Repro Flashcards
What is the normal temperature / HR / RR of a dog or cat neonate
35.2-37°C
200-250 bpm
30 brpm (15 brpm just after birth but increases over a couple of hours)
When is the hematocrit the lowest in puppies and kittens
Around 1 month (30% in puppies, 27% in kittens)
Differences in laboratory values in puppies and kittens
- Increased lactate
- Anemia
- Leukocytosis
- Increased ALP (more pronounced in puppies)
- Increased GGT in puppies
- Mild increased bilirubin
- Decreased BUN, creat, albumin, TP, cholesterol
- Increased Ca and P
- Isosthenuric urine
- Glucosuria
What is the normal MAP is a 1-month-old puppy
50 mmHg
What are the preferred IV fluids for neonates
LRS
What supplement can help manage refractory hypoglycemia in puppies / kittens
Carnitine (200-300 mg/kg q24)
What is the volume of a fluid bolus and maintenance rate in puppies and kittens
Bolus: 40-45 mL/kg (puppies) ; 25-30 mL/kg (kittens)
Maintenance: 80-100 mL/kg/day
What is the normal weight gain in puppies and kittens
- Puppies: double their weight within first 10 days of life, then gain 5-10% of weight per day for 8-12 weeks
- Kittens: double their weight within first 10 days of life, then gain 10-15g per day for 8-12 weeks
What is the safest antibiotic class in neonates? At what dose?
Beta-lactams
Dosing interval should be decreased to q12h
(decreased hepatic metabolism, decreased renal excretion, decreased volume of distribution due to lower fat and albumin)
What is the preferred vasopressor in neonates
Vasopressin
(sympathetic nervous system is still immature, response to catecholamines is unpredictable)
What is the duration of pregnancy in the bitch and the queen
Bitch: parturition is 57-72 days post-mating (63 +/- 1 days after ovulation)
Queen: parturition 52-74 days
Name risk factors of dystocia
- Brachycephalic and chondrodysplastic breeds (materno-fetal disproportion)
- Small litter (especially singleton pregnancy)
- Excessively large litter
- Age of the bitch
- Underlying metabolic diseases
What are indicators for clinical examination in a bitch / queen in parturition
- Signs of systemic illness
- Stage 1 labor extending beyond 12 h
- Abdominal contractions without puppies within 2h (or kittens within 1h) or forceful contractions and no fetus within 30min
- Stillborn fetuses passed
- Uteroverdin in discharge with no fetus passed within 2h
- Pregnancy over 72 days
- Drop in rectal temperature > 1°C around due date followed by rise again with no sign of labor
What are the 3 stages of labor and their duration
- Stage 1: 6-12h
Nesting behaviour, uterine contractions - Stage 2: 2-12h (up to 24 for queen)
Overt abdominal contractions and expulsion of fetuses - Stage 3: happens with stage 2
Expulsion of placentas + uterine involution
What is the best indicator of fetal distress
HR < 180 bpm on ultrasound
What is the medical management of dystocia? What are indications?
Oxytocin 0.5-2 IU SQ or IM and Ca gluconate
Only attempted if labor has not been prolonged, fetal size is normal, obstruction has been ruled out, cervix is dilated, and fetuses are not in distress
What is an adequate suture pattern for hysterotomy closure
Double layer:
- First layer simple continuous (without going through the muscle)
- Second layer continuous Cushing’s pattern
Use monofilament absorbable suture on a taper-point needle
What are the stages of eclampsia in dogs
- Stage I: anxiety, restlessness, facial pruritus, diarrhea, vomiting, PUPD
- Stage II: Ataxia, tremors, mydriasis, lack of interest in offspring
- Stage III: Muscle stiffness, hyperesthsia, panting, tachycardia, possible agression
- Stage IV: Tonic-clonic muscle spasms, laboured breathing, disorientation
- Stage V: Arrhythmias (VPCs), seizures, death
What is the dose of calcium supplementation recommended for eclampsia
5-15 mg/kg of elemental calcium -> 10% calcium gluconate 1-1.5 mL/kg for dogs and 2.5 mL/kg for cats
Can follow with CRI of 1-3 mg/kg/h elemental calcium
Then calcium carbonate 100 mg/kg per day during lactation
What are the parameters of the Apgar score? What score indicates distress of the neonate?
