15 Canine Pregnancy, Parturition, and Neonatal Management

TRUE

TRUE OR FALSE: you can continue heartworm preventative WHILE a bitch is pregnant

1. abdominal palpation: 28-35 days = "string of pearls"

2. radiography: after day 40 = best in final week of gestation for fetal *count*

3. ultrasound: can start days 24-28 = confirms pregnancy and fetal viability but *NOT count*

4. relaxin = in serum after days 21-28

Name when and why:

1. abdominal palpation

2. radiography

3. ultrasound

4. and relaxin

would be useful in pregnancy diagnosis in bitches?

28-35 days ONLY

When is the ONLY TIME you can palpate "string of pearls" to diagnose bitch pregnancy?

AFTER days 21-28

Relaxin assays pregnancy diagnosis can be used in dogs, as it comes from their placenta. When is this test used, at what days?

Dorsal recumbency

What recumbency is best to scan the uterus in in bitches?

Lateral recumbency

What recumbency is best to scan the ovaries in in bitches?

0.5-1 cm

How big is the uterus in bitches in anestrus?

2 cm off caudal pole of kidney

Where are the ovaries in relation to the kidney in bitches?

About 2x the mothers

What should the fetal heart rate be in health?

UNDER 150 bpm

What heart rate indicates fetal stress or emergency?

a. taking 6x gestation sac diameter and adding 20

d. take 3x crown-rump length and add 27

If breeding was *less than* 40 days ago in the bitch, you can calculate gestational age by:

a. taking 6x gestation sac diameter and adding 20

b. taking 15x head diameter and adding 20

c. take 7x body diameter and add 29

d. take 3x crown-rump length and add 27

b. taking 15x head diameter and adding 20

c. take 7x body diameter and add 29

If breeding was *more than* 40 days ago in the bitch, you can calculate gestational age by:

a. taking 6x gestation sac diameter and adding 20

b. taking 15x head diameter and adding 20

c. take 7x body diameter and add 29

d. take 3x crown-rump length and add 27

Increase calories by 50% and provide MULTIPLE small meals

What should happen to the bitches nutrition in the last trimester of pregnancy?

This is a place big enough the puppies can get under but the bitch cannot lay on them

What does it mean when a whelping box has "pig rails"?

1 week prior to welping

When should you introduce a bitch to her welping box?

AFTER 40 days

After what day are radiographs safe to perform on bitches for the puppies?

Best to do one week prior to due date so you can properly count the number of fetuses so you can know when labor is complete or if dystocia might happen when you measure fetal head and maternal pelvic canal

X-rays can be done after 40 days on bitches to assess the fetuses. However, when is the best time to do it and why?

5

How many puppies are there?

Pig rails

What is this pointing to?

Body temp will drop 24 hours before welping because progesterone is dropping and this hormone is thermogenic. If temp has dropped below 98F, she will likely welp within 24 hours

How is welping related to body temperature in bitches?

Progesterone drop

Which hormone is related to the prewelping temp drop in bitches?

Whelpwise

Which company provides monitors that track uterine contractions and fetal heart rate, that ideally starts monitoring 1-2 weeks prior to due date to establish baseline?

1. serum progesterone at 10 ng/mL = 36 hours to welping

2. serum progesterone at 4 ng/mL = 18 hours to welping

3. serum progesterone at 2 ng/mL = 9 hours to welping

Describe the progesterone levels at the following times of pre-welping in bitches:

1. 36 hours to welping

2. 18 hours to welping

3. 9 hours to welping

a. LH peak

Gestation length in bitches is 65 days if you are counting from:

a. LH peak

b. post ovulation

c. post breeding date

d. onset of diestrus

b. post ovulation

Gestation length in bitches is 63 days if you are counting from:

a. LH peak

b. post ovulation

c. post breeding date

d. onset of diestrus

c. post breeding date

Gestation length in bitches is 61-63 days and the most inaccurate if you are counting from:

a. LH peak

b. post ovulation

c. post breeding date

d. onset of diestrus

d. onset of diestrus

Gestation length in bitches is 56-57 days if you are counting from:

a. LH peak

b. post ovulation

c. post breeding date

d. onset of diestrus

63 days

On average, how long is feline pregnancy?

ABNORMAL: though hemorrhagic mucous can be normal, it may be a sign of impending abortion, so evaluate cytology

ABNORMAL: purulent discharge = pyometra or dead fetus

Occasional mucous and SOMETIMES hemorrhagic mucous can be normal vaginal discharge for pregnancy in bitches. Talk about what ISN'T normal

a. clavamox

b. cephalosporin

c. quinolones

f. ampicillin

Select the antibiotics that are safe to use in pregnant bitches:

a. clavamox

b. cephalosporin

c. quinolones

d. macrolides

e. sulfonamides

f. ampicillin

Ultrasound

What is the best way to confirm fetal wastage in bitches?

