Periparturient Problems in Dogs and Cats
Periparturient Problems in Dogs and Cats
Embedded Files
DELIVERY ENVIRONMENT AND GENERAL MANAGEMENT
DELIVERY ENVIRONMENT AND GENERAL MANAGEMENT
• Location: Dogs and cats should deliver in a familiar area where they will not be disturbed.
• Location: Dogs and cats should deliver in a familiar area where they will not be disturbed.
• Impact of Disturbances: Unfamiliar surroundings or strangers may:
• Impact of Disturbances: Unfamiliar surroundings or strangers may:
◦ Impede delivery.
◦ Impede delivery.
◦ Interfere with milk letdown.
◦ Interfere with milk letdown.
◦ Adversely affect maternal instincts (especially in young or primiparous animals).
◦ Adversely affect maternal instincts (especially in young or primiparous animals).
• Neonatal Care Necessity: Neonates must be kept warm and receive colostrum; nursing must be closely supervised.
• Neonatal Care Necessity: Neonates must be kept warm and receive colostrum; nursing must be closely supervised.
BEHAVIORAL AND MATERNAL PROBLEMS
BEHAVIORAL AND MATERNAL PROBLEMS
• Nervous Dam/Apprehension:
• Nervous Dam/Apprehension:
◦ May subside in a few hours.
◦ May subside in a few hours.
◦ Treatment: Acepromazine at low dosages (0.01 mg/kg, PO, 2–3 times daily) can relax nervous dams without detectably sedating neonates or interfering with milk production.
◦ Treatment: Acepromazine at low dosages (0.01 mg/kg, PO, 2–3 times daily) can relax nervous dams without detectably sedating neonates or interfering with milk production.
• Abnormal Maternal Attention:
• Abnormal Maternal Attention:
◦ Dam may ignore neonates or give them excess attention.
◦ Dam may ignore neonates or give them excess attention.
◦ Excessive licking/biting the umbilical stump can cause hemorrhage or damage to the abdominal wall, potentially leading to evisceration.
◦ Excessive licking/biting the umbilical stump can cause hemorrhage or damage to the abdominal wall, potentially leading to evisceration.
◦ Excess grooming of the neonate may prevent nursing.
◦ Excess grooming of the neonate may prevent nursing.
• Failure of Maternal Instincts:
• Failure of Maternal Instincts:
◦ Dam may assume sternal recumbency and not allow nursing.
◦ Dam may assume sternal recumbency and not allow nursing.
◦ Dam may leave the neonates unattended.
◦ Dam may leave the neonates unattended.
• Normal Behavior: The dam may pick up and rearrange pups after each delivery, but she should then assume the normal nursing position.
• Normal Behavior: The dam may pick up and rearrange pups after each delivery, but she should then assume the normal nursing position.
PRINCIPAL METABOLIC DISEASE
PRINCIPAL METABOLIC DISEASE
• Puerperal Hypocalcemia:
• Puerperal Hypocalcemia:
◦ Principal metabolic disease associated with pregnancy.
◦ Principal metabolic disease associated with pregnancy.
◦ Rare in cats.
◦ Rare in cats.
◦ Most common in dogs weighing < 20 kg.
◦ Most common in dogs weighing < 20 kg.
◦ Exacerbated by improper perinatal nutrition (imbalanced prenatal diet or excessive calcium/phosphorus supplementation).
◦ Exacerbated by improper perinatal nutrition (imbalanced prenatal diet or excessive calcium/phosphorus supplementation).
COMMON POSTPARTUM INFLAMMATORY DISEASES
COMMON POSTPARTUM INFLAMMATORY DISEASES
• A. Metritis
• A. Metritis
◦ Cause: Retention of a placenta or its remnants.
◦ Cause: Retention of a placenta or its remnants.
◦ Signs: Continued straining (as if in labor), presence of a fusiform mass (best identified by ultrasonography), abnormal vulvar discharge, fever, and lethargy.
◦ Signs: Continued straining (as if in labor), presence of a fusiform mass (best identified by ultrasonography), abnormal vulvar discharge, fever, and lethargy.
◦ Treatment for Retained Placenta:
◦ Treatment for Retained Placenta:
▪ Oxytocin (if given within 24 hours of labor).
▪ Oxytocin (if given within 24 hours of labor).
▪ If oxytocin is ineffective or >24 hours postpartum: Prostaglandin F (0.1 mg/kg, SC, every 12–24 hours) or cloprostenol (1–3 mcg/kg, SC, every 12–24 hours to effect).
▪ If oxytocin is ineffective or >24 hours postpartum: Prostaglandin F (0.1 mg/kg, SC, every 12–24 hours) or cloprostenol (1–3 mcg/kg, SC, every 12–24 hours to effect).
• B. Mastitis
• B. Mastitis
◦ More common in female dogs than in queens.
◦ More common in female dogs than in queens.
◦ Associated Bacteria: Coliforms or Staphylococcus spp..
◦ Associated Bacteria: Coliforms or Staphylococcus spp..
◦ Predisposing Factors: Galactostasis or excessive human manipulation of the mammary glands.
◦ Predisposing Factors: Galactostasis or excessive human manipulation of the mammary glands.
◦ Management: Mammary glands should be observed to ensure all are being nursed.
◦ Management: Mammary glands should be observed to ensure all are being nursed.
◦ Can coexist with metritis.
◦ Can coexist with metritis.
