Reproductive disorders Flashcards
Anorchia
Absence of testicles (rare)
Monorchidism
Single testicle
Crytorchidism
Usually unilateral and retrained within the abdomen
Orchitis
Inflammation of the testes
Phimosis
- Inability to extrude the penis
- Abnormality or small preputial orifice/congenital
- Result in trauma or inflammation
Paraphimosis
- Failure to retract penis into prepuce
- Penis becomes dry and necrotic
- Urethral obstruction may occur
Priapism
-Persistent enlargement in the absence of sexual excitement
What is pseudopregnancy and its clinical signs?
- False pregnancy/phantom pregnancy
- Anorexia/abdomen enlargement
- Nest making
- Nursing inanimate objects (toya)
- Mammary development and lactation
What is pyometra and its clinical signs?
- Serious infection of the womb/uterus
- Pus filled womb caused by a bacterial infection
- Malodorous
- Creamy yellow to blood-stained vulval discharge
- Lethargy
- Inappetence
- Pyrexia
- Vomiting
- Abdomen pain
- PD/PU
What is endometritis?
- Inflammation of the endometrium
- Common cause of pyometra and infertility in the dog, less common in cats
- Often caused by pathogenic micro-organisms
Neonate
First 7-14 days of life
Paediatric
Between 2 and 6 weeks of age
What are the expected mortality rates of puppies and kittens?
- 20% die before they are 21 days old
- 70% of deaths occur in first week postpartum
What are some possible causes for neonatal deaths?
- Aspiration pneumonia
- Malnutrition and hypoglycaemia
- Infectious disease
- Hypothermia
- Genetic defects (PDA/cleft palate/hydrocephalus)
- Failure of passive transfer
- Faecal impaction
- Fading puppy syndrome
What is fading puppy syndrome characterised by?
- Restlessness
- Crying (starting shortly after birth)
- Increasing weakness
- Failure to nurse
- Weight loss
- Hypothermia
What are some possible causes of fading puppy syndrome?
Prepartum disease
- Hypoglycaemia
- Pregnancy toxamia
Post partum disease
- Hypoglycaemia
- Metritis
- Mastitis
What considerations should be made with neonatal in relation to their nervous system?
- Not fully developed at birth (cannot shiver or regulate vessels)
- Healthy neonates twitch whilst sleeping
- Should respond to odour, touch and pain
- Should show strong suckle and rooting
- Withdrawal reflex should be present, but often slow
- Menace reflex fully developed at 16 weeks of age
- PLR should be present around 10 to 20 days of age and vision normal by 30 days
- Full neurological exam performed around 6-8 weeks old
What rectal temperatures would be expected for the first 4 weeks of a puppy/kitten?
First week = 35-37.2C
Second and third week = 36.1-37.8C
Fourth week = 37.8-38.9*C
Why is thermoregulation in neonates difficult?
- Nervous system not developed (unable to shiver, poor peripheral vasoconstriction in response to hypothermia)
- Reduced cellular metabolism
- Little body fat
- Larger surface area:body weight ratio
BUT:
- Poor peripheral perfusion = poor vasodilation in response to hyperthermia
- Inability to pant
How is blood pressure maintained in a neonatal?
With a high heart rate (200-220 BPM)
Why are neonates naturally more susceptible to hypoxia?
- Large metabolic requirement
- Immature chemoreceptors
- High compliance of body wall (need to work harder to take breath)
What are some other potential conditions that could cause cardiorespiratory issues in neonates?
- Aspiration of milk
- Congenital defects (eg PDA, swimmers syndrome)
- Decreased surfactant production in lung
- Failure to manually stimulate first breath
- Respiratory depressant drugs during caesarean
How do neonates respond to hypoxia and what does this mean?
- Respond with bradycardia and hypotension (150 BPM is concerning)
- Patient with even mild respiratory distress can be fatal
What treatment and nursing care can be done for a neonate in cardiorespiratory distress?
