1. Breed characteristics

2. Conformation

3. Temperament

4. Fertility of line, etc., dam, sire

5. Mothering ability: teats (4-6 pairs) (dam, aunts)

Problems: Inbreeding--stillbirth, embryonic death, lethal genes

Specific breed problems: Dystocia

Congenital abnormalities

1. Nutrition

2. Socialization

3. Preventative medicine

i. Deworming

ii. Vaccinations

iii. Exercise

1. Time of attainment

2. Examination of reproductive system

3. Behavior at teasing

4. Time to breed

Problems: Hymenal Remnants

Vaginal Constriction

Delayed Puberty

Single: Dog: Small kennel--routine, large kennel occasional

1. General physical and reproductive system exam

2. CBC

3. Vaginoscopy/speculum/digital vaginal exam

4. Culture of vaginal smear

5. Immune Status: vaccinations

6. Titer Tests: Brucella

1. Prime body condition--good conformation not fat

2. Complete vaccinations

3. Deworm; ectoparasites

4. Proper plane of nutrition

5. Environment: exercise

1. Increase food intake: 5-10%

2. Reproductive system examination, culture

3. Examination of stud: semen evaluation

Problems:

i. prolonged bleeding

ii. too little or no bleeding

iii. excessive bleeding

iv. infection

v. vaginal prolapse

1. Time to breed

2. Tests for standing estrus

3. Breeding techniques, frequency, stud management

Problems:

Psychic and physical incompatibility

Prolonged estrus

Infection

Vaginal prolapse

1. Reduce feeding regimen: stop supplementation

2. Weight twice a week

3. Pregnancy diagnosis, 21-28 days.

4. Exercise

5. Changes in personality

Problems: Infections -- pyometra

Fetal resorption

Early abortion

Overfeeding

1. Feeding: increase quantity between week 5-6 until whelping. Feed several times/day.

2. Exercise

3. Consultation on whelping

4. Selection and preparation of whelping area

5. Preparation of dam: clip hair etc.

Problems: Abortions

Prepartum eclampsia

1. Due date

2. Signs of approaching parturition: behavior, temp

3. Whelping

4. Be around

Problems: Uterine inertia

Premature parturition, less than 56 D.

Prolonged gestation

Placental separation

Dystocia--secondary uterine inertia

1. Examination of dam

2. Examination of pups: attitude, nurse, sleep, position, reflexes, weight gain - 5-10%/D--double in 10 days, temp 94-99--1-2 weeks, 97-100--3-4 month, Naval, cull, etc.

Problems:

Dams: A) Retained pup

B) Retained membrane

C) Postpartum hemorrhage

D) Subinvolution of placental sites

E) Metritis

F) Failure of milk let down

G) Mastitis

H) Hysteria: Rejection of pups

I) Cannibalism

Pups:

A) Stillbirth, mummified, peripartum death

B) Fading pup syndrome

C) Chilling/overheating

D) Toxic milk

1. Nutrition--increase intake 2-3 X maintenance level.

Problems: Eclampsia

Subinvolution of placental sites

A. Prolonged gestation: Gestation lengths may be prolonged for a few to several days over the average for the breed.

1. Prolonged gestation usually due to fetal death and mummification.

2. Uterine inertia (in fat, sluggish dogs; and in certain breeds e.g., terriers, bulldogs).

3. Prolonged use of progestins during pregnancy.

- During examination in cases of suspected prolonged gestation, one should be sure the breeding date is correct (early breedings may be associated with apparent increased gestation length). Examine for signs associated with late gestation (mammary growth; milk in nipples). Determine if fetuses are viable (radiograph, ultrasound, auscultation).

-C-section.

- Induction of parturition: No reliable method available. Use of prostaglandins has been effective in limited cases if administered at day 55-58 of gestation.

- Administer 5 mg PGF2a IM one or two treatments 12 hours apart. Parturition should occur within 12-60 hours.

- In order to prevent prolonged gestation, bitches should be exercised during pregnancy; all pregnant bitches should be monitored closely for signs of approaching parturition, and all progesterone treatments should be withdrawn at least a week to the calculated due date.

B. PREMATURE PARTURITION: Parturition before day 56 is considered premature. Note that late breedings result in whelping 58-60 days later.

- Usually fetuses are small, weak and do not survive.

- Note that premature parturition can be induced by accidental use of high doses of estrogens, or glucocorticoid treatment in late gestation.

- In Corgies and some miniature breeds, occurrence of premature parturition has been attributed to extreme variation in fetal sizes.

Dystocia: Difficult birth, inability to expel conceptuses through birth canal. Dystocia may be suspected: if gestation is prolonged and only mild signs of approaching parturition. Assistance is needed if uterine contractions occur and the first pup is not delivered within 5 hours; or if the interval after the last pup is more than 2 hours despite evidence of strong contractions. Strong contractions for 30 mins. or more but no fetus delivered. Presence of greenish discharge at vulval lips without delivery of a pup within 30 minutes.

A. Maternal causes:

Primary uterine inertia: Occurs in all breeds and all ages but common in older bitches. In Bulldogs, due to insufficient contractions of abdominal wall. Chihuahua, Dachshund and Terrier breeds more susceptible. Inertia may be associated with over distention of uterus, overweight and under exercise during late gestation, and hypocalcemia.

Secondary inertia: Obstruction due to fetal or maternal origin e.g., insufficient dilation of cervix; vaginal stenosis; neoplasms in the vagina, abnormal fetus (hydrocephalus, monsters, etc.); abnormal pelvis e.g., small pelvis; or previous pelvic fractures may cause narrow canal and complicate delivery of large fetuses (may need surgery).

B. Fetal: Jamming of pelvic inlet by two fetuses. Abnormal presentation, position and posture (posterior presentation is normal).

C. Handling of dystocia:

--breeding dates

--breed and size of male dog

--problems during pregnancy

--pregnancy diagnosis, when done, how many?

--parturition traits

--signs of parturition

--number of puppies born

--interval between pups

--what has been done prior to presentation?

Clinical examination: General clinical examination include temperature, pulse, and respiratory rate; inspection of visible mucous membranes. Abdominal palpation - to determine position of fetus, size and tone of uterus, and viability of fetus. Abdominal auscultation or ultrasound examination may determine viability of fetuses.

Inspection of vulva for evidence of injuries. Clean and disinfect vulva.

Digital examination of vagina: introduce one or two lubricated fingers into vaginal canal and note. Note lubrication of canal, state of cervical dilation, presence of fetus or fetal membranes, and viability of the fetus (finger in mouth or rectum). Note presentation, position, and posture of fetus. Radiographic examination may be used to determine location of fetus and number of fetuses present.

