Retained Placenta, SIPS, Pyometra, Vaginal Hyperplasia, Brucellosis, and ORS Flashcards
What do you give for hemorrhage post-partum?
Oxytocin
What is the Hct of dogs commonly at term?
30%
What are clinical signs of retained placenta?
Thick vaginal discharge
Possible toxic discharge
What is given as treatment for retained placenta?
Oxytocin q4-6 hours for 3 days
Prostaglandins for ecbolic effects
Antibiotics if showing clinical signs
What is acute metritis?
Ascending infection of the uterus
What are clinical signs of acute metritis?
Fever Dehydration Anorexia Depression Purulent discharge
Is a nonodorous, greenish black liquid in the uterus normal?
Yes, it is normal lochia
What is helpful in diagnosing acute metritis?
Culture and cytology to look for degenerative nutrophils
Why is supportive care needed for acute metritis?
Hypovolemic shock
How can you treat acute metritis?
Antibiotics
Prostaglandins more commonly
Oxytocin can be used
What is a clinical sign of sub-involution of placental sites?
Sanguineous vaginal discharge for longer than 6 weeks (up to 16 weeks)
What causes sub-involution of placental sites?
Trophoblastic cells invade the endometrium and erode into a blood vessel
What is the treatment for sub-involution of placental sites?
Young bitches <3 years: OHE in worst cases
Generally resolve spontaneously: several weeks to net proestrus
OHE in worst cases
When is vaginal hyperplasia typically seen?
During proestrus and estrus
What is vaginal hyperplasia a condition of?
Estrogen exposure
What are the treatment options for vaginal hyperplasia?
Ovulatory induction
OHE
Topical therapy
Surgery
What are clinical signs of acute mastitis?
Hot, painful, enlarged glands
Hematogenous, ascending through teat orifice
What are common causes of acute mastitis?
Staphylococcus sp.
Streptococcus sp.
E. coli
What do you treat acute mastitis with?
Supportive care and antibiotics
What is a rule out for acute mastitis?
Mammary adenocarcinoma
What is pyometra?
Cystic endometrial hyperplasia
What is pyometra secondary to?
Repeated exposure to progesterone
When does the uterus become infected leading to pyometra?
During estrus
When does the uterus become pus filled with pyometra?
During diestrus
What is a common problem associated with pyometra?
Releases toxins into the circulation
What is the most common cause of pyometra?
E. coli
What is the signalment associated with pyometra?
4 to 8 weeks after estrus
Middle to older aged intact female
What are the clinical signs of pyometra?
ADR PU/PD Anorexic Vaginal discharge Depressed Shock and death
True or false: dogs with a closed cervix pyometra are less sick.
False. Dogs with an open cervix pyometra aren’t as sick because they are getting some relief. Closed has more clinical signs because it is full of pus that can’t get out
Why does PU/PD happen with pyometra?
E. coli releases endotoxin which causes a problem with ADH absorption
What diagnostics are used for pyometra?
Vaginal cytology CBC Chem panel Rads and US Culture
If you had one diagnostic tool to use for pyometra, what would it be and why?
US
A pyometra will appear hyperechoic and will look like a snow globe
What are the cytology findings with pyometra?
A lot of degenerative neutrophils
What will show up in most cases on CBC?
Leukocytosis, though if it is normal or less we would not rule pyometra out
May have changes in BUN
What would be the results of a urinalysis with pyometra?
Concurrent UTI with the same bacteria
True or False: you would use cystocentesis for obtaining a urine sample in a dog with pyometra.
False. DO NOT USE CYSTOCENTESIS. Free catch is a better option.
What is the best treatment for pyometra?
OHE
What is the medical management for pyometra?
Select patients carefully. If extremely ill do not use. Only consider with valuable breeding animals and those with open cervix
Prostaglandins: 0.25 mg/kg/day, SQ, for 5 days starting with a lower dose
Supportive care
OHE once breeding career is finished
What is ORS a complication of?
OHE
Is ORS more common in cats or dogs?
Cats
When does ORS occur?
When a piece of retained ovary becomes functional
What are clinical signs of ORS?
Spayed female exhibiting signs of proestrus/estrus: vuvlar swelling, mucoid to serosanguious discharge, behavioral signs
Pseudocyesis
What are the various conditions that cause blood vaginal dischatge in spayed females?
