sml repro Flashcards
(122 cards)
1
Q
Identify the following marks of the bitches anatomy ?
A
Answer: Anatomy of the bitch
purple = fornix
green = external uterine ostium of the cervix
blue = vaginovestibular junction
yellow = clitoral fossa
red = clitoris
pink = dorsal median fold.
2
Q
Identify the anatomical mark 3 and 4 in the anatomy of the bitch ?
A
Anatomy of the bitch
3 = dorsal median fold
4 = external os of the cervix
3
Q
Identify the anatomy (coloured circles) of the external genitalia in the bitch ?
A
External genitalia of the bitch
purple = anus
blue = cutaneous bridge
green = dorsal comissure
yellow = ventral comissure
4
Q
Identify the male anatomy in the dog ?
A
Male anatomy of the dog
- the testicles are orientated horizontally and the epididymis is located dorsally
- large prostate gland palpable per rectum
- Os penis
yellow = ureter
purple = urinary bladder
light blue = prostate gland
light green = bulbospongiosus muscle
pink = cremaster muscle
Dark colours
- blue = prepuce
- glans penis
- bulbus glandis
5
Q
In the bitch why would you direct a speculum dorsally ?
A
Direct the speculum dorsally upon entry
- to avoid the urethral orifice and clitoral fossa
6
Q
How can you identify if a Tom cat has been castrated ?
A
Is this Tom castrated
- if testicles can be identified
+
Spines on the glans penis disappear about 6 weeks after castration.
7
Q
Characterise the oestrous cycle of the bitch; duration, seasonal effect and time of puberty ?
A
Oestrous cycle of the bitch
Mono oestrous, litle seasonal affect 1-3 cycles per year
cycle duration; 7 months (range 4-12 months)
Puberty is obtained by 7-12 months of age
(Fertility tends to decline from four years of age, with seriously lowered fertility beyond the age of eight.
- some breeds including Tibetan mastiffs, Basenjis like wolves only have one cycle per year.
8
Q
Describe the length and characteristics of pro oestrous and oestrous in the bitch ?
A
Oestrous cycle of the bitch
Pro oestrous
- usually 5 to nine days (range 2-25)
- swelling of vulva, vulva discharge and becomes attractive to males
- oestrogen increases and declines entering oestrus
- progesterone starts to increase
Oestrus
- usually 6 - 12 days
- bitch stands to be mated
- beginning of oestrus LH peak
- unique as oestrogen declines and progesterone continues to increase
- progesterone levels begin to rise prior to ovulation
- the bitch ovulates primary oocytes (not immediately fertilizable) 2-3 days
9
Q
Describe the length and hormonal changes which occur during dioestrus and anoestrus ?
A
Dioestrus and Anoestrus in the bitch.
Dioestrus (some may call it metoestrus)
- The period following estrus during which progesterone is the dominant hormone
- pregnant bitch 57 days from D1
- non pregnant bitch 2-3 month
Anoestrus
- The period following dioestrus when progesterone levels are low.
- apparent quiescence “resting”
- usually last around four months in duration
10
Q
Describe the hormonal changes over the oestrous cycle in the non pregnant bitch, including relevant time frames ?
A
The non pregnant bitch
Pro-estrous:
- 5-9 days
- oestrogen increases then decreases as the bitch enters ostrus
Oestrus:
- oestrogen is decreasing
- progesterone is increasing
- this stimulates an LH surge and ovulation at the begining of oestrus
Dioestrus (metoestrus)
- during this period progesterone is the dominant hormone
- non - pregnant bitch 2-3 months
Anoestrus
- The period following dioestrus where progesterone levels are low
- reproductive quiescence ‘ resting’
- usually last around four months
11
Q
Describe the hormonal changes over the oestrous cycle in the pregnant bitch, including relevant time frames ?
A
The oestrous cycle in the pregnant bitch
Pro-estrus
- 5-9 days
- oestrogen increases then decreases as the bitch enters ostrus
Oestrus:
- oestrogen is decreasing
- progesterone is increasing
- this stimulates an LH surge and ovulation at the begining of oestrus
Dioestrus (metoestrus)
- during this period progesterone is the dominant hormone
- pregnant bitch 57 days from D1
Anoestrus
- The period following dioestrus where progesterone levels are low
- reproductive quiescence ‘ resting’
- usually last around four months (large range 3 -10 months)
12
Q
Describe the role of oestrogen in the oestrous cycle of the bitch ?
A
The role of oestrogen in the bitch.
Attracting the male and getting the female ready for mating.
- oedema - swelling of the vulva and vaginal mucosal folds
- thickening of the vaginal epithelium
- bleeding from the endometrium
Behind the scenes
- development of endometrial glands and mammary tissue ducts
- increases the number of progesterone receptors within the uterus
13
Q
Describe the role of progesterone in the oestrous cycle of the bitch ?
A
The role of progesterone in the bitch
Get the bitch mated and pregnant, or thinking that she is.
- stimulate further development of endometrial glands
- stimulate secretion of endometrial glands
- suppress contractility of the uterus
- close the cervix
- suppress the leukocyte response in the uterus
14
Q
What is unique about the bitches cycle ?
A
There are two factors very unique to the bitches cycle.
- Standing heat (although variable) is associated with decreasing oestrogen and increasing progesterone levels.
- progesterone levels start to increase before ovulation - The bitch ovulates primary oocytes
- which undergo meiosis 1 to be ready for fertilization
- a process which takes 48 to 72 hours.
15
Q
Identify six methods Vets can utilise to monitor the oestrous cycle of the bitch ?
What factors could affect the method we use ?
A
How can we monitor the oestrous cycle of the bitch ?
- Behaviour
- Sexual reflexes
- Vuluar consistency
( highly swollen = high oestrogen, doughy = decrease in oestrogen + increase in progesterone). - Vaginoscopy
- Vaginal cytology
- Hormone assay : progesterone to a lesser extent LH
Note ultrasound is not effective; as there is a fatty bursa making it difficult / impossible to ultrasound the ovary in the dog.
16
Q
Why would using fresh, frozen or chilled sperm affect the intensity of oestrous monitoring ?
A
The intensity of oestrous monitoring will depend on the type of breeding planned.
