SA 3 Flashcards
1
Q
estrogen-responsive urinary incontinence happens in ____ females.
A
spayed
2
Q
estrogen-responsive urinary incontinence: what is the typical clinical presentation? what does it sometimes present as?
A
spaced female, pooling of urine where animal was sleeping
sometimes presents as lower UTI
3
Q
estrogen-responsive urinary incontinence has a mean interval to onset time of ____
A
3 years (as late at 10 y)
4
Q
estrogen-responsive urinary incontinence is more common in dogs ______ BW and there’s a higher incidence in _____.
A
> 20 kg
Boxers
5
Q
what is the pathophysiology of estrogen-responsive urinary incontinence?
A
E2 increases affinity of alpha-adrenergic receptors for their neurotransmitter. response of receptors is decreased after spay
causes incompetence of urethral sphincter
6
Q
how do you treat estrogen-responsive urinary incontinence?
A
- phenylpropanolamine (Proin)
- estriol (Incurin)
7
Q
how does phenylpropanolamine treat estrogen-responsive urinary incontinence?
A
it’s an adrenergic agonist
increases urethral tone
8
Q
how does estriol tx estrogen-responsive urinary incontinence?
A
weak natural estrogen
increase response to sympathetic nervous system - urethral tone
9
Q
cystic endometrial hyperplasia can progress to ____.
A
pyometra
10
Q
cystic endometrial hyperplasia is a disease of what stage?
A
post-estrus luteal phase
11
Q
tell me the pathophys of cystic endometrial hyperplasia.
A
repeated progesterone exposure (diestrus) causes hyperplasia of endometrium and growth of cysts from glands in endometrium
12
Q
CEH changes are reversed if ____ is removed.
A
progesterone
13
Q
tell me how pyometra and CEH are related (pathophys)
A
prolonged estrogen exposure leads to:
- hyperplasia of the endometrium
- open cervix –> bacteria can ascend
prolonged progesterone exposure leads to:
- secretory function of endometrium increases
- CEH
prolonged estrogen exposure consequences lead to prolonged progesterone exposure and vice versa
14
Q
true or false: estrogen and progesterone concentrations differ during pyometra as opposed to not pyometra (?????)
A
false. they do not differ (??????)
15
Q
how is pyometra induced iatrogenically?
A
- admin of estrogen as mis-mate shot (pre-luteal phase)
- progestins for estrus suppression, when used in the wrong stage of the cycle
16
Q
what is the most common pathogen that causes pyometra?
A
E. coli
17
Q
what is the hallmark clinical sign of pyometra?
A
PU/PD
18
Q
how does E. coli cause systemic illness and pyometra?
A
endotoxin release
19
Q
PU/PD during pyometra is most likely caused by what? is it reversible after OHE?
A
endotoxin effects
yes, reversible after OHE
20
Q
what clinical history/signalment is common in pyometras?
A
usually older females, recently in heat
or
hx of estrogen or progesterone tx
21
Q
tell me the difference between open and closed pyometra
A
open: vaginal discharge, dog is relatively healthy
closed: NO VAG DISCHARGE, lethargy, anorexia, vomiting, PU/PD, high WBC with left shift, BUN elevated
22
Q
what is the treatment for pyometra?
A
surgical: OHE
medical: PGF2alpha/Dinoprost, antiprogestin, antiprolactin
23
Q
when you perform an OHE to tx pyometra, how should you handle antibiotics?
A
AB tx for at least 1 week
24
Q
in a pyometra, the uterus can be fragile. what can you do to mitigate any complications arising from this?
A
- manipulate with great care
- lay sx drapes under uterus after exteriorization and prior to placing any ligatures
25
what is the goal of medical treatment of pyometra?
**eliminate progesterone** to allow for uterine contractions and cervical relaxation
26
Dinoprost is what type of medication?
PGF2 alpha
27
how does PGF2 alpha/dinoprost treat pyometra?
- acts directly on the CL to lyse it
- ecbolic agent (means it causes uterine contraction)
28
what kind of pyometra is contraindicated with PGF2alpha / dinoprost?
closed pyometra --> uterine rupture possible
29
what must you do before using PGF2 alpha /dinoprost to treat pyometra?
measure P4 prior to tx
30
how does antiprogestin treat pyometra?
competitively binds to progesterone receptors
31
what is the best thing about using antiprogestin to treat pyometra?
no side effects!
32
true or false: you should combine antiprogrestin with antibacterial therapy when treating pyometra
true
33
prolactin is ____ during the second half of diestrus
luteotropic
34
how should you use antiprolactin to treat pyometra?
in addition to PGF2 alpha
35
medical management of pyometra commonly ___ interestrus interval. you should breed on the ___ cycle after pyometra.
decreases
next
36
what are follicular cysts?
follicles that are >8 mm in diameter (normally 5-8mm)
37
what is the ddx for follicular cysts?
ovarian neoplasia (granulosa cell tumor)
38
with ovarian/follicular cysts, the granulosa cells may produce ____, resulting in what C/S?
estrogen
- hair loss (bilateral, often symmetrical)
- female will attract males
- bone marrow toxicity
39
how do you dx follicular cysts?
hx, vag cytology, US
40
how do you tx follicular cysts?