Management of dystocia: Extraction of fetus - useful if fetus accessible, and in non-protracted cases. Fetus extracted with finger or forceps. During extraction - traction should be synchronized with uterine contraction; and undue force should not be used. Forced extraction can be used to deliver a dead fetus with a firm grip on cranium or pelvis in an anesthetized bitch.

Medical management: Can be used in cases of dystocia due to primary or secondary inertia. Administration of 10% calcium borogluconate solution 5-15 ml SC stimulates uterine contractions in preeclampsia cases and aid delivery.

Administration of Oxytocin 2-10 IU SC stimulates uterine contraction and milk let down. Do not use oxytocin until abnormalities of position, posture and presentation have been corrected. Repeat treatment two times, at most three times and if no response despite lactation - consider C-section.

--C-Section: Should be first consideration in all cases of prolonged and difficult dystocia.

A. HYSTERIA/CANNIBALISM: Characterized by rejection of pups, biting or mutilation of pups; or poor mothering ability. Condition is common in primigravidae, or after a difficult birth, or due to painful condition of the mammary gland and nipples.

Fairly common in some breeds, such as Cocker Spaniels, German Shepherds and Great Danes. Note that bitches normally pay little attention to deformed fetuses or dead fetuses postpartum. Furthermore, a bitch that shows very little interest in the pups should be examined for retained pup or placenta.

Management: Tranquilize bitch and let pups nurse. (Acepromazine 0.25-0.5 mg/kg SC). Remove the pups between feedings. Prompt treatment of mammary gland or nipple problems. Foster pups to another bitch. Rear pups: Bottle feed - Esbilac or suitable product.

B. POSTPARTUM HEMORRHAGE: Postpartum hemorrhage in the bitch can be caused by lacerations during delivery or forced delivery, uterine rupture, performing C-sections prematurely and excessive pressure for placental removal at surgery.

Bleeding may start immediately after delivery (trauma), may be small in amount (vaginal laceration); moderate, or profuse if major vessel ruptured.

Bleeding from the uterus after C-section can be treated with Oxytocin 2-10 IU S/C or IM repeated every 2-4 hours for 3 treatments. Ergonovine maleate: 0.2-0.5 mg IM, injection can be repeated at 3 hour interval if bleeding continues (this compound is better than oxytocin since it directly stimulates vascular smooth muscle). If uterine rupture is suspected, exploratory laparotomy is indicated.

C. SUBINVOLUTION OF PLACENTAL SITES (SIPS): Condition characterized by prolonged bleeding or spotting from the uterus during the postpartum period. Bleeding episodes lasting 3-12 weeks have been reported. The bleeding may consist of periodic vaginal discharge of fresh, clotted blood, or persistent serosanguineous vaginal discharge. The condition has been diagnosed in all breeds of all ages, but appears to be more common in young bitches after the first and second litters. Bleedings are from granulomatous lesions at the implantation sites. Cause is unknown.

Clinical signs: Persistent bloody or serosanguineous discharge lasting 3 weeks up to 3 months. Normal lochia lasts 3-4 weeks, and is smaller in amount after first week. The bitch appears normal, but excessive bleeding may result in anemia and exhaustion. Occasionally uterus may rupture at affected sites resulting in peritonitis and death. Abdominal palpation reveals uterine enlargement, at the implantation sites. One or more of the implantation sites may be involved, and are palpable as distinct, discrete enlargements of the uterus.

Routine postpartum oxytocin treatment is reported to be beneficial in preventing the occurrence of subinvolution of placental sites.

Ovariohysterectomy.

A pup, a placenta or placentae may be retained following parturition in bitches. If not treated, this may lead to endometritis, severe metritis, and death.

A bitch with retained fetus or placenta is restless, shows no interest in the pups during the period (6-12 hours) following the last delivery.

There is copious greenish-black vaginal discharge by 12 hours, and signs of toxemia within 24-48 hours. Diagnosis based on history. Absence of one or more placenta(e). Abdominal palpation: A fetus may be easily palpable either in the pelvic inlet or in the abdomen (hard mass). Placentae are palpable, as softer masses. Diagnosis is confirmed by radiographs (pneumoperitoneum); after use of contrast media.

Treatment: Routine oxytocin administration 1-10 IU IM after delivery of last fetus, repeat in 6 hours. This aids uterine involution and delivery of placenta.

In cases of confirmed placental retention - administer oxytocin 1-5 IU IM once every 45 minutes for 3 treatments. Attempts can be made to massage uterus, and remove placenta with forceps.

If fetus is retained - oxytocin treatment as above may be useful.

If fetus or placenta is not delivered by 12 hours - exploratory laparotomy is indicated.

Prevention: When attending at whelping, count numbers of placentae - should match number of pups. Advise owners to match number of pups with placentae. Note that some dogs may eat placenta.

Carefully examine all bitches behaving abnormally in the immediate postpartum period; e.g., no interest in pups and restless.

Postpartum metritis results from acute bacterial infection during the immediate postpartum period; can be fatal. Predisposing factors include prolonged and difficult labor, retained placenta, subinvolution of the uterus. Bacterial invasion of uterus occurs due to the prolonged period of cervical relaxation. Bacteria may also be introduced if unhygienic measures are used during obstetrical procedures; or whelping in dirty surroundings.

The condition is characterized by fever, toxemia, depression and copious purulent to bloody purulent odorous (tomato soup) vaginal discharge.

During the latter stages 48-72 hours, the bitch is weak, dehydrated, strains, and exhibits fast and shallow respiration, and frequently licks the vulva repeatedly. There is reduced milk production. The puppies exhibit signs of ingestion of toxic milk (bloated, diarrhea, cry incessantly, reddened rectum). If not treated, bitch may die within 3-5 days. CBC reveals hemoconcentration, leucocytosis - followed by leucopenia.

Diagnosis: History of difficult parturition; assistance. Vaginal swab culture - large numbers of pathogenic bacteria. Abdominal palpation - large soft doughy mass - subinvoluted uterus. Differential diagnosis - radiography to rule out retained fetus, and retained placenta.

Treatment: Broad spectrum systemic antibiotics for at least a week. Uterine irrigation - if cervix patent - using antibiotic of choice based on sensitivity testing. Fluid therapy - prevent dehydration. PGF2a 50-250 m g/kg SC once or twice a day until uterine evacuation completed. Oxytocin 5-20 IU may be useful during the first 12-24 hours. Remove and hand raise pups to prevent toxemia and death. If cervix closed, and bitch is very sick, ovariohysterectomy should be done after stabilization with fluid therapy.

Prevention: Attend and supervise parturition, and promptly assist with dystocia cases using hygienic measures. Whelping should take place in a fairly clean area. Routine administration of oxytocin following whelping.

Sometimes referred to as eclampsia, (canine milk fever) is an acute life threatening condition in lactating bitches.

It may also occur during late pregnancy in some bitches. Commonly diagnosed during weeks 2 to 6 of lactation, and more often in small and medium sized and excitable dogs nursing a large litter.

