1. PROFESSIONALISM “No man ever reached to excellence in any one art or profession without having passed through the slow and painful process of study and preparation.” -Horace

2. THE ESTROUS CYCLE

3. NORMAL ESTOUS CYCLE: THE BITCH Estrous Cycle: Defined as the time from the beginning of one heat period to the beginning of the next. Onset of puberty: 6-24mths; Avg.: 9-10mths The stages of the estrous cycle: Proestrus Estrus Metestrus Diestrus Anestrus

4. NORMAL ESTROUS CYCLE: PROESTRUS PROESTRUS: the period when the bitch is sexually attractive, but rejects the male’s advances Physical signs of proestrus: Serosanguinous vaginal discharge Vulvar swelling Vaginal edema Internal physical signs: Lengthening and hyperemia of the uterine horns Enlargement of the cervix Thickening of the vaginal wall

5. PROESTRUS Hormonal signs of proestrus: Increasing serum concentrations of estradiol (estrogen) estrogen is responsible for the physical signs of proestrus Estrogen is being produced by the maturing follicles in the ovary (under the influence of Follicle Stimulating Hormone or FSH) As proestrus progresses, the estrogen levels begin to peak and initiate the onset of estrus.

6. PROESTRUS Cytologic signs of proestrus: Vaginal Cytology Parabasal cells and intermediate cells predominate; wbc’s and rbc’s present Duration of proestrus: 3-17 days; Avg.: 9 days

7. VAGINAL CYTOLOGY

10. PROESTRUS INTERMEDIATE CELLS RED BLOOD CELLS

11. THE NORMAL ESTROUS CYCLE: ESTRUS ESTRUS: The period of acceptance of the male Physical signs of estrus: The swollen vulva is less turgid The vulvar discharge is usually less bloody The bitch allows mating “standing” heat “flagging” behavior (tail deviated to the side)

12. ESTRUS Hormonal signs of estrus: Serum estrogen peaks in late proestrus and early estrus. The estrogen peak initiates a surge of luteinizing hormone (LH) LH results in ovulation (rupture) of the mature follicle and release of the oocyte. LH also stimulates the cells left behind in the empty follicle to multiply into the corpus luteum (See metestrus) serum progesterone levels begin to increase toward the end of estrus (and beginning of metestrus) Progesterone is produced by the corpus luteum which is forming from the empty follicle (see metestrus) Progesterone is the hormone that maintains pregnancy

13. ESTRUS Cytologic signs of estrus: Vaginal cytology: Superficial and superficial anuclear squamous cells predominate (aka cornified cells); rbc’s usally present, wbc’s usually absent Duration of estrus: 3-21 days; Avg.: 9 days

14. ESTRUS: VAGINAL CYTOLOGY CORNIFIED EPITHELIAL CELLS

15. THE NORMAL ESTROUS CYCLE: METESTRUS METESTRUS: The period after ovulation when the corpus luteum develops. Internal signs of metestrus: Lining of the uterus is thick and “juicy” in preparation for implantation of a fertilized ovum Loss of the cornified epithelial lining that developed in the vagina during proestrus and estrus

16. THE NORMAL ESTROUS CYCLE: DIESTRUS DIESTRUS: the period when the corpus luteum has reached maximum size and effectiveness. Begins with the bitch’s refusal to mate Physical signs of diestrus: None except the cessation of signs of estrus Hormonal signs of diestrus: Serum progesterone levels continue to increase and peak during diestrus In a pregnant bitches, there is a rapid pre-partum drop in progesterone ~24 hours before partuition In non-pregnant animals, the decline may be more gradual

17. DIESTRUS Cytologic signs of diestrus: Vaginal cytology: A sudden decrease in the number of superficial cells and a reappearance of intermediate and parabasal cells, and wbc’s. Duration of diestrus: ~2mths Dogs and cats are unique in that their corpora lutea appear to have preprogrammed life spans.

18. DIESTRUS: VAGINAL CYTOLOGY INTERMEDIATE CELLS PARABASAL CELLS

19. DIESTRUS PSEUDOPREGNANCY: A prolonged diestrus Animal may show signs of pregnancy: Nesting behavior Mammary enlargement –Lactation in extreme cases Clinical signs fade with time

20. THE NORMAL ESTROUS CYCLE: ANESTRUS ANESTRUS: Follows diestrus and ends with the onset of proestrus; criteria vary First time plasma progesterone reaches a level below 3 nmol/L The moment that the influence of progesterone on the endometrium is no longer evident. Cytologic signs of anestrus: Samples are almost acellular The cells present are parabasal cells and small intermediate cells. Duration of anestrus: Avg.: ~4.5mths.

