SA 2 Flashcards
tell me when parturition occurs when compared to these in the bitch:
1. after LH surge
2. after ovulation
3. after onset of cytological diestrus
- 65 d ± 1 d
- 63 d ± 1 d
- 57 d ± 2 d
GnRH is produced in ____ concentrations in pregnancy in the bitch.
low
LH is _____, which means it stimulates progesterone from the CL during pregnancy.
luteotropic
FSH is released ____ in pregnancy, causing a mild increase in ____.
mid-term
estrogen
prolactin is ____, which means it supports CL during pregnancy. when is it released in pregnancy?
luteotropic
mid-term through parturition
what does prolactin do?
development of mammary tissue
progesterone is released from the ____ when in pregnancy?
CL, throughout
why do you not use progesterone in pregnancy diagnosis?
progesterone profiles are similar in pregnanct and non-pregnant bitches
how do you diagnose pregnancy in the bitch?
- relaxin
- abdominal palpation
- US
- rads
what is the only pregnancy-specific hormone in the dog?
relaxin
relaxin is produced by the ____ and peaks _____ _____ parturition.
placenta
2-3 weeks before
when is relaxin detectable?
until 3rd to 4th week of pregnancy
28-30 d post LH surge
how do you use abdominal palpation for pregnancy dx and timing of pregnancy?
- ovoid swellings as early as 17-22 d after ovulation
- most distinct 28-30 d after ovulation
- by 35-45 d after ovulation, swellings elongate
true or false: you can use US for determining number of fetuses
false.
when can you detect pregnancy in bitches using US?
21 days after LH surge
what do you use to determine litter size in pregnant bitches?
rads
how do you use radiographs to diagnose pregnancy and timing of pregnancy?
- 21-42 days after ovulation: fluid-filled horns
- calcification begins 43-46 d after ovulation
true or false: a Hct of <40% is alarming in a pregnant bitch.
nope. pregnancy associated anemia can happen. it’s normocytic and normochromic
when should you evaluate rectal temp in a pregnant dog and why do you do it?
2-3 times/day, starting 5 d before due date
temp drops by 1C and then increases again just prior to whelping bc progesterone is thermogenic (parturition is within 24 h)
tell me about diet management of a pregnant bitch
avoid overfeeding: gradually increase feed intake by 25-30% over the last 4 weeks of gestation
changing to puppy diet is usually enough
dogs have a _____ and ______ placenta.
zonary, endotheliochorial
true or false: seeing greenish-black discharge after whelping is super bad in the dog! where does it come from?
false! this is NORMAL!
comes from placental separation during whelping (biliverdin break-down product)
true or false: placental hematoma is normal in pregnancy dog
true. it’s circumferential and marginal
how can you use progesterone to predict parturition?
<2 ng/mL means that parturition is within 24 hours
what is uteroverdin?
greenish-black discharge before or during whelping, means that there’s a detachment of placenta and at least 1 puppy is compromised. the delivery needs to be soon
tell me 2 ways to predict parturition in a bitch.
- temperature
- progesterone serum level
how many stages are in dog parturition?
3
describe stage 1 dog parturition - what happens, how long does it last, and what does the dog do?
uterine contractions –> dilation of cervix
6-12 hours
restlessness, anorexia, separation
describe stage 2 dog parturition - what happens, how long does it last?
- Ferguson’s reflex
- expulsion of puppies every 30 min-1hr (up to 4 hr)
- large litter size = birthing can last up to 24 h
- female removes fetal membranes (licking), may eat them (causing diarrhea)
- licking also stimulate’s pup’s CV system
what is Ferguson’s reflex?
pressure in cervix by puppy –> oxytocin release –> cervical contractions –> push da baby OUTTA THERE
what 2 fetal membranes does the mom remove by licking?
allantoamnion and allantochorion
describe stage 3 of dog parturition - what happens, how long?
expulsion of fetal membranes (with puppy or 5-15min after birth)
endometrial involution takes 3 months
true or false: retained fetal membranes are common in the bitch
false. they are very uncommon
describe the endocrinology of parturition in the dog.
- pituitary-adrenal maturation = increased fetal cortisol
- increased fetal cortisol + increased maternal cortisol = increased PGF2alpha
- increase PGF2alpha = luteolysis = rapid progesterone decrease <2ng/ml
= 24 hours later, whelping
what are the maternal factors involved in dystocia?
- primary uterine inertia - no fetus delivered
- secondary uterine inertia
- brachycephalic breeds
tell me about primary uterine inertia
- terrier breeds predisposed
- large litter = overstretching
- hypocalcemia
- obesity
No uterine contractions
tell me about secondary uterine inertia
- hypocalcemia
- secondary to fetal obstruction
- increased cortisol
Uterine contractions stop before they’re supposed to
what are the fetal factors of dystocia?
- presentation, position, posture
- increased fetal size (singleton)
- abnormal developments
- death of fetuses
what does it mean when a dog’s “water breaks”?
chorioallantois ruptures
tell me how to diagnose dystocia in the bitch.