Caused by decrease in Ca concentration of blood to levels below 8 mg/dl. May be complicated by hypoglycemia.

Signs: Initially animal is restless, nervous (anxiety, apprehension, disorientation) and shows no interest in pups. This progresses to panting, whining, hypersalivation during the early stages, followed by shivering, muscle tremors (tonic and clonic convulsions); stiff legs, stilted and erratic gait, and incoordination.

Animal falls forward or to the side in attempts to walk; and later unable to rise. Other clinical findings include - dilated pupils and reduced pupillary reflex. Increase in temperature up to 41° C due to muscle spasms.

Diagnosis: Lactation period; large litter; decrease Ca < 8 mg/dl (normal 9-12 mg/dl); may be complicated by secondary hypoglycemia; clinical signs: (Neurologic signs or nervousness).

Treatment: Intravenous administration of Ca: Administer 5-10 ml of a 10% calcium gluconate or borogluconate solution IV, IP, or SC.

Administration should be done slowly, and monitor heartbeat during treatment, stop administrations if cardiac problems identified. Response is rapid and dramatic. Intravenous treatment should be followed by subcutaneous or oral administration of Ca salts to prevent relapse. Such treatment should be continued for 3-5 days, or until full recovery. (Ca gluconate or dicalcium phosphate (Calphos) 1.0 g/10 lb body wt per day). Ensure adequate amount of Ca and Vit D in diet. Remove pups and bottle feed until dam recovers. If seizures continue - anticonvulsants e.g., Diazepam (2.5-20 mg IV), pentobarbital, or phenobarb should be administered to control seizures.

Glucocorticoid treatment useful in severe cases and prevents recurrence (Prednisolone 0.5-1 mg/kg body weight per os BID).

Prevention: Provide adequate amount and quality feed for lactating bitch.

Prophylactic oral administration of calcium salts to lactating bitches.

Supplement feeding - with Esbilac.

May occur due to stress of whelping and lactation; or may occur secondary to muscle tremors associated with hypocalcemia. Characterized by convulsion, low blood glucose levels. Treatment - 10 ml of 20% glucose solution IV.

Failure of milk flow either due to lack of milk production or failure of milk let down. Failure of milk production may result from failure of mammary development (hormonal deficiency); poor nourishment (protein deficiency); or failure of prolactin secretion near parturition. Failure of milk let down - milk present in mammary gland, but let down does not occur. This may be temporary. Failure of milk let down is common in nervous bitches, following treatment with tranquilizers, or anesthesia; and in cases of mastitis.

Signs: May include poor mammary development. Mammary glands engorged but pups exhibit signs of hunger. Rarely, some teats may be blocked due to scarring.

Treatment: If problem is due to failure of mammary development - foster puppies, bottle feed. In rare cases, some bitches may commence lactation 1 to 3 days after whelping. In cases of failure of milk let down - massage and stimulate glands and allow pups to nurse or administer 1-5 IU oxytocin SC; or Syntocinon (nasal oxytocin spray) 3-4 times/day. Milk flow occurs 1-5 minutes after oxytocin treatment. If problem due to insufficient lactation - administer 2 IU prolactin daily to maintain lactation.

Characterized by edema and swelling of the mammary gland, and failure of milk let down. Usually congestion is first noted during the last week of gestation and the first few days of lactation. Common in well-fed pregnant bitches and heavily lactating bitches.

Signs: Include mammary edema, with the glands diffusely firm and warm to touch. The bitch is anorectic and exhibits signs of discomfort.

Treatment: Warm massage and stimulation of glands 4-6 times a day. Helps reduce congestion. Strip milk from grossly distended glands; helps keep flow of milk and prevent mastitis. Withhold food, and reduce water intake - lower milk production. Administered diuretics: Lasix - Furosemide, 1-2 mg/kg IM once a day or 2-4 mg/kg per os BID.

Inflammation of single or all glands due to infection. May be acute, chronic and may lead to abscessation. Common in the early postpartum period, during warm months of the year, and in bitches whelping in unsanitary environment. Mastitis may occur secondary to postpartum metritis or delayed uterine involution (toxemia). Common organisms isolated: Staph, Strep and E. coli.

Signs: Swollen gland, discolored, warm and painful. Bitch is febrile, listless, anorexic, and loses interest in the pups. Pups bloated, restless and cry frequently (due to toxemia) from drinking toxic milk. Milk is thin, contains clots, yellow to brown in color; and may contain WBC and RBC. Culture milk.

Treatment: Systemic antibiotics; local treatment with antibiotic creams; ointments. Cold packs in early stages; warm/hot packs in later stages. Periodic stripping of affected glands (3-4X/day). Prevent pups nursing from affected gland, if generalized remove pups and foster or feed Esbilac.

Several conditions in young bitches are characterized by a history of absence of estrus, although they are past the age and size (weight) of puberty. Following are the causes:

Bitch shows estrus, but is not detected, Causes: This is usually due to the owner's ignorance (new owner) of the various phases of the estrous cycle. The bitch may exhibit minimal bleeding and fastidiously lick the vulva so that no evidence of bleeding is seen. The bitch is isolated from other dogs, hence perceptive (attraction) and receptive behavior is not noticed. Bitches raised in isolation from other dogs and bitches that are closely attached to owners do not develop the normal sexual behavioral patterns, and many times exhibit poorly defined signs of estrus.

Diagnosis and management: Based on accurate history, age, environment, owner's knowledge of estrous cycle characteristics. Periodic examination of the reproductive system including serial vaginal cytological examination will help predict the next estrus; and breeding can be carried out. Education of owners with regards to what to look for e.g., vulval swelling, interest of other dogs in bitch.

Bitch has passed the age of puberty, but has not exhibited estrus. If preliminary history and examinations indicate that unobserved or silent estrus’s are not the problem, then the following should be considered.

i. Spayed bitch: Common in situations where the bitch has changed hands, or the owner is unaware of spaying, especially if animal was acquired from humane societies. Detailed history, including contact with previous owners may elicit history of spaying. Examination of the bitch may reveal presence of surgical scars.

ii. Intersexuality: Occurs sporadically in all breeds. The condition may be true hermaphrodite with the presence of both ovaries and testes and abnormal genitalia or pseudohermaphrodite. The spontaneous condition is hereditary in some breeds: Pug, Spaniel, Doberman, and German Shepherd. Hermaphrodites/intersexes occur due to faulty differentiation and function of fetal gonads. This condition can also be induced by exogenous estrogens or progestin administration to pregnant dogs during sexual differentiation; that is week 4-7 of gestation. Such treatment results in the masculinization of the female pups.

Clinical findings: History of absence of estrus, although littermates have exhibited estrus. Determine if dam received hormones during pregnancy. Examination reveals abnormal genitalia including enlarged clitoris, incomplete formation of vagina, and ventro-cranial direction of the vulva.

