Transcript Pregnancy diagnosis and prepartum conditions affecting does

Pregnancy losses or prepartum
problems in does
Lionel J. Dawson B.V.Sc, MS, DACT
Veterinary Clinical Sciences
Oklahoma State University
and
E (Kika) de la Garza Institute
Langston University
Gestation
• Does -145 to 155 days (average 150)
Prepartum conditions affecting does
• Pregnancy disease –
Twinning disease,
pregnancy ketosis,
pregnancy toxemia
• Pseudopregnancy or
false pregnancy
• Injury – ruptured
prepubic tendon or
hernia
• Vaginal prolapse
• Abortions
Pregnancy toxemia
• Pregnancy disease
• Twinning disease
• Pregnancy ketosis
Pregnancy Toxemia
 Epidemiology
 Multiple fetuses > 2
 Mature does/ewes
 Too thin (≤1/5) or
obese (5/5)
 Last trimester
 Predisposing factors
 Poor-quality feed
 Weather extremes
 Stress- processing,
transportation
 Etiology
 NEGATIVE ENERGY
BALANCE
 Rapid fetal growth
 ↑ Late-gestation
 Nutritional demands
 ~80% fetal growth in
last 4-6 w of gestation
 ↑ Fecundity = ↑ Energy
requirements
 Single: 150 %, Twins: 200
%, Triplets: 200-250%
 ↓ Rumen capacity
 +/- Concurrent diseases
Clinical Signs
 Initially
 Lag behind
 Isolated
 Fail to escape
 Depression
 Stiff walk
 Poor appetite
Clinical Signs…
 As the condition progresses
 Staggering gait →
recumbency
 Edema distal
extremities
 Apparent blindness
 Teeth grinding
 Sweet breath
 Tachypnea
 Muscle tremors
 Constipation
 ↓ Rumen contractions
Clinical signs
 Eventually
 Severe depression - comatose
 Recumbency – unable to rise
 Rumen atony
 Dehydration
 Nervous signs*
 Muscle tremors
 Opisthotonos
 Death within ~ 3-4d
Other Clinical Observations
 ↑ Incidence of dystocia
 Fail to go in active labor – Uterine inertia
 Ringwomb
 Poor mammary development
 ↓ Colostrum quality & quantity
 ↓ Milk production vs. ↑ Demand
 ↑ Neonatal mortality
 +/- Renal failure
Uterine inertia
Pregnancy Toxemia
 Diagnosis
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Clinical signs
↑ fetuses
Ketonuria
± Hypoglycemia & ↑ Ketones
↑ Serum BHBA* ( ketones are
acetoacetic acid + BHBA )
NEFAs > 0.4mEq/L
Rule out other common diseases
Pregnancy Toxemia
 Treatment
 Stimulate appetite/ forced feeding
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Buffet
Propylene glycol PO*
Transfaunation, AAS drench mix*
B- vitamins
 Treat ketosis, acid-base, electrolytes
imbalance
 IV fluids w/ dextrose 5% +/- amino acids
 Insulin SC: 0.4 units/kg SC SID for 1-2 days
 Abortion or c-section
 Treat concurrent diseases if present
Treatment by inducing abortion
• Can induce parturition after 143 days without
compromising fetal survivability, in conditions like
pregnancy toxemia, vaginal prolapse and ruptured prepubic
tendon?
• Does - Dexamethasone 16- 20 mg followed in 24 hours with
10 mg of Lutylase done in early induction. Parturition 24 –
36 hours. 16 mg Dex + 10 mg Lutylase – 30±5 hours.
• Ewe – 16 to 20 mg of Dexamethasone, 24 hours apart.
Parturition 24 – 36 hours.
• Not recommended in final stages of Pregnancy toxemia (i.e.
seizures, coma)
Pregnancy Toxemia
 Prevention
 Ensure good body condition score
at breeding
 Good nutrition in late gestation
 Energy dense
 Parasite control !!!
 Ultrasound pregnancy check – 40
to 50 D
 Separate dams with >2 fetuses from
the rest
 Ketostix on urine
 Plasma BHB levels
Prevention
 Does should be on an increasing plane of nutrition
the last 8 weeks of pregnancy. Should gain weight
(9 lbs. for a single, 15 lbs. for twins).
 Feed small quantities 3 or 4 times a day.
 Exercise – especially if the doe is fat.
 May want the obese doe at breeding to loose
weight during the first 2 months of pregnancy.
Pseudopregnancy
(Hydrometra or Mucometra)
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↑ seen in dairy goats and
also does synchronized for
off season breeding.
Have been in heat, may or
may not been bred.
Elevated progesterone - CL
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Appear to be pregnant –
‘Cloud Burst’ at the end of
five months
Hemorrhagic discharge
Ultrasound: Real time
ultrasound – fluid filled
Usually will conceive
subsequently, but can recur
Treatment – prostaglandin
9.
