SA Postpartum Disorders

Question 1

Normal Canine PP Vulvar discharge:

Answer 1

Immediately green->reddish brown->brown
Watery-mucoid-> mucoid
No odor
Decreases over time (until 3-4 wk pp)
Vaginal cytology- some neutrophils, RBCs, & bacti normal

Question 2

Normal SA mammary glands postpartum

Answer 2

Engorged but not hard/swollen/painful/red
Colostrum (yellow/white)-> mature milk (white)
Peak lactation at 2-4wk pp

Question 3

Normal feline vulvar discharge postpartum?

Answer 3

Scant, visible only up to 4 days
reddish, mucoid
no odor
VC: RBCs and <20% neutrophil granulocytes normal

Question 4

Clinical signs of retained placenta?

Answer 4

persistence of green vulvar discharge, restlessness, no systemic illness

Question 5

Tx of retained placenta: (bitch)

Answer 5

Spontaneous breakdown & passage
-Close monitoring for metritis
-Let puppies nurse (Oxytocin)
Can give oxytocin but only effective up to 1-2 days pp
NO prophy abx

Question 6

Risk factors for SA Acute metritis:

Answer 6

Retained placenta/fetus, dystocia, prolonged labor, poor hygiene, concurrent mastitis

Question 7

SA Acute metritis:

Answer 7

Uterine infection with inflammation of the endometrium & myometrium
Within first 2 wks pp

Question 8

Clinical signs of SA Acute metritis:

Answer 8

malodorous, red-brown or purulent vulvar discharge
Systemic signs
Decreased lactation, poor mothering

Question 9

Vaginal cytology associated with SA acute metritis:

Answer 9

high numbers of degenerate neutrophils & bacti
Non-cornified vaginal epi cells

Question 10

Treatment of SA Acute metritis:

Answer 10

Medical- PFG2a (but concerned)
OHE
Abx

Question 11

Common signalment of SIPS:

Answer 11

Usually young (<3) primiparous bitches

Question 12

Clinical signs of SIPS:

Answer 12

Persistent serosanguinous vulvar discharge up to 8-16wks pp

Question 13

SIPS pathophysiology:

Answer 13

Tropoblast like cells keep invading deeper endometrium and myometrium-> damage to BV-> hemorrhage

Question 14

SIPS Tx:

Answer 14

Spontaneous remission

OHE if severe hemorrhage, perforation

Question 15

Signalment of SA uterine prolapse:

Answer 15

Queen»» Bitch
<48hr pp
Usually associated with dystocia

Question 16

Tx of SA Uterine prolapse:

Answer 16

Stabilization, control of hemorrhage
Cleaning- cold hyperosmotic solution, lubrication
Manual reduction or Amputation & OHE
Abx/Supportive care

Question 17

Galactostasis:

Answer 17

Accumulation of milk in the mammary glands without infection

Question 18

Risk factors for SA Galactostasis:

Answer 18

heavy lactation
teat conformation
lack of adequate suckling

Question 19

Clinical signs of galactostasis:

Answer 19

swollen, edematous, firm, painful mammary glands
milk is normal, no systemic illness
dam is more comfortable & swelling goes down after nursing

Question 20

Tx of SA Galactostasis:

Answer 20

Ensure pups nurse, strip milk if necessary
Alternate warm & cool compresses

Question 21

SA Acute Mastitis Etiologies:

Answer 21

Ascending- lesions from nursing pups, hygiene, contamination with vaginal secretions
Hematogenous
Can be any time in lactation
Normal bacti culprits
Bitch >Queen

Question 22

Risk factors for SA acute mastitis:

Answer 22

Heavy lactation, abrupt weaning, teat conformation, teat/skin trauma

Question 23

Tx of SA acute mastitis:

Answer 23

Abx based on milk C/S
NSAIDs
Cooling and stripping of affected glands
Prolactin inhibitor if weaning
Supportive care

Draining & Debridement of abscessed/necrotic glands

Question 24

Agalactia/Hypogalactia:

Answer 24

absent or insufficient milk production to meet neonatal demands

Question 25

Primary SA Agalactia/Hypogalactia:

Answer 25

Rare Anatomical abnormalities or lack of response to stimuli No tx

Question 26

Secondary SA Agalactia/Hypogalactia:

Answer 26

as a result of mastitis, metritis, systemic illness, hypocalcemia, stress, premature deliver, inadequate nutrition

Question 27

Tx for Secondary SA Agalactia/Hypogalactia:

Answer 27

Tx underlying cause Dopamine D2 receptor antagonists (Metoclopramide or Domperidone) +/- Oxytocin Supplement Puppies in the meantime (and serum if necessary)

Question 28

SA Hypocalcemia:

Answer 28

Within first 4 wks pp Small breeds or large litters Blood ionized calcium ≤0.8-1.00 mmol/L

Question 29

Causes of SA PP Hypocalcemia:

Answer 29

Ca supplementation during pregnancy-> suppression of PTH Inadequate nutrition

Question 30

Clin Signs of SA PP Hypocalcemia:

Answer 30

Loss of interest in pups, panting, restlessness, facial pruritis, salivation, hyperthermia (>105), msucle twitching, tremmors May see anorexia, excitability, and flaccid paralysis in cats

Question 31

Tx of SA PP Hypocalcemia:

Answer 31

Wean babies for minimum 12-24 hr Emergency tx with IV 10% Ca-Gluconate & ECG monitoring Short term tx with SQ 0% Ca-Gluconate, once stable until PO is option Long term PO Ca tablets through lactation Regular rechecks Correct dam's nutrition

Question 32

Common causes of SA Poor mothering:

Answer 32

Anesthetic drugs pain associated with CS Primiparous dam anxiety/agitation unfamiliar environment strong human bond Medical conditions Genetic predispositions