrane
5. fetus is expelled
second stage of parturition
What is physically observed during the second stage of parturition?
- water breaks
- active abdominal contractions (she may frequently lie down)
- delivery of fetus
What stage of parturition is described as:
1. placental circulation is lost
2. placental separation begins
3. uterine and abdominal contractions continue
4. placenta is expelled
third stage of parturition
T/F: the time for the placenta to be expelled varies between species
true
which stage of parturition is the longest? which is the shortest?
longest = stage 1
shortest = stage 2 and 3
T/F: expectancy dates are precise based on age of individual and species and by just watching the signs of parturition
false – they are more precise when assistance was provided during the breeding (prog/ovulation timing, timed AI, early preg detection, fetal aging, marking by male, etc.)
What are the 2 most effective ways to predict parturition in dogs?
- twice daily rectal temperatures to see the transient drop (97.5-98)
- ultrasound for fetal gut motility and renal T pelvis
In mares, you can measure milk Ca and pH to predict parturition. What would the values be if she were going to foal within the next 24-72 hr?
milk Ca = > 200 ppm
decrease in milk pH (acidic, 6.5-6.8)
What are the 2 most reliable ways to predict parturition in ruminants?
- breeding dates and physical changes
- size of fetus (US, palpation) – less accurate for multiple fetuses
what are signs of impending parturition in pigs?
- enlarged mammary glands 1-2d before
- restless, nesting 12-24 hr before
- frequent urination/defecation, increased RR within final few hours
- lie in lateral recumbency in last 15-60 min
Myometrial defects, biochemical deficiencies (milk fever, ketosis), and environmental disturbances (temp stress) can cause primary uterine inertia which leads to what?
failure of expulsive forces and subsequent dystocia
Secondary uterine inertia leading to dystocia can be caused by …
exhaustion as a consequence of another cause of dystocia
T/F: uterine damage/rupture can lead to failure of expulsive forces and dystocia
true
A older cow presents to you for dystocia. You believe the source is abdominally-related. What could be the issue?
- inability to strain
- prepubic tendon rupture
- abdominal herniation
When a farmer wants to breed his new cows, you want to do a pelvic exam first in order to check for 2 things to ensure her birth canal is not obstructed and the risk for dystocia is as low as possible?
- minimum area (LxW) is at least 150 cm2
- bony pelvis does not have any fractures, neoplasia, disease, or spurs.
What are the 4 soft tissues that can obstruct the birth canal and lead to dystocia?
- vulva (congenitally too small, fibrosis, immature)
- vagina (congenital, fibrosis, prolapse, neoplasia, perivaginal abscess, hymen)
- cervix (congenital, fibrosis, failure to dilate)
- uterus (torsion, deviation, herniation, adhesions, stenosis)
What is the required treatment for true ringwomb in sheep (idiopathic failure of cervix to dilate)?
c-section and cull ewe
If dystocia is due to lack of cervical dilation as a result of lack of stimulation (fetus malpositioned, fetus too large, does not engage properly in birth canal, vaginal prolapse, uterine torsion), what can your plan for treatment be?
stimulate manually
if the cervix has adhesions or fibrosis, what is your concern with regard to the parturition process?
it will not be able to dilate due to previous trauma and c-section will be necessary. You will cull this female
T/F: if uterine torsion is present, the cervix will dilate but the fetus will be unable to be expelled
FALSE - cervix will not dilate because it is closed from the torsion. c-section will be the best option
if the cervix is closed due to uterine torsion in a cow, what can you as the veterinarian do that is non-invasive?
roll/plank the cow
if the cervix is open with uterine torsion, what are your options for treatment?
detorsion rod – twists the baby and the uterus
c-section if you cannot fix the torsion
deficiency of ________ can cause fetal-induced dystocia due to failure to initiate parturition.
