Companion Animal Theriogenology Flashcards
(411 cards)
1
Q
discuss the type of cycle for a bitch
A
- non seasonal
- mono-estrus
- with spontanous ovulation
2
Q
which animals are poly estrus
A
- queen
- horse
- rodents
- pig
3
Q
which animal is a long day polyestrus
A
horse
spring breeding season
4
Q
which animals are short day polyestrus
A
- ewe
- doe
- elk
- nanny
- breed in autumn
5
Q
which animals are monoestrus
A
- dogs
- wolf
- fox
- bear
- around march to may
6
Q
when do the dogs have their first estrus?
A
9 mnths(7-14 mnths)
breed and individual variations
7
Q
The physiological oestrous cycle of dog
A
- Non seasonal
- Mono-oestrous
- Spontaneous ovulation
- Domesticated dogs show 1-3 oestrous cycles
8
Q
discuss length of Inter-pro-oestrus interval in dogs
A
- averages 6 to 7 months
- Variable between breeds
– eg. German Shephard (closer to) 4 months to 12 months in the Basenji - Variable within breed
- Possibly individual variation from 1 cycle to another
- In some breeds and wild dogs: eg. Basenji and Dingo
- Mono-oestrus = one cycle per year
- Seasonal - autumn
9
Q
in which breeds are nomoestrus and seasonal
A
- In some breeds and wild dogs: eg. Basenji and Dingo
• Mono-oestrus = one cycle per year
• Seasonal - autumn
10
Q
define Anoestrus
A
- Commences when the concentration of
plasmatic progesterone is < 1 ng/ml if not
pregnant
• Day of whelping if pregnant
• Until pro-oestrus
11
Q
discuss the duration for anoestrus
A
average 90 days (60+)
12
Q
discuss endocronology of anoestrus
A
- steroids- basal
- FSH rises at end of anoestrus: follicular growth
=\> subsequent rise of oestrogens =\> inducing pro-oestrus - Prolactin still elevated at debut
- Pseudopregnancy
13
Q
discuss events/activities of anoestrus
A
• Phase of uterine and mammary involution and
regeneration
• duration of regeneration of the uterus = 12 weeks
post partum
14
Q
discuss the duration of regeneration of the uterus
A
- 12 weeks post parturm
- occurs in anoestrus
15
Q
discuss the behavioral changes in anoestrus
A
- Unattractive to males and refuses mounting / mating
- Maternal (pseudopregnancy)
16
Q
discuss Physical changes in anoestrus
A
- Vulva small
- Vaginal cytology→Small and non-keratinised cells
17
Q
factors that do not induce period of anoestrus in a bitch
A
– pregnancy
– lactation / presence of pups
– season
– stress
18
Q
which factor can induce Physiological period of anoestrus
in the bitch
A
pathology
19
Q
which hormone is increased at the end of anoestrus
A
the basal plasma FSH
concentration increases, followed by
folliculogenesis
20
Q
divisions of heat
A
- proestrus
- and estrus
21
Q
duration for proestrus
A
• Average 9 days (3 to >20 days)
22
Q
discuss events in proestrus
A
- Follicular growth
- Stimulation with LH and FSH
- Follicular secretion of oestrogens
23
Q
discuss endocronology of proestrus in a bitch
A
- Oestrogens
* Maximum at onset of LH surge * Diminution of oestrogens thereafter
- Progesterone <2 ng/ml
24
Q
bitch behaviour in proestrus
A
- attracts but refuses the male
- but variations as to male acceptance
25
physical changes in proestrus
* vulva swollen and turgid
* sanguineous uterine discharge
* swelling of vaginal mucosa
26
vaginal cytology in preoestrus
• reflects thickening and keratinisation
(cornification) of epithelium
• increasing percentage of larger cells -
"Superficial" cells, also: erythrocytes and
bacteria
27
define estrus
• from acceptance of mating until the onset of
dioestrus
• acceptance of the male dog
28
duration of diestrus
average 8 days (4 - 15 days!)
• problem is that sexual behaviour does not
always correlate with endocrinology
29
Endocrinology of estrus
* transitional
* oestradiol
• increased but declining
* progesterone
* produced by luteinized follicular cells
* increases before ovulation!
30
discuss estrus events and ovulation
* Events (relative to/after LH surge)
* • 2 days: ovulation → oocytes type I (primary) expulse
1. 4-5 days: maturation to oocyte II
• fertilization possible after maturation
* Thus, oocytes are fertilized from 4 to 5 days
after the LH surge onwards
31
discuss behaviour of estrus
• accepts male
• sometimes well before the LH surge
• sometimes during early dioestrus
• sometimes only for few days around most fertile
time
• temperament of male and female may cause
variation
• no reliable association with hormones!
32
physical changes in estrus
vulva less turgid
• discharge becomes serous
• reduction and/or disappearance of sanguineous
discharge
•but not always!
33
discuss vaginal cytology in estrus
vaginal epithelium now keratinised
• \> 90% cells superficial cells
• often less erythrocytes
• bacteria, many
34
clinical parameters due to Increase of plasma oestradiol 17β
Vulvar swelling
– Serosanguinous vaginal discharge
– Swelling of vaginal mucosa / increase of the
number of cell layers of the vaginal mucosa:
• Vaginoscopy
• Cytology
– Behaviour?
35
what does does mating occur after onset of proestrus
day 11
36
defination of diestrus
commences when mating is no longer
allowed by the bitch, or
• imprecise!
– commences at the start of a reduction of
≥20% of number of keratinised epithelial
cells in vaginal cytology after oestrus in a
non-pregnant bitch
– until plasmatic progesterone \< 1.0 ng/ml
– some use metoestrus for this phase
37
discuss endocrinology of diestrus
• production of progesterone by the CL lasts
approximately 2 months
– avg. 75 days
– in case of absence of pregnancy
• progesterone increases until around day 30,
then declines
• concentrations similar to pregnancy
• no active luteolysis
• luteotrophic hormones
– prolactin (LH?)
38
how long does the production of progesterone lasts in diestrus
production of progesterone by the CL lasts
approximately 2 months
– avg. 75 days
– in case of absence of pregnancy
39
discuss events of diestrus
• early di-oestrus
• vaginal epithelium reduces dramatically in size (“falls off”)
• may still stand (behaviour)
• day 1 of di-oestrus (cytologically)
• useful marker to calculate length of pregnancy
but more T=0 are possible!
eg. ovulation
•optimal time of breeding (retrospectively)
40
discuss behavior of bitches during diestus
nattractive to the male and refuses mating
41
discuss physical changes in diestrus
* vulva reduces in size
* reduction and disappearance of discharges
* may have a white discharge first few days
* mammary hyperplasia as progresses
42
discuss vaginal cytology of diestrus
• early dioestrus:
• reduction in the number of keratinised epithelial cells \>
20%
• influx of neutrophils
• less bacteria
• appearance of “Metoestrus” cells and “Foam” cells
43
discuss luteolysis in bitches
discuss hormones involved
• No prostaglandin F2α from the uterus
• First half of the luteal phase: pituitary-independent
• Second half of the luteal phase: prolactin = most
important luteotrophic factor
44
discuss pseudopregnancy in bitches
Onset usually 4-6 weaks after oestrus
• Pseudopregnancy is physiological
• Plasma prolactin concentration increases in response
to a plasma progesterone decrease
• Mammary development, secretion of milk, digging of
holes, collecting and guarding of “objects”
– sometimes agitated / agressive
– sometimes lethargic
45
onset of pseudopregnancy in bitches
4-6 weeks
46
tx for pseudopregnancy
* dopamine=PIF(prolactin inhibiting factors)
* Serotonine antagonists
metergoline
* dopamine agonists(cabergoline and bromocriptine)
47
how do you dx brucella canis
serology
* Important in USA and South America
* Absent Northern Europe, U.K., Australia
48
discuss viginal microscopy in prebreeding exams
normal flora
– especially during pro-oestrus and oestrus
49
discuss prebreeding culture
* unnecessary
* – isolation of microbes alone ≠ vaginitis
– only indicated if bitch has other signs of
disease
• inflammation, abnormal discharge
50
• Timing of mating / insemination,
considerations
* fresh sperm can survive in the tract up to 8
days
– oocytes are fertile for 2 to 3 days
fertile mating is possible over a relatively
long period of time
• Target the most fertile period
– 2-3 days after ovulation, oocytes are ready
for fertilisation
51
best time for fertilization
2-3 days after ovulation
52
time of cervical closure after ovulation
5 days
53
beggining of luteal phase after ovulation
8 days
progesterone levels rise
54
why is timing ovulation the best method for optimum fertilization
* Length of follicular phase is highly variable, therefore:
* ovulation timing can be necessary, especially if semen quality is impaired such as frozen-thawed semen
55
discuss aim of ovulation timing
* determine period of optimal fertility
* Monitor during (pro-)oestrus (3 times weekly)
56
how to monitor for ovulation
* vulvar swelling,discharge (amount,color)
* vaginoscopy
* cytology(vestibulum vaginoscopy)
* plasma progesterone concentration
*
57
when does ovulation occur in bitches
approximately 7 days after start of proestrus
ealier if known short cycle
58
discuss vaginoscopy to determine time of ovulation
* pro-oestrus vs oestrus
• reflects oestrogen concentrations
• pro-oestrus - vaginal oedema
• vaginal folds / wrinkling during oestrus
– di-oestrus & anoestrus
* **not accurate enough to determine day of **
* **ovulation**
• Vaginal abnormalities
* – vaginal bands (septum), vaginitis
59
vaginal cytology is useful for the dx of
crude cycle stage: “(pro-) oestrus?”