21. THE NORMAL ESTROUS CYCLE: THE QUEEN Onset of puberty: 6-9mths Female cats are seasonally polyestrous Cycle controlled by the photoperiod and body weight 12-14 hours of light and 2.5kgs In the absence of ovulation or pregnancy, repeated estrous cycles occur every 10-14 days

22. THE NORMAL ESTROUS CYCLE: PROESTRUS in the queen PROESTRUS: The period of follicular development, but refusal to mate Physical signs of proestrus: Owner may notice increased affection No vulvar swelling or vaginal discharge in cats Hormonal signs of proestrus: Characterized by increasing serum estrogen concentrations Cytologic signs of proestrus: Epithelial cells become cornified Duration of proestrus: 1-2 days

23. THE NORMAL ESTROUS CYCLE: ESTRUS in the queen ESTRUS: The period of sexual receptivity and follicle maturation Physical signs of estrus: Queen allows copulation Extreme affection (head rubbing, vocalization, crouching of the thoracic limbs with rigid extension of the pelvic limbs, lordosis, lateral deviation of the tail) Hormonal signs of estrus: Peak serum concentrations of estrogen Cytologic signs of estrus: Maximum vaginal epithelium cornification Duration of estrus: 7-9 days

24. ESTRUS Cats are known to be “induced ovulators” Ovulation of the mature follicle occurs as a result of stimulation of the vagina and cervix during mating

25. FRIENDSHIP “Friendship is like peeing on yourself: Everyone can see it, but only you get the warm feeling that it brings.”

26. PREGNANCY AND BIRTH

27. VAGINITIS Definition: an inflammatory process, not necessarily infectious. Prepuberal bitch (aka puppy vaginitis) VS. Adult vaginitis

28. VAGINITIS PUPPY VAGINITIS Causes: Inverted vulva Hormonal fluctuations Clinical signs: Purulent vulvar discharge +/- licking the vulva Treatments: systemic antibiotics topical douching –Signs will return when treatment is discontinued –Condition resolves naturally after the first heat cycle

29. VAGINITIS Inverted vulva

30. VAGINITIS ADULT VAGINITIS Causes: Anatomical abnormalities Canine herpesvirus Clinical signs: purulent vulvar discharge +/- licking the vulva peri-vulvar skin irritation or infection Perceived urinary incontinence

31. VAGINAL HYPERPLASIA/PROLAPSE Hyperplasia/prolapse Occurs under the influence of estrogen Results in edematous vaginal tissue that protrudes from the vulva Treatment: Ovariohysterectomy resolves the condition permanently and is the tx of choice Will usually resolve spontaneously but will recur with subsequent estrous cycles

32. VAGINAL HYPERPLASIA/PROLAPSE

33. OTHER REPRODUCTIVE DISORDERS: PYOMETRA: Literally “pus in the uterus” High levels of progesterone cause several changes in the uterus: hyperplasia and hypertrophy of the endometrial glands of the uterus Decreased myometrial contractions Predisoposes the uterus to bacterial infection –Most common bacteria isolated is E.coli

34. PYOMETRA CLINICAL SIGNS: Vulvar discharge Vomiting Dehydration PU/PD Azotemia DIAGNOSIS: Radiology Ultrasound Bloodwork Ieukocytosis, neutrophilia with a left shift

35. PYOMETRA This is a potentially life-threatening condition

36. PYOMETRA Preferred treatment is ovariohysterectomy As well as antibiotics and fluid therapy An open pyometra is when the Cervix is open and allows drainage Of the pus

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38. PREGNANCY PREGNANCY DIAGNOSIS: Palpation (~days 25-36) Hormone assay Ultrasonography (~20 days) Radiography (~day 45)

39. PREGNANCY: RADIOGRAPHS

40. PREGNANCY GESTATION: the period of pregnancy DOGS: 62-65 CATS: 62-65 THREE STAGES OF LABOR: 1 ST :uterine contractions 2 nd :delivery of the newborn 3 rd :delivery of the placenta Typically, newborns and placentas are delivered alternately

41. PREGNANCY SIGNS OF IMPENDING PARTUITION: Nesting behavior:12-24 hours before Inappetance Panting, shivering Drop in rectal temperature ~24-48 hours before partuition (caused by abrupt decrease in progesterone): <100°F

42. PREGNANCY LABOR, STAGE I: intermittent uterine contractions with no sign of abdominal straining Restlessness, panting, nesting may continue through stage I Cervix dilates

43. PREGNANCY LABOR, STAGE II: delivery of the newborn Rectal temp begins to rise to normal or slightly above Passing of fetal fluids Expulsive uterine contractions accompanied by abdominal contractions 1 st fetus usually delivered within 4 hours Bitch will break the amniotic membrane, lick the neonate intensely, and sever the umbilical cord

