Page 1624 - Cote clinical veterinary advisor dogs and cats 4th

818 Pregnancy

Advanced or Confirmatory Testing Behavior/Exercise • Uterine monitoring (www.WhelpWise.com)
• Serum progesterone levels can be monitored No alteration of normal physical activity is may be required for high-risk pregnancies
VetBooks.ir enough to maintain pregnancy (>2 ng/mL). dogs may continue normal activity throughout or uterine inertia.
to ascertain if endogenous levels are high
required during pregnancy. Active and athletic
in bitches with a history of premature labor
gestation. Obese dogs may be encouraged to
○ May be assessed for bitches diagnosed
nonpregnant to rule out luteal insuf-
muscle tone and reduce fat stores (decreasing
ficiency as the cause (pp. 539 and 1375) increase exercise during pregnancy to improve PROGNOSIS & OUTCOME
○ May be run for bitches with high-risk feed is not recommended for weight loss during Parturition usually occurs without complica-
pregnancy to monitor progesterone pregnancy). tions.
supplementation therapy
• Uterine monitoring (www.WhelpWise.com) Drug Interactions PEARLS & CONSIDERATIONS
may be required for high-risk pregnancies. • Certain drugs may be detrimental to the
developing fetuses and should be avoided Comments
TREATMENT unless benefit to the health of the dam • Superfecundation: a bitch bred to multiple
outweighs the risk to the fetus. Consult males can have pups in the same litter that
Treatment Overview package inserts for all drugs before use. are from different sires. Paternity can be
• Intentional, normal pregnancies require no Selected examples: determined for registration by DNA testing.
treatment. ○ Antifungals (e.g., ketoconazole, griseoful- • Elevated serum progesterone levels do not
• Unintentional, unwanted pregnancies may vin) are teratogenic. indicate pregnancy. Progesterone concentra-
be terminated (p. 819). ○ Antibiotics: penicillins and cephalosporins tions remain elevated throughout diestrus
• High-risk, threatened pregnancies require are the antibiotics of choice in pregnant whether pregnancy is established or not. Pro-
advanced and continuous monitoring. Many animals. gesterone concentrations remain elevated for
therapeutic options are inferred from human ■ Fluoroquinolones (e.g., enrofloxacin) ≥ 65 days post LH surge in the nonpregnant
medicine, have no proven efficacy, and may inhibit cartilage formation. bitch and for 40 days post LH surge in the
be detrimental to the welfare of the dam or ■ Tetracyclines inhibit dental enamel nonpregnant queen.
the fetuses. production.
■ Chloramphenicol suppresses bone Prevention
Acute General Treatment marrow. Preventing unwanted pregnancies: surgical
• To halt premature uterine contractions: ■ Aminoglycosides may be neurotoxic neuter of nonbreeding animals and proper
terbutaline 0.01-0.03 mg/kg PO or SQ (gentamicin appears to be safe but supervision of intact animals
q 8h, titrated to effect based on uterine should be used with caution and owner
monitoring consent). Technician Tips
○ If ongoing terbutaline treatment is ○ Chemotherapeutics are teratogenic or Pregnant dogs and cats brought to the veterinary
required, it should be discontinued 24 abortifacient. clinic for pregnancy diagnosis are generally
hours before the due date. ○ Cimetidine may decrease androgen healthy. Because other patients visiting the
○ Safety and efficacy in dogs have not been production, resulting in increased risk veterinary clinic may have contagious diseases
properly researched. Efficacy of oral treat- of cryptorchidism. detrimental to pregnancy (e.g., herpesvirus,
ment is disputed in human literature. ○ Glucocorticoids may cause anasarca or parvovirus, Leptospira spp infections), it is
○ Tachycardia is a common and potentially induce abortion (prednisone is recom- recommended that bitches or queens present-
life-threatening side effect of terbutaline. mended if treatment it unavoidable as it ing for pregnancy diagnosis be escorted out of
The effect on fetuses is uncertain. is less likely to cross the placenta). the public waiting room as soon as possible
○ Hormone supplementation (e.g., to await evaluation in a clean and disinfected
Chronic Treatment altrenogest, diethylstilbestrol, estradiol exam room.
• For maintenance of pregnancy when endog- benzoate, testosterone) may affect sexual
enous progesterone levels prematurely fall development. Client Education
below 2 ng/mL ○ Nonsteroidal antiinflammatories (e.g., • More than 4 million unwanted dogs and cats
○ Progesterone in oil 2 mg/kg IM q 72h; ketoprofen, aspirin, carprofen): terato- are euthanized annually in humane societies.
discontinue 3 days before due date. genesis • Breeding is recommended to improve the
○ Altrenogest 0.088 mg/kg PO q 24h; ○ Opioids (e.g., buprenorphine) are the breed standard and is not encouraged to
discontinue 24 hours before due date. analgesics of choice during pregnancy and witness the miracle of birth.
• Serum progesterone levels can be used for lactation. However, chronic use has been • Designer breeds that are early-generation
monitoring endogenous progesterone if associated with adverse fetal effects; over- crosses of purebred dogs (e.g., the product
altrenogest is used but not if progesterone dosage may result in the dam’s inattention of a mating between a poodle and a golden
in oil is used. Altrenogest is a synthetic to neonates and accidental smothering. retriever) do not breed true to their own
progestogen that is not reliably measured phenotype and should not be purchased as
with standard progesterone assays. Possible Complications breeding animals.
• Dystocia (p. 278)
Nutrition/Diet • Abortion (p. 2) SUGGESTED READING
• No supplemental nutrition is required during • Early embryonic loss (fetal resorption) Concannon PW, et al: Recent advances in small
pregnancy if the bitch or queen is receiving • Mastitis animal reproduction. International Veterinary
high-quality feed. Supplementing calcium • Insulin resistance (pregnancy-associated Information Service (IVIS) (website), 2001.
during pregnancy may be detrimental to diabetes) http://www.ivis.org/advances/Concannon/wanke/
whelping or result in postpartum complica- chapter_frm.asp/.
tions (p. 281). Recommended Monitoring AUTHOR: Richard Wheeler, DVM, DACT
• Caloric intake should be increased 1.5- • In high-risk, threatened pregnancies, serum EDITOR: Michelle A. Kutzler, DVM, PhD, DACT
to 3-fold after whelping/queening to progesterone levels should be monitored
sustain the dam’s energy requirements during every other day or as needed to confirm
lactation. that levels are > 2 ng/mL.

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