- history
- passage of green lochia
- significant blood discharge
- acute abdominal pain/prolapse/shock signs during labour
- vag exam
- US
- rads
- fetal maturation
what are you looking for in the history to diagnose dystocia?
- gestation length
- > 4 h after water breaking
- strong straining during stage 2 for > 30 mins
- > 2h b/t delivery of puppies
what does green lochia mean?
first puppy within 1-2 hours
what are the most important C/S to diagnose dystocia?
significant blood discharge
acute abdominal pain/prolapse/shock signs during labor
when diagnosing dystocia, what are you looking for in the vag exam?
- Ferguson’s reflex
- presence of a fetus in the canal
- anatomical abnormalities
how can you diagnose dystocia on US?
fetal distress = consistently under 180bpm
remember to evaluate >1 fetus
how can you use rads to dx dystoica?
looking for obstructions, dead fetuses, size of fetuses, that sort of thing
tell me the indications for medical management of dystocia
- female in good health condition
- no fetal obstruction
- Ferguson reflex present
- length of dystocia not too long
- fetal HR >180 bpm consistently
tell me the indications for surgical management of dystocia
- health compromised
- fetus in the birth canal
- Ferguson reflex absent
- dystocia for too long
- fetal distress (HR consistently < 180bpm)
in these circumstances, tell me if the dystocia mgmt should be medical or surgical:
1. mom seems healthy, you can feel a Ferguson reflex during vag exam, owner brought dog in right away when they suspected dystocia
2. you do a vag exam and you don’t feel a Ferguson reflex
3. you do a vag exam and you feel a fetus in the birth canal
4. you do US and fetal HR is >180bpm consistently
5. you do US and fetal HR is <180bpm consistently
6. mom comes in in shock, owner says mom has been this way for many many hours
- medical
- surgical
- surgical
- medical
- surgical
- surgical
tell me options for medical treatment of dystocia
- calcium
- oxytocin
should you use calcium alone to tx dystocia?
nope. use with oxytocin
why does using calcium to tx dystocia work?
increases strength of uterine contractions, will work even if serum [Ca] is normal
tell me how to use calcium to tx dystocia in the bitch. like give dosage
10% Ca gluconate 10-20 mg/kg IV or SQ
reassess 15-40 min later
use with oxytocin
what “gets the uterus going” according to Kastelic?
oxytocin
how do you use oxytocin to tx dystocia? like give me dosage
0.1-1 IU, SQ, IM, or IV
repeat every 20-30min/response
fetus after no more than 3 doses
what should you do before using oxytocin to tx dystocia? why?
rads
rule out pup obstruction birth canal
what happens when you use too high of a dose of oxytocin when treating dystocia?
uterine tetany
pregnancy toxemia results from a relative lack in _____.
carbs
____ usually develops during late gestation in females with ______ and/or _______.
ketosis
inadequate nutrition
large litter
how does pregnancy toxemia present clinically?
anorexia late gestation
ketone bodies in urine with no glycosuria
how do you treat pregnancy toxemia?
one case report - 5% dextrose
preg termination?
why do dogs often develop diabetes mellitus when pregnant?
during diestrus (pregnant or non pregnant) –> increase progesterone –> increase GH
GH = insulin antagonist
female with subclinical DM will show overt signs of dz during pregnancy
acute puerperal metritis happens within _____ after whelping.
1 week
acute puerperal metritis, aka postpartum metritis, is caused by …? what
retained fetal membrane
retained pup
what are the clinical signs of postpartum metritis in dogs? specifically, what is the discharge like?
fever, malodorous vaginal discharge (normal lochia can pass up to 3wk)
degenerative neutrophils in discharge
what is the treatment for postpartum metritis?
medical: antibiotics and support therapy
surgical: OHE
true or false: mastitis is common in lactating pseudopregnant bitches, and not in postpartum females
false. it’s the other way around
primarily of postpartum females, rarely in lactating pseudopregnant bitches
true or false: mastitis can be acute and life threatening.
true
how do you diagnose mastitis?
culture purulent discharge from affected teats
what are common etiologies of bitch mastitis?
E. coli, staphylococci, streptococci
how do you treat bitch mastitis?
antibiotics; amoxicillin with clavulinic acid or cephalosporins
sx might be indicated (drain and flush with 1% povidone-iodine)
after diagnosing mastitis in the dog, should you allow the pups to continue nursing?
yes, unless abscess or gangrene present
what does SIPS stand for?
sub involution of placental sites
why does SIPS happen?
trophoblast cells do not degenerate and invade the endometrium and even myometrium
SIPS is more common in _______ (parity) females _____ (age).
primiparous
<3 years
how do you diagnose and treat SIPS?
prolonged hemorrhagic discharge
no systemic illness
spontaneous remission
what are your options for terminating pregnancies?
