Small Animal repro Flashcards

1
Q

Explain anatomy of the canine/feline reproductive tract

A
  • Vagina Body: Made of longitudinal folds which increase under oestrus due rising E2 levels → can be used as a guide to stage the oestrus cycle
  • Male Dog:
    Testes: Orientated horizontally, epididymis is dorsal
    Penis: Os penis
    Accessory Glands: Large prostate that is palpable via rectum
  • Male Cat:
    Testes: Orientated horizontally/diagonally, epididymis is cranio-ventral
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Describe the canine oestrus cycle

A

Type: mono-oestrus 1-3 cycles/year. except Basenjis, wolves, Tibetan mastiffs cycle once a year.
Cycle duration: 7 months (range 4-12)
Ovulation: Lasts 3 days 2d post LH
Puberty: 7-12 month (6-24 month)
Fertilisation: 48-72 hours
Fertility: Decreases from 4 years, lowered sig. beyond age of 8

Gestation: 57+-1d post D1 OR 65+-2d post LH OR 58-72d from a single mating

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What the phases of oestrus in canines?

A
  • Pro-Oestrus: 5-9d (2-25d), Bitch has swollen vulva & blood, E2 ↑ and peaks prior to oestrus
  • Oestrus: 6-12d (2-21d): Bitch allows mating, E2 decreases and P4 increases towards the end
  • Dioestrus: P4 is the dominant hormone, last in pregnant 57d from D1, non-pregnant 2-3m
  • Anoestrus: P4 levels are low causes reproductive quiescence, (resting) lasts 4m (3-10m)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the effects of hormones in the oestrus cycle?

A
  • Oestrogen:
    o Oedema of the vulva & vaginal mucosal folds
    o Thickening vaginal epithelium
    o Bleeding from endometrium o ↑ P4 receptors on the uterus
    o Development of endometrial glands & mammary ducts
    o Attracts males
  • Progesterone:
    o Stimulate further endometrial gland development & secretion
    o Suppress contractility of uterus
    o Closes cervix
    o Suppress leukocyte response in uterus
    o Get mated & keep pregnant
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are some unique features of the oestrus cycle?

A
  • P4 ↑ before oestrus
  • Standing heat via ↓ E2 & ↑ P4 (increasing oestrogen and decreasing progesterone).
    Progesterone levels start to increase BEFORE ovulation.
  • Ovulation of primary oocytes: Not fertilisable immediately, must undergo meiosis (48-72hrs), to ber eady for fertilisation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How to monitor the oestrus cycle?

A
  • Vulvar turgidity/consistency
    Pro-oestrus: Turgid
    LH Surge: Sudden drop in turgidity
    Oestrus: Doughy

*Vaginal cytology tells you that the bitch is in oestrus, and marks the day that she enters dioestrus

*Vaginoscopy helps to decide when to breed the bitch during oestrus (shrunken angular, pale, dry phase - late oestrus)

  • Vaginoscopy/Speculum:
    Method: NO lube (sperm toxic), gentle twisting motions whilst avoiding the clit & urethra
    1. Pro-Oestrus: Swollen, pink, moist vagina folds
    2. Late Pro-Oestrus to Early Oestrus: ‘Shrinking Rounded’ Folds large but shrinking, becoming drier & paler, 2nd transverse folds appear
    3. Early Oestrus: ‘Shrinking-Rounded’ Folds large but shrinking as oedema decreases due to E2↓, becoming pale/dry, primary & secondary folds still round
    4. Mid-Oestrus: ‘Shrunken Angular’ Oedema almost completely gone, folds are small & becoming angular, is pale-pink/pale & dry
    5. Late-Oestrus: ‘Shrunken angular’ Small angular folds, pale & dry
    6. Very Late Oestrus: Folds are sharply angular but some crests are becoming rounded & pale with increasing pinkness via epithelial sloughing, malodourous cell-rich opaque discharge
    7. Early Dioestrus: Folds are small, pink, moist and round, foul smelling brown discharge (+- White/bloody) for 2-5d, bitch may still be attractive for a few days
    8. Dioestrus: Folds are small, round, pink, moist and ‘rosette-shaped’
    9. Anoestrus: Same as Dioestrus
  • Vaginal Cytology:
    Method: Moisten sterile cotton bud with saline inserted dorsally in the vestibule to access the cranial vagina through a speculum → twirl 360→ roll on a microscope slide & stain with diff-quik

Superficial Cell Index (SCl): Proportion (%) of superficial cells present on a smear
–> Oestrogen increases the number of layers of cells within the epithelium. Increases distance between most superficial layers and blood supply.
–> Can see which stage of the oestrus cycle