Diagnosis: confirmed by karyotyping or at exploratory laparotomy.

Treatment: ovariohysterectomy, clitoridectomy.

iii. CONGENITAL OVARIAN AGENESIS, OR HYPOPLASIA: Ovaries are very small and non-functional. Diagnosis is based on failure to respond to stimulating hormones and the finding of small ovaries at exploratory laparotomy. This may be associated with aplasia of the uterine horns.

Abnormalities of hormonal control of reproductive function resulting in delayed puberty (primarily anestrus) can arise

a) from poor nutrition during the peripubertal period

b) the presence of concurrent diseases

c) chronic debilitating conditions such as heavy parasitic infestation and systemic diseases

d) hypothyroidism

e) Cushing's or Addison's disease.

Clinical examination should aim at ruling out parasites; diseases as causes of delayed puberty. Appropriate chemistry and hormonal assays should be used to rule out other endocrine conditions, e.g., hypothyroidism. Detailed history should rule out use of compounds, such as Mibolerone or Ovaban to prevent estrus. Management:

a) If condition is due to stressful factors like intensive training, working, racing and showing - wait. Estrus should occur within 3 months after withdrawal

b) Treat concurrent diseases and wait. Estrus occurs in 1-3 months.

c) If convinced the problem is due to dysfunction of H-H-O axis, proceed as follows:

Recommend: Improve feeding regimen in prepubertal bitches and make sure they are vaccinated and dewormed regularly. Attempt to induce estrus using following regimens:

1) PMSG* 250-500 IU im/sc daily for 8-10 days. Followed by 500 IU of hCG on the second day of estrus. Breed next day. Proestrual bleeding is usually seen 3-5 days after first injection. Response to this regimen is unpredictable and treatment is costly.

2) PMSG 50-100 IU/kg or 500-1500 IU im/sc once a week for 3 treatments. Administer 500-100 IU hCG 1st or 2nd day of estrus or 50 m g of GnRH two doses 6 hours apart. Ovulations occur with or without hCG/GnRH. Intramuscular administration of PMSG appears to be more effective.

3) FSH 25 mg im/sc weekly for 2-4 treatments or until vulval discharge occurs. Perform serial vaginal cytology and breed when cytology indicates estrus. If proestrus occurs but does not proceed to estrus decreasing doses of FSH 25 mg on day 1, 15 mg on day 2 and 5 mg on day 3 can be administered and is usually effective. Administer 500-1000 IU hCG IM on day 1 when cytologic changes are indicative of estrus.

4) DES – 5 mg capsule for 10 days (1-800-673-8277) Kay’s Pharmacy, Baltimore, MD.

II. REPRODUCTIVE FAILURE IN THE MAIDEN BITCH

Characterized by failure to conceive after repeated matings may be due to:

i) breeding at wrong time, usually late breeding, in some cases failure of conception may occur due to asynchrony of estrus and ovulation.

ii) infertile male: check male; semen evaluation prior to use.

iii) Aplasia of parts of Mullerian ducts - may result from treatment of dam with progesterone or estrogen during period of sexual differentiation in pregnancy.

Infertility due to these conditions are usually due to inability to mate. These may be congenital or acquired. Stenosis of vestibulo-vaginal canal, persistence of hymen and vaginal abnormalities may be associated with intersex states. These conditions occur in all breeds and clinical signs include persistent vaginal discharge, vulval pruritus, perivulvar dermatitis, vaginitis, and incontinence. Diagnosis is based on history of difficult mating or pain at intromission. Confirmed by digital vaginal palpation or vaginoscopy. Correction involves surgical dilation, or "opening up" using increasing diameters of rods; using fingers to increase vaginal diameter in order to permit natural mating; if all fail animal may be inseminated; may need C-section at whelping. Fertility is normal after breeding in these cases.

Prevents intromission, but A.I. is possible. Vulva is small and sunken. Perivulval dermatitis may accompany underdeveloped vulva. Vaginogram [Hypaqueâ meglumine 60% (diatrizoate meglumine injection--Winthrop Pharmaceuticals)] should be performed to determine condition of rest of vagina. Vaginoscopy procedure is used to diagnose the problem.

Young bitches may refuse mating because of poor socialization; frightened by the stud, or due to painful condition of the vagina (due to infection or vaginal constriction, persistent hymen). Assurance at mating and use of a gentle stud are management procedures that can be used; after correction of congenital problems. A.I. is recommended in these cases.

Characterized by vaginal bleeding for only a few days during proestrus. Some bitches exhibit vaginal bleeding for only 2-5 days. Condition tends to be repeatable on subsequent estruses in the individual bitch. In these bitches, the physiological events of follicular maturation and ovulation appear to occur at a faster rate. The animal may progress into estrus due to fast increase in progesterone or fall in estrogen concentrations. Infertility in these dogs are due to missed chances of breeding (owner believing dog will bleed for several days). This may be a problem with new owners (who are not familiar with estrous cycle or a particular animal) or failure to tease or a delay in instituting teasing of the proestrous bitch. Diagnosis: Based on previous history. Short bleeding intervals. Vaginal cytology may reveal fast rate of cytological changes. In some cases the owner may miss the onset of bleeding or the bitch may fastidiously lick the vulva.

Management: Use previous history to predict estrus and ovulation. Observe closely for signs of bleeding, especially in longhaired dogs and dogs that fastidiously lick the vulva. Tease bitch starting very early during proestrus; even as early as first day of bleeding. Use serial vaginal cytological examination starting early, starting from day 1 of proestrus, to determine time to breed.

Condition characterized by proestrual bleeding lasting for more than 14 days. Sometimes up to 21-42 days, followed by a normal period in estrus, and ovulation. Fertility is normal if breeding occurs at estrus.

Diagnosis: Serial vaginal cytology reveals a slow progression in cellular maturation in vaginal smears. Bitch does not respond to teasing until several days to weeks after onset of proestrus (21-45 days). Hormonal assays may reveal a constant and moderately elevated estradiol concentrations for long periods, failure of LH release and failure of mature follicle to luteinize and no fall in estradiol levels. These findings suggest a slow rate of follicular maturation. Examination should be performed to rule out hypothyroidism, which can be characterized by abnormal proestrus bleeding (resting T4 assay; TSH stimulation test). In some cases vaginoscopy examination may cause trauma leading to continuous bleeding or in cases like Von Willebrandts disease. Cystitis or urolithiasis, neoplasm of the external genitalia (urethral carcinoma) and transmissible veneral granuloma should be ruled out.

