Term
| Which of the following diseases is an important predisposing condition for a bitch to develop pyometra? |
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Definition
| Cystic endometrial hyperplasia |
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Term
| For a bitch that has an important breeding future (in the opinion of the owner), and who does not exhibit significant systemic signs of disease (aside from a purulent vulvar discharge), which of the following is PART of the most appropriate treatment for an open pyometra? |
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Definition
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Term
| For a bitch that is not considered to have an important future in breeding, the most appropriate treatment for pyometra is: |
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Definition
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Term
| Aglepristone is a treatment for pyometra and is what type of drug? |
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Definition
| Progesterone-receptor antagonist |
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Term
| The hormone which continually rises throughout estrus in the bitch is: |
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Definition
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Term
| All of the changes we note in vaginal cytology are due to which hormone(s)? |
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Definition
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Term
| What is the origin of the serosanguinous discharge noticed during the estrous cycle of the bitch? |
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Definition
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Term
| This cytology is indicative of which stage of the canine estrous cycle? |
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Definition
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Term
What stage of the canine estrous cycle is most likely represented by this picture?
https://bb.its.iastate.edu/courses/1/F2011-VDPAM-450_-ALL/assessment/66d6529b97aa45108dc45b9376d695fb/Quiz%202a.jpg |
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Definition
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Term
What stage of the canine estrous cycle is most likely represented by this picture?
https://bb.its.iastate.edu/courses/1/F2011-VDPAM-450_-ALL/assessment/432e7150bdb24334ab05a67a446acd12/Quiz%202b.jpg |
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Definition
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Term
What stage of the canine estrous cycle is most likely represented by this picture?
https://bb.its.iastate.edu/courses/1/F2011-VDPAM-450_-ALL/assessment/a71e4349eb364f50be4739b3fe93f62f/Quiz%202c.jpg |
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Definition
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Term
| Vaginoscopy in the bitch reflects changes in which of the following hormones? |
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Definition
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Term
| Which of the following hormones in the serum is most useful in diagnosing pregnancy in the bitch? |
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Definition
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Term
| Which of the following modalities offers the most reliably accurate count of the number of fetuses? |
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Definition
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Term
| Which diagnostic test gives the most information about the health of the fetuses? |
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Definition
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Term
| Which drug(s) offer(s) the best choice for pharmacological mismating treatment in the US? |
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Definition
| Prostaglandins & dopamine agonists |
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Term
| A client called you this morning and says, "Hey doc, you managed the breeding of my poodle bitch a couple months ago and ran all those progesterone assays and told me that she should whelp between October 8th and 10th. She hasn't whelped yet. What should I do?" You respond: |
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Definition
Bring her in today and let's have a look at her.
While there is normal variation to some degree in whelping dates, the window of time for whelping is pretty tight if you know the date of the LH surge. This may be normal, but probably not. It is certainly worth looking at sooner rather than later. If the ultrasound appears normal and progesterone is normal, you may decide to wait. Otherwise, earlier intervention will have much better results than later intervention. |
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Term
| Name one of the drugs discussed in the article that can be used to medically treat a non-obstructive dystocia in a normoglycemic bitch. |
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Definition
oxytocin
calcium
calcium gluconate |
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Term
| An after-hours call comes to you at midnight, "Hey doc, my little Shih-tzu is pregnant and had two puppies earlier this evening. Then she began to push again and seemed to be pushing pretty good for about an hour but no puppy was born and then for the last hour she hasn't had any contractions and she's just resting and we still only have the two puppies. Do you think she's done?" You answer: |
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Definition
No. Bring her in to the hospital now.