Cell Types:
Superficial Cells: Dead, dark-staining cells with a large angular cytoplasm & either no/pyknotic nucleus (Not vesicular cf. alive cells)

Intermediate Cells: Alive, vesicular living nucleus with clear outline, partly angular (Small) or angular (Large) cytoplasm

Parabasal Cells: Alive larger living nucleus, similar to intermediates but smaller & rounder

Basal Cells: Alive, largest vesicular nucleus, smaller & darker than parabasal cells

Phases:
Dioestrus & Anoestrus: SCI- Low <20%, RBC – No,
Neutrophils - +/- (Most in dioestrus), Debris - +++,
Bacteria - +++,
Thin layer of cells on slide

Pro-Oestrus: SCI – Rising 60-80%+,
RBC – Many sometimes but ↓ progressively,
Neutrophils – Some but progressively ↓, Debris – progressively ↓,
thin layer of cells on slide

Oestrus: SCI – 100% (All superficial), Debris – No (Clear),
RBC - +/-,
Neutrophils – NONE (Otherwise indicates infx/endometritis),
Cell layer progressively thickens with superficial cell rafts (Sheets of superficial cells) in the last 1-2d

(D1) First Day of Cytological Dioestrus: The first day where SCl drops by >20% with an ↑ of >10% intermediates/parabasal cells.
Marks the end of the fertile period
–> Stop further inseminations

  • Behaviour Sx:
    Tickle/rub the perirenal area between the anus and vulva
    Reflexes (Tickle/Rub Perineal Region):
    o Vulva reflex: Vulva lifts upwards
    o Tail reflex: Deflects to one side
    o Lordosis: Less useful, sometimes slight back arching
  • Hormonal Assays
    1. LH: Snap test, not quantitative. Requires, 1-2 times daily, blood sampling to catch LH surge
    2. Progesterone: Test every second day. LH surge coincides with a rise in progesterone above 6 nmol/L. Ovulation occurs around 16 nmol/L.
    P4 rise above 30 nmol/L = confirms ovulation

*Aim to breed 4-7 day after LH surge using identified P4 (or LH)
*P4 value cannot indicate when it is too late to breed/D1
–> Only vaginal cytology can tell

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Describe the Feline Oestrus Cycle

A
  • Type: Seasonal polyoestrous (Summer) induced ovulation +- spontaneous, esp. in Orientals
  • Puberty: 4-12m age
  • Ovulation: 29-40hrs post coitus
  • Oestrus: 7d
  • Gestation: 66d (64-69d)

Phases
- Non-mating: E2 follicular phase for 1wk & interoestrus for 2wks (Low E2)
- Ovulation w/o Conception: LH surge in follicular phase → dioestrus (4-5wks) → ovarian inactivity (2wks)
Dx of Pregnancy

Diagnosis of pregnancy
- Abdominal Palpation: 15-30d
- US: >16d
- Radiographs: >40d
- Nipples Pinking: 2-4wks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How to approach breeding management?

A
  1. Ask owners to bring in bitch a few days after noticing vaginal bleeding
  2. Perform basic oestrus monitoring (OM), e.g, Reflexes, turgidity, vaginoscope, cytology
  3. Repeat OM every 2-4d initially; preferably 2d once LH surge until breeding/D1
  4. Add P4 (+-LH) as required
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How to manage fresh semen via AI or natural breeding?

A

Fresh semen AI or natural breeding:

  • Breed when enter the pale-dry-shrunken angular (100% SCI) phase, usually 4 days after LH surge
    –> Oocytes 4-5 day prep for fertilisation + 2d ovulaion post LH = 4-5 window before D1
  • 2-3 inseminations/matings done every second day, during the most fertile period (last 4 days of oestrus)
  • Lifespan: 1 week
  • Dose: > 150 million

Method for Fresh Semen AI:
- Check semen motility beforehand → carefully draw into warm pipette & syringe
- Insert pipette dorsally into vulva avoiding the clit/urethra to the fornix, as deep as possible
- Lift the bitches back legs and expel the semen → massage clit for 30s to encourage oxytocin
- Keep hindquarters elevated or 10m unless using TCI or Mavic catheter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is a Mavic AI Catheter?

A
  • Mimics the bulbus glandis of the dog penis
  • Balloon is inflated following placement of catheter into vagina
  • Sperm is passed through the catheter, followed by post-sperm fraction/semen extender. Injected slowly over 10 minutes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How to manage fresh chilled semen/frozen semen?