– start di-oestrus
– abnormalities
60
vaginal cytology is not used for
– determining ovulation or the time of maximum
fertility
61
• Small round cells with scanty cytoplasm in vaginal cytology
parabasal cells
non keratinised
62
discuss the characteristic for small intermidiate cells
cytoplasm larger than parabasal
non kiratinized
63
discuss the characteristics of the large intermidiate cells
cytoplasm larger than small interm
64
discuss the superficial cells in vaginal cytology
* Keratinised
* Nuclear and anuclear
65
increase in vaginal epithelial cells increases with ......
estrogen increase
66
blood cells seen in vaginal cytology
rbc
wbc
67
discuss the type of cells found with diestrus with viginal cytology
• Metoestrum cells
– appear to have neutrophil in cytoplasm
• Foam cells
– lipid inclusions (? macrophages)
– Spermatozoa, \<24 h after mating
68
this cells appear to have neutrophil in cytoplasm
Metoestrum cells
69
when is matingg possible after ovulation
between day two and 5
cervix close after day 5
70
how long is frozen sperm viable
12-24hrs
71
diferentiate cs of vagina in proestrus and estrus
* pro-oestrus - vaginal oedema
* • vaginal folds / wrinkling during oestrus
72
which test reflects estrogen concentration
vaginal cytology
73
vaginal cytology is useful for dx of
crude cycle stage:pro, estrus?
start of diestrus
abnormalities
it basically gives same info as vaginoscopy
74
vaginal cytology is not usful in
determining ovulation or the time of maximum
fertility
75
when will u see blood cells in vaginal cytology
u wont see them in the fertile period n ovulation period
76
u see cells with lipid inclusions in cell cytology
name those cells as well as the stage of estrus cycle the dog is in
Foam cells
onset of diestrus
77
when do u see sperm in vaginal cytology
\<24 hrs after mating
78
which ezyme can u measure for timing ovulation
* Measurement of progesterone is necessary to optimise the results
– to estimate LH surge and ovulation
– sample frequency: every 2-3 days
* Measurement of LH is possible, but
relation to moment of ovulation is less rigid
79
disucss progesterone levels at LH surge as well as ovulation when doing ovulation timing
* the time of LH surge:
– ± 2 ng/ml (or rapid augmentation of P4)
* ovulation:
– ± 5 ng/ml (4 - 8 ng/ml)
* fertile period:
– 10 - 25 ng/ml
* But, values highly depend on assay used!
- RIA, ELISA, chemiluminescence assay etc.
80
benefits of natural breeding
* Always try natural mating first
* Results with breeding menagement are
good
– sucess rate 90% AI fresh \> AI chilled (70-
90%) \> AI frozen (20-65%)
– Also ethics concerning use of AI
81
discuss cooled semen preservation
@ 5 OC
• conservation of 1 hour to 2 days
• dilute with extender and refrigerate
82
discuss frozen sperm collection
Frozen; @ -196 OC, liquid nitrogen (LN)
83
advantages of using cooled semen
easy and relatively cheap
• good results, similar to fresh semen
84
discuss disadvantages of cooled semen
* logistics are important, not much time – import restrictions
• 2 days (max 3-5 d)
85
advantagews of frozen sperm
long conservation - indefinite
– “gene banking”
• allows international exchange
86
disadvantages of frozen sperm
* viability variable after freezing
* cost of equipment, procedures and exportation
* administrative complications
* specialised centres necessary
* pregnancy rate lower
87
discuss insermination dose
* Not clearly defined
– normally whole ejaculate inseminated
* with fresh / cooled semen
– minimum 100 - 150 million normal sperm or
200 million sperm in total
• corrected for (post thaw) motility and morphology
88
methods of AI in dogs
* Vaginal
* Intra-uterine
Trans-cervical
endoscopic
Norwegian catheter
Laparoscopic / surgical
89
advantages of endoscopic insermination
Accurate and sure
– Animal conscious
90
disadvantages of endoscopic insermination
Difficult to learn
– Equipment expensive
– Sedation sometimes necessary
– Risk of perforation
91
advantages of nowargian catheter
inexpensive
– no general anaesthesia
92
disadvantages of norwaigean catheter
sedation
– risk of perforation
– difficult in large, stressed or obese bitches
– performed blindly
93
advantages of surgical insermination
easy / certain: visual inspection
94
disadvantages of surgical insermination
surgical complications
– anaesthesia
– one dose of sperm only
– ethics - questionable, banned in some
countries (eg. The Netherlands)
95
how long is the primary anoestrus
\> 18-24 months
96
discuss the pathological and physiological causes of anoestrus
* congenital disease: disorder of sexual
development
– eg. hermaphroditism, aneuploidy (X0
/XXY / …), ovarian agenesis etc.
* physiology
* silent heat / observational flaws
* exogenous cause
–eg. treatment with progestagens
97
dx for anoestrus
Complete history and gynaecological exam:
– anatomical abnormalities
– cycle stage: (pro-)oestrus?
• Plasma progesterone concentration
• Imaging of the reproductive tract
– ultrasound
• Function test of the hypothalamus pituitary
gonadal axis
– GnRH stimulation test
• Karyotype
• Induction of oestrus
98
2dary anoestrus
Prolonged inter oestrus interval
99
interval for interestrous( secondary proestrus)
\>1 year or
\>2x interoestrus interval normal to that
individual
100
causes of interestrus(2ndary proestrus)
* inadequate observation
• systemic illness, poor body condition
• endocrinopathies
• prolonged luteal phase (??)
• exogenous cause
–eg. treatment with progestagens
101
dx for 2dary anoestrus
Complete history and physical /
gynaecological exam:
– cycle stage: (pro-)oestrus?
• Plasma progesterone concentration
• T4 / TSH, urinary corticoid/creatinin ratio
• Imaging of the reproductive tract
– ultrasound
• Function test of the hypothalamus pituitary
gonadal axis
– GnRH stimulation test
• Induction of oestrus
102
how long is persistent (pro) estrus.
Definition: \> 6 weeks
103
risk of persistent (pro) estrus
* bone marrow hypoplasia
thrombocytopenia, leucopenia, anaemia
* prognosis: very grave
– endometritis
104
discuss cs of persistent (pro)estrus
* Aberrant ovulation; often in young bitch, especially first oestrus
split heat: (pro-)oestrus stops before ovulation, often resumes after several days or weeks
* Ovarian cysts
* Functional ovarian tumour– Granulosacell tumour
* Exogenous estrogens
* Liver disease,– eg. portosystemic shunt
105
dx for persistent (pro) estrus
* Complete history and physical /gynaecological exam:
– confirm cycle stage: (pro-)oestrus?