Management: Use vaginal cytology and teasing to detect onset of estrus. Consider supportive treatment with hematinics to prevent anemia. Attempt to speed up follicular development by giving SC/IM injections of 50-100 IU of PMSG once every 3-4 days starting on day 3 or 4 of proestrus, until estrus or use FSH, is given at the dose of 25, 20, 15, 10, and 5 mg on consecutive days starting from day 10 after onset of proestrus. Give hCG (500-1000 IU) on day 1 of standing estrus, or GnRH (50-100 m g) 6 hours apart to insure ovulation. Note that these treatments may induce superovulation.

Characterized by malodorous vaginal discharge, large numbers of leukocytes and bacteria on vaginal smear and isolation of pathogenic bacteria on culture of a vaginal swab. Mating during estrus may result in failure of fertilization (spermicidal effect). Acute metritis, endometritis or possibly pyometra may occur after mating.

Diagnosis: Abnormal nature of proestrual discharge (malodorous). Presence of large numbers of leukocytes (lymphocytes and neutrophils) in vaginal smear. Large numbers of neutrophils with engorged bacteria. Inflammation (cherry-red appearance) of the vagina is obvious in vaginoscopy examination. Vaginal cultures reveal the presence of E. coli, Staph and Strep spp. In some instances Proteus mirabilis and Pseudomonas aeruginosa have been isolated in pure cultures in moderate to large numbers.

Treatment: Systemic antibiotic therapy for at least a week, plus local treatment, consisting of vaginal infusion of saline containing antibiotics after vaginal lavage. Various fluids, e.g., saline, or 1% Betadine solution have been used for lavage. Mating should be allowed if culture of vaginal smear at end of treatment is negative. Post breeding infusion with antibiotic may be used, i.e., breed day 1, infuse day 2, breed day 3, and infuse day 4, to prevent re-establishment of infection. Monitor bitch during post breeding period for signs of recurrence of infection, metritis or pyometra.

a. OVULATION FAILURE: Bitch exhibits estrus for more than the normal period (9-14 days) due to failure of ovulation. Sometimes bitch stays in estrus for more than a month. Clinically, the vulva is engorged, there is serous to mucoid vaginal discharge, and the bitch is continuously receptive. This may result in irritated vagina, due to numerous matings. Fertility in such cases is poor.

Diagnosis: Is based on history of prolonged estrus and cytological indications of estrus. If available, a hormone assay would indicate failure of LH release and only moderate increase in progesterone concentrations in plasma for several days.

Treatment: Immediate treatment should consist of administration of hCG 500-1000 IU IM or 10-20 IU/kg - repeat three days later or 25 to 50 m g GnRH twice a day for 2-3 days to induce LH release and ovulation. Conception rates following these treatments are variable. On the subsequent estrus, administer 25-50 m g of GnRH twice on day 1 of standing estrus. Mate starting from day 2 of estrus.

b. CYSTIC FOLLICLES: Ovarian cysts, usually follicular cysts are common in older dogs, lead to hyperestrogenism and prolonged periods in estrus. The onset of estrus signs occurs at unexpected time after previous estrus. Estrus behavior may be irregular, the bitch is attractive to male dogs, ride male dogs, but does not usually stand for mating. Animal is sterile. In long standing cases the bitch becomes irritable and bad tempered. The vulva is usually moderately swollen, and there is moderate serous discharge at vulval lips. In chronic cases there may be moderate mammary development. Vaginal cytology reveals predominantly superficial cells which persist over long duration. Vaginoscopy reveals typical signs of estrogenic influence. Abdominal palpation may detect presence of enlarged ovaries, but laparoscopy or laparotomy provide accurate diagnosis.

i. hCG 100-1000 IU given IM. Variable response.

ii. Twice daily administration of 50 m g GnRH for 5 days; costly.

iii. Hemiovariectomy if only one ovary is involved (advised only in valuable bitches).

iv. Megestrol acetate (Ovaban) 10-20 mg orally daily for 1-5 days; then 2.5-10 mg (large bitches); or 2.5 mg (small bitches) orally daily until cytological signs of diestrus seen. Note danger of pyometra in 10% of treated cases. (least preferred)

v. Ovariohysterectomy if both ovaries involved.

c. OVARIAN TUMORS: These are usually associated with prolonged periods in estrus. Tumors are infrequent, the most common being granulosa cell tumors and cystadenocarcinoma. The incidence of ovarian tumors is low. Tumors are common in older bitches, but they have been diagnosed in young bitches. Granulosa cell tumors vary in size and are usually hormonally active.

Clinical signs: Include irregular, frequent or persistent estrus, engorged vagina, persistent serous to straw colored vaginal discharge, bilateral symmetrical alopecia of the upper flank area, and ascites. There may be also thinning of hair over abdomen and perineal region. In some cases there may be evidence of mammary growth but not lactation. Although the affected animal is attractive to male dogs, she does not stand for mating.

Diagnosis: Is based on abdominal palpation; and radiographic examination. Cytological examination of ascitic fluid for indications of neoplastic conditions and vaginal cytology that reveals predominantly cornified vaginal cells.

Treatment: Ovariohysterectomy or hemiovariectomy.

d. False estrus: There are certain conditions which are characterized by exhibition of estrual signs, which may persist for long periods. This can be a problem for the breeder, and these conditions must be recognized and differentiated from normal estrus.

i. For instance animals being treated with estrogens diethylstilbestrol (DES) for other conditions such as urinary incontinence, vaginitis or skin problems - may exhibit vulval enlargement, cornified vaginal epithelium, may be attractive to male dogs but nor flirt or stand for mating. Signs regress after withdrawal of treatment. Find out if bitch is on hormonal treatment.

ii. Bitches treated with estrogens as "mismate shots", usually exhibit estrus for several days, continue to be receptive after treatment.

iii. Chronic low grade vaginitis, traumatic vulvitis due to bite wounds, scratches - may be associated with vulval enlargement that may be confused with estrus. In cases of vulvitis the vulval hair is matted with discharge, and there may be perivulval dermatitis. The bitch is attractive to male dogs, but resents vulval inspection and will not stand for mating. Diagnosis is based on culture of bacteria from vaginal swab. Vaginal cytological characteristics of small non-cornified vaginal epithelial cells and large numbers of white blood cells.

iv. Bitches housed in groups in kennels may exhibit mild signs of estrus, when a group member comes in heat. Some may progress into full-blown estrus.

e. SPLIT estrus: May be confused with prolonged periods of estrus. Most common in peripuberal bitches, but does occur in adult bitches. Condition is characterized by vulval swelling, proestral discharge. The bitch may be receptive for a few days then become non-receptive, (anestrus) for a few days followed by another period of receptivity. Others may exhibit proestrus and estrus activity in 3-4 weeks. This is due to failure to ovulate during the first period in estrus. The cause is not known but it has been seen in bitches after transportation; in bitches in training or endurance racing. It is common in bitches treated with FSH-like hormones to induce estrus. Abnormal hormonal patterns, follicular development may be a factor. Fertility is normal if the bitch is mated on the second period in estrus.