A

Fresh chilled Semen
Timing: 4-5d post LH surge

Frozen Semen
Lifespan: 24hrs once inseminated Timing: 5.5d post LH surge
Dose: Small dose 100 mil
Method:
- Using either a Norwegian pipette, surgical or using an endoscope to catheterise cervix (TCI)
- Inseminate directly into uterus instead of cranial vagina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are important hormones in pregnancy?

A
  • Progesterone – not specific for pregnancy
  • Prolactin – increases throughout dioestrus, not specific
    –? luteotrophe (maintains the CLs)
    –> preparing for, and maintaining, lactation
  • Oestrogen – small rise during second half of gestation
  • Relaxin – pregnancy specific – detectable from D21, rises through second half of gestation

Diagnosis:
- Abdominal palpation
- Radiography
- Ultrasound
- Hormone assays: Relaxin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How do you estimate gestation length?

A

Indications:
- When dealing with dystocia
- Managing a C-section or pregnancy termination

Whelping:
- 58 to 72 says from a single mating
- 63-67 days after the LH peak
- 56-58 days post D1

  • Long fertile period due to longevity of sperm in the reproductive tract (7 days of fresh semen)
  • ALSO 4 day fertilisation period at the end of oestrus
    *11 days prior to D1 during which mating result in pregnancy
    –> Range of when birth will be due to this

Estimating Gestation date:
- Number of days from mating to today
- Gestation length range from D1
- Further mating dates: Widens the window

Also use progesterone levels to predict:
- If p4 lower than 8.7 nmol/L: 48 hours
- If P4 < 3.18 nmol/L: 24 hours
- If P4 low, likely to be close to whelping
- If P4 high, unlikely to whelp within 12 hours

Other methods:
- Ultrasound measurements of amniotic sac, embryo/foetus
- Radiography
- Auscultation of foetal heartbeats: last 5 days gestation
- Relaxation of abdomen, preineal area and paracervical area
–> Abdomen changes from barrel shape to pear shape
–> Cervix becomes visible when paracervical area relaxes
- Mucoid discharge: Liquifaction of mucous plus: 4 weeks to 1 day prior to whelping
- Lactation: 2 weeks prior to whelping
- Rectal temperature may fall one degree witihin 24 hours to 36 hours of parturition. Not reliable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the stages of parturition?

A
  • Stage I: onset of uterine contractions, relaxation of the cervix, ~ 6 – 12 hrs
  • Stage II: full dilation of cervix to expulsion of final foetus (hrs)
  • Stage III: expulsion of foetal membranes (usually follows each pup)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is Dystocia?

A
  • Maternal vs foetal causes
  • Primary inertia: Failure to push
  • Obstructive dystocia: Pushing is futile

Signs:
- Strong tenesmus (painful defecation) for 20-30 min without pup
- Weak intermittent tenesmus for more than 2-3 hours
- More than 4 hours between pups
- Green discharge before the birth of first pup
–> Placental separation: Oxygen supply may be compromised
- Abdominal discharges e.g. black, bloody, purulent, stinking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How to diagnose Dystocia

A

Abdominal radiographs:
- Number of foetuses present/left
- Gestation length

Ab US:
- Normal foetal heart rate: >220 beats per minute
- HR < 180 bpm: Getting nervous
- HR <150 bpm: Proceed to C-Section

Digital palpation
Vaginoscopy
- Identify foetal membranes = cervix dilated
- If dilated: C-section safe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is primary inertia?

A

Is the inability of a dam to deliver normal sized foetus through a sufficient birth canal

Cause: Excess myometrium stretch, weak myometrium, HypoCa, Hypoglycaemia, anxiety

Treatment:
- C-section: After 3x oxytocin or prior
- Glucose supplement

  • Oxytocin:
    Timing: Wait 30-60m between doses, give only a max 3 doses before C-section
    Contraindicated: High foetus no. as it may cause uterine tetany → foetal hypoxia or premature separation
    –> Obstructive dystocia or if cervix still close it is also contraindicated
  • Ca supplement:
    Total Ca may be normal but Ionised is low
    Admin: Slow IV given to effect
    Sings of Success (saturation): Stop if bradycardia, calm, nausea, vomiting, licking lips & uterine contractions
18
Q

What is Obstructive Dystocia?

A

Pushing is futile → may cause 2nd inertia (Exhaustion)
Causes:

  • Maternal: Small pelvic canal, Abnormal expulsion, abnormal uterus, or caudal repro tract
  • Foetal: Increased size, abnormal presentation, abnormal development

Tx: C-section, resolve cause, e.g., correct malposition but is difficult due to small opening (Raising forequarters may help)
– hygiene is important

C-section:
- Short gestation length so do not cut until cervix is dilated on vaginoscopy
PPC < 6nmol/L considered safe
Estimated date for LH surge or D1 is major advantage

19
Q

How to manage neonate resuscitation and care?