More than 30 minutes of strong abdominal contractions is abnormal. This is an obstructive dystocia followed by secondary uterine interia until proven otherwise. |
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Term
| A golden retriever bitch has been in labor for 6 hours and has had 12 puppies so far. Radiographs from 4 days previous indicated 14 puppies in the litter. The last puppy was born 5 hours ago and during the intervening time, the bitch has been mostly resting in the whelping box with the puppies, allowing them to nurse. No further abdominal contractions have been noted. What is your most likely diagnosis? |
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Definition
Secondary uterine inertia
After giving birth to 12 puppies, this mother's uterus is tired out. |
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Term
| Homework: What stage of the estrous cycle do you think best fits the cytology pictures for Daisy? (Choose one) |
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Definition
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Term
| Homework: If serum progesterone results for Daisy revealed 0.8 ng/mL, which state of the estrous cycle is represented by this examination? |
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Definition
Anestrus
This question takes the actual situation where you had cytological and vaginoscopic information and says, "What if you HAD checked progesterone concentrations and they were 0.8?" Then where would you KNOW she was in her cycle? |
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Term
| Homework: If serum progesterone concentrations for Daisy were measured, instead, at 4.2 ng/mL, which stage of the estrous cycle would be represented by this examination? |
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Definition
Diestrus
Very similar to the previous question, except now we imagine how our diagnosis might change if the serum progesterone came back higher, say around 4.2 ng/mL. This value in a vacuum could suggest late proestrus or early estrus as it would correlate with the stage just prior to ovulation OR at the other end of the curve (what goes up must come down) when progesterone was declining in late diestrus. Now, when you consider this case with the cytological and vaginoscopic information, it is not consistent with either late proestrus or estrus. It is, however, completely consistent with late diestrus (which, of course, will resemble anestrus to some extent). |
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Term
| Homework: What is your clinical advice for the client wishing to breed Daisy at this time? (Choose one of the responses below) |
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Definition
Bring Daisy back when you notice the first signs of proestrus.
Bring Daisy back in 3 or 4 months and we can attempt to induce estrus at that time.
Depending on the circumstances of the case and the owner's wishes, you can either just have the owner monitor Daisy very closely for signs of proestrus (serosanguinous vulvar discharge) or you can have her come back when she should be in late anestrus and attempt to induce estrus. |
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Term
| HOemwork: Which stage of the estrous cycle was represented for Kali on 12/26? |
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Definition
Metestrus
Even though we don't see the rush of neutrophils that we often see in metestrus, we see the unmistakeable shift in the population of epithelial cells from nearly 100% superficial cells on the 24th to all intermediate cells on the 26th. We have clearly left estrus. The presence of red blood cells on the 26th is not usual for metestrus, but not unheard of. It all depends on the level of estrogen still present. |
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Term
| Homework: You have one breeding dose of frozen/thawed semen to use in Kali. Which day did you choose to inseminate? (Choose only one date). |
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Definition
12/25
12/26
12/27
I think the best days would be the 26th or 27th, but you could probably get away with breeding on the 25th. My question is, "Why would you??!! It's Christmas!" Maybe you and your client don't celebrate Christmas, and so that would certainly be a valid reason, except that with frozen semen and only one insemination, you really want to place that semen in the uterus right in the middle or towards the end of the fertile period for the best results, which would be the 26th or 27th, no matter what your views on Christmas are. My apologies to the Canadians wanting to celebrate Boxing Day. You might just have to work... |
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Term
| Homework: The owners of Kali are anxious to know if she is pregnant and if everything is normal with the hoped-for pregnancy. What date should you schedule for the first pregnancy evaluation? |
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Definition
January 15
The first pregnancy evaluation should be scheduled when you can both palpate and use ultrasound, ideally, to diagnose the pregnancy. This will give you the most information and will be the only way you can tell them if everything is normal. Day 25 post LH surge will be a good time to do this. |
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Term
| Homework: Kali's owners want to allow her to whelp naturally at home. You recommend radiographs to count the fetuses. What day should them come in for radiographs? |
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Definition
Feb 17
February 4 is day 44 and you will likely not be able to see the pregnancy at this point. February 10 is day 51, which is probably late enough to pick up the fetal skeletons, but you could still lose a fetus between then and 2 weeks later when she whelps. If you have the choice, I'd wait till February 17, which is day 58. Waiting till February 23 will be day 64 and she could be whelping already: too late to take radiographs! |
