Blackwell's Five-Minute Veterinary Consult: Canine and Feline 4th Edition

1016 Pages·2008·12.95 MB·English

by  Larry P. Tilley

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SPONTANEOUS ABORTION AND PREGNANCY LOSS IN CATS
BASICS
OVERVIEW
“Abortion” is the delivery of one or more fetuses before it is (they are) capable of surviving outside of the uterus
“Pregnancy loss” is the death of the embryo, reabsorption of early fetuses, mummification (shriveling or drying up of the fetus, like a
mummy), abortion, stillbirths, and outcomes of difficult birth (known as “dystocia”)
The “queen” is a female cat
GENETICS
Nonspecific; inbred lines experience higher levels of pregnancy failure than seen in other cats
SIGNALMENT/DESCRIPTION of ANIMAL
Species
Cats
Breed Predilections
Persians and Himalayans—difficult birth (dystocia)
Mean Age and Range
Noninfectious causes—more common at the birth following the first pregnancy and in queens greater than 6 years of age
Infectious causes—all ages
Predominant Sex
Females
SIGNS/OBSERVED CHANGES in the ANIMAL
May have no clinical signs, especially early in pregnancy or gestation
Failure to litter on time
Decrease in abdominal size
Weight loss
Delivery of recognizable fetuses or placental tissue
Lack of appetite (known as “anorexia”)
Vomiting, diarrhea
Behavioral changes
Discharge from the vulva that contains blood or pus—frequently unnoticed in fastidious queens (that is, queens that groom or clean
themselves with meticulous attention) or with early pregnancy or gestational losses; the “vulva” is the external genitalia of females
Disappearance of fetuses previously documented by physical examination (palpation), ultrasound examination, or X-rays
Abdominal straining, discomfort
Depression
Dehydration
Fever
CAUSES
Infectious Disease
Viruses—feline panleukopenia virus; feline herpesvirus; feline calicivirus; feline leukemia virus (FeLV); feline immunodeficiency virus
(FIV)
Bacteria—Escherichia coli; Streptococcus; Staphylococcus; Salmonella; Mycoplasma; Mycobacterium
Coxiella burnetii (Q fever)
Toxoplasma gondii (probably uncommon)
Noninfectious—Reproductive Causes
Early loss of the embryo
Difficult birth (dystocia)
Disease of the lining of the uterus (known as “endometrial disease”)—cystic endometrial hyperplasia (CEH), a condition in which the
lining of the uterus thickens abnormally and contains fluid-filled sacs or cysts; very common
Hormonal disorders
Inadequate placenta
Fetal defects—genetic or developmental (anatomic, metabolic, and chromosomal abnormalities)
Excessive or poorly planned inbreeding and/or poor choices of breeding stock—indirect evidence; difficult diagnoses without thorough
family history and test matings
Effects of social hierarchy in group setting; behavioral disorders in individuals
Agents that induce abortion (known as “abortifacient drugs”)—luteolytics (such as the prostaglandin, PGF ); estrogens; prolactin
2α
inhibitors (such as cabergoline); steroids; tamoxifen citrate (dogs); mifepristone (dogs); epostane (dogs)
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Noninfectious—Nonreproductive Causes
Nutrition— low taurine intake (taurine is an amino acid [protein] that is an important component of the diet of cats; cats cannot
produce enough taurine in their bodies and so, must obtain taurine from their food to maintain health); nutritional fads; some
nutraceuticals
Severe stress—environmental; physiological; psychosocial
Trauma
Some medications
Consequence of severe, generalized (systemic) disease involving systems other than the reproductive system
RISK FACTORS
Prior history of pregnancy loss or poor reproductive performance (may be history of individual queen or the cattery)
Coexistent, severe sudden (acute) or long-term (chronic) disease
Excessive inbreeding
Birth following the first pregnancy or queen greater than 6 years of age
Environmental stress—crowding, poor sanitation, noise, temperature or humidity extremes
Social order in cattery
Exotic breeds—often reproduce poorly in large catteries or high-density environments
Obesity or inappropriate nutrition
TREATMENT
HEALTH CARE
Outpatient medical management—medically stable patients; suspected hormonal disorders; disease of the lining of the uterus
(endometrial disease); noninfectious/nonreproductive pregnancy loss
Inpatient medical management—abortion imminent or taking place; clinical illness; potential zoonoses—diseases that can be passed
from animals to people (unless safe and effective outpatient treatment can be assured); patients being treated with the prostaglandin,
PGF
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Aborted fetus or discharge may be infectious; isolate patient
Practice strict sanitation for inpatient or outpatient treatment
Correct dehydration—administer fluids (such as Normosol® or lactated Ringer’s solution)
ACTIVITY
No limitations, unless an infectious agent is suspected or documented for outpatients
Isolate infectious patients (preferred)
DIET
No special dietary considerations for uncomplicated cases
Persistent diarrhea or other causes of fluid loss—veterinary diet and fluid therapy
SURGERY
Surgical management—spay or ovariohysterectomy (surgical removal of the ovaries and uterus) for stable patients with no breeding
value or if necessary to preserve queen’s life
MEDICATIONS
Medications presented in this section are intended to provide general information about possible treatment. The treatment for a
particular condition may evolve as medical advances are made; therefore, the medications should not be considered as all inclusive.