OHE, or induce luteinization of cystic structures (GnRH)
41
what is ovarian remnant syndrome?
incomplete removal of ovarian tissue during OHE
causes recurrent estrus after OHE and even false pregnancy
42
what are the ddx for bloody vulvar discharge in spayed females?
- neoplasia
- ovarian remnant syndrome
- coagulopathy
- trauma
- exogenous estrogen (or endogenous from adrenals)
43
how do you diagnose ovarian remnant syndrome?
- track estrous cycle and detect increase in progesterone
- anti-muellerian hormone (AMH) - only produced by granulosa cells
--> 0-90pg/ml = spayed ; >90pg/ml = intact or remnant
44
what is the treatment for ovarian remnant syndrome?
surgery when luteinized tissue is present
45
vaginal prolapse occurs primarily during what stage of the estrous cycle?
estrus
may also occur near parturition
46
why does vaginal prolapse occur?
exaggerated response to estrogen
47
vaginal prolapse occurs either ___, ____, or ____ cycle.
1st, 2nd, 3rd
48
what is the treatment for vaginal prolapse?
**remove estrogen stimulus**
- surgical = OHE
- medical = induction of luteinization using hCG & potentially remove affected tissue
49
what is the rate of occurrence with vaginal prolapse?
high (66-100%)
idk if we need to know percentages lol, just know its a high recurrence
50
at what age does juvenile vaginitis occur?
less than 1 year, as early as 8 weeks of age
51
what are the clinical signs of juvenile vaginitis?
vulvar discharge, not systemically ill
52
what does juvenile vaginitis culture usually come back as?
inconclusive
53
if juvenile dog has purulent vulvar discharge, how do you treat? what do they likely have?
antibiotic tx
juvenile vaginitis
54
with juvenile vaginitis, going through what may hasten resolution?
first cycle
55
transmissible venereal tumor occurs in what environment? what do the lesions look like?
in tropical and subtropical areas with stray dogs
cauliflower-like lesions (5mm-10cm) that often ulcerate and bleed easily
56
how is transmissible venereal tumor transmitted?
sex ;)
transplantation of neoplastic cells from mucosa to mucosa
57
how do you tx transmissible venereal tumor tx?
Vincristine
58
what is this US showing?
hint: it's not pyometra
CEH
cystic endometrial hyperplasia
59
what is this showing?
pyometra
60
what are 2 ddx for this? what is the correct diagnosis?
1. vaginal prolapse
2. transmissible venereal tumor
it's vaginal prolapse
61
what are 2 ddx for this? what is the correct diagnosis?
1. vaginal prolapse
2. transmissible venereal tumor
it's transmissible venereal tumor
62
Queens are _____ _____ breeders and are ____ ovulators.
seasonal, polyestrous
induced
63
when is puberty in the queen?
4-12 months (depends on when they're born - they cycle the next spring)
2.3-2.5 kg BW (avg)
oriental breeds: early puberty
long haired breeds and Manx: late puberty
64
how long is proestrus in the cat?
0-2 days
65
how long is estrus in the cat?
2-19 days
66
how long is diestrus in the cat *if pregnant*?
60 days
67
how long is diestrus in the cat *if pseudopregnant*?
40 days
68
how long is postestrus in the cat?
8-10 days
69
how long is anestrus in the cat?
30-90 days
70
tell me about the estrus cycle in the cat.
anestrus --> proestrus + estrus
if induced to ovulate, then diestrus
then can go back to proestrus + estrus OR go to anestrus
if not induced to ovulate, then postestrus
then can go back to proestrus + estrus
OR go to anestrus
71
list 3 induced ovulators in the domestic animal world
domestic cat, ferret, rabbit
also: mink, skunk, 13-lined ground squirrel, camel, llama, short-tailed shrew, giant fruit bat
72
true or false: duration of cat estrus is influence by whether ovulation is induced or not
false!!!! it is NOT influenced by ovulation
73
with a single copulation, what % of cats ovulate?
50%
74
in cats, the magnitude of LH peak ____ with the number of copulations.
increases
75
queen vag cytologies have the ___ (same/different) principles as the bitch, EXCEPT... what?
same
dog: E2 peaks in proestrus, cornification peaks in estrus
cat: E2 and cornification peak simultaneously
76
true or false: proestrus in the queen is not seen commonly - most enter estrus directly
true
77
tell me about the behaviour of the queen in proestrus
- continuous rubbing of the head on any object
- would not allow copulation
78
during proestrus, tell me about E2
rises
79
tell me about what you'd find in vag cytology in queen during proestrus
intermediate cells, parabasal cells, nucleated superficial, neutrophils
80
tell me about queen behaviour during estrus
- receptive to mating
- crouching and hyperextension of the back, vocalizations, head rubbing
81
when does E2 peak in the queen?
estrus
82
____ is released in response to copulation in the queen
LH
83
what is postestrus?
interestrus period in non-induced queens
84
tell me about behaviour during postestrus in the queen
no sexual behaviour or receptivity
85
what is E2 doing during postestrus?
low
86
what does vag cytology look like during postestrus?
intermediate cells, parabasal cells, nucleated superficial cells, anuclear superficial cells, few neutrophils
87
what is the main hormone during diestrus in the queen?
progesterone
88
diestrus occurs when in the queen?
it's the period after the queen was induced to ovulate
89
what happens after diestrus in the queen?