Low intensity monitoring with fresh semen
- lifespan of sperm up to a week or more
We gotta be on the ball for
- fresh chilled semen
- Frozen semen which lifespan - is 24 hours once thawed and inseminated.
17
Q
Describe what you would expect to see in a bitch comming onto heat through behaviour, sexual reflex and vulvar consistency ?
A
What to see a bitch in oestrus
Behaviour
- more aggression, clingyness
- potentially trying to run away from home
Sexual reflex
- Tickle rub the perineal area between the anus and vulva
- vulva reflex = vulva lifts up
- Tail = tail deflects to the side
- Lordosis = (less useful) sometimes a slight arching of the back is seen
Vulvar consistency
- turgid during pro-oestrous
- sudden drop in turgidity often correlates to the LH surge (layperson)
- becomes doughy in oestrus
18
Q
Describe what we would observe through Vaginoscopy during pro-oestrus, early to late oestrus and dioestrus ?
A
Vaginoscopy
- sterile, clear or glass perspex speculums are useful
- light source
- gentle twisting motion, avoiding clitoris and urethra (push against roof)
- no lubricant / sperm toxic
Pro - oestrus
- swollen pink moist vaginal folds
Early oestrous
- folds are large but getting smaller as oedema subsides
- oestrogen dropping
- getting paler and drier
- “shrinking rounded”
Late oestrus
- small angular folds
- pale, dry
- “shrunken angular”
Dioestrus
- Folds are small round pink and moist
- “rosette shaped”
19
Q
On vaginoscopy identify the stage of the oestrous cycle in the bitch ?
A
Late pro-oestrous to early oestrus
- folds are still large but starting to shrink
- secondary transverse folds start to show
- becomming progressively drier and pale pink
“shrinking rounded”
20
Q
On vaginoscopy identify the stage of the oestrous cycle in the bitch ?
A
Pro - oestrous
Swollen pink, moist vaginal folds.
21
Q
On vaginoscopy identify the stage of the oestrous cycle in the bitch ?
A
Early oestrous
Folds are still large but getting smaller as oedema subsides
(oestrogen level dropping)
- primary and secondary folds still rounded
- getting paler and drier
“shrinking rounded”
22
Q
On vaginoscopy identify the stage of the oestrous cycle in the bitch ?
A
Mid oestrous
Oedema almost completely subsided
- folds are smaller and become angular
- pale pink to pale
- dry
“shrunken angular”
23
Q
On vaginoscopy identify the stage of the oestrous cycle in the bitch ?
A
Very late Oestrus
Folds are sharply angular although some crest are becomming slightly more rounded due to epithelial sloughing
- pale (pink due to epithelial sloughing)
- cell rich opaque discharge which has a pungent smell.
“shrunken angular”
Late oestrus is the most fertile period dry pale shrunken angular.
24
Q
On vaginoscopy identify the stage of the oestrous cycle in the bitch ?
A
Dioestrus
Early dioestrus
- discharge is usually foul smelling, brown / white
- bitch may still be attractive to males
Dioestrus
Folds are small round and pink, moist
“rosette shaped”
25
Describe the technique for collecting a sample for vaginal cytology ?
Vaginal cytology technique
- Sterile cotton bud
- prefer to extend with forceps or wire to allow access to the cranial vagina through the speculum
- moisten the tip with sterile saline
- insert between vaginal folds, twirl through 360 degress remove
- gently roll onto microscope slide
Stain with Diff Quik
26
Describe the effect of oestrogen on the vaginal epithelium ?
The effect of oestrogen on the vaginal epithelium.
Under the influence of oestrogen, the number of layers of cells within the epithelium increases.
This increases the distance between the most superficial layers and the local blood supply.
- thus leading to cellular death of the most superficial cells
- this can be utilised clinically to determine the stage of the oestrous cycle.
27
Identify the four cell types you would see with vaginal cytology ?
Cell types seen on cytology
Epithelial cells
1. Superficial cells
2. Intermediate cells
3. Parabasal cells
4. Basal cells
White and red blood cells.
28
Identify and describe this cell type seen on vaginal cytology ?
Superficial cells
- Dead, dark staining cells
- Large angular cytoplasm
- Pyknotic nucleus or no nucleus
- sometimes referred to as cornified cells
29
Identify and describe this cell type seen on vaginal cytology ?
Intermediate cells
- Vesicular, living nucleaus with a clear outline
- Partly angular (small) to angular (large) cytoplasm
30
Identify and describe this cell type seen on vaginal cytology ?
Parabasal cells
- Similar to intermediate cells, but smaller and rounder
- Large, living, vesicular nucleus
31
Identify and describe this cell type seen on vaginal cytology ?
Basal cells
Even smaller and darker then parabasals
- Large, living, vesicular nucleus
32
What is the superficial cell index (SCI) ?
Superficial cell index (SCI) = the proportion of superficial (epithelial) cells present on a smear (%).
33
Identify the timming of the oestrous cycle through vaginal cytology ?
Dioestrus and anoestrus
- SCI low <20%
- very few superficials, mostly basal and parabasal
- no red blood cells unless traumatised
- +/- neutrophils
- +++ debris
- +++ bacteria (normal vaginal flora)
- very thin layer of cells on the slide.
34
Identify the timming of the oestrous cycle through vaginal cytology ?
Pro-estrus
SCI starts to rise (60-80%)
until it nears 100% by the end of proestrus.
- many red blood cells (usually decrease progressively)
- some neutrophils but progressively less seen
- debris also progressively decreasing
- thin layer of cells on the slide
35
Identify the timming of the oestrous cycle through vaginal cytology ?
Oestrus
- 100% SCI (all superficials)
- clear background (litle debris)
- no neutrophils should be seen; could indicate infection / endometritis if seen now
- smear becomes progressively thicker throughout oestrus, until it is very thick with sheets of superficial cells "rafting" by the last day or two.
36
Define D1?
The first day of cytological dioestrus (D1)
Defined as the first day that the SCI drops by more than 20%
- with an increase of atleast 10% small intermediate or parabasal cells.
37
Why is D1 helpful ?
Why is D1 helpful
It marks the end of the fertile period
- stop inseminations very little chance of achieving pregnancy post D1
- if bitch was inseminated 4 days prior AMAZING !!!