Fetal wastage

In pregnant bitches, trauma, heat stress, cystic endometrial hyperplasia, luteal insufficiency, and infections may cause what?

Evacuate uterine contents using PGF2alpha

How can you treat fetal wastage if all puppies and kittens are dead?

Need to collect feti that are not degenerated, placentas in good condition, and 2 (paired) serum samples collected 2 weeks apart

What do you need to send to the lab if you are going to test what caused an abortion?

X ray

What is the best way to confirm pregnancy in bitches?

Prolonged gestation and primary uterine inertia (progesterone under 2 ng/mL but no labor)

What particular problem do singleton puppies (especially in large to medium breeds) cause?

Uterine torsion

This complication of pregnancy is uncommon in dogs, clinically presents with acute abdominal pain and distress, diagnosed thru exploratory laparotomy

1. progesterone rapidly falling to under 2 ng/mL

2. transient drop in temperature

3. milk evident in glands (unreliable)

4. nesting behavior 12-24 hours prior

Describe the signs of impending parturition:

First stage

Which stage of pregnancy in bitches:

begins after progesterone block, occurs with removal of progesterone block from uterus so myometrial activity can begin, has an increase in oxytocin receptor sites, nesting, anxiety, and vomiting

Second stage

Which stage of pregnancy in bitches:

has active contractions, fergusons reflex, amnion appears, greatest effort to deliver head, averaging 6-12 hours with 30-60 min intervals between puppies

b. increased oxytocin receptor sites

e. removal of progesterone block

f. starts when progesterone drops

Select the signs of stage 1 parturition:

a. active contractions and greatest effort to deliver head

b. increased oxytocin receptor sites

c. amnion appears

d. greenish-black uteroverdin

e. removal of progesterone block

f. starts when progesterone drops

a. active contractions and greatest effort to deliver head

c. amnion appears

d. ferguson's reflex

f. greenish-black uteroverdin

Select the signs of stage 2 parturition:

a. active contractions and greatest effort to deliver head

b. increased oxytocin receptor sites

c. amnion appears

d. ferguson's reflex

e. removal of progesterone block

f. greenish-black uteroverdin

b. passage of placenta

f. passed within 5-15 minutes

Select the signs of stage 3 parturition:

a. active contractions and greatest effort to deliver head

b. passage of placenta

c. amnion appears

d. greenish-black uteroverdin

e. removal of progesterone block

f. passed within 5-15 minutes

Uteroverdin

This is the accumulation of maternal blood that supplies the fetus with iron throughout pregnancy that comes form the placental marginal hematomas

Alternatively: left horn puppy, then right horn puppy, then left horn puppy, then right horn puppy

In what order are fetuses delivered from the horns in stage 2 of parturition in bitches?

Areas of marginal hematomas = where the green black uteroverdin discharge will come from when the placenta has detached from the uterus and normally comes out with the puppy

What is circled here?

PRESENTATION: cranial OR caudal

POSITION: dorsosacral

POSTURE: extended limbs

Describe the normal presentation, position, and posture of puppies

60% cranial longitudinal, extended forelimbs

40% caudolongitudinal, extended hindlimbs

Both cranial and caudal longitudinal presentations are normal in puppies. Which is MORE COMMON

1. panting, restless, anorexic bitch for over 12 hours

2. weak contractions over 4 hours before first pup

3. active contractions more than 30 minutes with no pup produced

4. rest period between pups is over 2 hours

5. black/green discharge without puppy

6. purulent/hemorrhagic discharge

7. temp. drops more than 24 hours before and still has no puppies

You need to tell the owner to bring the bitch to you IMMEDIATELY if WHAT dystocia factors are present:

e. over 24 hours

If the bitch's temp has dropped more than _________ ago and there still haven't been puppies, GO TO THE VET:

a. over 12 hours

b. over 4 hours

c. over 30 minutes

d. over 2 hours

e. over 24 hours

d. over 2 hours

If the rest period between puppies is more than _______, GO TO THE VET:

a. over 12 hours

b. over 4 hours

c. over 30 minutes

d. over 2 hours

e. over 24 hours

b. over 4 hours

If the bitch is having weak contractions for more than ________ before having the first pup, GO TO THE VET:

a. over 12 hours

b. over 4 hours

c. over 30 minutes

d. over 2 hours

e. over 24 hours

c. over 30 minutes

If active contractions happen for more than _______ with no pups produced, GO TO THE VET:

a. over 12 hours

b. over 4 hours

c. over 30 minutes

d. over 2 hours

e. over 24 hours

a. over 12 hours

If the bitch is panting, restless, anorexic or vomiting for more than _______ with no puppies, GO TO THE VET:

a. over 12 hours

b. over 4 hours

c. over 30 minutes

d. over 2 hours

e. over 24 hours

30-60 minutes

Because bitches deliver litters, there is normally a rest period between puppies. How long is this rest period in health?