* Imaging of the reproductive tract
– Ultrasound
106
discuss the effect of granulosa cell tumor
* the stage of estrus they affect
* their effect
(pro)estrus
```
Relative overrepresentation in remnant
ovarian tissue (ROT)
```
Most ROT patients present with
unexpected (pro-)oestrus symptoms
107
tests for persistent (pro)estrus due due to ROT
1Gynaecological exam
2. Plasma progesterone concentration
3. GnRH stimulation test
n.b estradiole should be low.if its high then u know u have ROT
108
tx for persistent (pro)estrus
Immediate surgery in case of
concurrent (stump)endometritis
109
list the dz of the vagina
* Congenital abnormalities
strictures, bands, rings
* Vaginitis
* Edema / hyperplasia
* Tumours
110
which type of viginitis is more common
prepurbital
111
tx for viginitis
r/o anatomical defects
tx of if bitch is severly affected
wait up until the first estrus before overectomy
* not conclusively proven
* weigh up against risk of mamary tumeors
112
pathogenesis of vaginitis in young bitches
* Hormonal influences (progesterone dominance)
* Anatomy
* Age: mostly \< 3 jaar
* Vestibulitis
113
discuss vaginitis in adult intact bitch
* rare
* mostly secondary to other problems, eg.
• disorders of sexual development
• urinary problems
• foreign bodies / trauma
• uterine disease
• vaginal neoplasia
• endocrine diseases, such as
hypercortisolism
114
discuss the vaginal tumors seen in intact bitcches
they are in old bitches
hormonal dependent
mostly benign-
* leiomyoma, fibroma
115
vaginal tumors are fast growing in which stage
(pro)estrus
116
tx for vaginal tumors
* surgical removal (episiotomy)
* prognosis is good
* local recurrence
* rarely in bitches after ovariectomy at young age
mostly malignant
117
which tumor is Friable surface: “cauliflower”
tvt
No neoplastic transformation of autologous
cells but transmission of a “cell line”
(different number of chromosomes
118
discuss tx for tvt
* Local removal, surgically
* Chemotherapy / radiation therapy
* vincristine (weekly, 4-6 weeks)
* remission in 90%, no relapse
119
discuss the signalment of mammary tumors in the dogs
* 42% of all tumours in intact bitches
* age: 6-10 y, rarely \< 4 y
* often multiple tumours
* appr. 50% is malignant
* breeds
120
characteristics of mammary tumors in a dog
* Definitely hormone-dependent for initiation
* . Growth-stimulated by progestins
* . After malignant transformation loss of hormone dependency (PR- and ER-)
121
discuss routes of Metastasis of canine mammary
tumours
* Hematogenous
• Lymphatic
122
discuss the sites of Metastasis of canine mammary
tumours
* Regional lymph nodes
* Lungs
* Adrenal gland
* Kidney, etc…..
123
dx for canine mammary tumors
* Physical and rectal examination to assess extent
of disease
* FNA: difficult to differentiate benign and
malignant tumours
Inflammatory carcinoma and metastasis to
regional lymph nodes
* imaging techniques for metatstasis
* TNM system for prognosis
124
tx for the canine mammary tumors
Aim: removal of all neoplastic tissue with the
simplest procedure, eg.:
• excisional biopsy: small mass: \< 0.5 cm, firm,
superficial, non-fixed
• local mastectomy: centrally located, \> 1.0 cm, any
degree of fixation
• Effect of ovario(hyster)ectomy on local tumor
recurrence is controversial
• some effect on benign tumour development
125
prognosis for mammary tumors
poor prognostic factors are
• \> 3.0 cm
• ulceration
• histologic grade and type
• always perform histopathology after excision
• Inflammatory carcinoma
126
cs of mastitis
* Classical signs of inflammation: “calor, rubor, dolor, tumor et functio laesa
* abscessation possible: demarcation
* Systemic illness: depression, anorexia and
fever
127
dx for mastits
Diagnose based on clinical signs
• Cytology of milk
• Bacterial culture
128
tx for mastitis
* antibiotics
* weaning of pups often not indicated
* if pups are weaned: dopamine-agonists
* surgery mostly not necessary
129
length of estrus in dogs
9 days
130
length of diestrus in bitches
2 mnths
131
discuss hormonal levels in diestrus
progesterone is declining while prolastin is incresing
132
source of progesterone in a preg. bitch
cl is the sole source
133
maternal recognition of preg.
Luteal function
– Recognition of “foreign” tissue
134
discuss endocrine difference of diestrus and preg.
Relaxin is present
• pregnancy specific: secreted by the foetal
placenta
concentration of plasmatic progesterone is
similar
• total production progesterone is increased
• pre-partum luteolysis by PGF2 alpha
135
where is the relaxin produced
by the foetus
136
when does progesterone drop in preg.
last 36 hrs
137
discuss the level of progesterone before parturition
no increase before parturition
• unlike most other species, eg. cattle
there is a significant decrease before parturition
138
discuss duration of gestation in bitches
56 to 72 days,
– counted from day of mating, highly variable
More accurate alternatives:
– 65 ± 1 day, based on LH surge
• day 0 = day of LH surge
– 61.5 days, mean, if determined after one
mating at the optimal time
– 57 ± 1 day, di-oestrus (cytology)
• Differences relevant in history of
parturition / dystocia cases!
139
discuss duration of gestation in relation to litter size
negatively correlated with litter size
– especially one and two puppy pregnancies
can be prolonged
• indication for elective caesarean section
at D65 / 66 after mating
• breed might also be a factor
140
when do u decide to do elective cesarian section
at D65 / 66 after mating
141
when does fertilization occurs
0-3 days
142
when does the blastocyte enter the uterus after fertilization
8-9 days
143
whaen does implantation occur
13-15 days
144
when is preg. ultrasound positive
d21
145
when can u palpate for preg.
days 26-30
146
when is relaxin present in plasma
d30
147
when is ossification visible
d49
148
when can u start counting the # of puppies with xray
7 weeks
149
when can u see a clear mucus in vagina after mating
3-4 wks after mating
150
discuss occurance of eclampsia / puerperal tetany
* mostly during first weeks post partum
• small bitches with large litters are at risk
151
cs of eclampsia / puerperal tetany
-behavioural changes
– salivation
– facial pruritus
– stiffness / limb pain / ataxia
– hyperthermia
– tachycardia
152
how to tx for eclampsia / puerperal tetany
* 10% Calcium gluconate, slowly iv to effect (1-20mL)
– CAVE: _arrhythmias, bradycardia_
• followed by subcutaneous infusion:
– equal volume diluted 1:1 (v/v), q 6-8 h
• followed by oral supplementation
• improve nutrition
• in severe cases: terminate pregnancy
153
discuss preg.loss before d30
\< ± D30: resorption
• common: 1 or 2 / pregnancy
154
discuss pregnancy loss after d30
* abortion by expulsion, discharge
* retention, fetal death: mummification
* neonatal death, risk dystocia
155
discuss prolonged preg.
\> 65 days, bitch
– more often in 1 and 2 puppy pregnancies
• Sequelae?
– increased risk prenatal death
• Caesarian operation
156
discuss uterine tumers
very rare
157
discuss inguinal hernia of uterine
uncommon
158
list uterine dz of diestrus
Mucometra
• Endometritis / Pyometra
159
discuss causes of Metrorrhagia
neoplasia
• cystic follicles
• subinvolution of placental sites
• physiology
• (pro-)oestrus
• parturition / puerperium (sometimes
unknown)
160
in which cycle stag do u get spontaneous CEH endometritis
luteal phase
161
discuss etiology of CEH-endometritis
Hormonal influences:
mainly progesterone preceded by oestradiol-17
162
why is the luteal phase a greater risk for CEH endometritis
Risk for development of bacterial infection is relatively high
during the luteal phase due to decreased local immunity
• example: high risk for endometritis after transcervical collection of endometrial
biopsy during the luteal phase, not in other cycle stages
163
experimental tx for CEH-endometritis
discontinuation of progesterone treatment or
ovariectomy: regression of endometrium
164
stage 1 of CEH-endometritis
uncomplicated CEH
165
stage 2 of CEH endometritis
CEH + plasma cell infiltration, no tissue destruction
166
stage 3 CEH-endometritis
(cystic endometrial hyperplasi)
CEH + acute endometritis. Myometrial inflammation in 40% of cases
167
stage 4 of CEH endometritis
CEH + chronic endometritis, endometrium is atrophied,
myometrium is hypertrophied / atrophied
168
uncomplicated CEH is stage
1
169
CEH + plasma cell infiltration, no tissue destruction is stage
2
170
CEH + acute endometritis. Myometrial inflammation in 40%of cases is stage
3
171
CEH + chronic endometritis, endometrium is atrophied,
myometrium is hypertrophied / atrophied is stage
4
172
cs of cystic endometrial hyperplasia(CEH) endometritis
Infertility due to cystic endometrium hyperplasia
– without concurrent symptoms
Mucometra
– mostly w/o any systemic clinical signs
– sometimes difficult to differentiate from endometritis, clinically
CEH-endometritis complex (≈ pyometra)
– open cervix
– closed cervix: pyometra
173
n age for CEM endometritis
7 yrs
first estrous possible
Breed predisposition
• Progesteron influence
– intact - recent oestrus (mostly \<8 weeks)
– remnant ovarian tissue (stump endometritis)
– treatment with progestogens
• Common disease!