Depend on underlying causes
Antibiotics—amoxicillin, pending results of bacterial culture and sensitivity testing
Prostaglandin (PGF )—may be used to stimulate and evacuate the uterus in cases with non-viable fetuses or significant uterine
2α
contents noted on ultrasound examination; discuss risks and benefits of prostaglandin treatment with your cat’s veterinarian
Progesterone/progestogens—safe and effective doses for pregnancy maintenance not established; may cause or worsen cystic
endometrial hyperplasia (CEH), a condition in which the lining of the uterus thickens abnormally and contains fluid-filled sacs or cysts
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FOLLOW-UP CARE
PATIENT MONITORING
Re-evaluate 7 to 14 days after completion of prostaglandin (PGF ) treatment
2α
Repeat ultrasound examination—evaluate uterine evacuation or fetal viability
PREVENTIONS AND AVOIDANCE
Genetic problems require attention to breeding program
Infectious causes require surveillance and control measures
Spay or ovariohysterectomy for cats with no breeding value
POSSIBLE COMPLICATIONS
Generalized bacterial infection (known as “sepsis”)
Shock
Uterine rupture
Inflammation of the lining of the abdomen (known as “peritonitis”)
Inflammation of the lining of the uterus (known as “metritis”)
Inflammation with accumulation of pus in the uterus (known as “pyometra”)
Bleeding
Infertility
Obesity following spay or ovariohysterectomy in mid-life queens
Cystic endometrial hyperplasia (CEH, a condition in which the lining of the uterus thickens abnormally and contains fluid-filled sacs or
cysts) following progestogen therapy; progestogen is any substance capable of producing the effects of the female hormone,
progesterone
EXPECTED COURSE AND PROGNOSIS
Symptomatic retrovirus infection—poor prognosis
Long-term (chronic) infertility—common after 6 years of age
Queens not bred prior to 3 to 4 years of age experience higher infertility
Severe cystic endometrial hyperplasia (CEH, a condition in which the lining of the uterus thickens abnormally and contains fluid-filled
sacs or cysts)—recovery of fertility unlikely; inflammation with accumulation of pus in the uterus (pyometra) is a common
complication
Genetic abnormalities causing difficult birth (dystocia) or loss of most or all of litter—guarded to poor prognosis for further
reproduction
Repeated difficult births (dystocias)—recurrence depends on cause; guarded prognosis if cause not ascertained
Hormonal disorders—often manageable; consider genetic aspects
KEY POINTS
Zoonoses (diseases that can be passed from animals to people) can be causes of abortion or pregnancy loss in cats; discuss the potential
of a zoonosis causing your cat’s abortion or pregnancy loss with your pet’s veterinarian
Maintain careful records of reproductive performance for each queen and for the cattery
Establish disease surveillance and control measures; may require significant changes in cattery management and breeding stock
selection
For breeding cats—consider risks and possible side effects associated with non-surgical solutions, particularly with infectious or genetic
causes of pregnancy loss
Infertility—may result despite successful treatment; may be secondary to conditions pre-existing the pregnancy loss
Prostaglandin treatment—consider risks and possible side-effects
Spay or ovariohysterectomy—indicated for primary disease of the uterus for queens with no breeding value
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ANAL SAC/PERIANAL ADENOCARCINOMA
(CANCER INVOLVING THE ANAL SAC OR AREA AROUND THE ANUS)
BASICS
OVERVIEW
Uncommon cancerous tumor (malignant neoplasm) that developed from glands of the anal sac
Locally spreading (invasive) cancer
High rate of spread to other areas of the body (metastasis), often to the lymph nodes under the lumbar spine (sublumbar lymph nodes)
Frequently associated with high blood calcium levels (hypercalcemia)
SIGNALMENT/DESCRIPTION of ANIMAL
Older dogs; extremely rare in cats
Females have had higher rates of anal sac/perianal adenocarcinoma is some studies
No breed has been proven to have increased likelihood of developing anal sac/perianal adenocarcinoma
SIGNS/OBSERVED CHANGES in the ANIMAL
Mass associated with anal sac, straining to defecate, and/or constipation