Primary

This type of uterine inertia is characterized by an incompletely dilated cervix, no signs of second stage labor, with normal sized pups/pelvis that may be caused by hypocalcemia

Secondary

This type of uterine inertia is characterized by a puppy obstructing the passage and the uterus becoming worn out so it can't push anymore

Bulldogs, boston terriers. Anything with broad head and narrow pelvis

Name dog breeds which are predisposed to dystocias

1. C-section

2. ultrasound to assess viability

3. x-ray to see what puppies are left

4. oxytocin if no obstruction

5. Ca

What kind of intervention can you do for dystocia in dogs

C-section

If puppies are in the birth canal and cannot be manipulated and the fetal heart rate is under 150 bpm, what should you do?

C-section

If the puppy is in the birth canal and cannot be manipulated, the heart rate is over 150 bpm, you have taken rads to see that the puppies are NOT too large but there are MORE THAN 4 puppies remaining, what should you do?

C-section

If the puppy is in the birth canal and cannot be manipulated, the heart rate is over 150 bpm, you have taken rads to see that the puppies ARE too large, what should you do?

Oxytocin therapy

If the puppy is in the birth canal and cannot be manipulated, the heart rate is over 150 bpm, you have taken rads to see that the puppies are NOT too large and there are LESS THAN 4 puppies remaining, what should you do?

c. can't deliver with gentle traction

d. puppies too large

Select the indications for a c-section in dogs:

a. heart rate over 150 bpm

b. response present to medication (oxytocin, Ca)

c. can't deliver with gentle traction

d. puppies too large

e. less than 4 puppies in utero

IMMEDIATE C-section

If there are signs of fetal distress, signs of placental separation (green uteroverdin discharge), or increased density of fetal fluid on ultrasound, what should you do?

Give Ca SQ, wait 30 mins, then give oxytocin

In dystocia, if there are less than 4 puppies left, all heart rates and palcentas are normal and ionized calcium is greater than 1.1, what should you do?

C-section

If there are less than 4 puppies left, all heart rates and palcentas are normal and ionized calcium is less than 1.1, what should you do?

Zonary endotheliochorial

Describe the placenta type of dogs:

Because this means it is not as important for puppies to get colostrum in comparison to horses/cows because they are more closely related to maternal blood

Why do we care that dogs have Zonary endotheliochorial placenta?

Intestinal motility = to term

When doing an elective c-section, what can you ultrasound for to see if the puppies are to term?

Normally have 3-4 in their lifetime and be okay. Will not affect fertility but WILL have reduced litter sizes after first C-section

How many repeat c-sections can dogs have in their life time and be okay? What is a common consequence?

Most expelled in first 2 weeks, but it is normal up to 4-6 weeks post partum

How long does it take for normal involution and lochia to be delivered from bitches?

Brown involution, mucoid. NO ODOR

Talk about the color and consistency of normal involution in dogs

Start at 3-4 weeks post partum by offering gruel, process should be completed by 5-8 weeks

When should you start weaning puppies?

The pressure in the glands is actually what signals her to stop making milk

Why do you want to maintain pressure in the gland and not milk the dam when weaning puppies?

At weaning

The bitch has unlimited food and water (puppy food) when nursing puppies. When do you reduce the food to the dam?

true

TRUE OR FALSE: puppies must be stimulated to urinate and defecate

It means they assume ambient temperature and cannot control their own body temp. We must provide heat lamps but they still need to be able to get away

Puppies are *poikilothermic* for the first 2-3 weeks of life. What does this mean and why do we care?

true

TRUE OR FALSE: crying indicates a problem in puppies

a. 85-90 F

For the first 1-7 days of life, the temperature of the room the puppies are in should be:

a. 85-90 F

b. 70-75 F

c. 80 F

c. 80 F

For the first 8-28 days of life, the temperature of the room the puppies are in should be:

a. 85-90 F

b. 70-75 F

c. 80 F

b. 70-75 F

Over 29 days of life, the temperature of the room the puppies are in should be:

a. 85-90 F

b. 70-75 F

c. 80 F

They are cold

What does it mean if you see puppies in "pig piles"

Hypothermia

What is the most IMPORTANT thing to monitor in puppies?