Repro3- Selected Topics SA

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Repro3- Selected Topics SA
2015-11-30 13:48:00
vetmed repro3

vetmed repro3
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  1. What dogs are at higher risk for pyometra?
    intact, nulliparous dogs, typically >8 years old
  2. What are the 2 steps to pyometra process?
    cystic endometrial hyperplasia, infection
  3. When during the cycle does pyometra usually occur?
  4. Cystic thickening of the endometrium, called _________________, is caused by __________ exposure followed by ____________.
    cystic endometrial hyperplasia; estrogen; prolonged exposure to progesterone (diestrus in dogs is 2 months)
  5. Does CEH always lead to pyometra?
    no; also, not all pyos are the result of CEH
  6. Describe the pathogenesis of pyometra. (5 steps)
    open cervix--> bacterial colonization of uterus--> bacteria trapped in CEH cysts--> cervix closes--> bacteria proliferate--> pyometra
  7. How does progesterone contribute to pyometra? (4)
    inhibits uterine contractions, stimulates secretion of "uterine milk", closes cervix, immune suppression----> IDEAL FOR BACTERIAL GROWTH
  8. What is the major pathogen that causes pyometra?
    E. coli
  9. What complications can arise from pyometra? (5)
    renal dysfunction (endotoxemia), immune suppression, endotoxemia, myocardial infarction, DIC
  10. Clinical signs associated with pyometra. (6)
    recent estrus, PU/PD, lethargy, vomiting, elevated WBCs with left shift, +/- vulvar d/c (if open pyo)
  11. Consider ____________ in ANY intact bitch that is sick.
  12. How do you diagnose pyometra?
    abdominal US to rule out pregnancy-thick uterine wall-pus in uterus
  13. How do you treat pyometra?
    ovariohysterectomy (progressive dz with no cure, CEH is irreversible, high chance of pyo next cycle)
  14. How do you treat a pyometra in a valuable bitch (owner will not spay)? (6)
    culture, IV antibiotics (amoxi, clavamox, cephalosporins), Lutalyse/Cabergoline (prolactin inhibitor)/Misoprostol (open cervix) [get rid of the CL!], antiemetics, opioids (NOT NSAIDS- don't ruin her kidneys any more), IV fluids
  15. What are the criteria for medical management of pyometra? (5)
    open cervix, young, good body condition, valuable breeding animal, normal renal function
  16. What is important after care of a bitch being medically managed for pyometra? (5)
    continue antibiotic for 10-14 days post-resolution (resolution= absolutely nothing in uterus on US), re-check P4 in 2 weeks, breed her on next cycle, antibiotics at every cycle, OHE once finished whelping
  17. What are differentials for a cat coming into heat when it has been spayed? (5)
    ovarian remnant syndrome, exogenous estrogen exposure (estrogen creams, etc), adrenal/ovarian neoplasia, uterine stump pyometra, vaginitis/UTI
  18. How do you diagnose ovarian remnants? (6)
    history, vaginal cytology, progesterone or LH assay, anti-mullerian hormone assay (very useful- only produced in gonads!), hCG/GnRH stim test, exploratory
  19. Describe how to interpret an LH assay when testing for ovarian remnants.
    LH will be high in spayed animal (+), (+) or (-) in intact animals depending on stage of cycle; must do test 2-3 days later
  20. Why is testosterone often not diagnostic to determine if a male is neutered or cryptorchid?
    b/c testosterone has pulsatile release...can get false negative
  21. What is the best assay for determining if there is a testicle left?
    AMH assay- only produced by sertoli cells in testicles [negative does not rule out- positive DOES rule in]
  22. The prostate is responsible for...
    the 1st and 3rd fraction of semen.
  23. BPH is a(n) ____________ condition that occurs in...
    androgen-dependent (caused by testosterone); intact male dogs (usually show signs by 5 years of age).
  24. Clinical signs of BPH. (5)
    most asymptomatic, tenesmus, hematuria, symmetrical enlargement, non-painful
  25. How do you treat BPH? (2)
    castration, Finasteride (if want to keep intact- blocks conversion of testosterone to DHT)
  26. Prostatitis is usually secondary to __________.
  27. Prostatitis is usually associated with... (3)
    abscessation, prostatic cysts, ascending infection.
  28. Dogs with pyometra DO NOT have a(n) ________.
  29. Clinical signs of acute prostatitis.
    painful, systemically ill, fever
  30. Clinical signs of chronic prostatitis. (5)
    subclinical, recurrent UTI, urethral d/c, infertility, non-painful on palpation
  31. How do you diagnose prostatitis? (5)
    culture prostatic fluid, CBC/Chem (acute-inflammation, liver enzymes; chronic-normal), urine culture, UA, ultrasound prostate
  32. How do you treat prostatitis?
    • acute- IV fluids, antibiotics, castrate
    • chronic- castration, oral antibiotics for 4-6 weeks or longer (fluoroquinolones, TMS, Chloramphenicol)
  33. Prostatic cancer is most common in ___________.
    neutered dogs
  34. Prostatic neoplasia is usually __(2)__; on rectal, the prostate feels... (3)
    adencarcinoma or TCC; asymmetrically enlarged, firm, calcification
  35. What is the prognosis for prostate cancer?
    Grave- usually metastasized by the time you diagnose it