- estrus 7-10 days after progesterone declines
- lactational anestrus
90
what is anestrus in the queen?
seasonal absence of cycling activity in the late autumn months (northern hemisphere), Oct-Dec in queens exposed to natural day length
91
tell me about P4 and E2 during anestrus in the queen
at baseline
92
how do you induce estrus in the queen?
- increase photoperiod (14 h light/10 h dark)
- FSH 2mg IM SID until onset of estrus (3-7 days)
93
how do you suppress estrus in the queen?
- megestrol acetate
- medroxyprogesterone acetate
- GnRH
94
what do you have to inform owners about when using megestrol acetate to suppress estrus in the queen?
- not approved for cats - consent form
- adrenal cortical suppression was reported
- weight gain
95
how long does bitch pregnancy last?
58-68 days (8-10 weeks)
96
medroxyprogesterone acetate can cause _____,.
mammary tumors
97
is medroxyprogesterone acetate approved for used in cats?
nope
98
how long does queen pregnancy last?
63-65 days (9 weeks)
99
true or false: superfecundation occurs in queens that roam free
true
100
cats: embryos pass the UT junction by day...
4-5
101
where is relaxin produced in the pregnant cat?
feto-placental unit
102
when is relaxin first detected in the pregnant cat?
day 25 of pregnancy
103
prolactin increases at day ___ of queen pregnancy.
35
104
cats have a _____ placenta
endotheliochorial, zonary
105
cats have a marginal hematoma in placenta. true or false?
true
106
tell me about using palpation to dx pregnancy in the cat
- as early as day 15
- best window = day 21-25
- **after day 35, swelling becomes confluent** ---> not as good at detecting pregnancy via palpation
107
you palpate a cat and you think she's pregnant. what's a ddx for what you're feeling?
segmentally dilated uterus in the case of pyometra
108
using radiographs for pregnancy dx in the queen:
1. when does calcification occur?
2. is it commonly used?
1. **day 40**
2. no
109
using transabdominal US for pregnancy dx in the queen:
1. how early can you detect pregnancy?
2. fetal HR averages...?
3. what are the parameters for fetal distress?
1. 16 days
2. 228 bpm
3. < 150 bpm = distress ; < 100 bpm = severe distress
110
true or false: right before birth, there's a temp drop in cats
false!
111
how long does delivery take in the cat typically?
2-3 days
112
true or false: dystocia is rare in cats
true
113
you have a delay in parturition in the cat. what should you assume in the main cause?
eutocia (normal birth)
NOT DYSTOCIA
114
dystocia is considered when there is...... what in the cat?
4 h before first kitten
more than 2h between kittens
115
nursing occurs typically _____ after parturition in the cat
30-40 mins after birth
116
tell me important viral causes of feline abortion
- feline herpesvirus
- FIV
- FIP
- FeLV
- FPLV
117
feline herpesvirus causes what in the pregnant cat?
abortion, fetla death, maceration, placental necrosis, congenital fetal infections
118
FIV causes what in the pregnant cat?
venereal transmission, congenital fetal infections
119
FIP causes what in the pregnant cat?
resorption
120
FeLV causes what in the pregnant cat?
fetal or neonatal death
121
FPLV causes what in the pregnant cat?
abortion, stillbirth, neonatal death
122
what bacteria cause abortion in the cat?
- brucella
- salmonella
- e. coli
- staph
123
what is a common parasite that can cause abortion in cats?
toxoplasma gondii
abortion in queens with systemic signs of the disease (lethargy, diarrhea, CNS)
124
what's going on here?
mammary hypertrophy
125
mammary hypertrophy occurs when in the cat?
- during the normal cycle
- when there is exogenous progesterone
- during pregnancy
126
mammary hypertrophy is ____ (speed)
rapid (2-5 weeks)
127
mammary hypertrophy is _____ (involvement of mammary tissue?)
diffuse, all mmamary glands
128
how do you tx mammary hypertrophy?
**remove source of progesterone = complete remission**
- OHE
- cessation of exogenous progesteorne
- aglepristone
129
true or false: intact cats have a higher chance of getting mammary neoplasia
TRUE! 7-fold higher risk
130
true or false: mammary neoplasia typically happens in male cats
false. < 2% occurs in males
131
what is the most common mammary neoplasia in cats?
malignant carcinoma
metastasis common
132
true or false: mammary neoplasia typically happens in older cats rather than younger cats
true (> 11 years old)
133
with cat mammary neoplasia, prognosis is associated with what?
tumor size and metastasis