174
symptoms of CEM endometritis
Vulvar discharge 85% (purulent or sanguineous)
• Depression, prostration 62%
• Anorexia 42%
• PU/PD 28%
• Vomiting 15%
• Nocturnal incontinence 5%
• Diarrhoea 5%
• Abdominal distension 5%
• Others: - Pain
- Fever – inconsistent (!)
175
sequela of Sequelae of bacterial infection: in CEM endometritis
* -endotoxaemia
* – bacteraemia, septicaemia
• renal dysfunction PU/PD
–tubular insensitivity to ADH, mostly reversible
–immune mediated glomerulonephritis, might induce chronic renal failure
• Systemic Inflammatory Response Syndrome (SIRS)
–in \> 50% of patients
–poorer prognosis, longer hospitalization
176
discuss haemotological and biochemistry of CEM endometritis
* –Haematology:
• leucocytosis, slight anaemia (Ht: 30-35%)
* –Biochemistry:
• hyperproteinaemia – dehydration
• alkaline phosphatase increased – very
aspecific
• urea and creatinine – renal dysfunction
–azotaemia, often pre-renal, mostly
reversible
177
effeciency of ultrasound in detecting CEM endometritis complex
CEH – if present poor prognosis for fertility
• important if pyometra (closed cervix) is
suspected but abdominal palpation is not
diagnostic
• characteristics of fluid in uterus
– muco- or pyometra: differentiation not always
possible
• complications present?
–rupture
–peritonitis (pre perforative)
178
CEH-endometritis complex therapy
**Ovariohysterectomy**
• after stabilization
• mostly: treat these cases as an emergency
–SIRS
**–Medical treatment**
•Only in selected cases
– no contra-indications
– valuable breeding bitches – reduced fertility and
recurrence possible
179
discuss CEH-endometritis complex medical tx
* Antimicrobial
• preferably culture concomitant to start of treatment
* Evacuation of uterus
• induce uterine contraction: PGF2α
– eg. dinoprost: 100-250 μg/kg bw, q 12 h, side effects / LD50!
* Progesterone : antagonist / luteolysis
–Aglépristone : EU market, Australia etc, not USA/Canada
–Antibiotics alone are not sufficient
180
tx for Acute puerperal (endo-)metritis
medical treatment is often curative with a good prognosis
–antibiotic
–uterine evacuation
• PGF2α
• oxytocin (??)
–IV fluids, if indicated
ovariohysterectomy
181
list the congenital penile dz of a dog
* Hypospadia(inadiquate fusion of urethral folds)
* Penile frenulum
* Phimosis (penis wont potrude from the skin
182
functional Diseases of the penis
Paraphimosis
– Priapism
– Urethral prolapse
• Breed: Engl. Bulldog
• Surgical treatment
183
most common tummer of the penis
tvt
others are rare
184
discuss inflamation of the penis
* therapy is hardly necessary with inflamation
* Balanitis and balanoposthitis (induce by testesetone castrate)mmation
185
causes of inflamation on the testes
environmental / chemical
– parasites
– allergic reaction / immune mediated
disorder
– infectious agents
• Neoplasia
186
dz of the testicle
Congenital
– Cryptorchidism
• Neoplasia
• Trauma
• Inflammation
• Torsion
187
Persistent Müllerian Duct Syndrome
(partial) presence of uterus in XY males
– Miniature Schnauzer, Basset hound
188
dicsuss discending of the testicles
**3 stages:**
– abdominal translocation
– transinguinal migration day 3-4 p.p.
– inguino-scrotal migration day 35 p.p.
• *** ***
189
most common tumer of retained tests
sertoli cell tumor
44% of testicular tumours
Size: 1-12 cm, typically solitary
• Metastasis is rare: 2-6%
190
cs of sortoli cell tumor
Hyperoestrogenism common (19%)
• Feminization
• Pendulous prepuce
• Attractive for male dogs
• Bilateral alopecia
• Gynaecomastia
• Atrophy of the contralateral testis
• If severe: bone marrow hypoplasia (irreversible!)
191
most important thing to remember about seminoma
**• no endocrine disruption**
192
discuss seminoma
31% of testicular tumours
• **benign**
• local metastasis: 15%
• distant ,, : 6-10%
• palpable mass / incidental finding
• no endocrine disruption-_-dnt produce estradiole_
193
discuss leydig cell tumor
= i_nterstitial cell tumour_
• 25% of testicular tumours
• _mostly benign_
• _hyperoestrogenism (5%)_
• often small (\< 1 cm), often multiple
• atrophy of contralateral testis
• Paraneoplastic syndrome similar to SCT
194
specific cause of orchitis
brucella canis
it is zoonotic
195
discuss the acute phase of orchitis
lymfocytic orchitis / epididymitis
possible
196
discuss chronic orchitis
infertility
197
discuss transmission of brucella canis
entry oro-nasally and vaginal
• Intracellular multiplication in macrophages
198
tx for orchitis
antibacterial treatment often not successful
castrate infected animal
199
methodes for testing for B.canis
Blood cultures
• positive for 2 to 4 weeks after infection and for 30
weeks (sometimes years)
• PCR
• Serology--• 8 weeks + post infection (Antibodies)
• RCAT (rapid card agglutination test)
• sensitive but not specific thus false positives are
frequent (40% true positives)
• 2-mercaptoethanol eliminates some cross reaction
• hardly any false negatives
•AGID (agar gel immunodiffusion test) 12 weeks +
• more specific than RCAT but + if exposed to B. ovis,
abortus or suis
• less sensitive than the RCAT
200
discuss risk level 1 for b.canis
situation:Mating or insemination, no suspicion of B. canis and no reproductive disturbances
recommendation:Blood sample for antibody
analysis
201
discuss risk level 2 for B.canis
situation:Mating or insemination with dog with previous reproductive disturbances, import of dogs without
reproductive disturbances
recommendations:Serology: 2 samples 4-6
weeks apart
202
discuss level 3 of b.canis
situation:Import of or mating/insemination with dogs
with previous reproductive disturbances, infection with B.
canis suspected
recommendations:Serology, 2 samples 4-6
weeks apart, blood culture
and culture or PCR from
semen or vagina
203
discuss level 4 of b.canis
situationImport of or
mating/insemination with dog
from kennel with endemic
infection of B. canis
recommendation:Dissuaded from mating or
import.
204
predisposing factors for testicular tortion
its rare
testicular neoplasia
• retained testes
205
cs of testicular tortion
“acute abdomen” in cryptorchid male
206
tx for testicular tortion
shock
• surgery
207
which hormone causes protate tumor
DHT
208
discuss dx for prostate abnormalities
Physical examination
Diagnostic imaging
Cytology / culture
Urine sediment
Ejaculate
Aspiration biopsy (FNAB)
Suction biopsy (via a catheter)
Histopathology
Large needle biopsy (percutaneous, Tru-cut needle)
Incision biopsy (surgical)
209
list the prostate dz of dogs
Benign prostate hyperplasia
Prostatitis
Prostate cysts
Paraprostate cysts
Prostate abcesses
Prostate tumours
210
discuss effect of benign prostate hyperplasia
put pressure on the colon which causes difficult defecation and pain
211
predisposing factor for prostatis
Benign prostate hyperplasia(BPH)
212
discuss prostatis
Diffuse infection and inflammation
Related to BPH en LUTI
Acute and chronical form
E. coli
Staphylococcus sp.
Proteus sp.
Klebsiella sp
213
discuss prostate cysts and abscesses
```
Paraprostatic cysts
(embryonic remnants mesonephros / Wolffian ducts)
2. Prostatic cysts as sequelae to BPH or metaplasia
```
214
tx for prostatic cyst
* cyst therapy is castratioon
* drain the abscess by surgery
* about 18% of the prostate cysts contains urine
215
primary neoplasia of the prostate
adenocarcinoma
216
secondary neoplasia of the prostate
mainly tcc
217
discuss predisposing factor for prostate neoplasia
Castration increases risk
Breed
eg. Bouvier des Flandres
Not dependent on androgens!