Most bitches whelp 65 days (+/2 days) after the LH peak, or 57 days (+/- day) after D1.
38
Why should we use vaginoscopy and vaginal cytology simulatneously ?
Vaginoscopy vrs vaginal cytology
Vaginal cytology
- tells you that the bitch is in oestrus (but stays fairly similar through out oestrus), and marks the day that she enters dioestrus (D1)
Vaginoscopy
- helps you to decide when to breed the bitch during oestrus
- can be used to distinguish early, mid and late oestrus
- the shrunken, pale dry angular phase = late oestrus.
39
Describe how we could interpret a hormonal essay for progesterone to determine the stage of the cycle in a bitch ?
Hormonal essays progesterone.
- requires serum samples
- a practical approach is too collect every second day (daily would be nice)
- usually the LH peak coincides with the shrinking rounded stage on vaginoscopy (oestrus smear 100% SCI).
First or only day of the LH surge coincides with a rise in progesterone
- above 6nmol/L (1.89ng/ml) on or the day before in most bitches
- ovulation occurs around 16nmol/L
We like to see P4 rise above 30nmol/L = confirmation of ovulation.
40
When should we breed the bitch, based off a progesterone assay ?
Progesterone assay and breeding
Aim to breed 4-7 days after the LH surge identified using P4.
Highest fertility achieved on the sixth day post LH surge
- usually progesterone will rise by 6nmol/L the day before or the of ovulation
41
When should the bitch be breed with frozen or chilled semen ?
When to breed the female dog
(progesterone rises by 6nmol/L the before or day of ovulation)
If using frozen semen
- 24 hrs survival time in female reproductive tract
- breed 5.5 days after ovulation
If using chilled semen
- Chilled semen can survive 7 days within the female reproductive tract
- For chilled semen (one dose available), aim to breed 4-5 days after the LH surge
42
Why should Veternarians be cautious when using progesterone to determine oestrus in the bitch ?
Progesterone to determine oestrus
(oestrus = rise 6nmol/L)
Be cautious by using vaginoscopy and cytology to confirm your conclusions.
Cautions of progesterone
1. Not all P4 assays are created equal
2. Reference labs use Roche or Immulyte
3. Inhouse machines; Catalyst may be less reliable
4. A fast turnaround time is very useful when clinical decisions need to be made promptly
5. Some accuracy may be sacrificed by using in house machines; validate your machine against a lab's results to understand the risks involved.
6. Variability between dogs
43
Describe the general approach to monitoring for estrus in the bitch ?
Monitoring the bitch for estrus
Ask owners to bring the bitch in a few days after they first notice vulval bleeding (be careful easily missed by owners)
Perform basic oestrus monitoring;
- reflexes
- vulvar turgidity
- vaginoscopy
- vaginal cytology
- may include a hormonal assay; Progesterone or LH as required, if available
Repeat this process every two - four days initially, after LH surge has taken place monitor daily until btreeding or D1.
44
Describe the timming and technique for breeding dogs with fresh semen ?
Fresh semen breeding in the bitch
Breed bitch when she enters the pale dry shrunken angular (100%SCI) phase, usually 4+ days after the LH surge.
- cranial vagina
- aim for 2-3 inseminations / matings, done every second day, during the most fertile period (last four days of oestrus)
- since this is fresh semen relax - good quality fresh semen survives upto 7 days (most dogs >48hrs)
If you are at all uncertain best to breed sooner rather than later.
Technique
- first assess semen motility
- dose for vaginal AI: >150 million sperm (usually whole ejaculate)
- insert pipette (mavic) gently passing as deep as you can
- lift bitches hindlegs + expel semen
- massage clitoris for 30seconds to encourage oxytocin release
- keep the bitches hindlegs elevated for ten minutes
45
What is a Mavic AI catheter
Mavic AI catheter
Mimics the bulbis glandis of the dog penis
- balloon is inflated following placement of the catheter into the vagina
- sperm rich fraction is passed through the catheter, followed by a large volume of post sperm fraction or a suitable sperm extender
- injected slowly over about ten minutes.
46
Describe the timming and technique for frozen semen AI in the bitch ?
Frozen semen AI
- must inseminate directly into the uterus rather then cranial vagina
- smaller doses (100 million sperm)
- some damage to semen quality by cryopreservation life span thawed semen = 24 hrs
Very difficult (almost impossible) to pass a regular pipette through the cervix via the vagina - **Norwegian pipette**
- many inseminations done surgically or using a endoscope to guide catherterization of the cervix ( transcervical AI, TCAI or TCI)
- surgical or transcervical AI
47
Describe the feline oestrous cycle; including the time of puberty, length of oestrus and gestation ?
The feline oestrous cycle
Cats reach puberty 4 to 12 months of age
- induced ovulator (29-40 hours post ovulation)
- spontaneous ovulations are possible especially in oriental breeds
- oestrus - last for around seven days +/- coinciding with the follicular phase
gestation length; 66 days (range 64-69 days)
48
What is the length of gestation in the cat ?
Gestation length in the cat = 66 days
- kittening in 13 weeks after ovulation
49
A. What hormones are important to maintain pregnancy in the bitch ?
B. What is the only hormone which is pregnancy specific in the bitch ?
**Hormones of pregnancy**
Hormones important to pregnancy;
1. Progesterone - not specific to pregnancy also high during diosestrus
2. Prolactin - increases throughout dioestrus / not specific for pregnancy
- essential luteotrophe (maintains the CL)
- important for preparing and maintaining lactation
3. Oestrogen - small rise during second half of gestation.
The only hormone specific to lactation;
**Relaxin (pregnancy specific)**
- detectable from day 21, rising through the second half of pregnancy.
- assess pregnancy with a hormone assay prolactin.
50
List the canine gestation lengths when calculated from ?
A. one or more matings or inseminations
B. LH surge
C. Ovulation
D. The first day of cytological dioestrus (D1)
Gestation length from
A. A single or multiple matings = 58-72 days
B. 65 days (+/- 2) after the LH peak
C. 63 days post the day of ovulation.
D. 57 days (+/-1) post D1
51
Explain why elective caesarian section in the bitch requires careful management ?
