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Theriogenology > Problem Pregnancy > Flashcards

Problem Pregnancy Flashcards

(75 cards)

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1
Q

Termination of Pregnancy

Why?

A

Problems during pregnancy or unwanted litter (ovariohysterectomy)

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2
Q

What must you do prior to terminating pregnancy

A

Make sure she is actually pregnant which requires you to wait 30 days to confirm with ultrasound

Recommended to be done prior to 45 days or will be delivering puppies and can become a mess/dangerous

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3
Q

Medical termination of pregnancy

Do NOT use…

A

Estrogen within 5 days of conception!

Does prevent embryo implantation but can cause pyometra and bone marrow dyscrasia

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4
Q

Medical termination of pregnancy

Luteolysis

A

Diminish progesterone -> luteolysis

Prostaglandin F2 alpha
Carbergoline or bromocriptine
Combination of PgF2alpha and cabergoline or bromocriptine (how you also treat pyometra!)

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5
Q

Prostaglandin F2alpha

Product

A

Natural dinoprost tromethamine (Lutalyse):
Micrograms
Narrow therapeutic index
50 mcg/kg to 250 mcg/kg (start with low end) 1-2x/day

Avoid strong prostaglandin synthetics (cloprostenol, Estrumate)

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6
Q

Prostaglandin F2alpha

Human

A

Absorbed through skin

Asthma and abortion may result

CANNOT be sent home
May want to hospitalize patient

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7
Q

Prostaglandin F2alpha

Adverse effects

A

Hypersalivation
Vomiting
Diarrhea

Mitigate by taking female on a short walk after administration

Start with low dose; patient will become acclimated so may have to increase dose

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8
Q

Prostaglandin F2alpha

Rx to Diminish effects

A

Atropine
Pirifinium bromide
Metazopine

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9
Q

Prostaglandin F2alpha

Monitoring

A

Monitor for adverse effects

Termination confirmed by measuring progesterone levels (< 1ng/mL)

If administered too early in pregnancy will require more drug due to low receptors

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10
Q

Vaginal Discharge During Pregnancy

3 things to pay attention to

A

Color (red, black, brown, green, yellow)

Quantity

Odor: mucus, purulent, hemorrhagic

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11
Q

Vaginal Discharge During Pregnancy

Possible Causes

A

Past term with abnormal whelping

Miscarriage/abortion:
Primary uterine disease
Infection
Other systemic disease
Trauma
Toxin
Coagulopathy (rodenticide)

Transient “problem pregnancy”

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12
Q

Diagnostics for vaginal discharge during pregnancy:

What is the MOST important one?

A

Brucella test!

Must be placed in isolation
Zoonotic

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13
Q

Diagnostics for vaginal discharge during pregnancy

A 
Brucella test
CBC and Serum Chem
Urinalysis
Ultrasound
Radiograph
Cytology of discharge and vaginal cytology 
Bacterial Culture and Sensitivity 
Serum progesterone test
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14
Q

Hypoluteoidism

What is it? Characteristics

A

Luteal insufficiency may be either primary problem or secondary to other disease

Might be in older females

Low progesterone level

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15
Q

Hypoluteoidism

Treatment

A

If no systemic problem is identified then treatment with progesterone to maintain pregnancy (first measure progesterone)

Can also do nothing and monitor

Kinds
Altrenogest, allytrenbolone (Regumate) - can be given at home with gloves
Oil by injection (longer duration)

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16
Q

Hypoluteoidism

Treatment Precautions

A

Progesterone:
Could result in pyometra if infection is present

Will diminish uterine muscular contraction and maintains cervical closure

Can masculinize the fetus (during beginning)

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17
Q

Treatment of Vaginal Discharge

A

Caesarean section if overdue
Ovariohysterectomy if serious disease
Antibiotics (usually based on culture and sensitivity, empirical while you wait)
Rest and monitor

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18
Q

Brucellosis

Background

A

Low incidence

Must screen for B. canis in breeding animals

Cats appear resistant to Brucella

Zoonotic disease! Must notify and warn owners

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19
Q

Brucellosis

Positive test

A

Must cull kennel because cannot guarantee eradication

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20
Q

Brucellosis

Infection

A

High bacterial load found in: vaginal discharge, semen, aborted tissues

Mid-late term abortions = most common; early embryonic death and abortion at any stage