May have lack of appetite (anorexia), excessive thirst (polydipsia), excessive urination (polyuria), and sluggishness (lethargy)
Mass associated with anal sac may be quite small despite massive metastatic disease
CAUSES
A hormonal cause is hypothesized
TREATMENT
HEALTH CARE
Surgery is the treatment of choice for the primary tumor
Surgical removal of the primary tumor and enlarged lymph nodes may prolong survival
Radiation may be helpful, but acute and chronic radiation side effects can be moderate to severe
Consult a veterinary oncologist for current recommendations
Monitor blood calcium levels and manage high levels (hypercalcemia), if present
DIET
Normal diet or as recommended by your pet’s veterinarian
SURGERY
Surgical removal (resection) of the tumor
Partial surgical removal to decrease the size (debulking) of the tumor in cases where the tumor cannot be totally removed
Surgical removal or decrease in size of lymph nodes with evidence of metastasis
MEDICATIONS
Medications presented in this section are intended to provide general information about possible treatment. The treatment for a
particular condition may evolve as medical advances are made; therefore, the medications should not be considered as all inclusive.
Limited reports of partial responses to platinum-containing chemotherapeutic compounds in dogs—cisplatin, carboplatin
Possible role for melphalan after debulking surgery
FOLLOW-UP CARE
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PATIENT MONITORING
Complete surgical tumor removal—physical examination, chest X-rays, abdominal ultrasonography, and blood work (serum
biochemistry tests) as scheduled by your pet’s veterinarian
Partial surgical tumor removal—monitor tumor size and blood calcium levels and kidney tests (blood work, urinalysis)
EXPECTED COURSE AND PROGNOSIS
Prognosis guarded to poor
Surgery often reduces the severity of signs (known as “palliative” treatment), but is not curative
May see both local progression of the tumor and metastasis occurring
Growth of the tumor may be slow and debulking lymph-node metastatic disease may significantly prolong survival
Presence of high blood calcium levels and metastasis were poor prognostic factors in one study
Median survival time (the time between diagnosis and death) ranges from about 8 to 19 months, depending on individual clinical status
Ultimately, dogs succumb to complications related to high blood calcium levels or from effects of the primary tumor or metastases
KEY POINTS
Uncommon cancerous tumor (malignant neoplasm) that developed from glands of the anal sac
High rate of spread to other areas of the body (metastasis)
Frequently associated with high blood calcium levels (hypercalcemia)
Surgical removal of the primary tumor and enlarged lymph nodes may prolong survival
Prognosis guarded to poor
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SPONTANEOUS ABORTION AND PREGNANCY LOSS IN DOGS
BASICS
OVERVIEW
“Abortion” is the delivery of one or more fetuses before it is (they are) capable of surviving outside of the uterus
“Pregnancy loss” is the death of the embryo, reabsorption of early fetuses, mummification (shriveling or drying up of the fetus, like a
mummy), abortion, stillbirths, and outcomes of difficult birth (known as “dystocia”)
The “bitch” is a female dog
GENETICS
No genetic basis for most causes of abortion
Low levels of thyroid hormone due to infiltration of lymphocytes into the thyroid gland resulting in destruction of thyroid tissue
(known as “lymphocytic hypothyroidism”); lymphocytes are a type of white-blood cell that are formed in lymphatic tissues throughout
the body; lymphocytes are involved in the immune process—single-gene recessive trait in borzois
SIGNALMENT/DESCRIPTION of ANIMAL
Species
Dogs
Breed Predilections
Familial (runs in certain families or lines of animals) low levels of thyroid hormone due to infiltration of lymphocytes into the thyroid
gland resulting in destruction of thyroid tissue (lymphocytic hypothyroidism) reported in borzois—prolonged interval between “heat”
or “estrous” cycles, poor conception rates, abortion mid-pregnancy or gestation, stillbirths
Many breeds considered at risk for familial (runs in certain families or lines of animals) low levels of thyroid hormone (known as “