Caesarian sections in the bitch require extremely careful timming.
1. Short gestation in the bitch: means every day counts
2. The bitch has 11 days or receptivity
- there is a long fertile period in the bitch - as a result of the longevity of sperm in the bitches reproductive tract (seven days fresh semen)
- in addition to four days fertilisation period at the end of oestrus
- This means the bitch may become pregnant over 11 days prior to D1, making an accurate estimation of a whelping date very difficult
52
Discuss signs which may indicate partuition in the bitch (imaging, behaviour, physical) ?
**Predicting spontaneous whelping**
- very rough estimate
- only sign which accurately indicates whelping is visualisation of the placenta within the females reproductive tract.
**Ultrasound**
- requires a formula specific to dog breed eg trunk length
- lung to liver ratio
- motility of the foetal gastrointestinal tract.
**
Auscultation of foetal heart beat**
- last five days of gestation
**
Relaxation of the abdomen**
- perineal area and paracervical area
- abdomen changes from barrel shape to pear shape
- cervix becomes visible as the paracervical area relaxes
**Mucoid discharge **
- liquifaction of the mucous plug
- anything from four weeks to one day prior to whelping.
**Lactation**
- could start as early as two weeks prior to whelping
**Rectal temperature**
- may fall by one degree 24-36hrs before partuition
- can encourage owners to monitor rectal temp the week prior to expected whelping
- common practice of many breeders
- associated with the drop in progesterone.
Radiograph
- formula can be used
- first eveidence of minerlisation of the skull day 43-46 bitch.
53
Disscuss the use of serum progesterone levels being used to predict whelping date ?
**Progesterone should decline prior to whelping date**
(may be used if mating date, and D1 is unknown)
< 8.7 nmol/L 99% chance of whelping within 48hrs
<3.18 100% probability whelping
- around 10% of bitches will enter stage one partuition with a concurrent P4 greater than -6nmol/L
- there are even reports of bitches reaching baseline days prior to whelping
- can be a large amount of variation
- its not that accurate ensure the owners are aware of the risk.
- monitor vaginoscopey / things change quickly.
In summary if P4 is low (<6nmol/L), then likely to be close to whelping - a C section is considered safe.
54
# There are five indications.
Describe the signs partuition may not be progressing normally ?
Signs that progression of partuition is not normal
( A perfect handout for clients)
1. Obvious systemic condition
2. Strong tenesmus for 20-30mins
- without production of a pup
- may strain for upto one hour with their first pup, especially first time mothers.
3. Weak intermittent tenesmus for more than 2-3 hours without production of a pup.
4. More than four hours passess between pups (recent evidence suggest this is too long)
5. Green discharge before the birth of the first pup
- indicates placental seperation; first foetus oxygen supply may be compromised.
55
What are the normal stages of partuition in the bitch ?
Stages of partuition in the bitch
Stage one
- onset of uterine contractions + relaxation of the cervix
- 6-12hrs
Stage two
- Full dilation of the cervix to expulsion of the final foetus (hrs)
Stage three
- expulsion of the foetal membranes (usually occurs after each pup, so stage two and three may occur simultaneously).
56
What are the two classifications of dystocia, and provide examples ?
Classification of dystocia
Dystocia is classified according to either maternal or foetal causes
For example
- maternal = primary inertia
- foetal obstructive dystocia
57
# Four major tools
Describe appropriate diagnostic plan for a bitch experiencing dystocia ?
Identify dystocia
**
Vaginoscopy**
- identify foetal membrane - is the cervix dilated
- if the cervix is dilated, a C section should be safe to perform
**Digital palpation**
**Ultrasound the big one **
- can measure foetal heart rate to identify the viability of pups
- normal foetal heart rate >220 beats per minute
- HR < 180bpm getting nervous.
- HR <150bpm - proceed to a C section
**Radiographs**
- count the number of foetuses present / left
- indication of gestation length
- be careful about comparing size of foetus to pelvic canal as magnification can result from being far from the casette.
58
Describe the risk factors for primary inertia ?
Primary inertia
Failure to push - inability of the dam to deliver a normal sized foetuses through a sufficiently large birth canal that is sufficiently relaxed.
The risk factors
- often a bullmastiff etc
- excessive stretching of the myometrium (very large litter)
- weak myometrium (senile, obese, severe debilitation)
- hypocalcaemia
- hypoglycaemia
- anxiety (particularly in the cat - cats may deley partuition >24hrs)
59
Disscuss the treatment options for primary inertia ?
**Treatment primary inertia**
(medical + caesarian section)
Medical management
**1. Calcium supplementation**
- ionized calcium may be low even if total calcium is normal
- slow IV given to effect
- stop as soon as signs of saturation (bradycardia)
**2. Supplement glucose if indicated **
- hypocalcaemia is a concern in pocket sized bitches
**3. Oxytocin**
- contraindicated in cases of obstruction or if the cervix is closed.
- three attempts - your out approach (wait 30mins between each dose to assess for response).
- high doses = tetany
**Caesarian surgery**
- surgical removal of pups
60
Describe the pathology and risk factors for obstructive dystocia ?
Obstructive dystocia
Maternal risk
- pelvis is too small
- brachcephalic breeds
- poor nutrition during growth period
- vaginal septae or stricture
- neoplasia / hyperplasia - may lead to inertia of the uterus.
Foetal causes
- too large, singleton
- brachycephalic breed
- wrong disposition of the foetus
- hydrocephalus
Note 40% of pups present caudally this is considered normal if the limbs are extended (toes first).
61
Disscuss the treatment for obstructive dystocia ?
Treatment of obstructive dystocia
CONTRAINDICATED OXYTOCIN
Attempts to resolve cause if possible
- eg malposition of foetus
- usually difficult due to small size of vagina
- hygiene is crucial - clean vulva with hibitane and water
- raising the bitches forequarters may help
If its not working move to caesarian section.
62
# Three methods to decide when we can carry out an abortion.
How do you know its safe to carry out an abortion in a bitch ?
When is it safe to carry out an abortion in the bitch.
Currently a bit of an enigma; dogs have a very short gestation length - every day counts
So when
- best to wait until the cervix is dilated on vaginoscopy
- many practitioners consider C section when PPC< 6nmol/L
- or estimate a due date from D1 or the LH surge
63
What can doxopram be utilised for ?