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Term
| Homework: Kali's owners are anxious to know when to expect whelping. Please supply them with the most appropriate range of dates. |
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Definition
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Term
| Homework: Kali did not have a purulent vulvar discharge, but there appear to be a large number of bacteria in these cytologies (did you notice?). Please recommend a diagnostic and treatment plan. |
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Definition
| No treatment is necessary. Bacteria are part of the normal flora of the vagina and do increase in number normally during proestrus and estrus. |
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Term
| Homework: Which series of diagnoses best fits Emiline's stages of the estrous cycle on her 5 visits from June 30 through July 9? |
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Definition
Proestrus, proestrus, estrus, estrus, estrus
The first two days have a predominance of intermediate cells, some neutrophils, and red blood cells. These are the signs of proestrus. July 6th now shows a predominance (>80%) of superficial cells and the disappearance of neutrophils. These are the hallmarks of estrus. July 7 and 9 are similar, with the exception that red blood cells are present on the 7th. This is not a problem, as you were taught that red blood cells are present throughout proestrus and into estrus. Why they were not seen on the 6th is a good question and the answer is that they likely lysed. The swab, as you may note, was still red on the 6th, indicating the presence of blood, even though it was not noted on the cytology. |
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Term
| Homework: Insemination of Emiline will be TCI using fresh semen collected from a fertile, local male. You plan on inseminating twice, 2 days apart. What day would be best for the first insemination? (Choose one). |
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Definition
7/7
7/8
7/9
This was a tricky one because you may have been simply looking for that magic number of "2 ng/mL" to indicate the LH surge and then counting from there as day 0. The problem is that you have to remember the physiology behind the numbers and how they rise. Progesterone rises slowly during the preovulatory luteinization phase when just a small number of luteal cells are forming. It climbs sharply after ovulation when all the rest of the granulosa/thecal cells convert to luteal cells. So, while a level of 2 ng/mL of progesterone usually correlates with when the LH surge happens, if it truly happens then you would expect to see progesterone concentrations rise very quickly in the subsequent days. That doesn't happen in this bitch. Progesterone rises a little, and stays there (around 6 or 7 ng/mL) for a couple days, and then finally climbs to close to 10 ng/mL on the 9th. This level is usually associated with the start of the fertile period. In this bitch, she may be running a little different, but at least she is climbing at that point and it probably means that she has at least ovulated and the fertile period will be starting within a day or two. Luckily this is fresh semen from a fertile male. Breeding for the first of two times anytime from the 7th to the 9th will likely yield good results. |
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Term
| Homework: Which day is the most likely for the LH surge of Emiline? (Choose only one) |
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Definition
7/4
7/5
This dog did not read the textbook. The magical number of "2 ng/mL" didn't work here. The steep rise that occurs after the LH surge lags. There appears to be no real difference between the samples on 7/6 and 7/7. But there is a rise between 7/7 and two days later on 7/9. Those two dates probably correlate with ovulation and the beginning of the fertile period, respectively. Backtracking places the LH surge probably on 7/5. Maybe 7/4. |
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Term
| Homework: Which diagnoses best fit the 2 visits of Miley on July 21 and 23rd? |
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Definition
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Term
| Homework: Miley presented for the first time in your clinic for breeding management on the morning of Monday, July 21. The goal is to breed with chilled/shipped semen from out-of-state that can be delivered by overnight FedEx service. Considering all the aspects, both biological and logistical, which day should breeding occur? |
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Definition
7/22
This question allows you the ability to say that you could have gone back in time and have semen shipped the day before you actually saw the animal for the first time, which is, of course, not realistic but lets you think of the physiology. But going back a day puts you on Sunday, and FedEx will not pick up a package on Sunday. So, having semen shipped on Monday for Tuesday delivery is the earliest you can do it. And that's just fine, because you are going to breed by TCI, so even if she is a little bit high for progesterone concentrations on Tuesday, you will still get the semen where it needs to go. |
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Term
| Homework: Considering all aspects (biological, logistical, the owner's finances, and best chances of success), which method should be used to inseminate Miley? |
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Definition
Transcervical insemination
She is in metestrus and you have to be concerned about a closed cervix. Natural service and vaginal insemination will not deliver the semen to the uterus. Surgical insemination will, but is usually more expensive and puts the bitch through a surgical procedure. TCI is the best. |