hypothyroidism”)
Mean Age and Range
Infectious causes, medications causing abortion, fetal defects—seen in all ages
Cystic endometrial hyperplasia (CEH), a condition in which the lining of the uterus thickens abnormally and contains fluid-filled sacs
or cysts—bitch usually is greater than 6 years of age
Predominant Sex
Females
SIGNS/OBSERVED CHANGES in the ANIMAL
Failure to deliver or whelp on time
Delivery of recognizable fetuses or placental tissues
Decrease in abdominal size; weight loss
Lack of appetite (known as “anorexia”)
Vomiting, diarrhea
Behavioral changes
Discharge from the vulva that contains blood or pus; the “vulva” is the external genitalia of females
Disappearance of fetuses previously documented by physical examination (palpation), ultrasound examination, or X-rays
Abdominal straining, discomfort
Depression
Dehydration
Fever in some patients
CAUSES
Infectious Disease
Brucella canis—bacteria that causes reproductive problems in female and male dogs; disease called “brucellosis”
Canine herpesvirus
Toxoplasma gondii, Neospora caninum
Mycoplasma and Ureaplasma
Miscellaneous bacteria—E. coli, Streptococcus, Campylobacter, Salmonella
Miscellaneous viruses—canine distemper virus, parvovirus
Uterine
Cystic endometrial hyperplasia (CEH, a condition in which the lining of the uterus thickens abnormally and contains fluid-filled sacs or
cysts) and inflammation with accumulation of pus in the uterus (known as “pyometra”)
Trauma
Tumors or cancer
Medications that are toxic to the developing embryo
Chemotherapeutic agents
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Estrogens
Steroids—high dosages
Ovarian
Prostaglandins—substances that have many effects on the female reproductive tract, one of which is the breakdown of the “corpora
luteum” or “yellow body” that develops at the site of ovulation in the ovary and produces the female hormone, progesterone, which
supports and maintains the pregnancy; breakdown or lysis of the corpora luteum decreases levels of progesterone and disrupts support of
pregnancy
Dopamine agonists—medications that mimic dopamine (a nervous system “messenger”) that leads to a decrease in the hormone,
prolactin, and to lysis of the “corpora luteum” or “yellow body” via suppression of prolactin; drugs include bromocriptine and
cabergoline
Insufficient secretion of progesterone by the “corpora luteum” or “yellow body” during pregnancy, leading to pregnancy loss (known
as “hypoluteoidism”)—abnormal function of the corpora luteum in the absence of fetal, uterine, or placental disease: progesterone
concentrations less than 1 to 2 ng/ml
Hormonal Dysfunction
Low levels of thyroid hormone (hypothyroidism)
Excessive levels of steroids produced by the adrenal glands (known as “hyperadrenocorticism” or “Cushing’s disease”)
Environmental factors—hormone or endocrine-disrupting contaminants have been documented in people and wildlife with fetal loss
Fetal Defects
Lethal genetic or chromosomal abnormality
Lethal organ defects
RISK FACTORS
Exposure of the brood bitch to animals carrying disease
Old age
Genetic factors
TREATMENT
HEALTH CARE
Most bitches should be confined and isolated pending diagnosis
Hospitalization of infectious patients preferred
Brucella canis—highly infective to dogs; bacteria shed in high numbers during abortion; suspected cases should be isolated
Outpatient medical management—medically stable patients with noninfectious causes of pregnancy loss, hormonal disorders, or disease
of the lining of the uterus (known as “endometrial disease”)
Partial abortion—may attempt to salvage any remaining live fetuses; administer antibiotics if a bacterial component is identified
Dehydration—use replacement fluids, supplemented with electrolytes if imbalances are identified by serum biochemistry blood tests
ACTIVITY
Partial abortion—cage rest
DIET
No special dietary considerations for uncomplicated cases
SURGERY
Spay or ovariohysterectomy—preferred for stable patients with no breeding value
MEDICATIONS
Medications presented in this section are intended to provide general information about possible treatment. The treatment for a
particular condition may evolve as medical advances are made; therefore, the medications should not be considered as all inclusive.
