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ECC > Reproductive emergencies (Allen) > Flashcards

Reproductive emergencies (Allen) Flashcards

1
Q

Fetal causes of dystocia

A
  • oversized fetus
    • persian
    • himalayan
    • bulldog
  • singleton
  • hydrocephalus
  • anasarca
  • fetal monster
  • fetal presentation
  • fetal death
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2
Q

Maternal causes of dystocia

A
  • Uterine inertia
    • primary
    • secondary
  • abdominal
    • age
    • hernia
    • diaphragmatic hernia
  • Pelvis
    • immaturity
    • fracture
    • neoplasia
    • breed
    • developmental
  • Uterus
    • trauma
    • rupture
    • torsion
    • developmental
  • Vagina
    • tumor
    • stricture
    • septum
  • Hydrops (golden retriever) => lots of fluid in amniotic sac
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3
Q

Causes uterine inertia

A
  • hormonal
    • abnormalities of estrogen, progesterone, relaxin, prolactin, PGs
  • metabolic
    • hypocalcemia, hypoglycemia
  • myometrial
    • single pup, age, toxic degeneration, overstretching
  • Cervix, vagina, vulva
    • immaturity, insufficient dilation, softening, fibrosis, disease, neoplasia, developmental abnormality
  • Physchologic
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4
Q

High risk for dystocia

A
  • Brachycephalic breeds
  • toy breeds
  • bitches with single fetus
  • primiparous bitches > 6y
  • hx abortion/dystocia
  • large litters
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5
Q

Dystocia diagnostics

A
  • Physical exam
  • vaginal exam
  • abdominal rads
  • fetal ultrasound
  • blood work
    • PCV/TS
    • NOVA (e-lytes, BUN, creat, i-Ca, glucose)
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6
Q

assisted vaginal delivery

A
  • sterile gloves
  • sterile lube
  • grab puppy’s body with fingers/gauze
  • gentle traction
  • Sometimes put it back in and wait a minute
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7
Q

Dystocia med tx

A
  • only attempt if
    • not obstructed, alive happy fetuses, no fetal oversize, failure to progress, contractions present
  • Calcium
    • inc strength of contraction
    • give 10-15 min before oxytocin
    • 1 ml/5.5 kg of 10% calcium gluconate
  • Oxytocin
    • inc frequency of contraction
    • 0.25 U SC or IM
    • max dose 2-4 units per bitch
  • +/- glucose and IV fluids
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8
Q

fetal heart rate 180

A
  • That is ok but probs time to respond
    • don’t let it get down to 150/160
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9
Q

cystocia pre-op

A
  • CV support with IV balanced e-lyte fluids during induction, anesthesia, recovery
  • Correct metabolic derangement pre-op
    • hypoglycemia
    • hypovolemia
  • clip fur before anesthesia
  • prepare neonatal resuscitation area
  • perioperative antibiotics
    • stop post-op
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10
Q

Neonatal resuscitation station

A
  1. Trained staff
  2. Sterile drapes
  3. Bulb or tube suction
  4. Small face masks
  5. Small ET tubes
  6. Reversal agents
  7. Hemostats
  8. Suture and dilute betadine
  9. Warm area for recovery
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11
Q

Anesthesia for C-section

A
  • Pre-oxygenate, induce in OR
  • Propofol induction
    • 4-6 mg/kg or TIVA
  • Iso maintenance
  • Analgesia
    • Opioids
    • Lidocaine/bupivicaine block
  • ECG, SPO2, BP, EtCO2
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12
Q

Surgical procedure

A
  • Ventral midline incision
  • tent linea prior to incision
  • exteriorize uterus (gently)
  • Options
    • C-section
    • C-section then OHE
    • En bloc
  • two layer closure
    • aposition of cut edges
    • inverting pattern to seal (cushings)
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13
Q

Uterine torsion

A
  • Near term and life threatening
  • Gravid uterus rotates about its long axis
  • Signs
    • abdominal pain
    • tenesmus
    • serosanguinous vaginal d/c
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14
Q

Uterine rupture

A
  • Near term and life threatening
  • Cause
    • uterine trauma
    • obstructive dystocia
    • OT, pyometra
  • CS
    • abdominal pain (severe)
    • fluid wave
    • signs of shock
    • febrile
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15
Q

Neonate resuscitation

A
  • Remove fetal membranes
  • Clear nose/mouth
    • bulb syringe
  • Clamp umbilical cord
    • 1/4 inch from body
    • suture, betadine
  • dry neonate with towel
  • if no breath after 30/45s
    • GV26
  • hot dog for warmth
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16
Q

Post-operative care

A
  • Analgesia
    • opioids
  • IV fluids
  • Abx if
    • abdominal contamination with fetal fluids
    • uterine rupture
    • uterine torsion
17
Q