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21
Q

Brucellosis

Location

A

Bacteria migrate to reproductive tissues; epididymitis, orchitis, prostatitis, discospondylitis, scrotal dermatitis, testicular degeneration

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22
Q

Brucellosis

Screening Test

A

Serology (antibodies):
Takes time to develop antibodies
Can go into quiescence

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23
Q

Brucellosis

Confirmation test

A

Agar gel immunodiffusion

Do NOT do a culture; dangerous to lab

PCR is a sensitive test

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24
Q

Brucellosis: Persistent infection

A

Antimicrobials; tetracyclines, aminoglycosides, fluoroquinolones

Depopulation of kennel; can resolve clinical signs but Brucellosis most likely still present

Isolate and test new animals

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25
Canine Herpesvirus 1 | Background
Only dogs are susceptible Virus located in oronasal and genital secretions Infection by mucosal route and transplacental
26
Canine Herpesvirus 1 | Clinical Signs
``` Variable and self-limiting Occular inflammation (can be serious) Trachea-bronchitis Vaginitis Posthitis ``` Lymphoid hyperplasia and vesicles on mucosa of vagina or penis
27
Canine Herpesvirus 1 | Diagnosis
PCR | Paired serum samples
28
Canine Herpesvirus 1 | Treatment
No effective treatment or vaccine
29
Canine Herpesvirus 1 | Most important fact to know (mom and puppies)
Infection of a naive female in late gestation or naive puppies after whelping results in abortion or death of the entire litter before two weeks of age After initial infection the female provides maternal immunity for puppies and neonatal loss does not occur
30
Infectious diseases reported as causing infertility or abortion in cats (5 main)
``` Feline leukemia virus Feline immunodeficiency virus Feline herpesvirus Feline panleukopenia Toxoplasma gondii ```
31
Pregnancy Edema
Rare Swelling of distal rear limbs, mammary glands and perineum; could interfere with whelping Generally large breed dogs with large litter See normal albumin level
32
Pregnancy Edema | Treatment
Caesarean section Termination of pregnancy Rule out systemic disease
33
Normal post-partum discharge time
4 to 8 weeks
34
Sub-involution of placental sites
Bleeding and discharge lasting more than 8 weeks and can be profuse Trophoblastic cells persist after whelping in endometrium and myometrium => uterus cannot involute
35
Sub-involution of placental sites | Diagnostics
Ultrasound | Cytology of discharge
36
Sub-involution of placental sites | Treatment
Spontaneous remission can occur No effective medical treatment -> requires ovariohysterectomy if severe
37
Post-partum metritis | What is it
Endometrial and myometrial inflammation (severe) immediately after whelping
38
Post-partum metritis | Causes
Difficult delivery Retained placenta Retained fetus Contamination during delivery
39
Post-partum metritis | Clinical Signs
Dark blood vaginal discharge Fever Depression Fading puppies Can go into shock and possibly die
40
Post-partum metritis | Diagnostics
CBC: normal to severe immature neutrophilic leukocytosis Cytology of discharge: neutrophilia and bacteria
41
Post-partum metritis | Treatment
IV fluid therapy Antibiotics Possible ovariohysterectomy Prostaglandin F2alpha may help with uterine evacuation if cervix is open and patient is systemically stable Oxytocin is too short acting and is already being produced by mom No flushing uterus like they do in large animal
42
Mastitis | What is it?
Focal or diffuse mammary gland swelling
43
Mastitis | Clinical Signs
Can occur secondary to metritis Reddened abnormally firm glandular tissue May progress to dark discolored and then open draining abscess (needs to drain but may not be enough to help) Can become systemically ill
44
Mastitis | Treatment
Antibiotic treatment early: Cephalosporin, clavulanate/amoxicillin Could do bacterial culture Okay if puppy drinks from infected gland, try and strip gland; will be hard to keep puppies away Warm compress May have to perform mastectomy with severe necrosis
45
Short Interestrus Interval How long? What is it?
Interestrus period is less than 4-5 months May not be long enough of a quiescence for uterine repair (involution, preparation for next estrus) --> could cause infertility
46
What is split heat?
