Page 1016 - Small Animal Internal Medicine, 6th Edition

988 PART VIII Reproductive System Disorders

minimal effective dose of PGF 2α has not been established. rate of pyometra in bitches can be 20% to 80%, and in queens
This dosage should only be used for natural PGF 2α . Clopro- 14%, higher in older individuals. Clients should always be
VetBooks.ir stenol, a synthetic prostaglandin, is more potent in its actions forewarned that successful resolution of pyometra can be
followed by chronic infertility due to underlying CEH.
than is natural PGF 2α , and use of synthetic prostaglandins at
the dosage recommended for natural PGF 2α may result in a
fatal outcome. Synthetic prostaglandins have more uterine- Suggested Readings
specific smooth muscle stimulation and cause fewer systemic Baan M, et al. Induction of parturition in the bitch with the
side effects, and currently are the author’s choice. Administer progesterone-receptor blocker aglepristone. Theriogenology.
cloprostenol (Estrumate [ICI, UK]) at 1-3 µg/kg SC q12-24h. 2005;63(7):1958–1972.
If cervical patency is questionable (closed cervix pyometra), Bassu G. Mammary gland disorders: agalactia, galactostasis and
misoprostol (prostaglandin E2) can be administered intra- mastitis. In: Greco DS, Davidson AP, eds. Blackwell’s five minute
vaginally (Cytotec, [Searle] 100 µg tablet dissolved in 5 mL veterinary consultant clinical companion: small animal endocri-
water; at 1-3 µg /kg q24h) in an attempt to relax the cervix nology and reproduction. Wiley Blackwell; 2017:325–336.
before ecbolic therapy is instituted. Transcervical endoscopic Bergstrom A. Cesarean section, elective and emergency. In: Greco
catheterization technique is advocated by some authors to DS, Davidson AP, eds. Blackwell’s five minute veterinary consul-
lavage viscous fluid from the uterus using LRS or 0.9% saline, tant clinical companion: small animal endocrinology and repro-
or acetylcysteine 1 : 5 parts 0.9% saline. Great care must be duction. Wiley Blackwell; 2017:45–51.
taken not to overdistend or perforate the uterus. Surgical Burdick S, et al. Endoscopic-guided laser ablation of vestibulovagi-
nal septal remnants in dogs: 36 cases (2007-2011). J Am Vet Med
lavage is also an option but rarely used due to the success of Assoc. 2014;244(8):944–949.
medical therapy. Prostaglandins are not approved for use in Chen YM, et al. Uropathogenic virulence factors in isolates of Esch-
domestic dogs and cats but are commonly used and are an erichia coli from clinical cases of canine pyometra and feces of
acceptable form of medical therapy. Successful clinical healthy bitches. Vet Microbiol. 2003;94:57–69.
response to medical therapy is best monitored by serial eval- Copley K. Uterine inertia. In: Greco DS, Davidson AP, eds. Black-
uations of uterine luminal contents with ultrasound, along well’s five minute veterinary consultant clinical companion:
with hematology, biochemistry, and clinical parameters small animal endocrinology and reproduction. Wiley Blackwell;
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outcome of medical therapy, defined as resolution of the Corrada Y, et al. Combination dopamine agonist and prostaglandin
signs of pyometra, should be evident at the completion of agonist treatment of cystic endometrial hyperplasia-pyometra
complex in the bitch. Theriogenology. 2006;66:1557–1559.
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At the time of release from the hospital, bitches and queen. Top Companion Anim Med. 2009;24(2):55–63.
queens should have an improved appetite, normal rectal Davidson AP, Cain J, Goodman M. Pregnancy edema in the bitch.
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reexamination should be scheduled within 2 weeks of the last consultant clinical companion: small animal endocrinology and
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illness. Abdominal ultrasonography should be used to evalu- Davidson AP, Cain J. Antibiotic stewardship in small animal repro-
ate for an overall reduction in uterine size and lack of fluid duction. In: Greco DS, Davidson AP, eds. Blackwell’s five minute
in the uterine horn lumens, compared with that of previous veterinary consultant clinical companion: small animal endocri-
examinations. Persistence of clinical signs warrants retreat- nology and reproduction. Wiley Blackwell; 2017:11–16.
ment; sequential treatment of recurrent pyometra can be Davidson AP. Tocodynamometry detects preterm labor in the bitch
before luteolysis. Top Companion Anim Med. 2015;30(1):2–4.
successful and could be considered if the bitch’s or queen’s Drobatz K, et al. Eclampsia in dogs: 31 cases (1995-1998). J Am Vet
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from 82% to 100%. Successful long-term response is defined Engl J Med. 1998;338(1):15–19.
as a return to normal estrous cycles and, if bred, conception Eilts B. Medical abortion, canine and feline. In: Greco DS, Davidson
and carrying a litter to term. Breeding at the next estrus is AP, eds. Blackwell’s five minute veterinary consultant clinical com-
recommended to avoid the potential complications after pro- panion: small animal endocrinology and reproduction. Wiley
gesterone’s effects on a nongravid uterus. Prostaglandins do Blackwell; 2017:357–376.
not resolve underlying cystic endometrial hyperplasia. The Freshman JL. Post-partum metritis/subinvolution of placental sites
more clinically benign hydrometra and mucometra com- (SIPS). In: Greco DS, Davidson AP, eds. Blackwell’s five minute
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guarded to poor prognosis for fertility. The onset of proestrus Gobello C, et al. Use of cabergoline to treat primary and secondary
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because diestrus was abbreviated by prostaglandin use. The long-term-release GnRH agonists and anti-estrogens in canine
onset of proestrus after prostaglandin treatment varies from reproduction: a review. Theriogenology. 2006;66:1569.
0.5 to 12 months in queens, due to the influence of day length Görlinger S, et al. Treatment of fibroadenomatous hyperplasia in
on this seasonally polyestrous species. The overall recurrence cats with aglepristone. J Vet Intern Med. 2002;16:710.