B. Failure to mate during estrus: A common cause of reproductive failure in bitches is failure to mate during estrus. Could be due to;

i. Refusal to stand: Situation in which the bitch refuses to stand, due to objection to a particular stud, or all male dogs. Such cases are seen in young terrified bitches; poor socialization and strong attachment to owner; or due to nasty experience at previous mating. Bitch exhibits normal vaginal cytological changes expected in estrus, will tease, and flirt, but objects to mating. Management consists of muzzling and mating; or A.I., using vaginal cytological changes to determine the best time to breed.

ii. Failure of mating due to anatomic barriers: These include persistent hymenal tissue and congenital vagino-vestibular stenosis in young maiden bitches. Acquired vagino-vestibular stenosis following previous vaginal infection or trauma in older bitches; vaginal growths, or acute vaginitis during estrus. In cases of stenosis - opening up or dilation of canal can be performed by natural mating. Artificial insemination is possible in all cases of stenosis. If the problem is due to acute vaginitis during estrus, the animal should be treated and breeding should then be attempted if infections is cleared.

iii. Failure of mating due to vaginal prolapse/vaginal hyperplasia: Vaginal prolapse, extravaginal hyperplasia, is a condition characterized by abnormal excessive tumescence (in response to estrogen levels) of the floor and lateral walls of the vestibule anterior to the urethra resulting in prolapse of the tissue at the vulva opening which prevents natural mating. A.I. can be tried. (Vaginal prolapse can also occur during pregnancy--JAVMA 202:295, 1993.)

Management: Administration of GnRH 50 m g IM twice a day for 2-3 days results in debulking of the mass to allow surgical resection or megestrol acetae, 2.2 mg/kg daily for 5-7 days. Ovariectomy prevents recurrence.

A. Pseudopregnancy (pseudocyesis): A condition considered as intensification of diestrous signs in the bitch (mated non-pregnant, or non-mated) is characterized by mammary development, lactation, and behavioral changes. There is no definite age or breed predilection for occurrence of pseudopregnancy but most clinical reports are in dogs aged 2-6 years nulliparous bitches. Once it occurs the recurrence rate in a bitch is high and repeated occurrences seem to predispose the animal to develop pyometra. The condition is believed to be triggered by the withdrawal of progesterone and increase in prolactin at the end of diestrus. A mild form is seen in dogs spayed early diestrus (mammary development and lactation) and after withdrawal of prolonged progesterone treatment.

Clinical signs: Clinical signs are seen 5-9 weeks after end of estrus; with signs being more severe around the end of diestrus i.e., 60-70 days after end of estrus. Physically there is a moderate increase in weight, and abdominal distention starting earlier than expected in pregnant dogs. Other physical signs include moderate to pronounced mammary development and lactation, and abdominal contractions and tenesmus similar to parturition and mucoid discharge. The animal exhibits spectrum of other signs including restlessness, disinterest in exercise, increased affection towards owner, vomition, diarrhea, increased appetite or anorexia. Abnormal behavioral signs vary from mild to intense and include nest making, self nursing, and nursing inanimate objects (or driving owners crazy). The bitch may monopolize pups of another bitch under kennel conditions.

Diagnosis: History, abdominal palpation, radiography, and blood chemistry.

i. If signs are only mild, leave alone, sign regress within 1 to 2 weeks.

ii. If signs are intense, treat symptomatically, e.g., sedation is useful if bitch is distressed; antiemetic should be considered for vomition.

iii. Administer megestrol acetate (Ovaban®) 2-2.5 mg/kg orally for 8 days. Commence at onset of signs. Signs may reappear after withdrawal of treatment.

iv. Mibolerone - 80-160 m g/kg orally daily for at least 5 days. It suppresses psychological signs within 24-36 hours and mammary glands return to normal size after 7 days of treatment.

v. Antiprolactin (Bromocriptine) 10-20 mg IM twice a day 2 days apart (expensive). This treatment can cause vomition, thus supplementary treatment with antiemetic may be necessary.

B. Fetal resorption: Characterized by history of breeding and positive pregnancy diagnosis at 3-4 weeks followed by fetal resorption (fetal loss) and no whelping.

Causes: Could be due to abnormal zygotes, early embryonic death, viral agents (herpes, parvovirus) or bacterial (Brucella canis). In some cases could be due to hypothyroidism.

Prevention: Check the vaccination history, adequate feeding of pregnant bitches, in habitual abortion due to progesterone deficiency administer progesterone 1 mg/kg starting 10 days before date of previous episode of abortion or loss and repeated once a week.

C. Acute metritis during diestrus: Characterized by septicemia and dark red malodorous vaginal discharge a few days after end of estrus. Condition results from infection during estrus, either by breeding of a bitch with vaginal infection or infection of the bitch through the use of unhygienic procedures at A.I.

Treatment: Systemic broad spectrum antibiotics (based on culture and sensitivity). Fluid therapy and PGF2a (100-250 m g/kg SC), once or twice a day for 2-3 days.

D. Cystic endometrial hyperplasia-pyometra complex: One of the commonest diseases of the reproductive system of the bitch. Characterized by progressive changes leading to cystic endometrial glandular hyperplasia, followed by infection and pyometra.

i. Cystic endometrial hyperplasia: The signs include copious mucoid vaginal discharge during diestrus and anestrus. Discharge may sometimes be blood-tinged. The duration of discharge varies from a few days to weeks. Condition is associated with infertility, small litter size, early embryonic death, abortion and irregular estrous cycles.

Management: Consists of administration of Mibolerone (Testosterone) treatment,
(30 m g/day for dogs up to 50 lbs; or 180 m g/day for dogs over 100 lbs) for 10-30 days or several weeks. Ovariohysterectomy is recommended if future breeding is not planned.

ii. Endometrial hyperplasia and endometritis: History consists of conception failure, irregular cycles, pseudopregnancy, embryonic death, still birth or fetal mummification. The condition is common in nulliparous and bitches treated with progesterone.

Signs: Include moderate amount of fetid discharge at vulval lips during the period of 30-90 days after estrus. Signs may spontaneously regress but reappear after next estrus. There may be a slight increase in body temperature but the animals not seriously ill. There may be slight increase in WBC.

Management: Parenteral antibiotic treatment for 2-3 wks, vaginal infusion (for 3-5 days) using appropriate antibiotic. Ovariohysterectomy is recommended if future breeding is not planned.

iii. Pyometra: Characterized by the accumulation of pus in the uterus due to closed cervix, or partial closure. Pyometra may develop rapidly, and is diagnosed during the period of 3-6 weeks after estrus (diestrous period). Body temperature is elevated in acute cases, but normal in chronic open cases, or subnormal in severe toxic cases.