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Term
| Homework: Give your best estimate for day 64 post LH surge (meaning the 3-day, whelping window starts on this day) for Miley. |
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Definition
9/18
You had to backtrack in your counting. Progesterone of 15.6 ng/mL most likely puts you in the middle of the fertile period, or day 5. That puts the LH surge at July 16. It's not as good as having actual values for those days, but it's the best you can do and will likely be pretty accurate. |
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Term
| Which combination of drugs offers a safe, effective, reliable method of terminating pregnancies in dogs? |
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Definition
| Prostaglandins and dopamine agonists |
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Term
| For the previous question (#1), what side effects to the treatment are most common? |
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Definition
Vomiting and diarrhea
These clinical signs will be diminished by using both drugs at lower concentrations than they would by using only one of them at higher concentrations. It is still relatively common, however, for dogs to vomit after the prostaglandin injections. Cabergoline causes less nausea than bromocryptine, and is a once-a-day instead of two-to-three-times-a-day treatment, though a little more expensive, so consider that when choosing your dopamine agonist. |
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Term
| After hours call: "Hey Doc, my dog started having puppies a couple hours ago. She had 4 already and they all are doing great and nursing. You took radiographs a late last week and told me there were 7 puppies. The last one was born almost an hour ago and she hasn't had any more since then; she hasn't even had any more contractions. She's just taking care of the other puppies and acting like she's done. What should I do?" You answer: |
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Definition
"Dogs may rest for up to a couple or even a few hours between puppies and that can be normal. Keep an eye on her for another hour or so, then call me back and we will discuss bringing her in at that point if she hasn't resumed whelping."
No need to have cases come in to see you if everything so far is within normal expectations. You may do more harm than good by interrupting the whelping process. |
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Term
| After hours call: "Hey Doc, my dog started having puppies about 15 minutes ago, I think. She's due to have her puppies any day now and that's what I think is happening, but I've never been through this before. She's in her box and she seems to be 'pushing' and she keeps licking her hind-end and when she pushes she cries really loudly, almost like screaming. What should I do?" (Extra credit) |
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Definition
"Bring her in now."
Whelping is not normally a painful experience for bitches. Outward signs of pain, beyond perhaps a very mild whimpering, are usually signs of an obstruction or other abnormal, painful experience. These dogs should be seen, the sooner the better. Be very careful about putting your job into the hands of the owner by asking them to do examinations for you, especially if the answer should not change your plan, anyway. |
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Term
| Which of the following drugs would be a good choice as part of a c-section protocol? |
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Definition
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Term
| While advantages and disadvantages of both approaches are presented, which approach is preferred for removing the fetuses from the uterus? |
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Definition
| Multiple incisions in the horns. |
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Term
| If you feel that antibiotics are necessary during a c-section procedure, which of the following would NOT be a good choice? |
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Definition
Enrofloxacin
Fluoroquinolones (e.g., enrofloxacin) have been shown to negatively affect the development of neonates. |
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Term
| Which of the following represents the BEST choice for analgesia during a c-section? (Extra credit) |
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Definition
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Term
| What is the most effective treatment for clinical benign prostatic hyperplasia? |
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Definition
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Term
| In a valuable breeding dog, in addition to the appropriate antibiotics, what therapy is the best choice to treat the BPH component of prostatitis? |
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Definition
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Term
| Which of the following prostatic diseases would you expect to see most commonly in castrated males? |
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Definition
Prostatic neoplasia
Recent studies have shown that there is a higher prevalence of prostatic neoplasia in castrated males compared to intact males. |
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Term
| How does finasteride work? |
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Definition
Blocks conversion of testosterone to dihydrotestosterone
DHT is the primary androgen to act on the prostate. Blocking its synthesis effectively decreases the size of the prostate over time due to lack of enough stimulation. Testosterone is preserved and can continue to stimulate libido and spermatogenesis. |
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