ACTH and/or cortisol
What is the term that describes the baby being too big thus causing dystocia?
fetomaternal disproportion
What is the term for when the fetus comes out in an incorrect position and causes dystocia?
fetal maldisposition
T/F: if the fetus is dead, it will still deliver normally
false – dystocia will occur because the fetus is responsible for initiating parturition
Black vulvar discharge is a sign of…
death of the fetus
Red bag in mares is indicative of…
premature placental separation.
the baby would be suffocating. You need to break the placenta and deliver.
prolonged gestation, mismating, edema of mammary glands, medical concerns (preg toxemia, hydrops), or high likelihood of needing intervention are all indications for __________.
parturition induction
T/F: induction of parturition can alter timing and increase occurrence of other post-partum conditions
true
You are called to medically induce parturition in a cow. What drug(s) will you use and how many hours after which she will be expected to calf
- dexamethasone if beyond 270d –> calf in 24-72hr
- prostaglanding + dex –> calf in 24-48 hr
T/F: retained placenta is common sequela of parturition induction in cattle
true
Survival rate of the calf is good if you induce parturition within _____ of their normal calving date
1-2 weeks
describe medical induction of parturition in sheep and how long post-administration it will take her to lamb
- dexamethasone if beyond 137d
- prostaglandin (lutalyse) + dex
lambs within 36-48 hours
Survival of lambs is good if you induce parturition within ______ of their normal lambing date
1 week
You are called to medically induce parturition in a goat that is 144d gestation. What drug(s) will you use and how long will it take her to kid post-administration?
GOATS ARE CL DEPENDENT
prostaglandin (lutalyse or cloprostenol)
she will kid within 30-36 hours
Survival of kids is good if you induce parturition within ______ of their normal kidding date
1 week
if you have concerns about prematurity when inducing parturition in goats, what can you add to the prostaglandin?
dexamethasone 6-12 hrs before induction
If you are called to medically induce parturition of a pig, What drug(s) would you use and how long will it take post-administration for her to farrow?
PIGS ARE CL DEPENDENT
1. prostaglandin at least 112-113d of gestation –> farrow in 18-36 hours
2. prostaglandin + low dose oxytocin (20hr after) –> farrow in subseq 6 hr
describe induction of parturition in mares
make sure cervix is dilated at least 2 cm before starting
give oxytocin IV or IM (10 IU)
describe induction of parturition in bitches/queens
bitches - algepristone
none for queens
what are 3 indications for equine castration?
- behavior
- unsuitable genetics
- disease (orchitis, neoplasia, trauma, torsion, hernia)
What pre-operative considerations should be taken into account prior to equine castration?
- physical exam – reschedule if not healthy
- inspect the scrotum – are both testes descended, are both the scrotum and testes normal (no inguinal hernia, hydrocele, or testicular abnormalities)
- give NSAIDs prior to sx and tetanus toxoid
What 5 decisions about the procedure do you need to make when preparing for equine castration?
- standing vs recumbent
- approach – 2 parallel incisions vs scrotal raphe
- method of removal – open, closed, mod closed
- which instrument to use and if ligatures will be placed
- will there be closure?
If your equine patient is tall, docile, and has well developed testes, what approach will you take to their castration?
standing with sedation and a local lidocaine block
(Standing/or/Recumbent) castration requires general anesthesia and a local lidocaine block.
recumbent
T/F: in the scrotal raphe castration approach, you are actually removing some of the skin tissue.
true
______ method of castration is described as incising through the skin, SQ, and parietal tunic of testes
open
________ method of castration is described as making the initial incision through the skin and SQ, then making an additional small incision in the parietal tunic allowing access to the vasculature.
modified closed
If a horse is in left lateral recumbency, which incision should you make first when doing castration?
LEFT testicle
whichever testicle is DOWN, you should incise first because blood will obscure the surgical field
What is the purpose and mechanism of the emasculator used in LA castration?
the emasculator crushes the tissue causing hemostasis and then cuts the testicle off after.
In what instance would ligatures be used in addition to the emasculator and where would they be placed? what are risks of this?
if the animal is larger and has more tissue to be crushed. the ligature ensures better hemostasis.
place proximal to emasculator. The risk is that the suture material serves as a foreign body.
Describe the difference between Serra and Reimer emasculators?
serra – squeeze and cuts at the same time
reimer – crush and cut at different times and has ratchet to lock into place once you’ve crushed
This castration tool uses high speed torsion of the spermatic cord as a means to do coagulation/hemostasis and remove the testis all at one fast pace.
henderson
what is the advantage to doing open castration and using the emasculator on the vasculature?
better hemostasis because there is less tissue
What are the 2 most common complications of LA castration?
edema**
hemorrhage
If cord remnants are left behind during LA castration, what type of infection can occur?
Champignon – streptococcus
Scirrhous cord – staphylococcus
Note – these infections will not resolve with antibiotics alone, they require you to go back in a remove the remnants.
What are 3 pre-operative things you should do prior to equine castration?
