Page 998 - Small Animal Internal Medicine, 6th Edition

970 PART VIII Reproductive System Disorders

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.
(Confirmed with (documented
tocodynaomometry) by tocody-
namometry)

*(Normal vital
signs, alert,
responsive)

Medical Therapy

FIG 55.16
Flowchart showing recognition, categorization, and management of dystocia.

calcium increases their strength. Calcium gluconate 10%
++
solution with 0.465 mEq Ca /mL (see Fujisawa) is given SC
at 1 mL/5.5 kg body weight as indicated by the strength of
uterine contractions (best measured with tocodynamome-
try), but generally no more frequently than every 4 to 6
hours. Oxytocin, 10 USP units/mL (American Pharmaceuti-
cal Partners), is effective at minidoses, starting with 0.25
units SC or IM per bitch or queen regardless of weight, to a
maximum dose of 5 units. The dose can be gradually
increased to effect (delivery) or until fetal distress is detected;
generally no more than 2 units is necessary. Higher doses of
oxytocin or intravenous (IV) boluses can cause tetanic, inef-
fective uterine contractions that can further compromise
fetal oxygen supply by placental compression. The frequency
of oxytocin administration is dictated by the labor pattern,
FIG 55.17 and it is generally not given more frequently than every 30
Canine twins, a rare condition. Malpresentation resulted in to 60 minutes. Calcium is given before oxytocin in most
dystocia and fetal death. cases, improving contraction strength before increasing