Causes: Exposure of reproductive tract to high concentrations of progesterone due to abnormal ovarian function or administration of exogenous progesterone has been associated with pyometra. Large proportions of the affected bitches have histories of previous treatment with progestins or estrogens (for mismating). Sequence of events in the pathogenesis seems to involve intense endometrial response to progesterone - glandular proliferation and secretion - invasion of uterus by pathogenic bacteria - bacterial proliferation - accumulation of pus - pyometra. Open or closed pyometra (cervix open or closed).

Clinical signs: Pyometra is easily recognized by history and signs. The signs include polyuria-polydipsia, vomition, anorexia, reduced exercise tolerance and purulent vaginal discharge in open cases. The abdomen is distended, and tender in some cases. Animal exhibits evidence of toxemia including increased heart rate and body temperature. Endotoxin produced in association with pyometra affects kidneys, bone marrow, liver, and other organs. Vulva is moderately enlarged and there is copious, purulent, serosanguineous or hemorrhagic discharge at vulval lips in cases of open pyometra. In cases of closed pyometra there is minimal discharge and gross abdominal distension is obvious. Bitch relents palpation of the abdomen. The total WBC ranges from 20-100,000 or more; being higher in acute cases of closed pyometra. Chronic cases of open pyometra result in bone marrow suppression and anemia. There is usually a shift to left or increase in band cells. Laboratory findings will vary depending on type (open or closed) and duration (acute or chronic): degenerative neutropenia, anemia, regenerative neutrophilia, azotemia, elevated BUN, hyposthenuria, hyperproteinemia, hypercholesterolemia, hypoalbuminemia, elevated alkaline phosphatase, LDH and PCV (dehydration).

Diagnosis: Based on recent history of estrus or previous treatment with exogenous hormones, estrogens or progesterone. Clinical signs, vaginal cytology, abdominal palpation, radiography, and ultrasound.

a. Ovariohysterectomy: This is the treatment of choice for nonbreeding bitches. Surgery may have to be postponed until fluid therapy and antibiotic treatment stabilize the animal. Culture of vaginal swab is necessary for choice of antibiotic. E. coli is the most common isolate. Chloramphenicol is the drug of choice (avoid using nephrotoxic antibiotic like gentocin).

b. Medical treatment: Very effective in open pyometra and in animals that are not extremely debilitated and in young animals < 8 years. Prostaglandins alone or in combination with antibiotics; PGF2a 100 to 250 m g/kg SC every 24 hr for 4-5 treatments. LD50 for PGF2a is 5.13 mg/kg BW. Prostaglandin treatment causes cervical relaxation and evacuation of the uterus in 24-96 hrs. Copious vaginal discharge is evident within hours after treatment. The discharge changes from purulent to serous within 3-4 days after, if drainage starts. After prostaglandin injection, especially in doses higher than 10 mg; the bitch will exhibit increased RR, incoordination, lacrimation, restlessness, hypersalivation, vomition and defecation. The severity of these signs increase with the dose, but the signs abate within 30-60 minutes after treatment. Parenteral antibiotic treatment should be continued for 10-20 days. Following and during prostaglandin treatment - daily abdominal palpation, ultra sound examination, or frequent radiographs are useful to monitor effect of prostaglandin dose being used. It may be advisable to start from low doses, 100 m g/kg, and gradually increased dose after cervical opening is attained and drainage has started. The series of prostaglandin treatment can be repeated in 2 weeks, if discharge still present. Recovery rate and prognosis for future reproductive function is fair to good after prostaglandin treatment.

A. "PROLONGED" ANESTRUS: Anestrus or failure to cycle is defined as a situation in which the adult bitch fails to exhibit estrus at the expected time after her last estrus. For example, if a bitch that has previously exhibited estruses at six month intervals, fails to show estrus 9-12 months after the last estrus, she is considered to be anestrus. Anestrus is usually a sign of other systemic conditions. The usual causes include age: anestrus in aged bitches, due to age related increases in the interestrous intervals. Treatment in these cases is not recommended, unless specific disease conditions are recognized. In breeding aged bitches, anestrus is usually associated with:

1) Hypothyroidism, Cushing's or Addison's disease. Diagnosis is based on appropriate hormone assays and chemistries. T4 replacement therapy, and treatment for Cushing's or Addison's is usually followed by resumption of estrous cycle.

2) Ovarian lesions - e.g., cystadenoma - treatment - ovariohysterectomy.

3) Use of estrus prevention treatments - Cheque, Ovaban.

4) Hypothalamic - hypophyseal - ovarian dysfunction: due to obesity, cachexia, chronic systemic disease, or stress of training, working, showing.

5) Neoplasia of the pituitary gland, midbrain or ovary.

6) Cystic ovaries.

--Treatment includes specific treatment for concurrent disease, followed by PMSG or FSH treatment for induction of heat.

--In cases of stressed animals estrus occurs within 1-3 months after cessation of stressful activity.

B. VAGINITIS DURING ANESTRUS: A common cause of infertility in bitches is vaginitis.

--As has been discussed, the most common types of vaginitis are puppy vaginitis; vaginitis during proestrus and estrus, vaginitis during anestrus; vaginitis in the spayed or old bitch. The underlying cause of vaginitis is altered vaginal defense mechanism (anestrus, spayed, old bitch); due to the absence of estrogenic effect, resulting in reduced resistance of vaginal epithelium to infections.

--Vaginitis may also result from primary infections during anestrus, unresolved metritis, endometritis or ascending infection from the bladder. Vaginal/vestibular foreign bodies, tumors, may predispose to secondary bacterial infections during anestrus. Anastral vaginitis is characterized by chronic, malodorous vaginal discharge and a history of persistent licking of the vulva. There is evidence of perivulvar dermatitis but no signs of systemic illness. The dog may be attractive to male dogs. Other signs include scooting and pollakiuria. Note that these signs may be associated with inflammation localized in the vestibule, clitoral fossa, vagina or due to perivulvar dermatitis.

Diagnosis: Inspect vulva and perivulvar skin folds and clitoral fossa (rule out vulvitis). Vaginoscopy - inflamed vaginal mucosa and presence of varying amount of purulent discharge. Foreign body may be visualized on examination. Culture of vaginal swab reveals large numbers of pathogenic bacteria, mycoplasma, and ureaplasma. Vaginitis due to herpes virus is difficult to diagnose due to difficulty in isolation. Vaginal cytology - small intermediate cells, parabasal cells, and large numbers of WBC (neutrophils and lymphocytes). Usually vaginal cells slough off in sheets. Culture of urine obtained by cystocentesis should be carried out to rule out ascending infection due to cystitis.

Differentiate from perivulvar dermatitis (skin fold pyoderma) in obese and spayed bitches; vulvitis due to enlarged clitoris, irritated or inflamed clitoris.

