When Will Sasha Have Her Pups? Flashcards
What is the incidence of pseudopregnancy in the dog?
All non pregnant bitches but with variable signs where commonly have covert signs ratehr than overt signs..
Is pseudo pregnancy associated with pregnancy loss?
No
What is the likely cause of pseudopregnancy in the dog?
Normal non-pregnanct luteal phase similar to pregnant luteal phase
What is the incidence of pseudo pregnancy in the queen?
20% of queens have 1 epidosde per year of spontaenous ovulation
Is pseudo pregnancy associated with pregancy loss in the queen?
There are 2 different forms - so yes and no
What is the likely cause of pseudopregancy in the queen? (2)
Not associated with pregnancy loss - ovulation without fertilisation
Associated with pregnancy loss - pregnancy loss after fertilisation
How do we clinical manage pseudopregnancy in the queen?
Non required for either type
What is the incidence of pseudopregnancy in the horse?
Up to 20% based on embryo loss
Is pseudo pregnancy in the horse associated with pregnancy loss?
Yes (for both types)
What are the likely causes of pseudo pregnancy in the horse? (2)
Type 1 - pregnancy loss after maternal recogition but before endometrial cups form
Type 2 - Pregnancy loss after endometrial cups but before day 120
How do we clinical manage pseudo pregnancy in the horse?
Type 1 - PG
Type 2 - none
What is the incidence of pseudo pregnancy in the pig?
Variable - mainly associated with infectious disease
Is pseudo pregnancy in the pig assocaited with pregnancy loss?
2 forms - so yes and no
What is the likely cause of pseudo pregnancy in the pig? (2)
Not associated with pregnancy loss - failure of CL regression
Assocaited with preganncy loss - pregnany loss and failure of CL regression
How do we treat pseudo pregnancy in the pig?
PG
What is the incidence of pseudo pregnancy in the goat?
Variable - 2-20% having one per year
Is psuedo pregnancy in the goat associated with pregnancy loss?
2 forms - so yes and no
What is the likely cause of pseugo pregnancy in the goat? (2)
o Not associated with pregnancy: failure of CL regression
o Associated with pregnancy: pregnancy loss and failure of CL regression
How do you clinically mange pseudo pregnancy in goats?
PG
What are the next possible steps in this case and why?
Carry out a full physical exam
Get a full history
What do you do next?
Ultrasound
What conditions does this U/S rule out?
What is the likely diagnosis?
Rule out: pregnancy, pyometra
Diagnosis: Pseudo pregnancy
Is pseudo pregnancy normal?
Relatively common in the post oestrus bitch - lathough majority do not exhibit clinical signs
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?
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
A different prolactin drug that you may use is?
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.
Discuss conservative management of psuedopregnancy?
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
Discuss reproductive steroid treatment for pseudopregnancy?
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….
Discuss the use of diurectics in treatment of pseudopregnancy?
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
Discuss the anti-prolactin drugs use for pseudopregnancy?
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.
Is Sasha likely to have these symptoms again?
These symptoms may reappear if she is not neutered.
Does anything need to be done for Sasha in the long term?
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)