A
  • Stretch the umbilical cord to encourage blood vessel closure → then cut 2cm away from ab wall
  • Clear airways, assess heartbeat & rub vigorously with towel to stimulate RR
  • If slow to breathe + HR present: Doxopram (1-2 drops sublingual/IM) & O2 or acupuncture philtrum/nasal philtrum to stimulate respiration
  • Once breathing warm the pup (Do NOT do before as ↑ acidosis)
  • Check for congenital abnormalities & weigh
20
Q

Describe causes of Pregnancy Loss

A

Non-Infectious
Cause: Severe malnutrition, trauma, endocrinopathy, uterine insufficiency, exogenous drugs, genetic

Infectious

Bacterial:
- Brucella Canis:
–> Transmission: Ingestion, inhalation, venereal
–> CS: Often subclinical

Pathogenesis:
- Entry through the mucosa → regional LN → bacteraemia into the following areas
- Male genital tract: Infertility, epididymitis, testicular atrophy, orchitis
- Pregnant female: 3rd trimester abortion, infertility
- Reticuloendothelial System: Splenomegaly, lymphadenopathy, hepatitis
- Filters: Discospondylitis, paresis, uveitis, meningoencephalitis, arthritis, glomerulopathy

Diagnosis:
- Bacteria Culture: Difficult, done on chilled tissues
- Blood Culture
- Rose Bengal Test (RBT): More sensitive (Not species specific)
- Complement Fixation (CFT): More specific (Not species specific)
- Slide Agglutination: High sensitivity, low specificity → follow with AGID

Treatment:
- Not recommended due to potential relapse and human susceptibility
- Castration + Ab therapy (Minocycline, Aminoglycoside)
Control (Endemic): Ensure kennels disease-free, test animals prior to external breeding, quarantine

Brucella Suis
Incidence: Widespread in feral pig populations (QLD & NSW)
Transmission: Pig hunting or ingesting raw pig meat Zoonosis: Careful w/ Sx on hunting dogs
Dx & TX: Same as B. Canis

VIral

Canine alphaherpes virus-1
CS:
- Adults: Tracheobronchitis, vesicular lesions on vestibulum/vagina/prepuce
- Bitches: Late abortion, mummified foetus, still-birth, ↓ litter size
- Neonates (<2wks): Anorexia, ab pain, crying, mucosal haemorrhage, death <48rs

Pathology:

  • Scattered haemorrhage in kidney
  • Necrosis of liver & lungs
  • Enlargement of spleen & LN’s
  • Intranuclear inclusion bodies

Dx: No readily available tests in Aus
Tx: No effective Tx, experiments on temp >37 degrees suppressed replication

Control: Minimise stress! Isolate pregnant & lactating bitches, vaccination during oestrus & final week of gestation

20
Q

What is the CEHMEP Complex?

A

Cystic endometrial hyperplasia, mucometra, endometritis, pyometra (CEHMEP)

CS: Infertility (CEHME)
Pathogenesis:
1. Oestrus: Oestridial causes development of endometrial glands & P4 receptors
2. Progesterone:
o Further secretion from endometrial glands → cystic changes
o Suppress motility of endometrium
o Closure of cervix
o ↓ Immune funct.

21
Q

What are other conditions of pregnancy and the puerperium?

A
  • Pregnancy Toxaemia
    Incidence: Uncommon Cause: Inadequate nutrition, large litter
    Dx: Ketonuria w/o glucosuria, hypoglycaemia, CS of depression & recumbency
    Tx: IV dextrose, improved nutrition, severe cases may warrant OVH/induction/abortion
  • Metritis
    Is inflammation of the endometrium and myometrium usually <1wk post whelping
    PF: retained placenta/foetus, traumatic/unhygienic obstetrics, unhygienic environment
    CS: Fever, malodourous red-brown discharge +- leukocytosis/leukopenia, shock, dehydration
    Dx: No P4 present post-whelping (Ddx pyometra cf. has P4), Vagina cytology (Degenerate N, bacteria), Ab US & radiographs (Uterine size & presence of foetus)
    Tx: Fluid therapy, broad spectrum Ab, ecbolic +- OVH (foetal remnants), dextrose supplement (Hypoglycaemia) but AVOID IU infusion