Pregnancy toxemia

A
  • Negative energy balance
    • late pregnancy
    • lac of carbs => ketosis
  • CS
    • hypoxemia
    • anorexia
    • weakness
    • lethargy
    • seizures
  • DX
    • ketosis w/o glucosuria
  • TX
    • nutrition
    • C-section
18
Q

Eclampsia

A
  • Severe hypocalcemia
    • usually 1-4 weeks after birth
  • Predisposing factors
    • improper nutrition
    • oversupplementation during pregnancy
    • heavy lactation
    • large litter
    • breed: chihuahua with large litter
19
Q

Eclampsia

Clinical signs

A
  • lethargy
  • hyporexia
  • muscle fasciculations
  • tremors
  • facial rubbing
  • ataxia
  • hyperthermia
  • seizures
20
Q

Eclampsia

DX

TX

A
  • DX
    • i-Ca < 1.4 mmol/L
    • tCa , 6.5 (dog)
    • tCa, < 6.0 cat
  • Treatment
    • ECG, 1 ml/kg calcium gluconate IV over 10-15 minutes
    • improve nutrition (puppy food)
    • supplement Ca
21
Q

Pyometra

A
  • Middle age/older animals
  • often preceded by cystic endometrial hyperplasia
  • occurs during distrus
    • high progesterone
  • open vs closed
  • causes
    • e. coli
    • strep, staph, enterobacter, proteus, klebsiella, pseudomonas
22
Q

Pyometra

CS

A
  • Polydipsia
  • Polyuria
  • Fever
  • vaginal discharge
  • vomiting
  • dehydration
  • anorexia
  • lethargy
  • hyperemia
  • septic shock
23
Q

Pyo

Diagnostics

A
  • CBC/Chem/UA FREE CATCH
  • abdominal rads
  • AFAST
  • culture and susceptibility once removed
24
Q

Pyo DDX

A
  • Pregnancy
  • CEH
  • mucometra
  • hydrometra
  • cancer
25
Q

Expected labwork with pyo

A
  • neutrophilia/neutrophilia with left shift
  • mild, non-regenerative anemia
  • azoteia
  • isosthenuria
  • hyperglycemia/hypoglycemia
  • mildly increased liver enzymes
26
Q

Pyo tx

A
  • stabilize
  • IV antibiotics
  • surgery OHE
  • aglepristone in Europe
27
Q

Vaginal hyperplasia

A
  • occurs under influence of estrogen
  • Diagnostic: visual
  • TX
    • if urination possible and no necrosis
      • keep clean
      • lubricate
      • e-collar
      • will repair self ince follicular phase of estrus passes
    • If very large may need ressection
    • SX OHE is definitive
28
Q

Mastitis

A
  • inflammation of mammary glands, bacterial infection
  • Dogs > cats
  • postpartum/lactating pseudopregnant bitches
  • Risks
    • sanitation
    • trauma by offspring
    • systemic infection
29
Q

Mastitis

Causes

CS

DX

TX

A
  • Causes
    • e. coli
    • staph
  • CS
    • asymptomatic to septic shock
    • swollen mammae, fever
  • DX
    • milk cytology, culture
  • TX
    • cidal abx
    • warm packing if abscessed
    • lance
    • drain
    • pack
    • remove
30
Q

Penile trauma

A
  • hematuria end of urination
  • examine under sedation
  • small nonabsorably suture
31
Q

Os Penis fracture

A
  • No treatment if non-obstructive
  • Penile amputation
  • Bone plating or wiring
  • Urethrostomy
32
Q

Scrotal Hematoma

A
  • R/O coagulopathy
  • Mild
    • ice, compress, rest
  • more severe
    • scrotal ablation

*hemophiliacs

33
Q

Testicular abscess

A
  • Cause
    • trauma
    • brucellosis
  • DX
    • culture, sensitivity
  • TX
    • antibiotics
    • neuter
    • scrotal ablation
34
Q

Paraphimosis

A

Protursino of nonerect penis w/o ability to retract

35
Q

Priapism

A

persistent erection w/o sexual stimulation

36
Q

Paraphimosis and priapism

TX

A
  • Sedation/anesthesia
    • avoid peripheral vasodilators
  • lubrication
  • hypertonic soak
    • sugar
    • saline
  • if necrosis
    • penile amputation and urethrostomy
37
Q

Phimosis

A
  • inability to extrude penis from prepuce
  • can cause
    • UO
    • abscess
    • severe urine scalt
  • congenital or acquired
    • trauma
    • neoplasia
    • genital sucking
    • stenosis of preputial orifice
  • TX
    • sx, explore
38
Q

Pyometra occurs in

A

diestrus

ECC (18 decks)

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