218
reliable dx for prostate adenocarcinoma
Cytology of a FNAB usually gives a reliable
diagnosis (80%)
219
method of choice of gonadoctomy
Ovariectomy / Ovariohysterectomy
‒ ovariectomy is the method of choice unless
uterine pathology is present or a late
pregnancy
‒ Goethem et al. Vet Surg 35 (2006) 136-43
‒ even after ovariohysterectomy some
endometrium is left behind
‒ stump endometritis in case of remnant ovarian
tissue (ROT)
220
OVX versus OVHX
* risk for development of CEH-endometritis
after OVX = OVHX, provided:
• no oestrogens / progestagens are
administered after the procedure
* incidence of urinary incontinence after
OVX = OVHX
221
advantages of gonadectomy in femal dogs
Incidence mammary tumours ¯
• bitches
– appr. 50% is malignant
– 0.5% if \< 1st oestrus
– 26% if \> 2 or more (Schneider et al. 1969)
• cats
–\> 90% is malignant
– 7 times less likely
No CEH-endometritis
– Diabetes mellitus ¯
• bitches, cats
– Acromegaly ¯
• bitches
222
advantages of gonadectomy n male dogs
Prevention of disease, male dogs
– Testosterone dependent disease
• Prostatic disease
– BPH
» prostatic cysts, prostatitis, prostatic
abcess, perineal hernia
• Perianal adenoma
– Testicular tumour
– Balanoposthitis (mainly social problem!)
• Effect on lifespan?
223
disadvantages of gonadectomy
Irreversible
• Anaesthetic – surgery risk
• Urinary incontinence
– bitches, breedpredisposition
• Changes in coat
– bitches, breedpredisposition, eg. Cocker
Spaniel, New Foundland, Afghan hound etc.
• Obesity
224
discuss Urinary incontinence after ovx
in bitches
* Urinary Sphincter Mechanism Incompetence (USMI)
– urine leakage usually during rest / sleep
• Onset mostly within 2-3 years after
OVX, sometimes \< 6 months
225
causes of Urinary incontinence after ovx
in bitches
decreased plasma oestradiol
concentration after OVX (RF Nickel, PhD Thesis)
• treatment with oestriolum (Incurin ®)
sphincter function
– increased gonadotrophin
concentrations
(Ponglowhapan et al. Theriogenology. 76(2011)1284-92, Reichler et al
Theriogenology. 63(2005)2164-80)
• treatment with GnRH-agonist (slow release)
extracellular matrix of the bladder wall
226
discuss age predisposition of Urinary incontinence after ovx
in bitches
most evidence: negative correlation between
age at ovariectomy and incidence of USMI
227
discuss breed predisposition with Urinary incontinence after ovx in bitches
* larger breeds \> 20kg
• Boxer, Briard, Bouvier des Flandres etc.
228
disadvantages of Disadvantages of gonadectomy
* Increased incidence
– joint disease (dog)
• HD, Rupture of the cranial cruciate
ligament (CCL)
– several cancers (dog)
• eg. lymfosarcoma
229
common castration procedure in cats
* Mostly OVX
oestrous behaviour
• risk unwanted pregnancy
• hardly any contraindications
• Age: before first oestrus
230
gonadectomy of male cats
behaviour
• hardly any contraindications
– no increased risk for FLUTD
– persistent penile frenulum if young
• Age: before puberty,
mostly \< 6 months
231
advantages of medical oestrus prevention
* Increased anaesthetic risk
* Reversibility
‒ eg. short term postponement of oestrus in
breeding animals
* ‒Non-invasive alternative for ovariectomy
‒Cost
232
LIST DIFFERENT MEDICAL TX OPTIONS
* Sex steroids
‒ Progestagens
* ‒ Androgens
* ‒ GnRH agonists
‒ Slow release formulations
* ‒ Immunocontraception
‒ GnRH
‒ Zona pellucida
* ‒ Intratesticular injections
‒ Zeuterin™/EsterilSol™
233
LIST THE SEX STEROIDS USED FOR MEDICAL CONTROL OF ESTOUS
PROGESTERONE
ANDROGENS
234
LIST THE 2 IMMUNOCONTRACEPTIONS
GnRH
‒ Zona pellucida
235
HOW DOES GnRH works
ecreases the production of the hormone estrogen
stops menstrual cycles
236
discuss Mechanism of contraceptive activity
of progestagens
Direct inhibition of pituitary release of gonadotrophins?
→ as yet unknown
237
oral progesterones
```
Medroxyprogesterone acetate (MPA)
– Megestrol acetate (MA)
```
238
parental progestagens
Proligestone (PROL)
– Medroxyprogesterone acetate (MPA)
239
discuss the disadvantage of parental progestorones
Proligestone (PROL)
– Medroxyprogesterone acetate (MPA)
240
when is parental progesterones adm.
Administration during late anoestrus
•Interval to first oestrus following treatment
241
discuss use of oral progesterone in queen
* Fewer side effects than parenterally
administered progestagens
• Only for temporary use (breeding animals)
• Duration of action of parenteral
formulations is unpredictable
• Administration can easily be stopped in
case of pregnancy
242
why shouldnt the progesterones be given to queens b4 the first estrus
increased risk of
•Fibroadenomatous hyperplasia
•Endometritis
243
Progestagens, side-effects
Cystic endometrial hyperplasia
• Diabetes mellitus
• Acromegaly (GH excess)
• Neoplasia of mammary tissue
• Pseudopregnancy
• Prolonged pregnancy
244
how to tx Cystic Endometrial Hyperplasia
* Bitch: use weak progestagen
– proligestone
* Bitch (and queen):
never before first oestrus
not during oestrus
risk of endometritis
effect dubious or not
245
Progesterone / progestagens
| (dog)
GH secretion
–originating from the mammary gland
–cause of a number of side-effects
246
discuss the side effects of pregesterone
Hypersecretion of GH may lead to acromegaly
247
discuss how progesterone causes diabetes
1) growth hormone excess of
mammary origin (bitch)
2) intrinsic glucocorticoid
properties of progestagens
(bitch and queen)
248
discuss the mechanism in which the androgens stops estrus
19-nortestosterone derivatives (mibolerone)
‒ Mechanism: inhibition of gonadotrophins
249
side effects of anrogens
Behaviour
‒ Clitoral hypertrophy
‒ Vaginitis
Not available for use (in most countries)
250
list the short acting GnRH agonists
Buserelin (Receptal ®)
• Gonadorelin (Fertagyl ®
251
list GnRH with sustained release formulations
Leuprolide
• Azagly-nafarelin (Gonazon ®)
• Deslorelin (Suprelorin ® / Ovuplant ®)
252
GnRH agonist implants
* Initial induction of oestrus, flare-up(may make prostate cancer worse)
* – Possible preventive measures:
* Age, prepubertal
* Cycle stage, metoestrus
* Medical strategies to prevent induction
* Duration of action, highly variable
* – Return to fertility
253
reproductive dz after GnRH administration
* persistent induced heats
* metropathy(endometritis)
age as risk factor
254
disadvantages of GnRH implants
Often oestrus induction initially,
– even in metoestrus, if combined with
progestagens or upon re-implantation
• Risk for medical problems
• Return to fertility?
• No real alternative for progestagens
remember that GNRH agonist works by increasing LH and FSH release to depress receptors in the pituitary
255
disadvantages of GnRH implants
A disadvantage of the GnRH agonist approach to
suppress reproductive activity is that initial administration
in males and females typically causes an initial temporary
increase in follicle-stimulating hormone (FSH) and
luteinizing hormone (LH). In females, this increase may
result in inducing estrous. In males, the increase in LH
causes an increase in testosterone that does not express
itself clinically. (When GnRH agonist implants are used
for treatment of human prostate cancer, the stimulation of
testosterone aggravates the condition, causing increased
bone pain from metastatic tumors and a stimulation of
tumor growth. This initial stimulation is called a “flare.”)