Doxopram
respiratory stimulant
- can be used if pups are slow to breath, and a heart beat is present
- 1-2 drops sublingually or injected
64
Describe eight steps to neonatal resuscitation and immediate care ?
Neonatal resuscitation and neonatal care
Pre-prepare any required equipment, towels, warm environment, haemoststas, suture, doxopram
1. Doxopram - respiratory stimulant
2. gentle stretch umbilical cord
- encourges closure of blood vessels, then cut 2cm from abdominal wall
3. clear airways
- swing pup or utilise a suction appartus
4. assess for the pressence of a heart beat
5. rub vigorously with a towel to resuscitate
6. oxygen
7. warm pups
8. assess pups for congenital abnormalities eg cleft lip, atresia ani
65
Demonstrate un understanding of Hypoluteodism ?
Hypoluteodism
= CL thought to be unable to produce sufficient progesterone to maintain a pregnancy.
- extremely rare cause of pregnancy loss
- diagnosis complicated; determine P4 levels regularly (there can be a huge variation between bitches.
- some breeders will swear by it and demand treatment
- treatment P4 supplementation <6nmol/L
- Stop treatment several days prior to birth to allow normal partuition to take proceed.
66
Describe the signalment and clinical signs of Brucella canis ?
Brucella canis
Signalment
- exotic to Australia / notifiable disease
- zoonotic
- Transmission = ingestion / inhalation / veneral contact
Clinical signs - non reproductive
- usually subclinical and picked up incidentally
- discospondylitis (infection of the intervertebral discs)
- paresis
- ataxia
- uveitis (eye inflammation)
Clinical signs - reproductive
Female
- late term abortion (last trimester), infertility
Male
- infertility
- epididymitis
- testicular atrophy
67
Describe how you could diagnose and treat a case of Brucella canis ?
Brucella Canis
Diagnoses
Bacterial culture difficult - submit chilled
- serology submit whole blood or chilled serum
- Rose Bengal test: more sensitive
Treatment
Not reccomended due to the possibility of relapse and potential for transmission to humans.
- overseas antibiotics and castration
68
Describe the signalment and pathology of Brucella suis
Brucella suis
Signalment
- Widespread in feral pig populations QLD, NSW and spreading
- dogs are usually affected during pig hunting or through ingetion of raw pig meat
**- zoonotic risk**
- consider your PPE when treating pig hunting dogs / drawing blood
69
Describe the signalment and clinical signs of CHV-1 ?
Canine alphaherpesvirus-1 (CHV-1)
Signalment
- A disease with life-long latency with short term immunity
Clinical signs
Neonates
- Highly fatal disease of new born pups upto two weeks
- anorexia, abdominal pain, diarrhea
- mucosal haemorrhagesconstant crying within 24 to 48 hrs of showing symptoms
- Loss of entire litres may occur
Clinical signs in adult animals
- tracheobronchitis
- vesicular lesions on the vestibule, vagina and prepuce
- late abortion
70
Describe the pathology underlying canine herpes virus ?
Canine herpes virus
Pathology
- scattered haemorrhages within the kidney
- necrosis of the liver and lungs
- enlargement of the spleen and lymph nodes
- intranuclear inclusion bodies on histiopath.
71
Describe how we can control or treat individual cases of CHV-1
Canine alpha herpes virus - 1
Treatment (Individual)
- There is no effective treatment
- some reserach show increasing body temp above 37 degrees may slow viral replication
**Control (Vaccinate bitch / not available in Australia)**
- The role of stress NB - virus is shed during times of stress
- minimise stress in kennels (feed, warmth, social structure)
- isolate pregnant and lactating bitches particularly new arrivals
72
Describe the pathology, diagnoses and treatment of pregnancy toxaemia ?
Pregnancy toxaemia
(rare in the cat and dog)
Pathology
- hypoglycaemia during pregnnacy may be related to inadequate nutrition or a large litter size.
Diagnosis
- ketonuria
- hypoglycaemia may lead to depression and recumbancy
Treatment
- IV dextrose
- supplement and improve nutrition
- in severe cases may warrant OVH induction or abortion
73
Describe the pathology and clinical signs of metritis in the dog ?
Metritis
Pathology
Inflammation of the endometrium and myometrium usually within one week post whelping
- no progesterone is present (CL lysed prior to partuition).
- Vaginal cytology numerous degenerative neutrophils and numerous bacteria
- ultrasound
Clinical signs of metritis
- pyrexia
- depression
- malodourous or putid, red brown vulva discharge
- dehydration and shock in severe cases
74
Describe treatment for metritis in the dog ?
Metritis in the dog
- treat any fluid deficit
- broad spectrum antibiotics systemically
- if hypoglycaemia present - provide dextrose
- surgery OVH can be considered post stabillisation if foetal remannats remain within the uterus
- provide supplement nutrition to the pups
- oxytocin
Intrauterine infusions: best to avoid as no experimental evidence indicating that there is any benefit
75
Describe the pathology and how you could identify a case of SIPs ?
Subinvolution of the placental sites (SIPs)
Clinical signs
- Bloody vulvar discharge lasting for more than six weeks after partuition
- common especially in young primiparous bitches (producing a pup for the first time)
Pathology
- poorly understood
- suspected to be due to abnormal persistance and invasion of the endometrium by foetal trophoblastic cells.
- this causes eroding of maternal blood vessels
76
Describe how we could go about treating a case of SIPS ?
Subinvolution of the placental sites.
Treatment
Do not treat
As long as the bitch remains otherwise healthy
- usually resolves spontaneously when the bitch enters into the next pro estrus
- monitor for signs of metritis or anaemia
77
Describe the pathology and clinical signs of milk fever in the dog ?
Milk fever in the dog
Pathology
- hypocalcaemia
- usually seen in a small bitch nursing a large litter - 3week old pups
Clinical signs
- nervous
- pyrexia
- panting, restlessness
- increased muscle tone, contractility and tetany
- tremors, staggering
- dry nose
- dilated pupils
78
Describe how you could diagnose and treat a case of milk fever ?
