Lecture 26

Question 1

What are the characteristics of ovarian remnant syndrome?

Answer 1

-causes proestrus and/or estrus in spayed bitch
-vaginal cytology will confirm proestrus/estrus
-serum progesterone > 2ng/mL following proestrus/estrus
-GnRH stimulation can induce luteinization
-expect regular interestrus intervals
-must remove ovarian remnant(s) to treat

Question 2

Which measurements can be taken to ensure ovarian remnant(s) have been completely removed?

Answer 2

*LH
-will be super high since there are no CLs to lyse

*anti-mullerian hormone
-will be low

Question 3

What are the characteristics of cystic ovaries?

Answer 3

-can be follicular or luteal cysts
-cysts rarely secrete significant amounts of E2 or P4
-diagnosis via ultrasound or exploratory surgery
-treatment includes repetitive administration of hCG or GnRH
-potential sequela is pyometra

Question 4

What are the characteristics of granulosa cell tumors?

Answer 4

-account for 50% of ovarian tumors in the bitch
-firm, lobulated, and consist of multiple cysts
-20% metastatic potential
-common metastatic sites include sublumbar lymph nodes, liver, pancreas, and lungs
-increased AMH

Question 5

What are the characteristics of vaginal anomalies?

Answer 5

-include vertical bands/vaginal septum, midline annular constrictions, and vaginal hypoplasia
-cause pain on intromission and chronic vaginitis
-surgical technique for correction depends on the anomaly present and the intended purpose of the bitch

Question 6

What are the characteristics of vaginal prolapse?

Answer 6

-seen in intact and/or young bitches in proestrus or estrus
-more common in large breed dogs
-E2 leads to edematous enlargement of vagina
-three stages are perineal swelling (1), eversion of vaginal floor (2), and eversion of entire vagina (3)

Question 7

What is the treatment for vaginal prolapse?

Answer 7

-ovariohysterectomy
-ointment and/or lube and e-collar
-GnRH to induce ovulation
-surgical resection (often recur)

Question 8

How does the presentation of vaginal prolapse differ from that of vaginal neoplasia?

Answer 8

*vaginal prolapse:
-young animals
-vaginal floor
-appearance and progression varies with estrous cycle

*vaginal neoplasia:
-older animals
-anywhere in vagina
-appearance and progression do NOT vary with estrous cycle

Question 9

What are the characteristics of vaginal neoplasia?

Answer 9

-leiomyoma and TVT are most common
-diagnosed via cytology or histopathology
-treatment is surgical removal

Question 10

What are the characteristics of transmissible venereal tumor?

Answer 10

-naturally occurring neoplasm
-unique chromosomal complement; 2n = 59
-venereal transmission
-single or multiple nodules or pedunculated masses

Question 11

What is the treatment for TVT?

Answer 11

-spontaneous remission possible
-surgical debulking
-chemotherapy with vincristine

Question 12

What are the characteristics of diestrus acromegalia?

Answer 12

-elevated serum P4 of the luteal phase
-may induce spontaneous and transient acromegaly
-can occur from excessive exogenous P4 administration
-P4 stimulates growth hormone production directly from mammary glands

Question 13

What is the presentation of bitches with diestrus acromegalia?

Answer 13

-listless/dull
-respiratory stridor
-increased abdominal size
-PU/PD
-diabetes mellitus/worsening of disease

Question 14

What are the treatment options for diestrus acromegalia?

Answer 14

-spay
-prostaglandin treatment
-spontaneous resolution at end of diestrus possible

Question 15

Why is it important to treat animals with diestrus acromegalia if they are concurrently diabetic?

Answer 15

to prevent hyperglycemic episodes

Question 16

What are the characteristics of pseudopregnancy/pseudocyesis?

Answer 16

-prolactin rises as P4 plasma declines
-mammary development and some lactation occur
-may show signs of mothering objects, nesting, and aggression

Question 17

What are the treatment options for pseudopregnancy in the event of severe behavior changes?

Answer 17

-reduce water and caloric intake
-avoid mammary gland stimulation
-drug therapy to lower prolactin; mibolerone or dopamine agonists

Question 18

Which disorders are chromosomal disorders of sexual development?

Answer 18

-kleinfelter’s; XXY
-turner’s; XO
-mosiac/chimera: XX/XY mix

Question 19

Which disorders are gonadal disorders of sexual development?

Answer 19

-sex reversal
-true hermaphrodite

Question 20

Which disorders are phenotypic disorders of sexual development?

Answer 20

-male pseudo PMDS
-female psuedo
-testicular feminization

Question 21

Which abnormalities can lead to female infertility?

Answer 21

-abnormalities in duration of anestrus, proestrus, or estrus
-abnormalities in diestrus or pregnancy
-abnormalities in whelping or lactation

Question 22

What are the important components of a reproductive exam in the bitch?

Answer 22

-abdominal palpation of the uterus
-digital palpation of vulva and vagina
-rectal palpation of vagina and bony pelvis
-procedures such as vaginoscopy or vaginal contrast radiography as needed

Question 23

What are the baseline lab tests that should be done in bitches dealing with infertility?

Answer 23

-vaginal cytology
-blood chemistry
-CBC
-urinalysis
-Brucella canis testing

Question 24

What are the supplementary lab tests that can be done in bitches dealing with infertility?

Answer 24

-TSH stimulation
-adrenal stimulation or suppression tests
-gonadotropins concentration
-LH assays
-karyotyping

Question 25

What is a split heat?