Uterine Prolapse
Incidence: Rare
Tx: Replace via laparotomy, OVH if traumatised/no longer breeding
–> Ovariohysterectomy
Px: Recurrence is uncommon

  • Subinvolution of Placental Sites (SIPS)
    Is bloody vulvar discharge lasting for >6 week after parturition but otherwise healthy
    Incidence: Common, especially in young primiparous bitches
    Pathogenesis: Abnormal persistence & invasion of endometrium by foetal trophoblasts causing erosion of maternal BV’s
    Tx: None if healthy, resolve spontaneously at pro-oestrus, monitor anaemia/metritis (OVH)
    Ddx: Oestrogenisation, vaginitis, metritis, neoplasia, haemorrhagic tendency
    Px: Doesn’t recur, doesn’t affect future fertility
  • Hypocalcaemia AKA Milk Fever
    Host: Usually small breed with a large litter of ~3wk pups
    Cause: Pre-partum or during parturition as a cause of primary intertia
    CS: ↑ Muscle tone, tremors, clonic spasms, dilated pupils, seizures, dry nose
    Dx: Total Ca <7mg (Normal 9-11), ionised Ca <0.8mmol or <2.4mg
    Tx: Calcium gluconate – admin slowly IV to effect, manage diet, ↓ suckling
    PX: If results not dramatic post Ca rethink Dx
    Ddx: Epilepsy, meningoencephalitis, poisoning (Coffee, 1080)
22
Q

What is a pyometra?

A

Causes: E. Coli!!! Strep, Staph, Klebsiella, Proteus, Actinomyces, Pasteurella, etc.

PF: Repeated non-pregnant cycles, oestrogens, progesterone

Timing: Dioestrus!! 1-12wks post-oestrus
Cause: NOT from the male → from bitches’ poo
Hosts: Middle-age/old unspayed nulliparous/low parous, history of exogenous steroids
CS: Purulent vulvar discharge, non-specific signs of illness (ALWAYS think Pyo in non-specific signs in intact bitch)

Diagnosis:
- Vaginoscopy
- Cytology +- Culture
- Ab US

  • Haematology: Severe leucocytosis w/ left shift (+- normal), Normocytic/chromic anaemia
  • Serum: Hyperglobulinaemic, hypoalbuminaemia, pre-renal azotaemia, liver dysfunction
  • Urinalysis: Low USG (ADH interference via endotoxin), renal casts +- Proteinuria/glucosuria
  • Contra-indicated: Do NOT palpate abdomen (Uterine rupture)

Tx:
- Stabilise & OVH: Lavage after, take care w/ ligatures, tie off arteries early, open large

  • Medical Tx:
    Indication: <4yo, valuable breeder, systemically healthy
    Methods: Similar to abortion induction, e.g., PGF2a, Aglepristone, Cabergoline +- Misoprostol (Cervix dilation), Oxytocin (Helps evacuate – only if cervix open & P4 at baseline)
    Adjuvant: Combine with Broad spectrum Ab (Amoxycillin + Metronidazole)
    Timing: Continue until uterus is normal on US, vagina discharge stops +- P4 reaches baseline
    Post-op: Advise breeding on subsequent oestrus
23
Q

What is Transmissible Venereal Tumour?

A

Transmission: During sex or sniffing/licking genitals, metastasis

Cause: ?Viral

Envi: Many free-roaming dogs in warm humid climates (NA)

Prevention: Strict biosecurity

CS: Tumours around penis/vagina/oral/nasal mucosa, pink/grey friable ‘cauliflower heads’ & discharge

Dx: Impression smear (Round cells), biopsy, response to vincristine

Tx:
- Chemotherapy: Vincristine (Doxorubicin), Treat weekly for 1-2 treatments post resolution of lesion

  • Surgical resection
  • Radiation: Small lesions
  • Sterilise ASAP
24
Q

What is Vaginitis?

A

Inflammation of vagina
CS: Vulvar discharge, frequent licking of vulva, attracts male dogs +- Dsy/Pollakiuria, concurrent dz
Cause: Usually bacterial (E. Coli, Strep, Pasteurella, Staph)
PF: Anatomical defects, foreign body, urinary tract disease

Juvenile Puppy Vaginitis
Host: <1yo, onset >8wks
Tx: Usually resolve after 1st/2nd oestrus cycle, Abfor severe cases, based on +ve culture of cranial vagina

Adult-Onset Vaginitis
Host: >1yo
Primary Vaginitis: Brucella canis (E), Canine herpes virus

Secondary: Urine pooling (Congenital abnormality), foreign body, Neoplasia, urinary tract disease (UTD), Urinary incontinence

Dx:
o Vaginoscopy: Hyperaemia, neoplasia, FB (foreign body)
o Cytology: Neutrophilia
o Culture: Bacteria is normal in vagina; Tx only if pure heavy culture
o Digital exam: Anatomical abnorm
o Urinalysis: Rule out UTI

Treat: Primary cause if seen, systemic antibiotics based on culture and sensitivity, low does E2 for spayed dogs, phenylpropanolamine if there is incontinence, surgery for anatomic defects

25
Q

What is the vestibulovaginal abnormalities?

