Page 1088 - Cote clinical veterinary advisor dogs and cats 4th

540 Infertility, Female Dog

oral, inhalation, and venereal routes and include PHYSICAL EXAM FINDINGS Advanced or Confirmatory Testing
beta-hemolytic Streptococcus, Mycoplasma, and Physical exam is usually normal. Special atten- • Vaginoscopy
VetBooks.ir 466). The most significant canine venereal and mammary glands. and assess luteal function. Progesterone
tion should be paid to the external genitalia
• Progesterone testing to document ovulation
Ureaplasma spp, and canine herpesvirus (p.
• Ambiguous genitalia may be an indicator of
disease is Brucella canis.
testing is recommended monthly to assess
cyclicity if the client has not observed cycles.
GEOGRAPHY AND SEASONALITY an intersex state (clitoral enlargement sug- • Ultrasonography of the uterus and ovaries
gestive) and may be supportive of primary
Female domestic dogs are nonseasonal, with the anestrus. • Canine herpesvirus titer
exception of the basenji, which enters pro-estrus • Digital vaginal exam: to assess patency and • Ovarian and/or uterine biopsy with histo-
only in the late summer/early fall. accessibility of the vulva and caudal vagina pathologic evaluation can be used in selected
• Vaginal exams should be performed gently cases.
ASSOCIATED DISORDERS and atraumatically; may not be feasible in • In cases of primary anestrus, it is wise to
Pseudocyesis (p. 831) occurs in many bitches toy-breed bitches that are anestrous at the determine the karyotype of the bitch to assess
whether they are pregnant or not, and it has not time of exam. her chromosomal makeup; trisomy X or XO
been linked to infertility. Vaginal hyperplasia (p. • Vaginal septa and circumferential strictures females and other abnormal chromosomal
1028) may contribute to infertility by limiting may interfere with natural service and with combinations have been reported. Many
or preventing natural service (does not interfere artificial insemination into the vagina. normal sighthound bitches do not cycle
with artificial insemination). • Visual inspection and palpation of the until nearly 24 months old.
mammary glands
Clinical Presentation
DISEASE FORMS/SUBTYPES Etiology and Pathophysiology TREATMENT
• Breeding management issues • Mistimed breeding is by far the most Treatment Overview
• Abnormalities of the estrous cycle common cause of infertility. Targeted treatment is based on the underlying
• Uterine abnormalities • Ovarian dysfunction: abnormalities in ovula- cause of the infertility. In most cases, correcting
• Systemic or infectious disease tion and maintenance of the corpus luteum, improper breeding management through client
persistent estrus, and primary anestrus (can education can correct the problem.
HISTORY, CHIEF COMPLAINT occur in XO bitches and XXY bitches)
Varies; medical history is the most important • Silent heat must be differentiated from Acute General Treatment
tool in the approach to infertility, including primary anestrus. • Shortened interestrous interval: mibolerone
these important elements: • Uterine dysfunction: lesions of the uterus 30-180 mcg/dose (small to large dog) PO q
• General health history: vaccination status of the (e.g.., cystic endometrial hyperplasia/ 24h (schedule IV controlled substance)
bitch; current and past medications (including pyometra, fibrosis with degeneration of • Treatment for cystic endometrial hyperplasia/
heartworm preventative and topical medica- endometrial glands), subclinical uterine pyometra if present (p. 854)
tions, vitamins, and herbal supplements) infection, shortened interestrous interval • Treatment for persistent estrus if present
• Housing details: kennel, home, indoor, outdoor, resulting in implantation failure (i.e., canine (p. 822)
and number of bitches in the household uterus requires 130-150 days after the onset • There is no reliable therapy to induce fertile
• Bitch’s age at first estrous cycle, which should of proestrus to complete endometrial repair) estrus in the bitch. There are many proto-
occur by 24 months of age cols in use with varying outcomes, but no
• Length of each cycle from onset of vulvar DIAGNOSIS controlled studies have been published. The
swelling to diestrous cytology most commonly attempted protocol includes
• Interestrous interval; average is 7 months Diagnostic Overview the use of oral anti-prolactin medication
but shorter or longer could be normal or The diagnosis is based on a compilation of cabergoline (5 mcg/kg PO q 24h until signs
abnormal, depending on the individual history (most important), physical exam, and of proestrus develop).
• Details of cycle: onset of vulvar swelling and results of laboratory evaluation. Historical
vulvar discharge, onset of estrous behavior information provided by the client is the Nutrition/Diet
(flagging), dates of mating cornerstone of the diagnostic process and must • Diet with an Association of American Feed
• Method of mating: natural service or artificial be elicited comprehensively. Without complete Control Officials statement that this diet is
insemination by bitch owner, stud owner, historical information, it is challenging to complete for all life stages, based on feeding
or veterinarian diagnose the cause of infertility and anestrus. trials
• Artificial insemination, including type of A global approach to diagnosis and management • If feeding a puppy food during the second
semen (fresh, cooled/shipped, or frozen) and is outlined on p. 1430. half of gestation, it should be a small-breed
site of semen deposition (vagina or uterus) puppy food.
○ Stud dog status: when did stud dog last Differential Diagnosis • No controlled studies to support any claims
sire puppies? • Pregnancy loss of over-the-counter supplements that they
• Dates of last B. canis serologic testing for • Ovulation failure can increase litter size, regulate estrous cycles,
the bitch and the stud dog • Silent heat (endocrinologically normal estrous promote normal delivery, and so on; some
• Method of pregnancy diagnosis: palpation, cycle with minimal to no external signs of may result in infertility
hormone assay, ultrasound, or radiographs proestrus or estrus) • Avoid calcium supplementation prepartum.
• Were hormone assays performed during the • Stud dog infertility
cycle? Was vaginal cytology and/or progester- Behavior/Exercise
one testing performed to determine optimal Initial Database • A bitch that was removed from her littermates
breeding time? If progesterone testing was • CBC, serum biochemistry profile, thyroid too early or that was herself a singleton
done, was it quantitative or qualitative? Was panel, B. canis serology, vaginal cytologic puppy may never demonstrate normal
ovulation confirmed after the luteinizing exam, vaginal culture if in estrus or if breeding behavior because of her lack of
hormone (LH) peak? discharge is present appropriate interaction with littermates at an
• Was the bitch being campaigned or under • Hypoproteinemia and/or renal dysfunction early age.
any other stressful event such as a new home? may contribute to infertility • A bitch that is the first canine in a household
• Is there a history of infertility in the pedigree? may not accept a male that is added to the

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