Prostaglandin (PGF —Lutalyse®)—stimulates and evacuates the uterus; also may consider Estrumate® (cloprostenol)—not approved
2α
for use in dogs; discuss the risks and benefits of treatment with your dog’s veterinarian
Antibiotics—for bacterial disease; initially institute broad-spectrum antibiotic; specific antibiotic depends on bacterial culture and
sensitivity testing of vaginal tissue or postmortem examination of fetus(es)
Progesterone (Regu-Mate®) or progesterone in oil—for documented cases of insufficient secretion of progesterone (female hormone
necessary to support pregnancy) by the “corpora luteum” or “yellow body” (hypoluteodism) only
Oxytocin (hormone that stimulates uterine contractions)—for uterine evacuation; most effective in the first 24 to 48 hours after
abortion
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FOLLOW-UP CARE
PATIENT MONITORING
Partial abortion—monitor remaining fetuses with ultrasound examination to determine if they are continuing to live and develop;
monitor general (systemic) health of the bitch for remainder of pregnancy
Vulvar discharges—check daily; for decreasing amount, odor, and inflammatory component; for consistency (increasing mucoid
content is good prognostically)
Prostaglandin (PGF )—continued for 5 days or until most of the discharge ceases (usually 3 to 15 days)
2α
Brucella canis—monitor after spaying and antibiotic therapy; yearly serum testing to identify reappearance of bacteria (extremely
difficult to eliminate infection successfully, even if combined with spaying or ovariohysterectomy)
Low levels of thyroid hormone (hypothyroidism)—treat appropriately; spaying recommended (possible genetic nature of
hypothyroidism should be considered)
PREVENTIONS AND AVOIDANCE
Brucellosis (disease caused by Brucella canis) and other infectious agents—surveillance programs to prevent introduction to kennel
Spay or ovariohysterectomy—for bitches with no breeding value
POSSIBLE COMPLICATIONS
Untreated inflammation with accumulation of pus in the uterus (pyometra)—generalized disease caused by the spread of bacteria in the
blood (known as “septicemia” or “blood poisoning”), presence of poisons or toxins in the blood (known as “toxemia”), death
Brucellosis (disease caused by Brucella canis)—infection and inflammation in other organs of the body, such as the vertebrae
(diskospondylitis) and eye (endophthalmitis, recurrent uveitis)
EXPECTED COURSE AND PROGNOSIS
Inflammation with accumulation of pus in the uterus (pyometra)—recurrence rate during subsequent cycle is high (up to 70%) unless
pregnancy is established
Cystic endometrial hyperplasia (CEH, a condition in which the lining of the uterus thickens abnormally and contains fluid-filled sacs or
cysts)—recovery of fertility unlikely; and inflammation with accumulation of pus in the uterus (pyometra) is a common complication
Hormonal dysfunction—often manageable; familial (runs in certain families or lines of animals) aspects should be considered
Brucellosis (disease caused by Brucella canis)—guarded prognosis; extremely difficult to eliminate infection successfully, even if
combined with spaying or ovariohysterectomy
KEY POINTS
If brucellosis (disease caused by Brucella canis) is confirmed as the cause of pregnancy loss, euthanasia is recommended owing to lack
of successful treatment and to prevent spread of infection; may try spay or ovariohysterectomy and long-term antibiotics with
long-term monitoring
If brucellosis (disease caused by Brucella canis) is confirmed as the cause of pregnancy loss, a surveillance program for kennel
situations should be developed and implemented
If brucellosis (disease caused by Brucella canis) is confirmed as the cause of pregnancy loss, zoonotic potential should be considered; a
“zoonosis” is a disease that can be passed from animals to people
Primary uterine disease—spay or ovariohysterectomy is indicated in patients with no breeding value; cystic endometrial hyperplasia
(CEH, a condition in which the lining of the uterus thickens abnormally and contains fluid-filled sacs or cysts) is an irreversible change
