Page 614 - Cote clinical veterinary advisor dogs and cats 4th

278 Dystocia

• Acetylcholine receptor antibody testing (MG consistencies are recommended on a case- process is critical for determining further
by-case basis.
[p. 668]) • Upright feeding may benefit animals with diagnostics and treatment.
VetBooks.ir • Electromyography to assess for neuromus- Possible Complications Technician Tips
• Type 2M muscle antibody serology (mastica-
esophageal dysphagia (p. 642).
tory muscle myositis [p. 637])
Animals with dysphagia are at risk for aspiration
cular disorders
• Muscle and nerve biopsies Aspiration pneumonia, weight loss events. Force feeding should be avoided.
• MRI (p. 1132), CT Client Education
• Cerebrospinal fluid analysis (CSF [pp. 1080 Recommended Monitoring Clients should be instructed to monitor respira-
and 1323]) • Body weight/condition tory rates at home as well as to monitor for
• Hydration status weight loss in patients with dysphagia.
TREATMENT • Respiratory rates to monitor for possible
aspiration events SUGGESTED READING
Treatment Overview • Frequent thoracic radiographs of asymp- Pollard R: Imaging evaluation of dogs and cats
• Treatment is location and disease specific. tomatic animals are not recommended. with dysphagia. ISRN Vet Sci 2012. https://www.
• Maintain good body condition with adequate hindawi.com/journals/isrn/2012/238505/.
caloric intake and minimizing risk of aspira- PROGNOSIS & OUTCOME AUTHOR: Megan Grobman, DVM, MS, DACVIM
tion pneumonia through appropriate feeding EDITOR: Leah A. Cohn, DVM, PhD, DACVIM
practices. Prognosis depends on the underlying disease
process. Long-term prognosis is poor for those
Acute General Treatment who cannot maintain body condition or those
Patients may present in acute crisis secondary with recurrent aspiration events.
to aspiration pneumonia (p. 793).
PEARLS & CONSIDERATIONS
Nutrition/Diet
• Ensure adequate nutrition; if oral feeding is Comments
inadequate esophagostomy or gastrostomy Dysphagia is a nonspecific descriptor for
tubes may be considered (pp. 1106 and a number of different disease processes.
1109). Localizing/identifying the underlying disease
• There is no ideal dietary consistency. Con-
trolled trials with food items of different

Dystocia Client Education
Sheet

BASIC INFORMATION pre-eclampsia), vaginal canal abnormalities • Time between sequential deliveries of neo-
(undetected strictures, vaginal hyperplasia, nates: normally, deliveries should be within
Definition vulvar edema), pelvic abnormalities (healed 1 hour of one another.
Difficulty giving birth by vaginal delivery, fractures with reduction in pelvic canal), • Stillbirths or weak neonates should prompt
resulting in morbidity or mortality for the and abdominal wall defects (hernias) can evaluation for dystocia.
dam, fetus, or neonate predispose a dam to dystocia. The clinician must quickly obtain a careful
• A previous uncomplicated cesarean section reproductive history:
Epidemiology does not predispose a bitch to dystocia. • Gestational length (canine) is determined by
SPECIES, AGE, SEX previous ovulation timing (day of LH surge
Dogs > cats; older > younger ASSOCIATED DISORDERS or the initial rise in progesterone is day 0;
Hypocalcemia, hypoglycemia, hypovolemia, normal gestation is 64-66 days). The first day
GENETICS, BREED PREDISPOSITION systemic inflammatory reaction, sepsis, post- of diestrus (the first-day vaginal cytology is
• Higher incidence in brachycephalic and partum metritis, fading puppy/kitten syndrome < 50% superficial cells) is 56-58 days before
hydrocephalic breeds normal parturition. If no ovulation timing
• Some purebred lines and service dog colonies Clinical Presentation was performed, establishing the first day
have a higher than breed average incidence DISEASE FORMS/SUBTYPES of behavioral diestrus (refusing the male)
of dystocia, suggesting heritability. Dystocia can be categorized as resulting from can approximate the first day of diestrus.
• Breed, parity (number of previous litters), maternal causes or fetal causes, but it most Breeding dates (58-72 days before delivery)
and litter size can influence gestational length commonly results from a combination of both. are not specific and do not correlate closely
by no more than 1-2 days. Fetal overgrowth with gestational length. See alternative
can result from prolonged gestation. Large HISTORY, CHIEF COMPLAINT ultrasonographic methods for determining
litters tend to have shorter gestations. A client’s perception that labor is not initiated whether pregnancy is term (below).
or progressing as expected, most commonly • For the queen, the mean gestation is 65-66
RISK FACTORS due to the following: days from a breeding with adequate coital
• Large litters (secondary uterine inertia) • Failure of labor to begin at perceived due contact to cause the LH surge.
• Poor prepartum condition of the dam date • Previous eutocia or dystocia
• Obese dam • Excessive time between stages of labor. Stage • General medical history, including diet and
• Small litters with resultant oversized fetuses I labor normally lasts no more than 12-24 medications/supplements and what, if any,
• Breed conformation, metabolic abnormalities hours; stage II, 8 hours (depending on litter therapeutics have already been administered
(pregnancy diabetes, pregnancy toxemia, size); and stage III, 12-24 hours. for dystocia

www.ExpertConsult.com