Mismating Management, Contraception, and Ovarian Remnant Syndrome Flashcards

1
Q

What are questions to ask during the initial consult?

A

Is she in heat?
Was a “tie” observed?
If not, how long was the bitch missing?
Are puppies wanted in the future and why?
Is this bitch a valuable breeding animal?
Will you let me spay her?

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2
Q

What should be performed on all mismated bitches?

A

Vaginal cytology

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3
Q

What should you look for on cytology?

A

Sperm heads

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4
Q

What are the options for pregnancy termination?

A
OHE
Prostaglandins
Estrogens
Prolcatin inhibitors
Corticosteroids
Progesterone antagonists
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5
Q

What is the mode of action of prostaglandins?

A
Direct luteolytic action with multiple doses
Removes source of P4
Causes myometrial contractions
Dilates the cervix
Pregnancy is expelled
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6
Q

What are the side effects of prostaglandins?

A
Panting
Excessive salivation
Vomiting
Diarrhea
Begine within 5 minutes and can last 20-30 minutes
Bitch may return to estrus sooner
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7
Q

What happens with repeated use of prostaglandins?

A

Side effects subside

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8
Q

How can you minimize the side effects of prostaglandins?

A
Give on empty stomach
Start with lower doses and increase
Dilute with saline
Walk immediately after injections
Atropine 0.1 mg/kg SQ
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9
Q

What is the dosing of prostaglandins?

A

Lutalyse: 50 μg/kg SQ TID for 2 days, then increase to 200 μg/kg SQ TID until abortion is complete
Cloprostenol: 2.505 μg/kg SQ every 24-48 hours for at least 2 doses

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10
Q

What is the problem with cloprostenol if used at the dose rate of lutalyse?

A

It could be fatal

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11
Q

When can estrogens be used?

A

Only during estrus

This is the only product that can be used at the time of mating

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12
Q

Can estrogens be used in the valuable breeding bitch?

A

No

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13
Q

What is the mode of action of estrogens?

A

Tightens the utero-tubular junction
“Kink” formed in the oviducts
Delays tubular transport of embryos
Alters estrogen:progesterone ratio leading to implantation failure
Direct embryotoxic effect
Collectively this leads to failure of pregnancy maintenance

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14
Q

What are the side effects of estrogens?

A

Pyometra
Bone marrow suppression
Prolonged estrus
Infertility at subsequent cycles

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15
Q

What are the estrogens that can be used?

A

Estradiol cypionate: 44 μg/kg IM once during estrus
Estradiol benzoate: 10 μg/kg IM twice at 48 hour intervals 2-3 days after mating
Diethylbesterol is not an effective mismating agent

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16
Q

What is the mode of action of corticosteroids?

A

High cortisol levels cause fetal production of prostaglandins leading to abortion
May have direct luteolytic actions

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17
Q

What are the side effect of corticosteroids?

A

Anorexia

PU/PD

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18
Q

When do you start corticosteroids?

A

Start after day 30 of gestation

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19
Q

What is the mode of action of prolactin inhibitors?

A

Increases dopamine release
Dopamine inhibits prolactin release
Prolactin is the primary luteotropin in the bitch

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20
Q

What do low prolacitn levels lead to?

A

Low P4 levels which causes abortion/pregnancy loss

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21
Q

What are the side effects of PRL inhibitors?

A

Nausea, vomiting
Anorexia
Diarrhea

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22
Q

What PRL inhibitor are side effects more common with?

A

Bromocriptine

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23
Q

When should you start using PRL inhibitors?

A

After day 30 of gestation

24
Q

What drugs require you to confirm pregnancy loss at the end of treatment?

A

Corticosteroids

PRL inhibitors

25
Q

What are examples of progesterone antagonists?

A

Mifeprostone
Agleprostone
Both are unavailable in the US

26
Q

What assures luteolysis has occurred?

A

Progesterone levels of <1 ng/ml at completion

27
Q

What are contraception options?

A

Intratesticular injection of sclerosing agents
GnRH vaccines
GnRH agonists
GnRH antagonists

28
Q

What are examples of intratesticular injection of sclerosing agents ?

A

Neutersol/esterilsol

29
Q

What are examples of GnRH vaccines?

A

Gonacon

30
Q

What are examples of GnRH agonists?

A

Gonazon

Suprelorin

31
Q

What are examples of GnRH antagonists?

A

Acyline

32
Q

What does Neutersol/Zeuterin/Esterilsol result in?

A

Sterility due to destruction of sperm production

33
Q

What is an ovariectomy?

A

Uterus is left but ovaries are removed

34
Q

What is an ovarian sparing spay?

A

Ovaries remain

35
Q

Why must the cervix be removed in an ovarian sparing spay?

A

Pyometra is possible

36
Q

What are the cons to ovarian-sparing spay?

A

Still show signs of estrus, mammary tumors

37
Q

What are pros to ovarian-sparing spay?

A

Decreased spay incontinence

Bone development and orthopedic problems

38
Q

What is a vesectomy?

A

Only renders male sterile but still will have testosterone present

39
Q

What are alternatives to vasectomies?

A

Castrate and prosthesis

40
Q

What is a flank spay in cats often used in cases of?

A

Mammary hyperplasia

41
Q

What is ovarian remnant syndrome a complication of?

A

OHE

42
Q

Is ORS more common in cats or dogs?

A

Cats

43
Q

When does ORS occur?

A

When a piece of retained ovary becomes functional

44
Q

What is the biggest indication of ORS?

A

Spayed female exhibiting signs of proestrus or estrus
Vulvar swelling
Mucoid to serosanguinous discharge

45
Q

What can be seen following “heat” in an animal with ORS?

A

Pseudocyesis

46
Q

What are DDx in animals with ORS?

A

Conditions that cause bloody vaginal discharge in spayed females: vaginitis, vaginal neoplasia, stump pyometra, trauma, foreign body, exogenous estrogen exposure

47
Q

What is the average interval from OHE to estrus?

A

Over 15 months

48
Q

What is used to diagnose ORS?

A

Vaginal cytology
Vaginoscopy
Raciographs/US are usually not helpful

49
Q

What are will you see on vaginal cytology from an animal with ORS?

A

Consistent with proestrus or estrus in the absence of exogenous estrogen exposure
Predominant cornified/superficial cells

50
Q

What are will you see on vaginoscopy from an animal with ORS?

A

Vaginal edema typical of proestrus/estrus

51
Q

What is the exception for using US with ORS?

A

May be helpful on large breed dogs with large follicles or cysts present

52
Q

What is the hormone profile of ORS females?

A

Elevated anti-mullarian hormone levels
Confirm rising P4 2 weeks later
High E2
LH concentration low on 2 separate tests

53
Q

How do you treat ORS?

A

Remove offending tissue surgically

Lifelong medical management if unable to remove surgically

54
Q

What is used for medical management of ORS?

A

GnRH analogue/GnRH antagonist
Megesterol acetate (Ovaban)
Mibolerone (Cheque)

55
Q

Why is medical management not recommended for ORS?

A
Side effects:
Mammary gland tumors
Acromegaly
Clitoral enlargement
Adrenocortical suppression