It is important to understand that the mechanism of action
256
duration of action of GnRH
16 - 37 mo (4.7 mg)
placement at retrievable site (eg. umbilical area)
Practical point: sedation is not necessary
to place the implants
257
a real reversible alternative to surgical castration
Deslorelin (Suprelorin ®)
is highly effective in male dogs
258
% of unwanted mating followed by preg
40%
259
tx options for Termination of unwanted
pregnancy
ovariohysterectomy
– no treatment
• check for pregnancy later
– medical termination of unwanted pregnancy
260
Medical termination of unwanted pregnancy
* **Interfere with progesterone influence**:
– progesterone-receptor antagonists
– prostaglandine F2a , luteolysis, contractions
– ergoline derivatives, inhibit prolactin release: luteolysis
* I**nterference with embryo transport / implantation**
– oestradiolbenzoate: not registered anymore in Europe
261
discuss Progesteron receptor antagonist aglépristone for preg. control
Competitive receptorblockage: average: 6 d
262
tx protocol for Progesteron receptor
antagonist aglépristone
use between day 0-45
263
side effects of Aglepristone(prog. receptor antagonist)
\< 23 days: resorption
\> 23 days: expulsion of foetuses within 4-7
days
– mostly mucous discharge, symptoms
resembling parturition if treated \> 40 days
– local irritation of injection site
– keep injected volume low / site
264
Aglepristone effect on the estrus cycle
Progesterone concentration basal within 8-34
days:
– shortening of the luteal phase: 52 versus 75 days
• Plasma prolactin concentration
– sometimes overt pseudopregnancy
• Shortening of interoestrus interval: 155 versus
199 days: anoestrus shortened as well as luteal
phase!
265
discuss Ovarian progesterone
production
* half of luteal phase:
– independent of pituitary support
* 2nd half of luteal phase:
– prolactin is main luteotrophic factor
266
discuss the most important point concerning bromocriptine concerning luteolysis
Bromocriptine does not induce luteolysis during
the first half of the luteal phase
267
when is PGF2A effecient as abortificient
Only in second half of the luteal phase
– ideally start around day 28
268
disadvantages of pgf2@
contraction of all smooth muscle
– short lived, usually \< 2 h
269
pgf2@ dosage and effect
Dosage: potency of available agents differs
• Effect only after 4-7 days
• Hospitalization is advisable
270
which drug can pgf22 be combined with
Combination therapy with dopamine-agonist
– increases effectivity
– allows lower dosage of PGF 2T
• If aglepristone is available: don’t use PGF2T for
this indication
271
when should Dopamine-agonists
as abortificient be used
Only in second half of the luteal phase
– ideally start around day 28, confirmed pregnancy
272
side effects of Dopamine-agonists
as abortificient
emesis
Effect often late: about 7 days after start of
treatment
• Combination therapy with PGF2T
– increases effectivity
• If aglepristone is available: don’t use dopamine
agonistsPGF2T for this indication
273
discuss mechanism of estrogen in preventing unwanted preg
Interference with embryo transport / implantation?
274
when should estrogen be used in preventing unwanted preg
Treatments on days 3 and 5 after mismating
– relation with ovulation?
275
side effects of estrogen when used to control unwanted preg.
Side effects can be serious
– prolonged (pro-)oestus, might develop endometritis
– bone marrow hypoplasia, virtually irreversible
Not recommended anymore and not available in
many countries
276
1st choice of preventing unwanted preg. medically
progesterone
277
discuss the type of cycle in a cat
sesonal
polyestrus
induced ovulation
278
when do cats reach puberty
5-6 mnths
depends on light/season
279
gow long does estrus lasts in a cat
7 days
280
how long does post estrus last in a cat
10 days
281
how long does proestrus last in a cat
1 day
u cant see it
282
signs of estrus in cat
* Mainly behavioural
– call to males (owners can think cat is ill)
– reflexes with posture- lordosis
– Restless
* hardly any physical signs
283
Melatonin in cats
•suppression of oestrus has been shown with
melatonin implants
•interoestrus: ± 113 d (a), ± 64 d (b)
•oestrus: ± 61 d (a)
•no postponement of puberty
284
factors that may cause spontaneous ovulation in cats
•Behavioural stimulation
•Excitation
•Relation with their owners
•\> 30% of cats living in colony may
ovulate spontaneously
285
when does ovulation occur in cats
Ovulation 24 to 36 h post-coitus
286
vaginal dz of cats
* Vaginitis is not found in cats
* Vaginal tumours are very uncommon
287
what actions should be taken in prolonged preg.in cats
Duration 65 days (52 to 74)
• no action in cases of prolonged pregnancy, as in
bitches
• Litter size 4,5 (median, range 1-9)
• Breed variation
288
discuss presentation of kittens during parturition
**Anterior and posterior presentation are
normal
• 69% anterior**
• Mean birth weight: 98 g (range 35-167 g)
• Stillbirth: 5 % (n=887)
• no correlation with presentation
• Interkitten time: 30 min (median, range 2-
343 min)
• 95% \< 100 min after preceding kitten
289
the type of tumer that developes in young queens due to mammary progesterone
fibroadenomatous
hyperplasia (FAH)
290
the type of tumer that developes in older queens due to mammary progesterone
adenocarcinoma
291
how to prevent development of mammary tumors
Ovariëctomy before progesterone
influence reduces chance on mammary
tumour development 7-fold
292
Fibroadenomatous hyperplasia in the
queen
* Young queens, \< 2 y:
– progesterone /progestagens
* Proliferation of themammary gland epithelium and stroma
* Prognosis is good!
293
discuss efficiency of fibrosarcoma therapy in cats
* Most therapies not effective,
– including often ovariectomy!
• Clear and lasting effect within 1-2 weeks in 22 cats
after aglépristone administration
294
side effects of tx of fibroadenomatous tissue
* endometritis in pregnant queens
* Treatment of pregnant animals with FAH:
– Veterinary supervision important!
• abortion complications/incomplete
abortion?
–Higher dose of aglépristone necessary
• 1st: 30 mg / kg sc
• repeat as often as necessary: 15 mg/kg
295
semen collection in tomcats
**Electro-ejaculation**
• The most certain way of collecting a semen sample in cats
• Sedation obligatory
• Representativity of sample
• Urine admixture
• Retrograde ejaculation
296
discuss oxytocin concentrations
during parturition in dogs
• Low during late gestation, sign. elevated
during parturition
• Increase around the time of expulsion, but
also in the absence of expulsive efforts
–Suckling of pups?
• Sometimes absent during a prolonged
period of straining
297
– inter-pup intervals during parturition
appr.45 mins
298
anterior presentation of fetus
situs
299
discuss events of dystocia in 30 minutes
Forceful and frequent abdominal straining without
progress
45 mins. first puppy
300
discuss events of parturition/dystocia in 1-2 hrs
now and then weak abdominal straining
without progress
301
iscuss events of partution/distocia in • 2 - 3
no abdominal straining with puppies in
utero
* Bitch is acutely ill (systemically)
* Abnormal discharge
302
Therapeutic options with uterine inertia
• **Medical rather than obstetrical**
– Oxytocin 0,1 I.U./ kg SC (max 3 I.U. per
injection)
– (Calcium: hypocalcaemia??
• 0,2 ml/ kg IV (Ca borogluconaat, 1:1; diluted with
saline
• monitor ECG!)