- tetanus prophylaxis
- palpate scrotum
- give NSAIDs (+/-)
is general anesthesia required in young farm animal castrations? old?
young – no
old - no unless dont have proper restraint
What type of analgesia is used for farm animal castration?
- NSAIDs (flunixin)
- lidocaine – local into spermatic cord (careful of hematoma)
- intratesticular lidocaine
- sedation (if not GA is used)
what are the 3 approaches to farm animal castration?
- scalpel blade (tent and cut distal scrotum)
- scalpel blade (2 parallel incisions)
- newberry knife
What 3 techniques can you use to actually remove the testicle after you’ve cut in farm animals?
- pull
- ligate and transect
- emasculate and transect
what is the bloodless technique for farm animal castration?
elastic banding around the scrotum, which causes loss of blood supply and subsequent necrosis until the scrotum just falls off.
young animals – elastrator (green ring)
old animals – calicrate bander/EZE bander
If you want to castrate a piglet, what is your approach? How would that differ if it were a pet pot belly?
piglet – anesthesia, restrain them by holding their hind limbs, scrotal or prescrotal incision, pull, and leave open to drain
pot belly – GA in dorsal recumbency
what are the 3 P’s for fetal presentation
- Presentation – longitudinal axis of fetus in relation to dams birth canal (Anterior vs Posterior vs Transverse)
- Position – relationship of the dorsum of fetus to the quadrants of the dam pelvis (Dorso-sarcal = fetus spine is toward dams sacrum; Dorsopubic = fetus belly toward dam sacrum)
- Posture – position of extremities, head, and neck; (head back, wry neck, leg back)
What is the normal presentation of the fetus during parturition?
anterior position
dorsal-sacral position
front limb and head extension
How would you describe “true breech” with the 3 P’s?
position = posterior dorsopubic/dorsosacral
posture = bilateral hindlimb flexion
What is the best recommendation if you have a transverse presentation?
c-section
T/F: Litter bearing species cycle between stages II and III of parturition until all of their fetuses are delivered.
true
How long is stage I of parturition in cows?
6 hr, up to 24hr (if heifer)
how long is stage II of parturition in cows?
she should be actively pushing and delivering the calf within 2-4 hours, but it can survive up to 8 hr with umbilicus intact
how long is stage III of parturition in cows?
passage of the whole placenta should take place within 8 hours
How long is stage I of parturition in mares?
final positioning of the foal can take 1-4 hr
note – she can and will delay if she is interrupted. and most mares will foal between 12am-6am
How long is stage II of parturition in mares?
delivery of the foal takes 11-20 minutes
How long does stage III of parturition in mares take?
It is critical that she passes the entire placenta within 3 hours**
the foal stands within 1 hr, nursing within 2 hr, and placenta passes within 3 hrs
How long is stage I of parturition in SR?
if first baby - 2-12 hr,
if pluriparous = 1-2 hr
How long is stage II of parturition in small ruminants?
delivery of the kid/lamb should take 1-3 hours, depending on the # of fetuses
How long should stage III of parturition in SR be?
passage of the whole placenta within 1 hr
considered retained after 12 hr
how long is stage I of parturition in small animals?
16-18 hours
How long is stage II and III of parturition in small animals?
pushing and delivery of fetuses can take 4-12 hours; she will cycle between stage II and III until all of her fetuses are delivered.
note that fetuses can have either anterior or posterior presentation
T/F: retained placentas are common in dogs and pigs
false – rare.
they are common in horses.
how long is stage I of parturition in pigs?
cervical dilation takes 2-12 hours, but she begins nesting 24 hr prior to farrowing
how long is stage II of parturition in pigs?
contractions and delivery take 2-4 hours, with piglets being expelled every 15 min
note that piglets can be delivered in anterior or posterior presentation
how long is stage III of parturition in pigs?
placenta expulsion takes place between each piglet similar to the dog.
how long is stage I of parturition in camelids?
4 hours
they usually do this between 6am-12pm, but there are usually few outward signs because they are stoic animals
how long is stage II of parturition in camelids?