44. PREGNANCY LABOR, STAGE II: WARNING SIGNS The bitch should be examined by a vet for the following reasons: Greenish discharge, but no pup is born within 2-4 hrs Fetal fluid passed more than 2-3 hrs previously, but nothing more has happened If she has had weak, irregular straining for more than 2-4 hours If she has had strong, regular straining for more than 20-30 minutes, but no pup born More than 2-4 hours have passed since the birth of the last puppy and more remain If she has been in stage II for more than 12 hours

45. PREGNANCY LABOR, STAGE II Interval between births Usually 5-120 minutes Partuition should never be allowed to last more than 24 hours

46. PREGNANCY LABOR, STAGE III: expulsion of the placenta Usually follows within 15 minutes of each fetus Bitch may eat the placentas, but sometimes can be associated with vomiting and diarrhea Lochia – greenish postpartum discharge of fetal fluids and placental remains will be seen for up to 3 weeks or more

47. PREGNANCY COMPLICATIONS

48. PEOPLE “Everyone has a photographic memory, it’s just that some people don’t have film.”

49. PREGNANCY DYSTOCIA: Difficult birth or the inability to expel the fetus through the birth canal without assistance Causes: Abnormal fetal position or size Uterine inertia Narrowed birth canal Diagnosis: Digital palpation of vagina Radiographs ultrasound

50. PREGNANCY: DYSTOCIA TREATMENT: Manual manipulation: a fetus lodged in the vaginal canal can be manually dislodged. For uterine inertia: oxytocin injections result in contraction of the uterine muscles; also, calcium preparations can be given C-section

51. PREGNANCY: INAPPROPRIATE MATERNAL BEHAVIOR DAM SHOULD: Allow nursing Grooming Stimulate CV,RS function Stimulates elimination and removal of waste material retrieving Protecting DAM SHOULD NOT: Attack, kill, or cannibalize her young Be overly protective, restless, or aggressive

52. PREGNANCY: LACTATION DISORDERS Agalactia: lack of milk production Causes include; Stress, malnutrition, premature partuition, or infection Galactostasis: milk stasis, which can result in mastitis Mastitis: a septic inflammation of the mammary gland Clinical signs: Pain, discolored milk, fever, reluctance to allow nursing, abscessed glands

53. PREGNANCY: LACTATION DISORDERS Treatment for mastitis: Antibiotics Warm compresses Do not allow nursing from affected glands

54. PROSTATIC DISEASES PROSTATE: Sex gland in the dog and cat Located just caudal to the bladder, encircling the proximal urethra at the neck of the bladder Purpose is to produce a fluid as transport and support medium for sperm during ejaculation

55. PROSTATIC DISEASE

56. BENIGN PROSTATIC HYPERPLASIA Caused by altered androgen/estrogen ratio Mild or no clinical signs Tenesmus Enlarged prostate but not painful TX: Castration results in a 70% decrease in size within 14 days

57. BENIGN PROSTATIC HYPERPLASIA

58. PROSTATITIS Bacterial prostatitis may be acute or chronic and it affects sexually mature dogs Clinical signs: Lethargy Anorexia Diagnosis: Urinalysis: hematuria, increased white blood cells, presence of bacteria Treatment: Antibiotics Castration Prostatitis can lead to abscessation

59. NEOPLASIA of the male genital tract Prostatic neoplasia is uncommon, but all prostatic neoplasms are malignant Transmissible venereal tumor (TVT) Occurs only in the canine Spreads during sexual contact Tumors found on the penis, prepuce, and scrotum Cauliflower-like Treatment: Chemotherapy Surgical removal of small localized masses

60. TVT These tumors are friable and bleed easily

61. CRYPTORCHIDISM One or both testicles have been retained in the abdomen or inguinal canal Often the retained testicle is still functional Dog can still produce testoterone, show sexual desire and breed A testicular tumor known as sertoli cell tumor is more common in retained testicles These animal should not be bred

62. CRYPTORCHIDISM Two normal testicles Unilateral cryptorchid Treatment is castration – testicle Should be removed from the Abdomen or pushed down from The inguinal canal

63. CASTRATION http://www.lbah.com/canine/dog_neuter.html

64. MAMMARY TUMORS Usually tumors of older intact females ~50% of all tumors in female dogs 3 rd most common tumor in cats Risk dramatically reduces with ovariohysterectomy (<1% if spayed before 1 st heat) 50% of canine tumors are benign Only 10-20% of feline tumors are benign

65. MAMMARY TUMORS Malignant tumors are usually fast growing, Invasive and ulcerated. Benign tumors are Often small and feel like a pea. Surgical removal is advised for all Mammary tumors. Biopsy is required To differentiate benign from malignant tumors

66. OVARIOHYSTERECTOMY Surgical removal of the ovaries and uterus http://www.lbah.com/canine/spay.html