**• Surgical**
303
sings of Subinvolution of placental sites
– persistent hemorrhage following whelping (\> 6 weeks)
– few inflammatory cells in the discharge
– hyperechoic area(s) in the uterus
estrogen and progesterone levels low
• self limiting; as late as after the next
oestrus
304
tx for Subinvolution of placental sites
low dose progestagen treatment
(Voorhorst MJ et al. Reprod Domest Anim 48(2013)840-3)
• rarely OVHX is necessary
305
sips
subinvuluted sites causing chronic vaginal hemorrages after welping
306
The effect of uterine contractions
on the fetus during parturition
→ reduced blood flow in uterus
→ short period of fetal hypoxia
→ = mainly respiratory
→ 1e fetal response is a decrease of the
FHR
→ after the uterine contraction FHR
returns to normal
307
causes of neonatal mortality
Dystocia: asphyxia
• Congenital problems
• Trauma
• Infection
• Low birth weight
– Relatively small liver: small glycogen storage
– Hypoglycaemia may develop quickly followed by
hypothermia
308
discuss colostrum
iGg is reduce 12h and afterwards
309
optimal day of breeding is measured by
LH
diestrus cytology
ovulation
310
constants for measuring gestational length
the LH surge,
ovulation,
optimal breeding data
or the onset of diestrus
311
discuss endocrinology of proestrus
Estrogen concentrations rise to peak and start to decline at the onset of the LH surge, usually at end of proestrus
• Progesterone concentrations low (\<2 ng/ml)
• FSH has already decreased
312
discuss events of proestrus
* Follicles grow and development
* Reproductive tract enlarges and is prepared for mating and conception
* Vaginal wall thickens and epithelium becomes keratinized
313
discuss vaginal cytology in proestrus
Increasing percentage of keratinized vaginal epithelial cells ("superficial cells”)
314
discuss vaginal appearance under vaginoscopy
Pale edematous appearance, no folds
315
definition of estrus
Preferred: LH surge is first day of estrus (average duration = 8 days)
• Traditional: Behavior, the bitch stands to be mounted (average duration = 9 days)
316
discuss endocronology of estrus
LH surge
• At start of estrus
• Lasts 24 hours (range 12 to 96 hours)
• Estrogen declines to basal levels
• Progesterone, increases before ovulation, pre-ovulatory luteinization of the follicles
• Rising concentrations + decreasing estrogen after LH surge usually causes sexual behavior
317
when does fertilization occur after lh surge
4 -5 days
its 2-3 after ovulation
318
when does fertilization occur after the first day of proestrus
10-12 days
319
behaviour of bitch in estrus
Accepts male but variable
• Some dogs start standing (show behavioral estrus) well before the LH surge or estrogen peak
• Some dogs continue standing for 10 to 12 days after LH surge, while others refuse to stand after less than a week post-LH
• Some will stand in diestrus
• Temperament of male and female may cause variation
• Thus no reliable association with hormones
320
discuss vaginal cytology in estrus
Cytological definition: superficial cells ≥ 90% ("cornification")
• Cytological estrus ranges from 6 days before LH to 4 days after
• Thus not reliable association with hormones
321
discuss viginal cytology in estrus
Pale appearance
• Folds appear in vagina and increase in size as progesterone concentrations rise
• Useful association with hormones but takes practice
322
definition of diestrus
Preferred: Based on vaginal cytology, dramatic decrease in the number of cornified cells (\>20%)
• Alternative - behavioral when refuses male but variable
323
duration of diestrus
around 60 days (approximately the length of gestation)
•diestrus is Luteal phase but terminology for luteal phase is confusing in the dog
• Some investigators still name diestrus (as well as other phases) as metestrus
• This is inconsistent with other species
324
discuss endocrinology of diestrus
Luteal phase with estrogen concentrations basal
• Progesterone concentrations increased (\>1.0 ng/ml)
• Progesterone peaks 30 days after LH surge
• Gradual decline for 4 to 6 weeks
• Progesterone concentrations similar in pregnant, unmated, & hysterectomized bitches
• No active luteolysis with uterine prostaglandins
8
• LH and prolactin increase during 2nd half of diestrus and are luteotrophic
• Relaxin only high in pregnant bitches (relaxin is primarily of placental origin in the dog)
325
discuss progestrone peak,and decline in diestrus
Progesterone peaks 30 days after LH surge
• Gradual decline for 4 to 6 weeks
326
discuss events of diestrus
* First few days of diestrus
* Vaginal epithelium is reduced in size
* Uterus is prepared for implantation in early diestrus
* Chance of conception greatly reduced due to closed cervix but may stand for mating
* • Day 1 of diestrus
* Used retrospectively to evaluate timing of breeding
* Can be used to predict day of whelping (in 57 days)
327
discuss cytology of diestrus
Day 1 of “cytological” diestrus
• Sharp decrease in the % of superficial cells \>20%
• Neutrophils in vaginal smear
• Metestrus cells and foam cells
328
definition of diestrus
From end of luteal phase (or pregnancy) to proestrus
• Anestrus usually lasts around 3 months (up to 9 months (Basenji) or even longer)
• Add the 2 months of luteal phase or pregnancy to get the usual inter-proestrus interval of 6 to 7 months)
329
discuss endocronology of anoestrus
```
Progesterone basal (\< 1 ng/ml)
• FSH and estrogens rise during last 2 months before estrus
```
330
events of anoestrus
Quiescent phase of cycle behaviorally and clinically
• Endometrium regenerates during 12 weeks of anestrus
• Pseudopregnancy (galactorrhoea) commonly occurs at end of luteal phase (early anestrus) and is a normal phenomenon
331
vaginoscopy of anoestrus
Pink and thin epithelium
332
the best test for brucella canis
serology
333
Fertile time Female considerations
Ovulation occurs 2 days after LH surge
• Oocytes are ready to be fertilized 4 to 5 days after LH surge for 2 to 5 days
334
Best time to mate
4-5 d after lh surge
335
the best hormone for breeding management
LH is a good piece of information for breeding management as events can be timed from the LH surge including ovulation
• LH surge lasts 12 to 36 hours normally
336
days of gestation after LH surge
65+/- 1
337
day of parturition from day of conception
60 ±1
338
day of parturition from diestrus cytology
57+/-1
339
gestational length of small pups
Long
340
gestational length of big pups
shorter
341
Differential diagnosis for ovarian dz
Cysts
• Tumor
• Hypoplasia/dysgenesis
342
ost important cyst clinically
follicular cyst
343
cs of follicular cysts
Hyperestrogenism
• Prolonged estrus
• Vulvar discharges (Metrorrhagia)
• Vulval swelling
• Alopecia
• Bone marrow aplasia
• Vaginal prolapse & tumors
• Irregular cycles
• CEH/ Pyometra
344
occurence of Tumors of reproductive tract
Mammary 80 to 85%
• Vagina & vulva 10 to 16%
• Ovary 3.5 to 5%
• Uterus 1%
• Cervix \< 1 %
345
ost common and important tumor of the reproductive system
Granulosa most common and important
346
cs of reproductive tumors
* Often few until large
* Abdominal enlargement
* Weight loss
* Ascites
347
which tumor causes hyperestrogenism
granulosa cell tumor
348
congenital abnormalities of the vagina
Strictures, bands, rings
• Cause problems with mating / parturition
349
discuss prepubitial viginitis
Common
• Rule out anatomical causes!