Milk fever (Hypocalcaemia)
Diagnosis
- total serum calcium <7mg/dl (normal 9-11mg/dl)
Treatment
**Calcium gluconate**
- very slow IV to effect
- monitor heart constantly while injecting
- stop treatment immediately with any signs of bradycardia or licking of lips
- nausea
- arrhythmia
Ongoing management
- ongoing management of the bitches diet (increase Ca)
- reduce puppy suckling
- additional supplementation Sc can be considered diluted with saline
79
Discuss the pathology of the CEHMEP complex ?
Pyometra and the CEHMEP complex.
CEHMEP complex
Cystic endometrial hyperplasia, mucometra, endometritis pyometra (CEHMEP)
- a complex of disease of the uterus of the bitch that are linked by pathogenesis
Pathogenesis
Oestrus
- development of endometrial glands
- progesterone receptors in the uterus
Progesterone
- further development and secretion of endometrial glands
- suppress motility of endometrium
- closure of the cervix
- decreased immune function within the uterus
- possible culprit = E.coli.
80
What does CEHMEP stand for ?
What does CEHMEP stand for ?
C = Cystic
E = Endometrial
H = hyperplasia
M= Mucometra
E = endometritis
P = Pyometra
81
Describe the signalment and clinical signs of CEHMEP ?
**CEHMEP Pyometra
Signalment**
- often middle aged to older, unspayed, nulliparous females
- usually 1-12 weeks since previous oestrous
- some breeds are predisposed.
**Always think pyometra in any intact bitch showing non-specific signs of illness.**
Clinical signs
Varies from apparent infertility - mild illness and purulent vaginal dischrage - life threatening multi systemic disease.
- infertility
- purulent vahinal discharge "open cervix pyometra"
- often far less specific depression, anorexia
- vomiting
- polyuria / polydipsia
- diarrhea
- fever
- dehydration, septicaemic or toxaemic in severe cases.
82
What are the major risk factors for CEHMEP ?
CEHMEP pyometra
Predisposing or aggravating factors
- repeated non pregnant cycles
- oestrogen
- progesterone
The highest risk is during dioestrus
83
Describe how to diagnose CEHMEP in a suspected intact bitch ?
Diagnosis of CEHMEP
**- vaginoscopy**
- abdominal ultrasound
- vaginal cytology
- culture is of limited value but may assist with antibiotic selection
**
Haematology**
- large variation
- severe leukocytosis with a left shift neutrophilia
- to leukopenia
**Serum biochemistry**
- hypoalbuminaemic
- signs of liver dysfunction I ALP and bilirubin
- pre renal azotaemia
**
Urinalysis**
- low specific gravity
- endotoxins interfer with the action of ADH in renal tubules
- proteinuria
84
Describe how you would go about treating a case of pyometra / CEHMEP
Treatment CEHMEP
1. Stabilisation followed by ovarriohysterectomy
- fluid stabilisation
- oxygen
- may need to flush abdomen post surgery
2. Medical treatment may be attempted in expensive breeding animals.
- similar to the induction of abortion, aim to cause luteolysis and knock out progesterone
- PGF2a
- Anglepristone
- Misoprosto may assist in dilation of the cervix
3. Once the cervix is open may utilise oxytocin
- may assist with uterine evacuation
4. Broad spectrum antibiotics
- amoxycillin / Metronidazole
5. Advice owner to breed on the subsequent oestrus
Monitoring
- continue treatment until ultrasound is normal
- vaginal dischrage resolves
- some reccomend treating until progesterone reaches baseline level
85
Describe the pathogenesis and clinical signs of Transmissable Venereal Tumour (TVT) ?
Transmissable veneral tumour
Clinical signs
- tumour masses
- vaginal mucosa, penis, prepuce or nasal / oral mucosa
- greyish pink nodules friable (cauliflower heads)
- abnormal discharges from orifices.
Pathology
- Highly contagious
- transmission of neoplastic cells during coitis or by transfer of cells licking and sniffing
- Viral ?
- metatases is uncommon
- occurs commonly with free roaming animals and a warm humid environment.
86
Describe how you would diagnose and manage cases of Transmissable Venereal Tumour (TVT) ?
Transmissable Venereal Tumour (TVT)
Diagnoses
- Impression smear = round cells
- biopsy
Treatment
- neuter / spey
- vincristine Rx / chemotherapy
- treat weekly + continue for one or two treatments after the lesion disappears
87
Describe the presentation, pathogenesis including predisposing factors of vaginitis ?
Vaginitis = inflammation of the vagina
Presentation
- adult and juvenile forms
- presents as vulvar discharge, frequent licking of vulva and may attract male dogs
- less common pain on urination or pollakiuria
- usually a bacterial cause
Pathology; Look for predisposing factors
- anatomical defect of vulva or vagina
- eg vestibulovaginal stricture, excessive perivulvular folds
- foreign body urinary tract disease.
88
Discuss juvenile "puppy" vaginitis, and its treatment ?
Juvenile "puppy" vaginitis < one year of age.
Vaginitis < one year of age
- treatment with antibiotics may resolve the problem, but reserve for severe caes (base on cranial vagina culture and sensitivity)
- usually resolves with time or after one or two oestrus cycles
- check for underlying anatomical abnormality or urinary tract disease.
89
Describe the pathology and diagnoses of adult onset vaginitis in dogs ?
Adult onset vaginitis > one year of age
Pathology
- Brucella canis (exotic), canine herpes virus
- Secondary vaginitis; urine poolingdue to a congenital abnormality, foreign body or neoplasia, urinary tract disease or urinary incontinance.
Diagnoses
- vaginoscopy - hyperaemia, neoplsia, foreign body
- vaginal cytology - excessive neutrophils
- vaginal culture - a healthy vagina will have numerous bacteria, treatment restricted to a heavy pure culture is obtained
- Digital exam - anatomical abnormality
- Urinalysis - too rule out urinary tract infection.
90
Discuss treatment of a case of adult onset vaginitis ?
Adult onset vaginitis >1year of age
Treatment
- Identify and treat the primary cause
- systemic antibiotic may be indicated (culture and sensitivity)
- generally require long courses of antibiotic upto 4 weeks
- low dose oestrogen supplement in spayed dogs
- surgical correction of any antomical defect
91
Disscuss Vestibulovaginal abnormalities; clinical signs, diagnoses and treatment ?