30-45 minutes
how long is stage III of parturition in camelids?
she will pass the entire placenta by 6 hours
What 2 species are we most concerned about retained placentas?
mares and camelids
What is the term for brachycephalic fetus heads being too large and not being able to fit through the pelvic canal causing dystocia?
fetal maternal mismatch
_____ hours of weak contractions and no puppy is indicative of a dystocia
4
> ___ hrs in between puppies is indicative of dystocia
2
> _____ minutes of active contractions and straining without a puppy produced is indicative of dystocia
30
_______________ vulvar discharge and no puppy delivered is indicative of dystocia
black or excessive green
T/F: it is normal for frank blood to come from the vulva during parturition in dogs.
false - especially in large amounts
T/F: dystocia in cats is common
false – relatively uncommon
When a patient arrives with dystocia, what is the typical work-up?
- consider finances
- complete a thorough PE on dam
- do vaginal exam on dam
- ultrasound
When doing a vaginal exam on a dystocia, what 2 things are you looking for?
- Ferguson’s reflex – is she bearing down and contracting if you push on the vaginal walls
- is there anything to feel (fetus, etc.)
If you are considering medical management of a canine dystocia, what test should be run on the dam first?
ionized calcium levels
When performing ultrasound on a dystocia case, what are you looking for?
- kidney development
- full GI peristalsis in a continual manner
- fetal HR
Absence of Ferguson’s Reflex is a (good/poor) prognostic indicator for medical management of a dystocia.
poor
What are the 3 things given to a dam experiencing dystocia if the Fergusons Reflex is present and you have chosen medical management?
- oxytocin – very small amount
- calcium gluconate / Tums – helps with muscle contractions
- glucose – for energy
Your patient is experiencing dystocia and only 2 out of 10 puppies have been born. Would medical management or surgical be the best option to proceed?
Surgery.
Medical management is better if the dam has shown that she has the ability to get most of the puppies out. If only 2 were born, there may be a bigger issue at hand. If 9/10 were born, med management may have been helpful.
What is adjunctive medical management in regards to small animal dystocia cases?
lube + warm water into red rubber catheter inserted into vaginal canal to help ease birthing process, relubricate, and deliver naturally without surgical intervention.
What are the 3 indications to perform a c-section rather than medical management in case of dystocia?
- failure of med management
- stressed puppies
- obstruction
During a c-section, all drugs and inhalants will pass from the dam to the fetuses. What is the goal to reduce fetal harm/death?
pre clip and clean, take less than 15 minutes from giving anesthesia to cutting, once the puppies are out, give dam buprenorphine.
What drug should never be used during c-section?
alpha 2s
What are the 3 biggest worries for neonate recovery?
- hypoglycemia
- hypothermia
- hypovolemia
During neonate recovery, you should warm, rub, suction, and provide ________.
oxygen flow by (preferably with a small mask that only covers their little nose because oxygen will decrease their body temp)
During c-section recovery and post-op, you should wipe disinfectant off the teats, extubate, make sure they can walk and urinate before discharge, and send them home with a short course of NSAIDs. What should be considered when introducing the puppies to mom?
NEVER leave them alone together for the first 48 hrs post-op. She could have aggression or even kill them.
what are the 4 indications to intervene in a mare during parturition?
- no evidence of strong contractions or no progression within 10 minutes of CA rupture
- obvious maldisposition of fetus
- constant or violent signs of colic
- red bag (placental detachment)
At what point should you intervene during a ruminant dystocia?
- if no progess in 30 minutes
- obvious maldisposition of fetus
what are the indications to intervene during parturition in pigs?
- failure of delivering piglets within 1-2 hr of onset of labor
- > than 1hr between piglets
- prolonged gestation (>116d)
- sow is ill
- abnormal vulvar discharge (purulent or smelly)
what are indications to intervene in camelid parturiton?
- if stage I exceeds 6 hr and signs of discomfort increase
- if stage II does not progress within 10 minutes of rupture of CA
- signs of colic
- abnormal vulvar discharge (bloody, purulent)
- obvious fetal maldisposition
How does a uterine torsion feel on vaginal examination?
vagina ends abruptly at pelvic brim and mucosa is drawn into tight, spiral folds
you can confirm the direction of the torsion via rectal palpation (d/t position of broad ligament)
If you do large animal vaginal examination and the cervix is CLOSED, what is the interpretation and what is the next step?
its likely the animal needs more time
you can attempt to stimulate the cervix with your fingers to elicit the ferguson reflex.
if the cervix does not open, you must do c-section
if the cervix is open during vaginal examination, you should check to see if the amnion is intact or broken, see if any fetal parts can be identified, and see if the fetus is alive (elicit reflexes). You always want to place your hand in between the head of the fetus and the pelvis to check for …
whether or not the fetus will fit.
if it does not, then c-section is the best option
if you do vaginal examination and feel fetal emphysema, hair detachment, and it smells, how long has this fetus been dead?
