Reproductive Emergencies Flashcards
(30 cards)
What can cause stump pyometra?
incomplete ovariectomy
When is hemorrhagic vaginal discharge normal in the bitch?
during proestrus phase
What are the 4 phases of the repro cycle in the dog?
- proestrus
- estrus
- diestrus
- anestrus
List 3 differentials for purulent vaginal discharge
metritis - usually postpartum animal
vaginitis
pyometra
When does pyometra occur?
Diestrus - when progesterone levels are high
typically within 1-4 months after estrus
preceded by cystic endometrial hyperplasia
What are the most common bacteria causing mastitis?
E. coli
Staph
Strep
What kind of uterus do bitches and queens have?
bicornuate uterus
Explain the initiation of parturition
initiated by fetuses
fetal adrenal gland maturation -> release cortisol
-> causes increased estrogen secretion by ovaries (45-60 days)
-> estrogen promotes prostaglandin E2 secretion
-> PGE2 is luteolytic -> corpus luteum regression
-> reduction in circulating progesterone
-> falling progesterone -> increase prolactin -> lactation
-> parturition within 24-48 hours of rapid progesterone decline
-> pressure on cervix -> oxytocin secretion -> myometrial contractility
Where is oxytocin secreted?
posterior pituitary
What are the stages of parturition and their duration?
stage 1
- 6-12 hours
- nesting, subclinical contractions
stage 2
- 2-12 hours (up to 24 hours in queens)
- overt contractions
- fetal expulsion
stage 3
- variable time
- placental expulsion
- uterine involution
What is the normal fetal heart rate?
200-220
List 5 indications for intervention in dystocia.
- obstruction (apparent on xrays, US, or vaginal exam)
- Fetal distress (HR <160-180)
- Dam is systemically ill
- uterine rupture or torsion suspected
- Dam has not entered labor and progesterone is < 2 ng/mL
What should be administered together with oxytocin?
Ca-gluconate
What are prerequisites for medical management for dystocia (i.e., oxytocin) ?
- labor has not been prolonged
- no obstruction
- fetusus deemed not too big for vaginal canl
- cervix is dilated
- electrolyte and acid-base abnormalities resolved/corrected
Describe how to perform a cesarian section
- ventral midline approach - incision from slightly cranial to umbilicus to just cranial to pubic bone
- visualize linea alba - lift linea alba before incising!
- identify uterus
- lift uterine horns and exteriorize them from the abdomen - laid on soaked/moistened laparotomy sponges
- make a small single uterine incision over the base with scalpel
- extend uterine incision with Metzenbaum scissors - extend just large enough to allow passage of fetus
- manipulate each fetus towards the same opening
- break the chorioallantois bluntly with hemostats to allow delivery of neonate from uterus
- rupture amnion and clamp and tie the umbilicus
- close uterus with inverting single layer (e.g., Cushings or Lemberts) - absorbable (e.g., 2-0 or 3-0 PDS or Monocryl)
- Administer SQ dose oxytocin AFTER uterus closure
- lavage abdomen
- close abdominal wall - make sure closing layer (external rectus fascia) is included in all bites (simple continuous or simple interrutped, PDS, 0 large dog, 2-0 otherwise)
- close subcutaneous space (Monocryl 2-0 or 3-0, simple continuous)
- skin closure (either simple interrupted or intradermal - puppies will nurse and higher risk of dehiscence if continuous with extern suture parts (Monocryl or PDS, 2-0 or 3-0)
What is the expected weight gain of neonatal puppies?
2-3 g per day per kg of expected adult weight
exception first 24 hours: may decrease slightly
What is the most common time for eclampsia to develop?
2-4 weeks post-partum (peak lactation time)
How does excessive prenatal Ca supplementation increase risk of eclampsia?
inhibits parathyroid hormone release and can promote parathyroid gland atrophy
stimulates thyroid calcitonin secretion
How does hypocalcemia cause muscle contractions?
increases nerve cell permeability to sodium ions»_space; excitatory effect»_space; spontaneous discharge of nerve fibers»_space; muscle contractions
why should Ca-chloride be avoided to treat eclampsia?
very corrosive perivascular effect if extravasated
What changes on the ECG indicate a too fast Calcium infusion?
- bradycardia
- QT shortening
- arrhythmias
How should the offsprings of a dam with eclampsia be managed (weaning etc.)?
- hand-feed with milk supplement for 24-36 weeks before reintroducing
- if > 4 weeks»_space; wean puppies
If persistent hypocalcemia/eclampsia is expected, how can this be treated?
Calcitriol administration - monitor iCa to identify iatrogenic hypercalcemia early
What medication can be given to help stop lactation after eclampsia episode?
Cabergoline (antiprolactinic drug)