--Remove inciting causes.

--Vaginal irrigation and infusion using selected (based on sensitivity) antibiotic in saline. In cases of ureaplasma and mycoplasma infusion with Spectinomycin is beneficial. Oily antibiotic preparations may also be useful, and confer soothing effect. Systemic antibiotic treatment for 10-21 days. For ureaplasma and mycoplasma vaginitis, treatment with tetracycline (doxycycline) for 2-3 weeks is recommended.

--Estrogenic treatments: increases vaginal resistance to infection. Diethylstilbestrol 0.5-1 mg orally for 5 days; Premarin (Estrone SO4) 0.3 mg/100 lb body wt. for 1-2 weeks; vaginal cream containing estrogens (Dienestrol). Note: Estrogen treatment should not be used in aged bitches used for breeding.

--In spayed or aged bitches vaginitis may occur once estrogen therapy is terminated.

C. HYPOTHYROIDISM: A common cause of acquired infertility in bitches. The condition has been diagnosed in all breeds and all ages. It is common in some breeds, e.g., Chow Chow, Great Dane, Irish Wolfhounds and less common in others.

--Ninety percent of the condition results from idiopathic thyroid necrosis and atrophy of lymphocytic thyroiditis, an autoimmune disease--primary hypothyroidism. Secondary hypothyroidism seen in 10% of the cases is associated with pituitary problems. History includes prolonged anestrus, poor conception rates, irregular cycles, short cycles, weak estrus, prolonged or abnormal proestrus (light or heavy bleeding; short or prolonged); and infertility. Clinical signs include lethargy, dull hair coat, dry scaly thickened skin, seborrhea, pyoderma, poor hair growth; symmetrical alopecia; hypothermia, sensitive to cold and poor exercise tolerance. Other non-specific signs include dullness, lethargy, obesity, bradycardia, limb stiffness, knuckling of feet. Clinical abnormalities are normochromic, normocytic anemia, eosinophilia, and lymphocytosis; elevated blood cholesterol concentrations (60% of cases).

Diagnosis: Assay of Resting T4 and T3 concentrations. Normal T4 levels range from 17-42 ng/ml or 22-54 nmol/L; normal T3 0.5-1.5 ng/ml. Generally T4 < 17 ng/ml and/or T3 < 0.5 ng/ml is indicative of hypothyroidism. However, resting T4 and T3 are not accurate for diagnosis of hypothyroidism. Resting values vary according to laboratory, reproductive stages; they are lower in some breeds like Shepherds, Cocker Spaniels, Dachshunds; and varies from region to region.

--In addition, wasting diseases such as diabetes, drugs, increased estrogens, androgens and chronic diseases alter T3 and T4 values. Interpretation of resting T4 and T3 data should therefore be done bearing these factors in mind.

--TSH stimulation test: This test provides a better means of diagnosis. A blood sample is collected followed by administration of 5-10 IU (0.1 IU/kg) of TSH. Another blood sample is collected 4-6 hours post-TSH. In normal dogs 2-3 fold increase occurs.

Test Description	Result	Normal Range
T4 6 hr. Post TSH	42.83 ng/ml	35.0 - 60.0
T4 0 hr. Pre TSH	22.55	8.0 - 26.0
T3 6 hr. Post TSH	1.24 ng/ml	1.20 - 2.20
T3 0 hr. Pre TSH	0.81	.7 - 1.5

Treatment: Aimed at replacement using synthetic products: e.g., Synthroid or Levothyroxine. 0.1 mg/7-10 lb. body weight every 12 hours (Synthroid, L-thyroxine) or 20 m g/kg daily. Other products are used at varying doses. Continue until cycles normalize and conception occurs. In case of overdose - animal exhibits anxiety, panting, tachycardia and hyperactivity. If this occurs decrease the dose. May have to maintain on permanent treatment. Periodic examination is necessary. Examination is recommended after 4-6 weeks treatment, for T4 assay 4 hours after the last treatment. If T3 indicated Cytoban or Cytomel 6 mg/lb body weight/day in divided doses TID. Euthyroid - combined therapy, where T4 and T3 conversion is suspected.

D. CANINE BRUCELLOSIS: Major infectious cause of abortion in dogs. An infectious condition in dogs caused by Brucella canis, characterized by abortion and infertility in bitches; orchitis in male dogs. It is the major infectious cause of abortion in dogs.

--Has been diagnosed in all breeds of dogs of all ages; usually a kennel problem, but has been diagnosed in dogs from single households. When it occurs in kennels the incidence is high.

Mode of infection: Organism is present in urine, semen, vaginal discharge, aborted fetuses, and placenta; invade mucous membrane of oropharynx, genital tract or conjunctiva. Incubation period is 1-3 weeks.

History: Failure to conceive after repeated matings to proven sires. Higher incidence of early embryonic losses, and fetal resorption during first month of gestation or mid-gestation and late abortions (abortion storms).

Clinical signs: Abortion without premonitory signs, 85% of abortions occur 45-55 days of gestation. Fetuses may be aborted weak and die within days; or dead and in varying stages of degeneration. Abortion is followed by copious serosanguineous to greyish green odorous vaginal discharge (containing large numbers of Brucella canis organisms) for 1-6 weeks. In prepubertal bitches and non-pregnant bitches - the infection is without clinical signs. Other clinical findings include lymphadenitis, splenomegaly, dry hair coat, and rarely, (2%) discospondylitis.

1. Ingestion of infected vaginal discharge, urine, aborted fetal and placental tissues.

2. Venereal: After infection bacteremia occurs within 1-3 weeks, and organism localizes and persists in lymph nodes, bone marrow and reproductive tract for as long as 1 year. Bacteria also present in macrophages and leukocytes (which engulf them). Antibody levels are detectable 2-3 weeks after infection, titers are low when blood cultures are negative.

--Isolation of organism: Culture of vaginal swab, lymph node aspirate, blood, or bone marrow, placenta, amniotic fluid, urine, and semen.

--In aborted pups - fetal stomach, liver, spleen, amniotic fluids. Serology: Rapid slide agglutination test (SAT) - Pitman Moore (Screening test). Not specific. False positives occur. Negative SAT is reliable.

--Positive SAT; retest using tube agglutination test. Titers of 1:200 are significant.

Treatment: No therapy known to be curative in the bitch. Broad-spectrum antibiotics for several weeks. Not recommended.

Prevention: Routine serological test for all dogs for Brucella canis - especially breeding bitches and stud dogs. In kennels: routine testing recommended especially if kennel is not closed. In an outbreak, test and euthanize all positive cases. Thereafter test monthly until no positives found.

--All incoming dogs should be segregated, tested, and accepted only after two negative tests, a month apart. Kennel hygiene - clean up after every whelping or abortion. Test all dogs before mating, especially after history of abortion in kennel.

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