Vestibulovaginal abnormalities strictures and bands
Clinical signs
- inability to mate
- chronic vaginitis
- chronic urinary tract infection
- dystocia
Diagnoses
- digital vaginal exam (speculum)
Treatment
- manual dilation may sufficient for minor strictures
- incision
- ovariohysterectomy to remove the chance of passing on a genetic defect.
92
Describe the pathology and grading of vaginal hyperplasia and prolapse ?
Vaginal hyperplasia and prolapse
This is associated with the pro oestrus rise in oestrogen.
- protrusion of oedematous vaginal wall into the vaginal lumen and sometimes through the vulva lips
- may also occur with pre partum rise in oestrogen
- ofyen recurs with subsequent oestrous cycle (66-100% recurrance)
Grade one; swelling caudal vagina, cranial to orifice
Grade two; mass protrudes through the vulva
Grade three; Whole vagina circumference protrudes from the vulva (donut shape)
93
Discuss a treatment plan for vaginal hyperplasia and prolapse ?
Vaginal hyperplasia and prolapse
Start with vaginal cytology to confirm pro estrus
- wait as it usually resolves as the concentration of oestrogen declines (1-3 weeks)
- protect mass (Elizabethan collar, keep moist and clean)
- confinement
- can consider manual replacement of mass and purse string suture
Advice OVH - prevents recurrance - heritability ( removes oestrogen source)
94
Describe how you could differentiate vaginal hyperplasia from neoplasia ?
Extremely important
Vaginal hyperplasia
- young dog
- arises from vaginal floor, cranial to urethral opening
- appearance and progression varies with the stage of the oestrus cycle
Neoplasia
- usually older dogs
- arises from anywhere in the vagina
- appearance and progression dose not varie with oestrus cycle.
95
Define a split oestrus ?
Split oestrus
- signs of pro-estrus, which subside (no ovulation)
- followed by a second pro-estrus to oestrus 3-6 weeks later
- Do not treat this
96
Describe the clinical signs and pathology of cystic ovarian degeneration ?
Cystic ovarian degeneration
Signalment and clinical signs
- rare, incidence increases with age
- 1-5cm in diameter
- anoestrus is the most common CS (non functional follicular cyst or luteinised cyst secreting progesterone)
- rarely nymphomania (oestrogen secreting follicular cyst)
Pathology
- cyst on ovary
Clinical signs
97
Describe the diagnoses and treatment for cystic ovarian degeneration ?
Cystic ovarian degeneration
Diagnoses
- ultrasonography
- steroid level analysis (remember hormones are usually present)
- exploratory laparotomy
Treatment
- ovariectomy / OVH
- surgical drainage via a needleaspiration during laparotomy
- may attempt luteolysis PGF2a
- this is not always successful and recurrance is common.
98
Describe the pathology and clinical signs of pseudopregnancy ?
Pseudopregnancy
Pathology
All bitches are essentially pseudopregnant during the non pregnant dioestrus phase
- associated with the decline in progesterone, and increase in prolactin towards the end of dioestrus
- may also occurs post OVH, abrupt stop of exogenous progesterone.
Clinical signs
- mammary development
- nesting behaviour; mothering of inanimate objects
- lactation
- over protectiveness, aggression, weight gain
99
Describe your approach to management of pseudopregnancy ?
Management of pseudopregnnacy
In most cases do not treat, usually spontaneously subsides after 1-3 weeks
- prevent licking of teats (Elizabethan collar)
- prolactin inhibitors (Cabergoline) could be used to suppress lactation
100
Describe the pathology and clinical signs underlying ovarian remnant syndrome ?
Ovarian remnant syndrome
Pathology
Physical and behavioural signs of oestrus after hysterectomy
- residual ovarian tissue left after spay
- or revascularistaion of ovarian tissuedisplaced to round or broad ligament
Clinical signs
- Consistent signs of oestrus
- vulvar swelling
- vulvar discharge
- attractiveness to males
- standing to be mounted by males
- cyclic pattern
101
Describe how to diagnose and treat remanant ovarian syndrome ?
Ovarian remnant syndrome
Diagnosis - Aim to identify true oestrus
- vaginal cytology
- serum progesterone (pressence can confirm the pressence of luteal tissue)
- abdominal ultrasound / exploratory laporatomy
*- LH will be chronically high*
Tretament
- surgical removal
- often easier during dioestrus (luteal tissue can be visualised)
- note bilateral remnants are common ensure complete exploration.
102
Describe the normal descent of the testicles and the pathology of cryptorchidism ?
Cryptorchidism (heritable)
Failure of testis to descend into the scrotum
In the embryo testes develop caudal to the kidneys, then move from this point to the inguinal canals and eventually into the scotum.
- normal descent has occured by ten days of age.
- most commonly unilateral
- retained testes could be anywhee from the inguinal canals to caudal of the kidneys (similar spot to ovaries).
The inguinal canals close at six months and no more descent likely beyond this time
103
What would be cryptorchid dog increase the risk of ?
Crytorchid dog
Retained testes carry an increased risk of neoplasia and torsion.
sertoli cell tumour
- secretes oestrogen
- causes feminization syndrome
- bilateral symetrical alopecia
104
Describe the pathology and clinical signs of orchitis and epididymitis ?
Orchitis nad epididymitis
Pathology
- infection
- usually from trauma especially bite wounds
- secondary to cystitis
- Brucella canis
- mostly bacterial; staphylococcus, E.coli, Proteus
Clinical signs
- acute painful swelling of the scrotum
- pyrexia, lethargy
- hindlimb lameness
- purulent preputial discharge
- more chronic cases are less painful
105
Describe how you would diagnose and treat a case of Orchitis ?
Orchitis
Diagnoses
- palpation, ultrasound
- semen culture and evaluation
- CBC needle aspiration
Treatment
Surgical removal is usually the best option
106
Describe the pathology and treatment for Paraphimosis ?
Paraphismosis
Inability to retract the penis back into its sheath.