Infertility or pregnancy loss—may recur in subsequent “heat” or “estrous” cycles despite successful immediate treatment
Prostaglandin treatment—discuss possible side effects of prostaglandins with your pet’s veterinarian
Infectious diseases—establish surveillance and control measures
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AGGRESSION BY DOGS TOWARD FAMILIAR PEOPLE
BASICS
OVERVIEW
Aggression (such as growling, lip-lifting, barking, snapping, lunging, biting), usually directed toward household members or familiar
people in situations involving access to preferred resources (such as food or toys)
Also referred to as “dominance aggression,” “status-related aggression,” “conflict aggression,” or “competitive aggression”
GENETICS
Breed bias or predilections exist and pedigree analyses have shown that it may occur more commonly within related dogs
Mode of inheritance is unknown
SIGNALMENT/DESCRIPTION of ANIMAL
Species
 Dog
Breed Bias or Predilections
 Spaniels (English springer and cocker), terriers, Lhasa apso, and rottweiler, but may be exhibited by any breed
Mean Age And Range
 Usually manifested at the onset of social maturity (12–36 months of age); may be seen in young dogs
Predominant Sex
 Male dogs (castrated and intact) more commonly are presented with aggression toward familiar people than are female dogs
SIGNS/OBSERVED CHANGES in the ANIMAL
Aggression often seen around resting areas, food, toys, handling (including petting) and reaching toward favorite possessions, including
people
Aggression usually is directed toward household members or persons that have an established relationship with the dog
Aggressive behaviors may be seen in other contexts, including (but not limited to) defense of territory, when dogs are reprimanded or
denied access to items or activities, toward other dogs, and toward unfamiliar people
Aggression may not be seen every time dog is in a certain situation and may not be directed uniformly toward each person within the
household
Stiff body posture, staring, head up, ears up and forward, or tail up usually accompanies aggressive behavior; a combination of these
postures may be seen with more submissive postures (for example, tail is up but ears are tucked, eyes averted), which may represent an
element of conflict, anxiety, or fear in the dog’s motivation
Dog may seem to be “moody” and this behavior may be a key to judging when the dog is likely to be aggressive in a given situation
Dog may show fearful behaviors (such as eye aversion, tail tucked, and avoidance) in early episodes; these fearful behaviors may
diminish as the dog becomes more confident that aggression will change the outcome of the situation
Anxiety may be noted in pet-owner interactions and other situations, such as owner departure or novel situations
Some dogs control their environment using aggression only because it is effective, but are anxious about every encounter, while other
dogs appear confident and secure
Generally the dog does not have any physical abnormalities related to the aggressive behavior; however, medical conditions, especially
painful ones, may contribute to the expression of aggression
CAUSES
May be part of a normal canine social behavioral repertoire, but its expression is influenced by environment, learning, and genetics
The manifestation of aggression may be influenced by underlying medical conditions, early experiences (learning that aggression works
to control situations), inconsistent or lack of clear rules and routine within the household and within human-pet interactions
Rarely a sign of a medical condition, but contributory medical conditions must be ruled out, since illness and/or pain may influence a
tendency for aggressive behaviors
RISK FACTORS
Inconsistent or inappropriate punishment and inconsistent owner interactions may contribute to the development of conflicted and/or
aggressive behavior
Medical conditions, especially painful ones, may contribute to the expression of aggression; extreme caution should be taken when the
veterinarian examines dogs that show aggression—including the use of muzzles or other humane restraint devices
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