Retained Placenta, SIPS, Pyometra, Vaginal Hyperplasia, Brucellosis, Ovarian Remnant Flashcards
Hemorrhage
Some post-parturient hemorrhage is normal
- were placentas pulled out?
- oxytocin
- dogs have Hct of 30% at term
- transfusion rarely needed
Retained placenta
- rare
- thick vaginal discharge
- possible toxic shock
- may be able to pull placenta out
- oxytocin q4-6 hours for 3 days
- prostaglandins for ecbolic effects
- antibiotics if showing clinical signs
Acute metritis
Ascending infection of the uterus
- fever, dehydration, anorexia, depression, purulent discharge
- culture and cytology –> degenerate neutrophils
- supportive care –> hypovolemic shock
- antibiotics, prostaglandins
Normal lochia
Nonodorous, greenish black
Sub involution of placental sites
Trophoblastic cells invade the endometrium and erode into a blood vessel –> sanguineous vaginal discharge for longer than 6 weeks
- young bitches <3 years OHE in worst cases
- resolve spontenously
Vaginal hyperplasia
Seen during proestrus and estrus
- condition of estrogen exposure
- ovulatory induction, OHE, topical therapy, surgery
Acute mastitis
Hot, painful, enlarged glands
- hematogenous, ascending through teat oriface
- staph, strep, E. coli
- supportive care, antibiotics
- rule out mammary adenocarcinoma
Pyometra
Cystic endometrial hyperplasia
- secondary to repeated exposure to progesterone
- uterus becomes infected during estrus
- becomes pus filled during diestrus
- releases toxins into circulation
- E. coli most common!
Pyometra commonly occurs ______
4-8 weeks after estrus
- middle to older aged intact females
Clinical signs of pyometra
- ADR
- PU/PD –> E. coli releases endotoxin which interferes with ADH ability to resorb fluid in the tubule
- anorexic
- vaginal discharge
- shock and death
Pyometra diagnostics
- vaginal cytology
- CBC
- chemistry panel
- radiographs and ultrasonography
- culture
Pyometra medical treatment
For open pyometra’s only!!
- prostaglandins (start with low dose)
- breed next cycle
- recurrence is common
- OVH once breeding career is over
Ovarian remnant syndrome
Not pathologic, complication of OHE
- more common in cats than dogs
- occurs when piece of retained ovary becomes functional
- revascularization of fragments can occur
ORS recognition
Spayed female exhibiting signs of proestrus/estrus
- vulvar swelling
- mucoid to serosanginous discharge
- behavioral signs of estrus, attracting male dogs
ORS rule outs
Condtions that cause bloody vaginal discharge in spayed females
- vaginitis
- vaginal neoplasia
- stump pyometra
- trauma
- exogenous estrogen exposure
Average interval from OHE to estrus is ______
Over 15 months
- could be years
ORS - vaginal cytology
Consistent with proestrus or estrus in the absence of exogenous estrogen exposure
- predominant cornified/squamous cells
ORS - vaginoscopy
Vaginal edema
ORS - radiographs
Not helpful
- exception: US may be helpful on large breeds with large follicles or cysts present
Hormone profile of ORS females
- measure P4 after estrus subsides –> 2 weeks later, P4 > 2 confirms presence of luteal tissue
- LH concentration –> spayed females have high LH (ORS dogs may have an LH surge)
- AMH levels –> produced by sertoli cells and granulosa cells, elevated AMH levels indicate functional ovarian tissue
ORS - surgical treatment
Most remnants are found at pedicles
- if ovarian tissues not visualized, do excisional biopsy of pedicles
- submit for histopath
- increased incidence of neoplastic changes in ovarian remnant vs intact females
ORS - medical management
Mibolerone (Cheque)
- not recommended
Canine Brucellosis
Identified in 1966 as cause of infertility and abortion in dogs
- incidence is low, can be endemic in some breeding colonies
- zoonotic
In what states is Brucellosis reportable?
GA and IL
- only Brucella abortus, suis, melitensis are reportable in MS
Brucella canis
Obligate intracellular gram-neg coccobacillus
- natural infection restricted to canines
B. canis - oral transmission
Ingestion of bacteria (most common)
- placental tissue
- vaginal discharge
- mammary secretions
B. canis - sexual transmission
- venereal
- AI: most extenders with antibiotics have been found to be ineffective against B. canis
B. canis - vertical transmission
- congenital infection if pups are born alive and survive
- ingestion of milk from infected bitch
Prolonged bacteremia without _____ is important in Brucellosis
1-2 years, without fever
Clinical signs in female
- abortion in late gestation
- early embryonic death
- seropurulent vaginal discharge
Clinical signs in male
- prostatitis
- epididymitis
- scrotal dermatitis
- testicular degeneration
- orchitis is rare
General symptoms of Brucellosis
- lymphadenopathy
- anterior uveitis (chronic and unresponsive)
- discospondylitis
- arteritis
- protein losing nephropathy
Serology
Significant lag time between initial exposure/infection to seroconversion/positive blood culture
- seroconversion: 8-12 weeks (need 3 consecutive monthly tests)
- blood culture: 4-6 weeks
RCAT
Rapid card agglutination test
- antibodies to Brucella LPS antigen
- very sensitive, not very specific
- cross-reacts with antibodies against Bordetella, Pseudomonas, Moraxella-type organisms
- 2-mercaptoethanol increases specificity!!
AGID
Used to confirm positive RSAT
- cytoplasmic antigens
- more specific
- 12 weeks to seroconvert
What is the gold standard of diagnosing Brucellosis?
Culture
- rarely done, danger to lab personnel
Other tests of Brucellosis
- PCR of semen
- vaginal swab
Brucellosis treatment
Euthanasia should be considered
- OHE/castration
- baytril
- doxycyline + gentamicin + rifampin
Control of Brucellosis
- quarantine
- clean 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