HR, resp effort, RR, reflex irritability, mobility, MM color
Distress (and decreased survival) when 6 or lower
Is atropine recommended in neonate CPR
No. (They don’t do vagally mediated bradycardia)
In which patients does neonatal isoerythrolysis happen
Type A kittens with a type B queen
What is the medical treatment for metritis
- Antibiotics (Clavamox is a good choice and is ok for puppies to keep nursing, TMS has less resistance but prevents nursing)
- Ecbolic agent: PGF-2alpha
How can antibiotics be selected based on milk pH for mastitis
- Acidic milk -> TMS
- Alkaline milk -> Clavamox / cephalosporins
What medical treatment can be considered for a closed cervix pyometra
- Antibiotics (often potentiated penicillins + fluoroquinolone)
- Progesterone receptor antagonist (antiprogestin, e.g. aglepristone) to open the cervix +/- PGF2alpha to increase intensity of uterine contractions
What are the 2 types of priapism and what is their management
- Ischemic priapsism (= occlusion of blood flow) -> more severe. Requires evacuation of blood (draining from corpus cavernosum) +/- irrigation +/- penile amputation if unsuccessful
- Non-ischemia priapism (= increased arterial blood flow) -> cold compresses, systemic alpha-agonists for vasoconstriction
In both cases, lubricate and put E-collar
What is the difference between priapism and paraphimosis
Priapism = erection lasting for at least 4 hours
Paraphimosis = inability of the penis to go in the prepuce, without active erection (usually follows erection)
When does pyometra occur most commonly in dogs and cats
Dogs: 7-8 weeks post estrus (can be 1-4 months)
Cats: 4 weeks post estrus (or before)
What are the most common bacteria identified in metritis, pyometra, etc.
E Coli, Streptococcus, Staphylococcus (+ Klebsiella, Proteus, Pseudomonas)
What is the parameter most associated with increased mortality in pyometra
Elevated creatinine
What is the treatment for vaginal prolapse in a pregnant bitch about to whelp
No treatment - parturition can usually happen normally (but monitor for dystocia)
What are the ligaments of the ovaries and uterus
- Suspensory ligament (attaches each ovary to the last rib)
- Proper ligament (attaches each ovary to each uterine horn)
- Broad ligament (attaches ovaries and uterus to the body wall dorsally)
- Round ligament (attaches the uterus caudally)
At what age does an animal develop an increased parasympathetic tone?
4 weeks
What is a particularity of thoracic radiographs in neonates?
The themes is present in the cranial left field and can mimic a thoracic mass
When is MAP expected to normalize in puppies?
9 months of age
- 49 mmHa at 1 month
What are some treatment options for hydrocephalus?
- Omeprazole (decreases CSF movement into the ventricles)
- Corticosteroids? Diuretics?
- VP shunt
How does metritis differ from pyometra?
Occurs within 7 days of parturition, when serum progesterone concentration is low
Why are patients with pyometra often azotemic?
Pre renal dehydration and/or endotoxin induced (E.Coli) renal tubular damage
What is the antibiotic of choice for pyometra?
Fluoroquinolone + estende spectrum penicillin
TMS
3rd gen cephalosporine
What precedes pyometra?
Cystic endometrial hyperplasia
What are the most common prostatic neoplasms?
TCC and prostatic adenocarcinoma
Antibiotic plan for infectious prostatitis
Fluoroquinolone + potentiated amoxicillin for 4 weeks
Reculture urine or prostatic fluid 1 week post antibiotic discontinuation and then again 2-4 weeks later
- consider castration
Describe the physiology of parturition
Progesterone secreted by corpus luteum to maintain pregnancy
Maturation of fetal adrenal glands release cortisol and triggers parturition –> increase estrogen release –> PG release from uteroplacental complex
–> PGE2 –> luteolysis –> decreased circulating progesterone –> increase in prolactin –> lactation
–> PGF2 alpha –> increases sensitivity of endometrium to oxytocin which is release by pituitary gland –> contractions + softening of cervix
