When Will Sasha Have Her Pups?

Question 1

What is the incidence of pseudopregnancy in the dog?

Answer 1

All non pregnant bitches but with variable signs where commonly have covert signs ratehr than overt signs..

Question 2

Is pseudo pregnancy associated with pregnancy loss?

Answer 2

No

Question 3

What is the likely cause of pseudopregnancy in the dog?

Answer 3

Normal non-pregnanct luteal phase similar to pregnant luteal phase

Question 4

What is the incidence of pseudo pregnancy in the queen?

Answer 4

20% of queens have 1 epidosde per year of spontaenous ovulation

Question 5

Is pseudo pregnancy associated with pregancy loss in the queen?

Answer 5

There are 2 different forms - so yes and no

Question 6

What is the likely cause of pseudopregancy in the queen? (2)

Answer 6

Not associated with pregnancy loss - ovulation without fertilisation

Associated with pregnancy loss - pregnancy loss after fertilisation

Question 7

How do we clinical manage pseudopregnancy in the queen?

Answer 7

Non required for either type

Question 8

What is the incidence of pseudopregnancy in the horse?

Answer 8

Up to 20% based on embryo loss

Question 9

Is pseudo pregnancy in the horse associated with pregnancy loss?

Answer 9

Yes (for both types)

Question 10

What are the likely causes of pseudo pregnancy in the horse? (2)

Answer 10

Type 1 - pregnancy loss after maternal recogition but before endometrial cups form

Type 2 - Pregnancy loss after endometrial cups but before day 120

Question 11

How do we clinical manage pseudo pregnancy in the horse?

Answer 11

Type 1 - PG

Type 2 - none

Question 12

What is the incidence of pseudo pregnancy in the pig?

Answer 12

Variable - mainly associated with infectious disease

Question 13

Is pseudo pregnancy in the pig assocaited with pregnancy loss?

Answer 13

2 forms - so yes and no

Question 14

What is the likely cause of pseudo pregnancy in the pig? (2)

Answer 14

Not associated with pregnancy loss - failure of CL regression

Assocaited with preganncy loss - pregnany loss and failure of CL regression

Question 15

How do we treat pseudo pregnancy in the pig?

Answer 15

PG

Question 16

What is the incidence of pseudo pregnancy in the goat?

Answer 16

Variable - 2-20% having one per year

Question 17

Is psuedo pregnancy in the goat associated with pregnancy loss?

Answer 17

2 forms - so yes and no

Question 18

What is the likely cause of pseugo pregnancy in the goat? (2)

Answer 18

o Not associated with pregnancy: failure of CL regression

o Associated with pregnancy: pregnancy loss and failure of CL regression

Question 19

How do you clinically mange pseudo pregnancy in goats?

Answer 19

PG

Question 20

What are the next possible steps in this case and why?

Answer 20

Carry out a full physical exam

Get a full history

Question 21

What do you do next?

Answer 21

Ultrasound

Question 22

What conditions does this U/S rule out?

What is the likely diagnosis?

Answer 22

Rule out: pregnancy, pyometra

Diagnosis: Pseudo pregnancy

Question 23

Is pseudo pregnancy normal?

Answer 23

Relatively common in the post oestrus bitch - lathough majority do not exhibit clinical signs

Question 24

Sasha was diagnosed with pseudopregnancy which is relatively common in post-oestrus bitches but the majority do not exhibit marked signs. This is considered a normal condition but one in which some animals show overt signs rather than being covert (subclinical). With overt signs often the owners want to do something about it, therefore we need to consider the clinical management of pseudopregnancy in the bitch.

Discuss Short term management treatment options?

Answer 24

Conservative

Does not impose medication on dog who is in a normal reproductive state and avoids side effects with possible exacerbation of the condition. Achieve by Interrupt nesting behaviour and increasing exercise works by distracting bitch.