HEMORRHAGE AND UTERINE INVolution
HEMORRHAGE AND UTERINE INVolution
• Postpartum Uterine Hemorrhage:
• Postpartum Uterine Hemorrhage:
◦ Significant hemorrhage is rare.
◦ Significant hemorrhage is rare.
◦ Treatment: Oxytocin (< 24 hours postpartum) and prostaglandins can be administered if the uterus is healthy.
◦ Treatment: Oxytocin (< 24 hours postpartum) and prostaglandins can be administered if the uterus is healthy.
◦ Severe Cases: Ovariohysterectomy must be performed if hemorrhage is unabated and significant (i.e., causing blood loss anemia).
◦ Severe Cases: Ovariohysterectomy must be performed if hemorrhage is unabated and significant (i.e., causing blood loss anemia).
◦ Associated Care: Screening and appropriate therapy for an underlying coagulopathy should be undertaken.
◦ Associated Care: Screening and appropriate therapy for an underlying coagulopathy should be undertaken.
• Uterine Subinvolution:
• Uterine Subinvolution:
◦ Results in hemorrhagic spotting for >12–16 weeks (the normal period of involution in dogs).
◦ Results in hemorrhagic spotting for >12–16 weeks (the normal period of involution in dogs).
◦ Treatment: Unnecessary unless blood loss is significant, as the condition resolves spontaneously.
◦ Treatment: Unnecessary unless blood loss is significant, as the condition resolves spontaneously.
◦ Future fertility is unaffected.
◦ Future fertility is unaffected.
LACTATION ISSUES (AGALACTIA)
LACTATION ISSUES (AGALACTIA)
• Agalactia: Uncommon unless caused by severe illness.
• Agalactia: Uncommon unless caused by severe illness.
• Assessment of Adequacy: Indicated by neonatal contentment and daily weight gain (after the first 24 hours).
• Assessment of Adequacy: Indicated by neonatal contentment and daily weight gain (after the first 24 hours).
• Causes of Inadequate Lactation:
• Causes of Inadequate Lactation:
◦ Metabolic or inflammatory disorders (metritis, eclampsia, mastitis).
◦ Metabolic or inflammatory disorders (metritis, eclampsia, mastitis).
◦ Nutritional and hydration status.
◦ Nutritional and hydration status.
◦ Periparturient pain.
◦ Periparturient pain.
◦ Disruption of the pituitary-ovarian-mammary gland axis (idiopathic agalactia).
◦ Disruption of the pituitary-ovarian-mammary gland axis (idiopathic agalactia).
◦ Premature delivery.
◦ Premature delivery.
◦ Iatrogenic agalactia (can result from progesterone supplementation during gestation, which should be avoided unless essential).
◦ Iatrogenic agalactia (can result from progesterone supplementation during gestation, which should be avoided unless essential).
• Milk Letdown Promotion: Triggered by nursing, which releases oxytocin; neonates must spend adequate time suckling.
• Milk Letdown Promotion: Triggered by nursing, which releases oxytocin; neonates must spend adequate time suckling.
• Stimulation of Inadequate Lactation (if prompt):
• Stimulation of Inadequate Lactation (if prompt):
◦ Oxytocin: Mini-dose (0.5–2 U/dose, SC, every 2 hours). Neonates are removed before injection and returned 10 minutes later.
◦ Oxytocin: Mini-dose (0.5–2 U/dose, SC, every 2 hours). Neonates are removed before injection and returned 10 minutes later.
◦ Prolactin Release: Concurrent administration of metoclopramide (0.1–0.2 mg/kg, SC, 3–4 times daily).
◦ Prolactin Release: Concurrent administration of metoclopramide (0.1–0.2 mg/kg, SC, 3–4 times daily).
◦ Milk Letdown Facilitation: Acepromazine at mild tranquilization dosages.
◦ Milk Letdown Facilitation: Acepromazine at mild tranquilization dosages.
◦ Suckling Management: Neonates must be supplemented adequately (for survival) but not excessively (to ensure vigorous suckling). Gently hand strip mammary glands if suckling is not vigorous.
◦ Suckling Management: Neonates must be supplemented adequately (for survival) but not excessively (to ensure vigorous suckling). Gently hand strip mammary glands if suckling is not vigorous.
◦ Duration: Therapy should continue until lactation is adequate, typically 12–24 hours later.
◦ Duration: Therapy should continue until lactation is adequate, typically 12–24 hours later.
CESAREAN SECTION AND OVARIOHYSTERECTOMY (OHE)
CESAREAN SECTION AND OVARIOHYSTERECTOMY (OHE)
• Lactation Evaluation: Determination that lactation is adequate should be performed before elective C-section.
• Lactation Evaluation: Determination that lactation is adequate should be performed before elective C-section.
• Ovariohysterectomy at C-section (Considerations):
• Ovariohysterectomy at C-section (Considerations):
◦ Lactogenesis: Mammary development adequacy should be assessed before removal of ovaries, as estrogen promotes lactogenesis.
◦ Lactogenesis: Mammary development adequacy should be assessed before removal of ovaries, as estrogen promotes lactogenesis.
◦ Risks: Associated with higher morbidity and mortality secondary to hemorrhage.
◦ Risks: Associated with higher morbidity and mortality secondary to hemorrhage.
◦ Procedural Drawbacks: Prolongs anesthesia time, is a more invasive procedure for the dam, and delays nursing of offspring.
◦ Procedural Drawbacks: Prolongs anesthesia time, is a more invasive procedure for the dam, and delays nursing of offspring.
Page updated
Google Sites
Report abuse