Comes into proestrus but never into estrus; skips estrus and enters diestrus Low progesterone after first estrogen bump when progesterone should raise
47
Split Heat | Vaginal cytology
Looks like diestrus
48
Short Interestrus Interval | Treatment
Suppress onset of estrus to prolong anestrus Milbolerone (testosterone analog) Testosterone Contraceptives Caution: may develop idiosyncratic liver failure
49
No Estrus in Past 12 Months | One question to ask:
Has estrus ever occurred?
50
No Estrus in Past 12 Months: | Never had an estrus...(4)
Primary anestrus Inadequate detection/silent heat Disorder of sexual development Stress related (working dogs; usually have to stop competing for about 1 year, also take off any performance enhancing drugs)
51
No Estrus in Past 12 Months: | Has had a estrus before...(5)
Metabolic disorder (thyroid, Addisons) Inadequate detection/silent heat Luteal cysts Past medications for estrus suppression prolonged effect Stress related (working dogs; usually have to stop competing for about 1 year, also take off any performance enhancing drugs)
52
Causes for a female to be persistently in estrus:
Neoplasia (granulosa cell or adrenal tumor) Follicular cysts Vaginal disease
53
Normal interestrus and has not come into estrus | 4 Causes
Breeding management (ovulation timing, semen quality, AI) Prolonged effect of medication to control cycles Infection (Brucellosis) Abnormal tubular tract (vagina, cervix, uterus, oviducts)
54
Estrus Induction | What should you do prior?
If she has never had an estrus cycle than this will not work Complete evaluation for other systemic diseases (hypothyroidism, hypoadrenocorticism, luteal cysts) Must be in proper body condition See if she is in silent heat by placing her with proven male
55
Estrus Induction | Estrogen use
Estrogen does NOT lead to normal estrus
56
Estrus Induction | GnRH
Variable success and not available in US
57
Estrus Induction | Dopamine agonist
Suppresses prolactin and stimulates FSH and LH production Cabergoline; daily oral med, estrus expected within 30 days, may not be fertile
58
Ovarian Remnant Syndrome | Clinical Signs
Estrus behavior in patient with previous ovariohysterectomy/ovariectomy
59
Ovarian Remnant Syndrome | Diagnosis
Performing abdominal explore Vaginal cytology may show estrogen effect Serum progesterone 2-4 weeks after display of estrus behavior Constant increase in LH = ovaries gone
60
Pyometra; disease of which part of cycle?
Diestrus Due to progesterone: decrease in uterine contractility and secretions, closes cervix
61
Pyometra | Breeds
``` Rough Collie Rottweiler Cavalier King Charles Spaniel Bernese Mountain Dog Golden Retriever Saint Bernard Chow ```
62
Pyometra - Dog Age Onset
8-9 years 0-15 weeks following estrus
63
True or False: Pseudocyesis increases chance of pyometra
False!
64
True or False: Females which have had one or more litters have lower incidence than females who have never whelped
True
65
Pyometra - Cat | Age
5 years
66
Pyometra | Treatment
``` Ovariohysterectomy Medical management (rare) ```
67
True or False: Once a female has had a pyometra and she cleared it she is not likely to have another
False Also, owner MUST get her pregnant next cycle and recommended to spay after this litter is delivered
68
Bacteria most commonly isolated from pyometra
E. Coli
69
Estrogen Function
``` Proestrus and estrus Endometrial proliferation Increase vascularity Relaxes cervix Sensitizes progesterone receptors Effects support conception and early pregnancy ```
70
Progesterone Function
``` Luteal phase of estrous cycle (diestrus) Closure of cervix Reduce uterine contractility Stimulates endometrial glands Inhibits local immunity Support pregnancy and pyometra ```
71
Cystic Endometrial Hyperplasia | What is it?
Degenerative changes to the uterus; a old uterus Cystic structures Increased glandular elements Chronicity -> fibrosis
72
Pyometra | Laboratory Findings
Leukocytosis (30,000+) Left shift and toxic neutrophils Anemia 25% = normal
73
Pyometra | Vaginal cytology
Diestrus with large number of degenerating PMNs and bacteria
74
Pyometra | Diagnosis Imaging modalities
Radiography Ultrasound
75
Pyometra | Stabilization
Usually in septic shock: IV fluids, oxygen, plasma expanders Short acting corticosteroids ``` Antibiotics: Broad spectrum (ampicillin, amoxicillin, clavulanate) ``` Must stabilize before surgery

Theriogenology (7 decks)

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