Medicinal

More rapid resolution of clinical signs in some/many cases depending on drug and individual

• Diuretics –> Reduce lactation
• Reproductive steroids –proligestone (delvosteron: LICENSED) –> Mimics progesterone and reduces prolactin
• Anti-prolactic drugs – cabergoline (Galastop: LICENSED) –> Reduces prolactin

Question 25

A different prolactin drug that you may use is?

Answer 25

Bromocriptine 2.5 mg (Parlodel®)

Bromocriptine is an anti-prolactin drug that can also be used to reduce the side effects of pseudopregnancy. It tends to have been replaced by Cabergoline (Galastop) which is licensed.

You may still see it used in practice, it is non specific and has some associated side effects: hypotension due to vasodilatation and emesis.

Via the cascade, cabergoline is the more suitable choice.

Question 26

Discuss conservative management of psuedopregnancy?

Answer 26

Conservative management (£0)

You advise the owner to do the following:

Restrict nesting

Remove toys

Consider the disadvantages of this treatment:

Relies on natural hormone changes to resolve signs which may take up to 12 weeks

Question 27

Discuss reproductive steroid treatment for pseudopregnancy?

Answer 27

A reproductive steroid (£10-30)

You opt for a reproductive steroid. You read Mrs W-L-P the side effects of using this drug and she decides to not use it.

Possible side effects:

Coat colour change following injection

Can induce anoestrus for up to 3 years

Long term use effects include temperament changes, polydypsia, polyphagia, acromegaly, mammary enlargement

Choose a different option….

Question 28

Discuss the use of diurectics in treatment of pseudopregnancy?

Answer 28

Use diuretics (£5-10)

Diurectics in human medicine have been reported to being used to help reduce lactation, although the mechanism for how this works is poorly documented.

In animals, this mechanism is also poorly researched, but diuretics could help reduce fluid retention in a pseudopregnancy.

The use of these drugs is both off cascade (even though it’s cheaper, this is not a reason to go off cascade use) and not well evidenced, and therefore not a recommended first line treatment.

A few days later…

Sasha becomes PUPD and Mrs W-L-P is cross. She wants a different treatment option without these side effects. You now decide to opt for something else.

Disadvantages of diuretic treatment

Consider some side effects of diurectic use:

Polyuria/polydypsia

Dehydration

Can worsen underlying renal disease

GI disturbances

Leucopenia

Anaemia

Question 29

Discuss the anti-prolactin drugs use for pseudopregnancy?

Answer 29

Give anti-prolcatin drugs (£50-70)

You decide to advice the use of cabergoline (Galastop). Sasha is a slightly large but typical SBT and weighs 16kg.

Bear in mind the disadvantages of giving this drug:

Anti-prolactin drugs: side effects are less common compared with reproductive steroids but more obvious (drowsiness, vomiting, anorexia)

Can take several weeks for side effects to resolve so may require more than one lot of dosing.

What is the dosing protocol for this drug, and how long is it given for?

Per os once a day for 4-6 days.

May require doing for 2 weeks.

Question 30

Is Sasha likely to have these symptoms again?

Answer 30

These symptoms may reappear if she is not neutered.

Question 31

Does anything need to be done for Sasha in the long term?

Answer 31

Things to consider:

The severity of signs e.g. amount of mammary development and lactation

The severity of the behavioural changes, including the spectrum of signs exhibited

Timing in relation to oestrus e.g. if signs occur later in relation to oestrus then they are likely to resolve spontaneously

Intention to breed?

Environmental circumstances e.g. how much of a problem are the signs in the household?

Consider the long term management options below and indicate your preferred option.

The following options are not recommended:

• Spaying in oestrus
• Spaying while signs of pseudopregnancy are present is not recommended
• The rapid drop in progesterone allows prolactin to rise and may result in permenant signs. If this were to happen, use of cabergoline may help, but this should not be relied upon
• Continue with long term use of cabergoline

The following options are more suitable:

• Manage conservatively
• Clinical signs are mild, the circumstances in the household suggest that these signs should not cause great problems
• Spaying in anoestrus (however this may not be suitable for owners that wish to breed)