> 24-48 hours
You do a rectal exam on a mare that is late gestation. You feel hindlimbs dorsally. Are you worried about needing to do c-section due to maldisposition?
No because this is how the horse naturally lays in the uterus during late gestation. Once parturition is intiated, the fetus will turn around and the front limbs will be protruding first. during your exam, you felt the hindlimbs in the uterine horn, which is completely normal.
in caudal presentation, equine fetuses are most at risk for what…
hypoxia due to compression of the umbilical cord under the fetal thorax
When fixing maldispositions of the hooves, how should you maneuver placing it into correct position?
ensure you cover the hoof with your hand so that it does not tear the uterus or vagina when exiting
Name a common maldisposition in small ruminants.
simultaneous presentation of twins
You are doing a vaginal exam on a dystocia. You reach in and feel only the tail and you determine this fetus is posterior, dorsal-sacral, with bilateral hip flexion. What well-known position is this fetus in?
breech position
If you are unable to manipulate a fetus when attempting to correct maldisposition due to contractions, what is the best option?
caudal epidural with lidocaine
If the dams has loss of fluid when youre attempting to correct maldisposition, what is your option?
stomach tube + lube to relubricate the birth canal
If the dam is contracting over the fetus during dystocia, what drug can you give to help with this?
epinephrine
If the fetus is dead, what is your best option for treatment?
fetotomy
When applying chains to help pull out calves, what should you ensure to do to dispense even pressure and prevent breaking the limbs? And when pulling, you should alternate the chains to prevent _____________ from occurring. Once the neonate is at the hip level, you should rotate it on its side to prevent _________.
Double loop above fetlock and below fetlock
Elbow lock
Hip lock
What is a calf jack used for?
it is used to help pull the calf when you have minimal people around to help. you must have good restraint and correct all 3 P’s before using this.
Once the umbilicus of the fetus enters the___________, the neonate loses source of oxygen, so you must move fast when pulling if the neonate is coming out backwards
pelvic canal
How do you know if you are feeling front leg vs back leg when palpating the fetus during a dystocia/fetal maldisposition situation?
front leg - 2 bends
back leg - one bend
If you are unable to correct fetal maldisposition and delivery of a foal within ________, you should do c-section
15 minutes
If a sow is farrowing, but there is not a fetus encountered when you do your vaginal exam because they are out of reach. What drug can you give to help her deliver?
oxytocin
confirm first that her cervix is open and that there is not fetal obstruction
Prolonged pregnancy is a common complaint in what species?
camelids
In what species should you NOT induce parturition unless there is absolute medical justification to do so?
camelids
You should perform a c-section if you do ultrasound and fetal HR is <_______ bpm
50
Postpartum, you should check the dam for ______ and any spare fetuses.
uterine and vaginal tears
minor vaginal - antibiotics and antiinflammatories
major uterine - oxytocin + Abs or euthanasia
T/F: You should only remove the placenta manually if it detaches easily
true
Giving oxytocin postpartum has what effect?
- uterine involution
- placenta expulsion
- milk let down
Giving _______ post-partum helps if the dam has pain from a dystocia, but this drug can also increase the risk for retained placenta
NSAIDs
How should you handle a LA neonate during resuscitation?
DO NOT hang upside down
sit them sternal, pat both sides to stimulate diaphragm, suction airway, check their eyes, check heart rate, and check respiration
If the eyes of a neonate are cloudy and grey, what does this indicate?
it has been dead for 6-12 hours
You arrive to help with a dystocia. Once the baby is born, you notice the neonate has no heartbeat what drug can you give them to attempt to bring HR back up?
epinephrine and do chest compressions or 30sec-1 min
You just performed a c-section on a frenchie. One of the puppies has a heartbeat but no respiration, what should you do?
rub them vigorously
stick fingers/hemostats in their nose to stimulate
pour cold water on head
positive pressure ventilation
or doxipram HCl
____________ is common after hard dystocias due to prolonged deprivation of oxygen. Loss of suckle reflex is common in these cases and these neonates require supportive care.
dummy neonates (neonatal maladjustment syndrome, hypoxic ischemic encephalopathy)
If the fetus is too large, you are unable to correct a maldisposition, or the calf is dead, what procedure is indicated in large animals?
fetotomy
what are the 2 advantages of fetotomy?