- O2 administration (not exceeding 40-60%)
- Stimulate new-born neonates if mum not available (tend to recover within 45 mins)
- Consider IPPV
- Reversal of any agents likely to cause respiratory depression (for opioids =nalaxone, for benzodiazepines = flumazenil)
- Consider administration of doxapram
Why is colostrum so important for neonates?
- High quality nutrients (including protein and lipid) and immunoglobulins (IgG)
- Essential during first 12-24 hours of life (intestinal barrier closes within 24 hours in puppies and 16 hours in kittens)
- Ideally need to receive within first 8 hours (IgG colostrum decreased after first few hours)
What can be done for a neonate if colostrum is not ingested?
150ml/kg s/c or IP of adult dog serum to deprived puppies has shown to produce serum IgG levels comparable with littermates that received colostrum
What are some considerations for neonates in relation to nutrition?
- Have limited glycogen storage, impaired glycogenesis and cannot concentrate urine therefore loose a lot of glucose
- Hepatic storage depleted after 24 hours of starvation
What are some possible reasons for malnourishment/hypoglycaemia in neonates?
- Nonexistent (eg death of dam/queen, agalactia = lack of milk)
- Insufficient (eg mastitis, large litter)
- Genetic disorder (eg cleft palate, lack of suckle reflex)
- Infection (V+/D+)
What needs to be taken into consideration when using a milk substitute in neonates?
- Dam/queen milk is high lipid
- Cows milk = rich in lactose but low in fat and protein
What considerations must be made when feeding a neonate?
- Assess the body temp and auscultate for gut sounds (hypothermia causes ileus, DO NOT FEED <34.4*C)
- Check for suckling reflex
- Bottle, syringe or orogastric tube
- Care not to overly stretch the neck
- Observe for sigs of overfeeding (milk at nostrils, regurgitation, abdominal distention or discomfort, D+)
What are some clinical signs of emergency hypoglycaemia in neonates?
- Hypothermia
- Weakness
- Seizures
- Lethargy
- Anorexia
What can prolonged hypoglycaemia result in?
- <40mg/dL
- Permanent brain damage
- Myocardium damage
What treatment is required for a neonate presenting with emergency hypoglycaemia?
- IV dextrose boluses (2mL/kg of 12.5% dextrose)
- Bolus should be followed by an infusion of isotonic fluids supplemented with 2.5% to 5% dextrose
- If IV access not available, oral glucose can be administered
- May require hourly dextrose boluses in addition to a dextrose-containing infusion
- Blood glucose monitored regularly until hypoglycaemia stabilised
- Care taken to prevent oversupplementation as prolonged hyperglycaemia may lead to osmotic diuresis, thereby worsening dehydration
- Slow warming over 1-3 hours (hypoglycaemia will worsen if patient old enough to shiver)
- Check body temp before feeding
What considerations are needed for neonates in relation to urine?
- Kidney function and development are incomplete
- Nephrogenesis continues for at least 2 weeks after birth
- Unable to concentrate urine
- Glomerular filtration rate is decreased
- Renal blood flow is dependant on arterial blood pressure (unable to regulate)
- Dehydrated/hypotensive patients likely have renal impairment (more so than adult patients)
- Caution when administering renally excreted or metabolised drugs
What are some reasons for fluid therapy in neonates?
- Infectious disease (eg Parvo/cat flu)
- Decreased fluid intake
- Increased fluid loss (eg flea burden causing blood loss, D+)
What are some reasons for. neonates to have a higher fluid requirement?
- Decreased body fat
- Higher metabolic rate
- Decreased renal concentrating ability
- Greater surface area:body weight ratio
- Increased respiratory rate lead to greater insensible fluid losses
What are some clinical signs seen with dehydration in a neonate?
- Pale MMs
- Long CRT
- Cold extremities
- Lethargy
- Decreased urine output
- Reluctance to suckle
Why is skin turgor not an accurate diagnostic for dehydration in neonates?
They have increased water content and decreased subcutaneous fat
What clinical signs relating to dehydration would you expect to see in an adult patient but NOT in a neonate?
- Tachycardia
- Concentrated urine