Pathology
- assess for abnormalities; hair ring, scar tissue, neoplasia, trauma of the preputial orifice
Treatment
This is an emergency
- anti inflammatory
- local irrigation
- try to return into prepuce by removing cause
- purse string suture
- amputation may be nessary in chronic cases.
107
Define Agalactia and its treatment ?
Agalactia
A failure of the mammary gland to develop or failure of milk let down.
Treatment
Oxytocin - to encourage milk let down
reduce stress for the bitch
108
Describe the diagnosis and treatment of mastitis ?
Mastitis
Diagnosis
- CS (erythemia and swelling of mammary glands)
- cytology of expressed milk - bacteria WBC
- haematology
Treatment
- encourage suckling (unless frankly purulent) or milk out affected gland
- hot and cold packs
- antiinflammatories
- antibiotics
Amoxicillin and clauvlinic acid.
109
Identify all the techniques avaiable to a Veternarian to prevent, postpone or suppress reproduction in the dog ?
Techniques for prevention, postponement and suppression of reproduction.
1. Desexing; ovariectomy, or ovariohysterectomy (OVH)
2. Progestatgens
3. Androgens
4. GnRH agonist
110
Disscuss the benefits and contraindications of ovariohysterectomy in the bitch ?
Ovariohysterectomy (OVH)
Benefits
- significantly reduce mammary tumours
- population control
- reduce incidence of pyometra
- delaying closure of growth plates
Nagatives
- urinary incontenance, hormonal issue
- obesity issues
- chronically high LH
- cancer
- osteosarcoma
111
Discuss the MOA of progestagens and any potential side effects ?
Progestagens
Act as an effective means of oestrus suppression in many species
- MOA is not well understood
- likely to involve negative feedback on the hypothalmaus (GnRH thus LH and FSH).
Potential side effects in the bitch;
- cystic endometrial hyperplasia
- pyometra
- benign mammary nodules, weight gain, behavioural issues
- skin / coat changes
- adrenocortical suppression
- may predispose to diabetes mellitus
112
Describe a technique to reduce the negative consequences of Progestagens ?
Progestagens
It is the most safe to use in anoestrus, before oestrogen rises in progesterone.
- remember boestrogen potentiates the effects of progesterone = pyometra
- too postpone oestrus - start atleast 1-2 weeks before next expect pro-oestrus
- extremely variable return to oestrus
- no adverse effect on fertility if used as directed.
113
Describe the mechanism of action fpr androgens in preventing oestrus ?
Androgens
Mibolerone, testosterone propionate
- exert negative feedback on the pituitary, preventing release of gonadotrophs (LH, FSH) and ovulation.
Contraindications; administration before puberty or during pregnancy, renal or hepatic disease.
114
Describe the contraindications of testosterone use for oestrus suppression ?
Androgens - testosterone propionate
Contraindications; administration before puberty, or during pregnancy, renal or hepatic disease
Side effects
- clitoral enlargement
- vaginitis
- masculinisation of female foetuses
- variable return to oestrus.
115
Describe the mechanism of action for a GnRH agonist (Suprelorin)
GnRH agonist (Suprelorin)
only registered for use in the dog to reversibly induce sterility, not the bitch.
MOA Suprelorin
binds to GnRH receptors on the pituitary
- initially may result in a flare response and induce oestrus
- the continued GnRH stimulation eventually leads to the downregulation of LH and FSH
- subsequent suppression of the gonads
Two doses available
- 4.7 suppress fertility 6 months in the dog
- 9.4 suppress fertility in the dog 12 months
116
Disscuss the advantages and disadvantages of suprelorin use to suppress fertility ?
GnRH agonist to suppress fertility
Advanatages
- few side effects, long acting after a single dose
Diaadvantages
- cheaper to sterilise surgically in the long run
- variable interval to return to oestrus.
117
Name a drug that may be used to treat bening hypertrophy in breeding dogs and explain its mechanism of actions ?
Deslorin GnRH agonist
Can be used to treat bening prostatic hypertrophy.
- continuous pressence of GnRH agonist eventually causes down-regulation of the gonadtrophins (LH and FSH) release from the pituitary.
- suppression of the gonads.
118
# There are five methods for termination.
What are the indications for terminating pregnancy, and identify all potential methods ?
Indications for terminating pregnancy
1. Dog serves a bitch not intended for mating
2. incorrect dog serves a bitch
3. a bitch of obstetric risk conceives
Available methods to terminate pregnnacy
- PGF2alpha
- Progesterone receptor antagonist (Aglepristone)
- Dopamine agonist
- Oestrogens
- Glucocorticoids
119
Describe the MOA, advantages and disadvantages of using PGF2A to terminate pregnancy ?
PGF2A Cloprostenol
MOA - causes luteolysis and uterine contractions
Advantage
- very effect especially second half of gestation
- cheap
Disadvantage
- Dog CL is relatively resistant to cloprostenol, it takes time
- nausea, vomiting, diarrhea
- abdominal discmfort
- issues usually subside after 60 mins.
120
Explain the mechanism of action for Aglepristone, and any potential side effects ?
Aglepristone - Progesterone receptor antagonist.
No progesterone = no pregnancy.
MOA progesterone receptor antagonist
- has an affinity for progesterone receptors
- 3X that of natural progesterone
- registered for day 0 to day 45 of pregnancy
- two doses 10mg/kg required
- subcutaneous (irritant)
- perform abdominal ultrasound days post injection to ensure success of treatment.
Side effects
- fewer side effects
- expensive
121
Describe the mechanism of action of Cabergoline ?
Cabergoline
Dopamine agonists / prolactin inhibitors
Prolactin is luteotrophic in the bitch
- gives support to the CL
- no prolactin = CL less supported, pregnancy at risk
- Carbergoline 50% efficiency after day 40 on its own.
- usually combined with PGF2a to ensure efficiency.
No great advantage over other drugs, except that it can be administered orally.
122
Describe how oestrogens may be used to terminate pregnancy in the bitch, and any contraindications ?
Oestrogens
MOA for pregnancy termination
- used to prevent implantation - given within a few days of mating
- interfers with uterotubal function / transport
- popular in the past
- illegal in food producing animals
Side effects
- bone marrow suppression
- pyometra
- cystic endometrial hyperplasia
- blood dyscrasias