- less traumatic to the dam (most of the time)
- can be quicker
The following describes what procedure?
place caudal epidural, pump lube+water into uterus with stomach tube, give epineprhine injection to relax the uterus, and dissect the fetus with gigli wire into 2 or more parts while it is still within the uterus or vagina
fetotomy
A partial fetotomy consists of…
cut the head off and one forelimb
If a fetus is in anterior position, what fetotomy technique is the best?
What about if in posterior position?
anterior – standard utrecht technique (head first, then forelimbs, +/- then trunk and then bisect pelvis)
posterior – 1st cut is pelvis, 2nd cut is other hind limb
You are performing a fetotomy and you want to gain better traction of the fetus by grasping the fetal vertebral column. What instrument can you use to do so?
Krey hook
Large fetus, small pelvis size, uterine torsion, maldispositions that are not correctable, emphysematous fetus, or fetal abnormalities are all indications to perform what procedure in large animals?
c-section
what is the most common operative site for fetotomy and c-section in ruminants and camelids?
left flank
left side contains the rumen which holds all extraneous organs within the body unlike operating on the right side where the intestines get in the way
what is the most common operative site for c-section in pigs?
paramedian
what is the most common operative site for c-section in horses?
ventral midline
In what position is physical strength most required to exteriorize the uterus during a c-section?
standing restraint
what is the risk of dorsal recumbency restraint for c-section?
it requires assistance, and there is a high risk for bloat and regurgitation because they are upside down.
T/F: Most c-sections in mares are performed in field
false — in hospital for general anesthesia
what is the anesthesia protocol for ruminants for c-section?
caudal epidural with lidocaine to help with straining
regional anesthesia – paravertbral block, inverted L, line block
what is the anesthesia protocol in pigs for c-section?
lumbosacral epidural with lidocaine to provide analgesia caudal to umbilicus
or alternatively do a line block
what are the 5 layers incised through when taking the flank approach for c-section?
- skin/fat
- external abdominal oblique
- internal abdominal oblique
- transversus abdominis
- peritoneum
what are the layers you must incise through for ventral midline approach for c-section?
- skin/fat
- cutaneous trunci
- linea alba
why do we want to ensure we exteriorize the uterus during c-section?
because the inside of the uterus is not considered sterile anymore (esp. if the cervix was open). If anything leaks into the dam’s body, it will likely cause peritonitis
T/F: when doing fetotomy or c-section, you should attempt to make as small of an incision into the uterus as possible to avoid healing difficulties and uneccessary pain.
false – make the incision big enough to get the fetus out with relative ease; tearing is worse than if you just make an actual incision
T/F: when completing a c-section, placental membranes should be left in the uterus and ensured to not be incorperated into the suture line.
true
what pattern do you use to close during c-section?
inverting pattern – cushing, lembert, utrecht
T/F: you should rinse the uterus with sterile saline prior to placing back into body
true
Match the layers that should be closed together during a paralumbar approach of c-section:
skin, external abdominal oblique, peritoneum, fascia, transversus abdominis, internal abdominal obliques
bonus if you name the pattern to be used for each layer
- peritoneum and transversus abdominis – simple cont
- external and internal abdominal obliques – simple cont
- skin and fascia – ford interlocking
Match the layers that should be closed together when doing ventral midline approach for c-section
linea alba, fascia, skin
bonus for naming the pattern to be used for each
linea alba – interrupted horizontal mattress, cruciate, or simple cont
fascia and skin – subcuticular vs skin
What meds should be a part of post-op care for every c-section?
- antibiotics – broad spectrum (given pre-op)
penicillin, ampicillin, or ceftiofur - anti-inflammatories (flunixin meglumine)
- oxytocin (vasoconstriction, uterine involution, placenta expulsion, milk letdown)
what is milk a combination of?
water, fat, protein, milk sugar, minerals and vitamins
Animals that nurse on a demand basis will nurse over longer periods of time (suckle frequently), therefore their milk can be _____________.
less concentrated
what is the protein/fat/lactose division of cows milk?
1/3 of each
what is the largest protein component of milk?
casein
When ____ (found in newborn stomach) or acid is added to milk, casein clots resulting in curd and whey separation.
rennin
_______ are formed within the mammary gland by lactational epithelial cells. Glucose is required for this step and is generated by ruminal proprionate or muscle breakdown.
proteins
_______ is synthesized in the mammary gland from blood glucose. This serves as a rate limiting step for how much milk cows can produce.
lactose
Half of milk fat is made in the udder from blood __________ and butyrate. The other half is made from ____________ in the blood.