Answer 25

when the bitch starts to come into heat but does not ovulate; then has a "second heat" where she does ovulate

Question 26

What are the problems that can occur during pregnancy/diestrus that cause infertility?

Answer 26

*shortened luteal phase due to premature P4 withdrawal -embryonic/fetal death *failure of corpora lutea to produce P4 -not maintaining a level that supports pregnancy -diagnosed via serial serum P4 levels < 2 ng/mL *bacterial and viral repro. tract infections

Question 27

What are the possible consequences of progesterone supplementation?

Answer 27

-pyometra -masculinization of female fetuses

Question 28

What are the characteristics of normal vaginal flora as a source of infertility?

Answer 28

-normal bacterial flora of the vagina can move into the uterus, which is normally a sterile environment -dogs will show clinical signs of infection, including fever and/or vaginal discharge -difficult to obtain culture samples from uterus; typically can only sample vagina -treatment decisions should not be based on vaginal culture alone; factor in repro. history, physical exam, and other lab tests

Question 29

What are the possible infectious causes of infertility?

Answer 29

-cystic endometrial hyperplasia -pyometra complex -endometritis -hydrometra/mucometra/hemometra -neoplasia

Question 30

What are the characteristics of cystic endometrial hyperplasia?

Answer 30

-E2 increases P4 receptors in the uterus -P4 induces endometrial gland proliferation and hypertrophy -P4 induces distention of endometrial glands with secretion -bitches older than 5-6 years will have some degree of CEH -exogenous E2 and/or P4 admin. can induce CEH/pyometra -CEH has no inflammatory exudate -pyometra due to ascending E. coli overlies CEH

Question 31

What is the pathogenesis of pyometra?

Answer 31

-associated with diestrus period -P4 suppresses immune response, stimulates endocrine gland secretion, and causes functional closure of cervix -often preceded by CEH -E. coli is common; Staph/Strep/Pseudo. also occur

Question 32

What is the clinical presentation of pyometra?

Answer 32

-several extragenital manifestations -gradual onset of signs -renal dysfunction -septicemia/bacteremia/endotoxemia -vomiting and lethargy -variable degree of cervical closure -variable distention of uterus -variable amounts of vaginal exudate

Question 33

What are the clinical signs of pyometra?

Answer 33

-bitch in diestrus with estrus 1 to 12 weeks prior -anorexia -depression -PU/PD -abdominal distention -vulvar discharge -sepsis -vomiting -diarrhea

Question 34

What are the characteristics of ultrasound as a pyometra diagnostic?

Answer 34

-uterus will be distended to a variable extent with fluid of a serous to viscid consistency -thickness of uterine wall can be determined -allows for early differentiation between pyometra and pregnancy

Question 35

What is seen on radiographs in the case of pyometra?

Answer 35

pus-filled uterine horns

Question 36

What is the treatment for a pyometra in which the cervix is closed?

Answer 36

spay the bitch

Question 37

What are the medical treatment options for a pyometra in which the cervix is open?

Answer 37

-aglepristone or PGF2alpha -antibiotics

Question 38

What is the outcome of medical treatment for pyometra?

Answer 38

-discharge may persist up to a month -may re-occur next cycle -typically treated so that bitch can have one more litter and then she is spayed

Question 39

What are the findings on CBC once a pyometra has been treated?

Answer 39

-neutrophilia that is decreasing -band neutrophils no longer present

Question 40

What are the characteristics of canine brucellosis?

Answer 40

-Brucella canis is zoonotic -late term abortion is most common sign -real threat in breeding kennels -diagnosed via serology -no treatment recommended; euthanize due to zoonotic and transmission risks

Question 41

What are the characteristics of canine herpesvirus?

Answer 41

-primarily causes neonatal deaths -experimentally shown to cause placentitis, abortion, and stillbirths -temp. sensitive virus that replicates in oronasal pharynx -increasing environmental temp. can kill virus -no illness in animals over 3 weeks of age

Question 42

When is canine herpesvirus of most concern, and when is it not a concern?

Answer 42

*most concern: -naive bitch -critical window: last 3 weeks of pregnancy through first 3 weeks of neonatal life *no concern: -exposure during breeding (dam) -exposure 2 to 3 weeks post-partum (dam) -past the poikilothermic period

Question 43

What are the clinical signs of canine herpesvirus?

Answer 43

*fading puppies -crying -greenish stool -abdominal pain *high mortality in affected litter *subsequent litters are normal *necropsy findings -petechial hemorrhages in kidney, liver, lung, and spleen -intranuclear inclusion bodies on histopath.

Question 44

How is pregnancy loss calculated?

Answer 44

based on the whelping rate -can be influenced by degree of inbreeding

Question 45

Which abnormalities in the bitch can lead to pregnancy loss?

Answer 45

-hormonal abnormalities -severe systemic illness -uterine illness -severe heart defects -severe metabolic disease -idiopathic loss of functional corpora lutea

Question 46

When are embryos most sensitive to teratogenic insult?

Answer 46

second trimester

Question 47

What is the result of chromosomal abnormalities in the embryo?

Answer 47

abnormal placenta and/or embryo development

Question 48

Which types of conditions can cause fetal death?

Answer 48

-genetic -iatrogenic -infectious

Question 49

What are the consequences of placental defects?

Answer 49

-insufficient fetal nutrition -death

Question 50

What is the consequence of uterine abnormalities?

Answer 50

prevention of adequate placentation