- OHE
- progesterone antagonist
- PGF2 alpha
- dexamethasone
- estrogens
how do progesterone antagonists terminate pregnancy?
antagonize progesterone lmao
progesterone maintains pregnancy, so blocking this and lowering the amount causes termination of pregnancy
when using progesterone antagonists to terminate pregnancy, when is it more effective, early or late pregnancy?
early
PGF2 alpha for terminating pregnancy –> effect depends on when you administer it around day ____ of pregnancy. what is this difference?
day 40
before day 40: resorption
after day 40: abortion
what are the side effects of PGF2 alpha for terminating pregnancy?
vomiting, hypersalivation, defecation (they subside within 60 mins)
dexamethasone will cause abortion ____ in pregnancy (timing).
later
what are the pros of using dexamethasone to terminate pregnancy?
inexpensive, can be administered at home
what are the side effects of using dexamethasone for terminating pregnancy?
PU/PD, anorexia
should you use estrogens for terminating pregnancy? why or why not?
nope
severe side effects
what viral etiologies cause abortion in dogs?
herpesvirus
what bacterial etiologies cause abortion in dogs?
- brucellosis
- campylobacter
- salmonella
- E. coli
- leptospira
is canine brucellosis zoonotic?
yes!!!
what is the most common pathogen that causes canine brucellosis abortion? name the other ones [maybe not important to know the other ones but I have this just in case ;)]
Brucella canis
B. abortus, B. melitensis, B. suis
4 out of 6 brucella species cause abortion in dogs
how is canine brucella transmitted?
- ingested of aborted fetal membranes
- vaginal discharge from infected bitches, esp in estrus
- venereal
- conjunctiva
infected can be asymptomatic
true or false: dogs with brucellosis are always symptomatic, which makes tracing the spread of the disease easy.
FALSE! INFECTED CAN REMAIN ASYMPTOMATIC
what can brucellosis cause in dogs?
- late-term abortion (7-9 weeks)
- prolonged vag discharge (brownish or serosanguinous)
- epididymitis
- generalized lymphadenitis
- discospondylitis and uveitis
how do you diagnose brucellosis in dogs?
- abortus presents with autolytic changes
- vag discharge ?
- culture - definitive diagnosis
- serology (RSAT, AGID) - screening only
what is important to keep in mind with blood cultures in brucellosis positive dogs?
> 80% of dogs can have positive blood cultures for up to 1 year
true or false: brucellosis can persist in dog kennels even after antibiotic treatment; therefore, infected animals are euthanized
true
how do you definitively diagnose canine brucellosis?
culture
how should you use serology with canine brucellosis? why?
only as a screening test
sensitive, but not specific (you can be sure that a true positive will show up as positive, but false positives are common)
why is serology not great for canine brucellosis? what does this result in?
antibodies cross-react strongly with antibodies to several nonpathogenic bacteria
false positives
you run a rapid slide agglutination test (RSAT) to test for canine brucellosis. You get a positive. what can you do to differentiate whether this is a true or false positive?
add 2-ME, which inactivates IgM –> prevents cross-reaction
if still +, use another testing method to confirm true positive
if -, test 15-45 days later to confirm negative result
what are the two methods of serology you can use to test for canine brucellosis?
- rapid slide agglutination test (RSAT)
- agar gel immunodiffusion (AGID)
a positive result with AGID is/is not considered definitive for a dx of canine brucellosis? why or why not?
is!
more specific = less false positives
how do you treat canine brucellosis?
- eradication of infected animals in a kennel
- tetracycline and streptomycin for 2 weeks; can clear blood culture BUT relapse possible
why is treatment often not successful in eliminating infection? Of brucellosis
intracellular localization of bacteria
what is the most prevalent species of campylobacter that causes abortions in dogs?
Campylobacter jejuni
what does Campylobacter jejuni cause in dogs?
- few reports of abortions
- GI dz
- vaginal hemorrhagic discharge
how do you diagnose Campylobacter jejuni in dogs?
culture from fetal or neonatal tissue (stomach/contents)
special conditions required to culture
how do you treat Campylobacter jejuni in dogs?
antibiotics based on C&S
(erythromycin and neomycin)
is camylobacter jejuni zoonotic?
YES! from human to dog and from dog to human
what can leptospirosis cause in dogs?
- abortion, uveitis, meningitis
- infertility and abortion (L. bratislava)
how is leptospirosis transmitted?
urine and rarely venereal
is leptospirosis zoonotic?
yes
You do a vag culture on a dog and find mycoplasma and ureaplasma. what should you do?
nothing - these can be part of normal vag flora
however, if present in large enough numbers, can cause disease
canine herpesvirus is transmitted by…?
licking or coughing - primary
in utero transmission and veneral spread - possible
tell me the difference between canine herpesvirus infection in a naive pregnant female vs an immune pregnant female
naive preg: virus spreads to fetus and causes fetal death, mummification, abortion, stillbirths
immune preg: not affected
how do you diagnose canine herpesvirus?
virus isolation from swabs of vesicular lesions on genitalia of affected females
females that have fetal death/abort may be tested for CHV-specific neutralizing antibody on a serum sample
what happens to puppies that are infected with canine herpesvirus at birth or postnatally up to 3 wks?
develop systemic dz that is usually fatal
what is hypoluteoidism?
insufficient secretion of progesterone by CL during pregnancy
how do you treat hypoluteoidism?
give progesterone
should you give altrenogest in a pregnant dog?
nooooooooooo