Acetate
Fatty acids
Glucose/lactose drives milk production. The protein concentration stays about the same, however fat is diluted out. In regard to milk composition, ______ should ALWAYS be higher than _______.
fat; protein
Diets high in ______ (proprionate) and low in fiber result in protein:fat inversion and often indicates subacute acidosis
CHOs
Milk is high in what 4 vitamins and minerals?
Ca
P
K
I
What vitamins and minerals is milk low in?
Fe
Se
microminerals
_____________ contains a high level of immunoglobins which provides humoral immunity for the calf. (90% IgG, 7% IgM, pulled from the blood 2 wks prior to parturition)
colostrum
In comparison to milk, colostrum is higher in solids, cellular content (lymphocytes, macrophages), fat, and protein. What component is milk higher in?
lactose
Colostrum contains factors that stimulate gut cell development, antimicrobial substances, vitamins and minerals, and it has ________ activity which prevents the digestion of IgGs
antitrypsin
What occurs during mammogenesis from birth to puberty?
the mammary gland grows to be proportional to the body
what occurs after/at puberty during mammogenesis?
estrogen, prolactin and growth hormone stimulate duct development
progesterone stimulates alveoli development
Alveoli development is most prevalent during which stage of gestation and is referred to as “bagging up”
last trimester
Pre-partum, what 2 hormones complete lobuloalveolar development? and what 3 things allow mammary epithelium (alveoli) to produce milk?
2 - estrogen and progesterone
somatotrophin (GH), prolactin, and cortical steroids
During lactogenesis, ________ and oxytocin are released which causes what?
prolactin
stimulation of cells to produce milk
You are presented with a horse who’s owner states she hasn’t produced milk for the foal in a few days. You know this to be “agalactia”. What could be the potential cause for this?
Lack of prolactin
(ex. if you gave dopamine agonist drugs or if fescue hay was consumed)
______________ is the stage in which biosynthesis of milk occurs. The alveolar secretory cells are producing milk. Lactose is pumped into alveolus, proteins are secreted (gives milk the white color), and milk fat forms.
galactopoiesis
Galactokinesis (milk ejection) is a reflex action of 3 things:
- physical stimulus of mammary gland or genitals
- auditory stimulus
- conditioned reflex
Oxytocin gets released from the pituitary gland and causes contraction of ____________ cells, which forces milk out of the alveolus, in addition to concurrent relaxation of muscles of the large alveolar ducts
myoepithelial
milk ejection can be inhibited by…
- pain
- noise
- stress/fear (epinephrine is release –> vasoconstriction –> oxytocin cannot get to myoepithelial cells and decreased released from pituitary)
In heifers, cows with udder edema, or cows in which you need to remove any residual milk, you can exogenously administer _______.
oxytocin
What is a typical amount of milk produced by dairy vs beef cows per day?
dairy = 80lb/day
beef = 20-30 lb/day
what are the typical amounts of milk produced per day by the following animals:
mare
goat
sheep
dog
mare = 20-30 lb
goats = 3-15 lb
sheep = 2-10 lb
dog = 5.5 oz/puppy
Nutrition, length of dry period, frequency of milking, and BCS are all factors that affect what in dairy cows?
milk production (specifically the amount)
T/F: if you milk a cow more times per day, she will produce more milk
true
which species does lactation affect reproduction the most?
pigs! results in absolute inhibition of cycling (lactational anestrus)
in what species does lactation have no effect on reproduction?
horses
What is the dry period for dairy cows?
45-60 days – allows for rumen and mammary gland to repair and for colostrum to build up.
what is the dry off / weaning length for sows?
24 days (21-28)
What is the weaning length/period for
beef cattle?
mares?
small ruminants?
dogs/cats?
beef cattle = 205d
mares = 4-6 months
SR = 2-3 months
dog/cats = when deciduous teeth appear (5-6 weeks)
What is the protocol for drying off?
reduce feed
no concentrate
only feed low quality forage
As intramammary pressure increases, what happens to milk secretion?
ceases rapidly
During fetal HPG axis maturation, cortisol is released. Fetal cortisol stimulates _______ release, which causes luteolysis and contributes to increased myometrial contractions
PGF2a
Fetal cortisol causes _________ to be released which leads to pelvic ligament stretching.
relaxin