A

CS:
- Inability to breed naturally
- Chronic vaginitis
- Chronic urinary tract infection
- Dystocia

Diagnosis:
- Digital vaginal exam
- Vaginoscopy (speculum, endoscope)
- Contrast vaginography

Treatment:
- Manual dilation: for minor vaginal strictiures
- Incision of small septae +- OVH (decreased heritability)

26
Q

What is vaginal hyperplasia and prolapse?

A

Is the protrusion of oedematous vaginal wall into the lumen +- through the vulvar lips
Cause: Associated with pro-oestrus rise in E2 conc +- Oestrus or E2 rise in pregnant dogs
Consequence: Often recurs (60-100%)

Grade 1: Swelling of Caudal vagina. Vagina cranial to urethral orifice → vestibule appears swollen
Grade 2: Similar to grade 1 but mass protrudes from vulva
Grade 3: Whole vaginal circumference protrudes from vulva (Donut)

Tx: Vaginal cytology to confirm prooestrus/oestrus if required

Protect until resolved (when ↓ E2),
–> Protect with E-Collar, keep clean and moist, confinement

Manual replacement of mass w/ purse-string around vulva. (Monitor for irritation)
Advise OVH (prevent recurrence and source of oestrogen)
+- P4, Surgical resection

Ddx: Vaginal neoplasia – usually older dogs, anywhere in vagina, doesn’t vary w/ cycle

27
Q

What is Split Oestrus?

A

CS: Signs of pro-oestrus → subside (no ovulation) → 2nd pro-oestrus to oestrus 3-6wks later
Timing: Common at 1st oestrus (Puberty)
Tx: Don’t – can breed at 2nd pro-estrus

28
Q

What is Cystic Ovarian Degeneration?

A

Incidence: Rare but increases with age
Size: 1-5cm
CS: Anoestrus (Non-functional follicular or P4 cysts), nymphomania (Rare – E2 secreting)
Dx: US, Ex-lap, steroid analysis, vaginal cytology, serum P4
Tx: OVH, Surgical drainage (needle Aspiration – laparotomy), Mechanical induce ovulation (GnRH, hCG, PGF2a – varied response, recurrence possible)

29
Q

What is Pseudopregnancy?

A

Incidence: All bitches essentially pseudopregnant (Dioestrus)
Pathogenesis: Decline in P4 & increase of prolactin towards end of dioestrus
Cause: OVH during dioestrus, abrupt stop of P4 Tx, Antiprogesterone Tx
CS: Mammary development, lactation, nesting, mothering inanimate, weight gain
Tx: Resolves 1-3wks, prevent licking teats, Prolactin inhibitors: cabergoline (↓lactation), treat for galactostasis/mastitis
Contraindicated: Phenothiazine – increase prolactin & milk secretion

30
Q

What is Ovarian Remnant Syndrome?

A

CS: Cyclic oestrus Signs post OVH (Vulvar swelling, discharge, stands to mount, attractive)

Cause: Residual tissue revascularises ovarian tissue OR ovarian tissue displaced to the in round/broad lig. in development

Dx: Cytology, Serum preogesterone (Post-oestrus Signs, presence of luteal tissue), Ab US/Ex-lap, rule out other Ddx

Ddx: Vaginitis, neoplasia, stump pyometra, exogenous E2, coagulopathy

Tx: Surgical removal – maybe easier in diostrus, bilateral remnants in 35% cases

31
Q

What is Cryptorchidism?

A

Failure of tests to descend into scrotum
Complications: Retained testes have higher risk of neoplasia (sertoli cell tumour – E2 secretion causing feminisation) & torsion

Dx:
- Palpation
- US
- Testosterone/AMG assay
- Ex-lap
- Stimulation Test: Baseline testosterone sample → GnRH/hCG & Rx sample at 1, 4, 8 hrs

Management:
- Remove internal testes prior to scrotal testes; never leave internal testis behind
- hCG & GnRH
- Castration/Vasectomy

32
Q

What is Orchitis and Epididymitis?

