SA Pregnancy + Parturition

Question 1

What is the gestation length in a dog? from LH surge, ovulation + mating date?

Answer 1

*65 days +/- 24hrs from LH surge
*63 days +/- 24hrs from ovulation
*From mating date = 57-73days

Question 2

How can you perform a pregnancy diagnosis in a dog?

Answer 2

*ultrasound - 25days onwards
*relaxin assay - 30days onwards
*Palpation - 30days onwards
*Radiography - 45days onwards

Question 3

How would you perform an ultrasound? What can you see?

Answer 3

*Front legs in air in small breed so uterus drops caudally
*Look for heart beats, ribcage, lungs (look like liver -no air)
*Pyometra = hypoechoic

Question 4

What are benefits of ultrasound?

Answer 4

*Rapid
*Earliest reliable detection method
*No sedation
*Can assess foetal size + heart rates

Question 5

What are limitations of ultrasound?

Answer 5

*Can see false negatives (too early)
*Need to learn to use

Question 6

Why can radiography only be done from day 45 onwards?

Answer 6

*Foetal ossification occurs from day 42 onwards

Question 7

What is stage one of normal parturition? What are the clinical signs?

Answer 7

*6-36hours
*drop in progesterone + rise in prolactin
*Temp drop in bitch
*Restless, anorexia, milk production, infrequent uterine contractions, nesting behaviour, vulvar licking

Question 8

What is stage two of parturition? CLinical signs?

Answer 8

Labour
*2-12 hours
*Rupture of allantochorion of 1st puppy
*Strong straining = puppy produced within 30mins

Question 9

What is stage 3 of parturition?

Answer 9

*expulsion of placenta

Question 10

When would we worry with parturition?

Answer 10

*Signs of foetal distress = 1.meconium
2.green vaginal discharge without puppy = indicator of placental detachment
*Maternal problems = Vaginal haemorrhage, severe pain, exhaustion or systemic disease
*Delays = foetal visible in birth canal with no progression of delivery (>30mins)
or >4hrs between pups

Question 11

What are the maternal factors for dystocia?

Answer 11

*Uterine inertia - primary / secondary
*physical obstruction of birth canal - narrow pelvis

Question 12

What are foetal factors of dystocia?

Answer 12

*Oversized foetus
*Malpresentation
*Malformation

Question 13

What is primary uterine inertia?

Answer 13

*Failure to START stage 2 (labour)
associated with litter size
- 50% <3pups
-very large litter = myometrial stretch + inability to contract

Question 14

What is secondary uterine inertia?

Answer 14

*Failure to progress through second stage labour + complete - usually after prolonged contractions
-Hormonal, fuel, maternal exhaustion

Question 15

What can be done to investigate dystocia?

Answer 15

*Physical exam
*Ultrasound
*Radiography
*Blood tests

Question 16

What can be done with physical exam to investigate dystocia?

Answer 16

*Pups - is there pup in birth canal / presentation / stuck?
*Ferguson’s reflex - vaginal palpation = strong uterine contraction if not = uterine inertia
*Discharge - concerning discharge = haemorhage / green without pup
*Obstructions

Question 17

What blood tests can be carried out for dystocia investigation?

Answer 17

*PCV + total solids
*Blood glucose
*Lactate
*Creatinine

Question 18

What can be checked on ultrasound?

Answer 18

*Evindence of rupture
*Foetal viability

Question 19

What is medical management of malpresentation?

Answer 19

*Gentle manipulation of lubricant + sterile gloves

Question 20

What is medical management of secondary uterine inertia?

Answer 20

*Correct calcium + glucose abnormalities
*Oxytocin if no obstruction

Question 21

What are the risks anaesthetic for the pups?

Answer 21

*Drug may cross placenta + impact pups
*Risk of hypothermia

Question 22

What are the anaesthetic risk to the bitch?

Answer 22

*Pregnancy increases oxygen demands
*Higher cardiac output
*Risk of venous obstruction from gravid uterus on vena cava
*Delayed gastric emptying
*Hypothermia

Question 23

Should you pre-med a pregnant bitch?

Answer 23

*Avoid if possible - only give if no choice

Question 24

How should you pre-oxygenate?

Answer 24

*Tight fitting mask = maximise oxygenation

Question 25

Why should you catheter before surgery?

Answer 25

*Correct fluid losses before surgery - maintain blood pressure

Question 26

What can be done as pre-op prep?

Answer 26

*Try clip before anaesthesia + initial skin scrub

Question 27

What can be used to induce anaesthesia?

Answer 27

Propofol or Alfaxalone

*Fast onset
*Titred to effect

Question 28

Where will local anaesthesia be needed?

Answer 28

*Skin /subcutis + linea alba

Question 29

When would you give systemic analgesia?

Answer 29

*After pups have been delivered so no placental transmission
*NSAIDS - meloxicam
*Opioids - methadone
*Paracetamol

Question 30

What is the surgical approach to a c-section?

Answer 30

*Midline approach = abdominal entry (large enough to exteriorise uterus)
*Exteriorise + pack abdomen with damp swabs
*Uterine incision = milk puppies down each horn
*Check for pups before closure
*Uterine closure = 2 layer closure - monofilament absorbable
*Flush + close - remove swabs + flush abdomen, dry + close abdomen in 3 layers

Question 31

What should be done as neonatal care?

Answer 31

*Warming equipment - box with warmed towels + heat pad
*Resus equipment - IV catheters (umbilicus), Clamps (umbilicus) + Resuscitation drugs = atropine, adrenaline

Question 32

What can be done during recovery of bitch?

Answer 32

*Clean teats
*Keep warm