• Treatment
• Only if bitch is severely affected
• Wait until after the first estrus before ovariectomy
• Not proven
• Weigh up against risk of mammary tumors
350
discuss vaginitis in Adult
uncommon
351
discuss causss of primary vaginitis in adults
b.canis
herpes
352
secondary causes of vaginitis in adults
Anatomical problems
• Intersex
• Foreign body
• Androgens
353
discuss vaginal hyperplasia
=Prolapse, hypertrophy, estrual hypertrophy, vaginal eversion, vaginal protrusion
• Excessive edema and swelling of vagina
• Origin just cranial to urethral orifice
• Mild to severe forms : pear shaped or doughnut shaped (minority)
• Can get ulceration
• Most often associated with proestrus and estrus
• Cause is estrogen concentrations are high
• In most cases, swelling regresses spontaneously after estrus
• Surgery may be necessary
354
discuss vaginal hyperplasia
Usually benign
Leiomyoma, fibroma (sometimes leiomyosarcoma)
• Slow growth under influence of estrogen
• Often localized
• If malignant, metastasis by local invasion
• Tumors versus Hyperplasia
• Diestrus versus Pro/estrus
Vaginal orifice lateral versus central orifice
• Hard versus soft
355
onset of pseudopregnancy
2-3 mnths after estrus
356
causes of pseudopregnancy
Decline of progesterone concentrations
• Increase in prolactin concentrations
• Natural
• Iatrogenic
• After ovariectomy in late diestrus
357
consequences of pseudopregnancy
Does not predispose to pyometra
• Associated with mammary tumors
• Repeated cycle effects
• Possibly allowed subordinate wild dogs to feed pups of dominant bitches
• Can last 6 weeks
358
dx for pseudopreg
Physical exam
• Exclude a pregnancy
359
tx for pseudopregnancy
Spontaneous remission, often not necessary to treat
• Medication
• Antiprolactinic agents
• Dopamine agonists
• Cabergoline (Galastop 5 microg/kg PO SID for 7 days), best choice
17
• Bromocriptine 20 microg/kg/day PO for 7 days
• Serotonin antagonists
• Metergoline (Contralac) 0.1 mg/kg PO BID for 7 to 10 days
• Androgens and estrogens have adverse effects
• Progesterone causes temporary relief by decreasing prolactin but can get relapse of pseudopregnancy as prolactin concentrations rebound
360
average age for mammary tumors
Average age of detection 9 to 11 years
be careful with ages when answering tq
361
what type of lesions do you see in mammary tumors
Often lesions pre-cancerous
362
most common mammary tumor
adenocarcinoma
363
which mammary tumors are inflamatory
mostly malignant ones
364
characteristics of inflamatory mammary tumors
Tumor associated with acute inflammation
• Often malignant tumors
• Acute onset
• Infiltration / lymphatic and vascular edema
• Often rapid extension of carcinoma associated with neo-vascularization
• Very painful
• Skin is inflamed
• Rapid necrosis→ abscess
365
tx for inflammatory mammary tumors
Surgery Immediately once diagnosed
• Prognosis extremely poor
366
1 risk for mammary tumors
progesterone
367
clinical findings of mammary tumors
Often the two caudal pairs (Gland 5- 41%)
• In 50% of bitches, there are mammary tumors on several glands
• Independent tumors generally
• Local metastasis possible but less common
• Multiple tumors can be observed on the same mammary chain or 2 different chains
• Especially when bitch has received repeated injections of progestogens
368
tx for mammary tumors
**prolactin inhibitors**
Reduces size of mammary tissue and stops lactation
• Makes surgery easier
19
• Clinical image much clearer of the tumor and the surgery site
• Small lesions (\<2 cm) can disappear
• In some animals small nodules (0.5 to 1.3 cm) not previously detected are observed on the day of the surgery
• Recommended in all cases with pseudopregnancy (or bitches with ovaries) to pre-treat with prolactin inhibitors for 7 to 14 days before the surgery
369
which method do u use to remove mammary tumers less than 10 mm
nodulectomy
370
which method do u use to tx tumors greater than 10 mm
simple mastectomy
371
adv. of simple mastectomy in tx mammary tumors
Many tumors are benign or of low malignancy
• Quick and cheaper
• Less traumatic for the bitch
372
disadvantages of simple mastectomy
Does not eliminate the risk of new tumors in the other mammary glands
• Lymph nodes not removed
• Possibility of second surgery if tumor malignant to remove the lymph nodes
373
overectomy prevents
Pyometra
• Pseudopregnancy
• Mammary hyperplasia
• Cycling (so no more MPA!)
374
describe levels of preogesterone during preg.
With the exception of the abrupt decline just before parturition, concentrations during pregnancy similar to diestrus
• Total production increases during pregnancy but increased blood volume dilutes so that blood concentrations are similar to those of diestrus
375
discuss levels of relaxin during preg.
peak levels
Produced by fetal placenta,
• Not detectable in males, non-pregnant diestrus & anestrus bitches
• **Peaks 2 to 3 weeks before parturition in pregnant bitches**
376
discuss levels of prolactin in preg
Low in first half of diestrus; elevated in late pregnancy and lactation
377
Abdominal palpation for preg.should be done when
24-32 days after mating
378
radiographic imaging should be done when
fetal calcification 43 to 46 days after LH surge
379
when should ultrasound be performed in preg.
fluid-filled vesicle first observed 20 days after LH surge
380
dz encounted throughout preg.
Metrorrhagia
• Diabetes mellitus
381
viruses in preg
Canine Herpesvirus
• Relation with abortion is controversial
• Canine Parvovirus type II
• Canine Parvovirus type I (Canine Minute Virus)
• Canine Distemper Virus
382
non infectious dz causing problems in preg.
Poorly defined but probably more common cause
• Hypothyroidism and hypoluteism
• Talked about a lot
• Poorly defined
• ? Immunological, genetic, nutritional, environment
383
types of uterine tumors
Leiomyoma
• Leiomyosarcoma
384
tx for uterine tumors
Ovariohysterectomy if no metastasis
385
how do u tx SIPS, if \> 6 weeks post partum
(subinvolution of placental sites)
low dose progestagen treatment
386
your ddx if a bitch develop pyometra \< day 20 of Diestrus
CEH
387
discuss dopamine agnists in tx for pyometra
Dopamine agonists (combination is a good idea like abortion, only if luteolysis is a partial goal of this treatment, not necessary in case of treatment with progesterone receptor blocker))
a) Cabergoline 5microg/kg SID
b) Bromocriptine 10 to 25 microg/kg BID or TID
388
discuss use of **Aglepristone** (Alizin) in tx for pyometra
Injection
• Blockage of receptors of progesterone (24 hours)
• Luteolysis not immediate (reduction of Progesterone), but **immediate reduction of progesterone influence, so first choice if available.**
• Results variable when used alone, always combine with at least antibiotics, preferably also with PGF2alpha in order to evacuate the uterus
389
patient monitoring during pyometra tx
Progesterone
• Obligatory!
• Attention with incomplete luteolysis as can get rebound of progesterone!
• Aim \<1 ng/ml constant
• Ultrasonography
• ± Hemogram + biochemistry if very ill
• After luteolysis and no fluid in the uterus
• Re-examine the bitch 1 and 2 weeks after
• Two to five days before amelioration
• Vaginal discharge
• Starts quickly or increases then changes, becomes serous and stops
• Bitch can deteriorate very quickly
• Uterine rupture possible
• Leads to severe peritonitis
• DIC possible
• If no better after 7 to 10 days or deteriorates: perform ovariohysterectomy
390
management of pyometra the following season
Pyometra is possible again
• Mate at the first season after the treatment
• Plan ovary(ohyster)ectomy after end of breeding career or after last litter.
391
discuss balanitis and balano-posthitis
Discharge completely normal
• Thus penis must be inflamed for diagnosis
• Exteriorization of penis to check for neoplasia or foreign bodies
• Penis and prepuce - Balanitis and balanoposthitis
• Bacteria usually
• Usual varieties
• CHV (canine herpesvirus)
• Blastomycosis
392
tx for Balanitis and balano-posthitis
* Antiseptic irrigation
* Cortisone antibiotic cream in the prepuce
* Antibiotics and NSAIDS
393
urethral prolapse are common in which breed
english bulldog
394
sings of urethral prolapse and tx
Sometimes prolapse only when has erection
• Surgical treatment
• Excision of the prolapse + Elizabethan collar
• Castration controversial
395
Extended penis will not return to the preputial sheath
paraphimosis
emergency
396
causes of paraphimosis
* Neurological problem
* Excitement
* Idiopathic, Trauma, Phimosis
* → Ischemia, drying, excoriation & edema
397
tx for paraphimosis
Clean and lubricate, reposition purse string + Elizabethan collar
• Surgical (medical failure or penis compromised)
• Enlargement of prepuce
• Amputation of penis
398
cs of penial trauma
Clinical signs may include dysuria and hematuria
399
=Prolonged erection
* propism
400
causes of propism
Neurological or vascular
401
Penis will not extend through preputial sheath
phimosis
402
Urethral opening in abnormal location
Hypospadias
Often intersex
403
y shouldnt u give progesterone during (first few days) of proestrus as birth control
increases risk for endometritis
404
mechanism of action of steroid hormones
Mechanism of action of steroids is presumed to be negative feedback at the pituitary and hypothalamus, suppressing estrus by suppressing GnRH, LH and FSH release, although this has not be proven scientifically yet.
405
when are Testosterone propionate injection used in birth control.
Used in racing greyhound females every 14 days
• Various testosterone preparations available
406
problem with GnRH analogs
Problem is that they initially induce estrus and bitches can become pregnant but later abort. Prolonged estrus can be followed by endometritis (with age as an important risk factor). Therefore, probably not a safe alternative
407
mechanisms of estrogens in preventing preg.
* Movement of ova through oviduct is impaired
* Estrogen delays the uterine gland production of proteins necessary for embryo survival (normally, progesterone would be the main steroid influencing uterine function)
* Estrogen impairs implantation
408
after how many days after estrus will u see a reaction with pgf2alpha
Rx days 5 to 8 of diestrus causes decline in progesterone
409
best options to terminate preg. in cats
Progesterone receptor antagonists (best option)
410
aglepristone
progesterone antagonist
411
causes of persistent (pro)estrus
Ovarian cysts
Functional ovarian tumour– Granulosa cell tumour
Exogenous estrogens
Liver disease,– eg. portosystemic shunt