A

Causes: Infection from trauma (Bites), Secondary to prostatis/cystits, haematogenous infection

Pathogens: Most commonly bacterial (Staph, E. coli, Proteus) or brucella canis

CS: Acute painful swelling of scrotum, fever, hindlimb lameness, purulent prepuce discharge

Dx: Palpation, US, semen culture/evaluation, CBC, needle aspirate (Brucella serology)

Tx: Surgical removal

33
Q

What is Paraphimosis?

A

Is the inability to retract penis back into sheath

Cause: Hair ring, abnormalities of prepuce, neoplasia, scars, os penis fx, balanoposthitis, in-rolling of prepuce

Tx: EMERGENCY, anti-inflam treatment, local irrigation, try return into prepuce by removing cause and retain with purse string
Chronic cases: Phallopexy (Cr.)

34
Q

What is Agalactia?

A

Failure of mammary development or milk letdown
Tx: Phenothiazine sedatives e.g. (ACP): suppress dopamine, Oxytocin

35
Q

What is Mastits?

A

CS: Pain, erythema & swelling of glands (Local or general) +- Pyrexia, Left shift neutrophilia

Pathogens: E. Coli, Strep, Staph

Dx: US (Abscessation), cytology of milk, haematology (WBC, RBC, Bacteria)
Hemorrhagic/purulent discharge from teat

Ddx: Inflammatory mammary adenocarcinoma – usually in older dogs

Prevention: Trim puppies’
toenails, keep whelping area clean

Tx:
- Encourage suckling (Unless purulent) or milk out

  • Anti-inflam
  • Hot/cold packs
  • Ab: 1st line – cephalexin, amoxicillin-clavulanic acid → must consider puppies/distribution
  • Gangrenous mastitis: May require Sx drainage, debridement and flushing
36
Q

How to Prevent, postpone or suppress oestrus in bitches?

A
  • Desexing: Ovariectomy +- OVH
    Adv (In order): Prevent pregnancy, mammary neoplasia, pyometra, gonad/prostate size, sexual behaviour
    Dis (In order): Urethra sphincter incontinence, Prostate neoplasia, obesity (diabetes mellitus, hypothyroidism)
    No Effect on: Hip dysplasia (Bone density & ability to train)
  • Progestogens
    MOA: Uncertain, likely negative feedback on hypothalamus (GnRH) & Pituitary (LH, FSH)
    Admin: AVOID depot formulas
    Timing: Safest in anoestrus prior to E2 increase (Potentiates P4 effects → pyometra)
    Dis: Cystic endometrial hyperplasia! Pyometra! Benign/neoplastic mammary nodules, adrenocortical suppression, ↑ appetite/Wt. gain/behaviour change/skin changes, predisposes DM & Acromegaly
  1. Megestrol Acetate (Ovarid)
    Timing: Postpone oestrus - start 1-2 wks prior to expected pro-oestrus,
    To suppress oestrus once it has begun – <3d of pro-oestrus
    Dis: Use during oestrus can ↑ side effects and pregnancy is still possible
    CI (Contraindications): Existing/previous pyometra, mammary neoplasia, diabetes, liver dz, pregnancy
  2. Medroxyprogesterone Acetate (Provera)
    Admin: AVOID depot formulation unless scheduled OVH Timing: In anoestrus
    Dis: Not recommended in dogs due to high side effects
  3. Proligestone (Covinan)
    Adv: Can be used for temporary or long-term postponement, less side effects of oestrus.
    Timing: During anoestrus <30d of heat → repeat at 3m, 4m, then 5m thereafter
    Dis: Small pyometra risk, delayed return to oestrus, permanent sterility +- Discoloured hair
    CI: Avoid in animals destined for breeding
  • Androgens
    Drugs: Mibolerone, Testosterone Propionate
    Role: Negative feedback on pituitary preventing release of LH & FSH → no ovulation
    CI: Admin prior to puberty, pregnant animals, renal dz, hepatic dz
    Dis: Clit enlargement, vaginitis, masculine foetuses, seborrhoea, aggravation or adenoma
  • GnRH Agonists
    Drugs: Deslorelin acetate, Azagly-nafarelin
    MOA: Binds to GnRH receptors in anterior Pituitary → may initially induce oestrus → eventual downregulation of LH & FSH → suppression of gonads (↓ Seminiferous tubules)

Dis: Not registered in bitch – only on males to induce sterility

Other Use: Benign prostatic hyperplasia, behaviour control, testing prior to surgical castration, incontinence in spayed bitches (After trying E2 & Phenylpropanolamine)

  1. Suprelorin
    Doses: 4.7mg supresses male fertility for 6month, 9.4mg for min 12month
    Timing: Takes 4-6 wks to become sterile
    Adv: Few side effects, long-acting after 1x Tx
    Dis: Cheaper to sterilise In long run, varied return to fertility
37
Q

Indications for Pregnancy termination?