ORS Vaginitis Vaginal neoplasia Stump pyometra Trauma Exogenous estrogen exposure
What is the average interval from OHE to estrus?
Over 15 months
What can be used for diagnosis of ORS?
Vaginal cytology
Vaginoscopy
Rads and US are usually not helpful
Hormone profile
What is seen on vaginal cytology with ORS?
Consistent with proestrus or estrus in the absence of exogenous estrogen exposure
Predominant cornified/superficial cells
What is seen with vaginoscopy with ORS?
Vaginal edema
When is using US an exception for ORS?
Large breed dogs with large follicles or cysts present
What hormones should be checked with ORS?
P4
LH
AMH
When should P4 be measured when testing for ORS?
After estrus subsides (2 weeks later)
What does the presence of P4 > 2 confirm?
The presence of luteal tissue
What should be given to cats to test their P4 for ORS?
GnRH because they are induced ovulators
How is the LH concentration used in diagnosing ORS?
Spayed females have a high LH, so if LH is low it is likely that the animal has ORS
You must be careful using this in a dog with potential ORS becuase they will still have an LH surge on one day, so test for a couple of days
What is AMH produced by?
Sertoli cells and granulosa cells
What do elevated AMH levels indicate?
Functional ovarian tissue
What is the treatment of ORS?
Remove offending tissue surgically
Lifelong medical management with mibolerone (not recommended)
What was canine brucellosis identified as a cause of if 1966?
Infertility and abortion
Is brucellosis zoonotic?
Yes
What states is brucellosis reportable in?
Georgia and Illinois
What causative agents of brucellosis are reportable in MS?
Brucella abortus, suis, and melitensis
What is the etiology of canine brucellosis?
Brucella canis is an obligate intracellular gram-negative coccobacillus
Natural infection restricted to canines
What are the modes of transmission of canine brucellosis?
Ingestion of bacteria (most common)
Venereal transmission
AI
Vertical transmission
What can be ingested that will contain the bacteria to cause brucellosis?
Placental tissue
Vaginal discharge
Mammary secretions
How can AI cause brucellosis?
Most extenders with antibiotics have been found to be ineffective against B. canis
How does vertical transmission cause brucellosis?
Congenital infection if pups are born alive and survive
Ingestion of milk from infected bitch
What are the clinical signs of canine brucellosis?
Infertility (most common)
Most dogs show no or few
Prolonged bacteremia (1-2 years) without fever
Reproductive disorders in the bitch: abortion late in gestation (classic sign), early embryonic death, sero-purulent vaginal discharge
Reproductive disorders in the male: Prostatitis, Epididymitis, Scrotal dermatitis, Testicular degeneration, Orchitis is rare
General symptoms: Lymphadenopathy Anterior uveitis Discospondylitis Arthritis PLN
What tests can be used to diagnose canine brucellosis?
Serology Rapid card agglutination test (RCAT) AGID Culture PCR of semen or vaginal swab
How is serology used when diagnosing brucellosis?
Significant lag time between initial exposure/infection to seroconversion/positive blood culture
Seroconversion: 8-12 weeks
Blood culture positive: 4-6 weeks
What is the RCAT?
Antibodies to Brucella LPS antigen
Very sensitive, not very specific
Cross reacts with antibodies agains Bordetella, Pseudomonas, Moraxella-type organisms
2-mercaptoethanol increases specificity
What is the AGID?
Used to confirm positive RSAT
Cytoplasmic antigens
More specific
12 weeks to seroconvert
What is the gold standard for diagnosing brucellosis?
Culture though it can be very difficult to grow and rarely done because it is a danger to ab personnel
What are animals that are chonically infected with brucellosis like?
May never be febrile despite persistent bacteremia
Males have testicular degeneration
What is the treatment of brucellosis?
Euthanasia should always be considered
OHE/Castration
Baytril for 30 days
Doxycycline + gentamicin + rifamoin
What are older therapies of brucellosis that rarely cured it?
Tetracycline + streptomycin
Minocycline + streptomycin
How can brucellosis be controlled?
Quarantine kennel
Clean kennels daily
Test and eliminate all positives
Test monthly until 3 negative tests in a row
Test every 6-12 months for surveillance
House new dogs separately for 2 months
Should have 2 negative tests before introduction