A

Indications: Unwanted female serve, unwanted male serve, conception in an obstetrics risk bitch

Methods:
- Ovariohysterectomy
Timing: Early in pregnancy – if done in late gestation give adequate fluids

  • PGF2a (Lutalyse)
    MOA: Causes luteolysis & uterine contractions
    Timing: V effective 2nd ½ gestation but takes time as CL is relatively resistant
    Admin: 25ug/kg first injection → 250ug/kg 2x daily for >4d until all are aborted
    OR lower doses (30ug/kg) every 8hrs for >5d (Fewer side effects)

Alt.: Synth PG (Cloprostenol; lower dose rates, only after 30d gestation but some dislike

Adv: Cheap ‘

Dis: Frequent Tx may require hospitalisation, Side effects (subside within 60min – nausea, diarrhea, discomfort)

CI: Heart/resp disorders, systemic illness, non-verified pregnancy

  • P4 Receptor Antagonist, e.g., Aglepristone (Alizine)
    MOA: Has affinity for P4 receptors 3x that of natural progesterone.
    No P4 = no pregnancy
    Timing: From mating (Post-heat D1) - 45d
    Admin: 2x doses, 24hrs apart
    Adv: Fewer side effects than PG, can be used In cats
    Dis: Expensive
    Post-op: US >10d after to check success (>30d from mating)
  • Dopamine Agonist/Prolactin Inhibitor
    MOA: Prolactin supports CL → lowering prolactin removes CL support
    Drugs: Cabergolin (50% efficacy >40d), Bromocroptine similar
    Adj: Combined with PGF2a (Cloprostenol)
    Adv: No major adv, can be admin orally
  • Oestrogen
    MOA: Prevent implantation by interfering with uterotubal function/transport
    Timing: A few days within mating Dis: BM suppression, cystic endometrial hyperplasia, Pyometra, dyscrasia
  • Glucocorticoids*Not recommended but don’t give whilst preg
    Dis: Difficult to induce abortion, high dose for prolonged periods required
    Side effects: PD, PU, Polyphagia CI: Pregnancy
    – Use low-dose, short acting formula for non-repro disorders in pregnant bitch
38
Q

What is the preferred methods for terminating pregnancy?

A
  1. Bitch not Destined for Breeding: Spay
  2. Destined for Breeding & Mating was Seen: (If owner saw the mating)
    a) Tx with Aglepristone ~1 wk post-mating → confirm non-pregnancy 1m post-mating OR
    b) Wait until 1m post-mating and examine for pregnancy → if pregnant Tx w/ Aglepristone/PGF2a to induce abortion
  3. Destined for Breeding & Mating not Seen:
    Take a vaginal cytology to see if bitch was in oestrus (+- presence of sperm)
    a) In oestrus: Follow point 2 b) Not in Oestrus: Confirm pregnancy 1m later
39
Q

What are the indications of inducing oestrus in a bitch?

A

Indications: Delayed puberty, protracted anoestrus (Not drug related), Sync of ovulation for ET

Prerequisites: Must be healthy, >4m from last oestrus (Anoestrus, with baseline progesterone levels)

CI: Intersex, chromosome abnormalities, hypothyroidism, other systemic illness

Effective treatment:
- Cabergoline: Daily at the start of anoestrus util 3-8d into pro-oestrus (May take a m). Induce fertile oestrus after 1 month.
- Deslorelin Implant: Explore flare at the beginning of Tx ~10d insertion to see LH surge→ remove
- eCG/hCG: LH-like effects

40
Q

How to control repro in dogs/cats (Summary)

A

Control of Repro in Dog: Castration, vasectomy, GnRH-agonist (superlorin), Intra-testicular injection of zinc Gluconate

Control of Repro in Cats
Pregnancy Termination: Rare. Usually OVH, otherwise PGF2a, Prolactin inhibitors, Aglepristone

Suppression of Oestrus
- hCG/GnRh/Cotton Bud: Induction of ovulation → oestrus returns ~6-7wks
- Progestogens: Risk the same as in a bitch, done during anoestrus/interoestrus
- Melatonin Implant: Induce seasonal anoestrus; not in aus

Oestrus Induction: eCG + FSH, Prolactin inhibitors