Early diagnosis
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Injury
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Older does
Fighting
Head butting
Leading to hernia
or ruptured
prepubic tendon
Vaginal prolapse
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Older does in late gestation
↑ Pygmy does
Moldy or estrogenic feed
Lack of exercise in small pens
Obese does (BC>4)with excess fat
in the pelvis causing laxity to the
ligaments
Hereditary aspect to the laxity of
pelvic ligaments
Tail docking in ewes
Reduce the prolapse, retaining
suture or retaining device
Up to 40% will die, the rest are
prone to dystocia and stillbirths
Induce parturition
Cull the affected animals and their
daughters
Linklater & Smith
Abortions
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Infectious – late term
Nutrition – BC
Environment – cold weather
Stress – transport, processing
Vaccination - < 2 weeks before kidding
Hormonal
Trauma – Coyotes, dog bite etc
Infectious causes of infertility /
abortions
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Chlamydophila
Toxoplasma
Coxiella
Brucella
Campylobacter
Leptospira
Listeria
Salmonella
Mycoplasma
BVD
Border disease
Caprine Herpes Virus
Blue Tongue Virus
Cache valley Virus
• Zoonotic
Chlamydiosis
• Most common cause of abortion in goats in NA, also common in
sheep
• Chlamydophila abortus, gram-negative intracellular bacteria
• Stress
• Late term abortions, ↑ stillbirths and weak kids
• Pneumonia, keratoconjunctivitis, epididymitis, polyarthritis
• Reservoirs – birds ( pigeons, sparrows )
• Transmission – oral/nasal from infected aborted fetuses and feces
• Infected does may not show signs till the cotyledons are infected
(90 days)
• Bucks may transmit through natural service
• Zoonotic – pregnant women
Clinical signs
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Late term abortions
↑ Still births and weak kids
Placentitis
Kids infected at birth → abort
Does infected early – abort
Does infect third trimester – abort subsequent
pregnancy
• Abortion – organism shed
Chlamydiosis - diagnosis
 Diagnosis – Impression
smears ( cotyledon,
placenta & vaginal
discharge ), PCR- Placenta,
spleen, liver and culture
 Impression smearmodified Ziehl-Neelson
stain stains elementary
bodies bright red
 Inter cotyledonary
thickening, cheesy pinkish
exudate, necrosis of
cotyledons
 Necrotic foci on the liver
 Serology - unrewarding
Elementary
bodies
Linklater & Smith
Treatment / Prevention
• Treatment – Tetracycline in feed (400-500 mg/head/day)
in last 4-6 weeks of gestation. Aureomycin 4 G crumbles
– 8 to 10 does fed a lb/day.
• Treatment: LA Oxytetracycline (20 mg/kg) q 14 days
• Prevention – Killed vaccines available; if used, administer
and booster before breeding
• Prevention - 150 mg OTC in the feed staring 2-3 weeks
before breeding and continue the first 50 days of
gestation.
• Prevention - LA OTC = 60, 90 and 120 days of gestation
Toxoplasmosis
• One of the most common causes of abortions in sheep and
goats – mummification, stillbirth and weak kids
• Toxoplasma gondii – protozoal disease
• Pathogenesis – cats are primary host - fecal contamination of
feed with oocytes shed by the cats.
– Kittens usually shed large quantities of oocytes in their
feces.
– Oocytes are ingested from grass, feed, water etc.
– Oocytes develop into bradyzoites.
• Bradyzoites are seen in muscle, liver, and brain in
nonpregnant ewes and does, later in pregnant ewes and does
they infect the placenta
• In endemic areas only younger does may be affected
• Zoonotic potential
Toxoplasmosis - diagnosis
 Infection early- resorption
 Infection later may be accompanied
by abortion with variation in fetal
ages
 Stillborn kids may be accompanied
by mummified fetuses
 Late infection leads to abortion and
perinatal losses
 Placental lesions usually limited to
the cotyledons
 Cotyledons dark red, speckled with
white foci of necrosis/mineralization
 Histology – cotyledon and brain of
the fetus ( leucoencephalomalacia )
 Serology - precolostral
Linklater & Smith
Prevention/Treatment
• Vaccination – available in Europe and NZ, not in
the U.S.
• Control – prevent exposure of pregnant females
to oocyte contaminated feed and bedding
• Cat control, especially pregnant queens & kittens
• Treatment – Decoquinate (2 mg/kg bwt/day) or
monensin (15-30 mg/head/day) throughout
gestation
• Zoonotic
Query fever
• Coxiella burnetti – intracellular rickettsial
organism
• Reported in NA and many other countries
• Cattle, sheep, goats, wildlife, and humans may
carry infection
• Spread by inhalation of dried organism, or
contact of fetuses, vaginal discharge and placenta
• Tick bites
• Vaccine available in Europe
• Zoonotic – causes acute, influenza-like disease,
may progress to hepatitis and endocarditis.
Q-Fever - Pathology
• Stillbirths and late term
abortions
• Fresh fetuses
• Naïve animals
• Severe placentitis, placenta
thickened/ leathery covered
with brownish red exudate
• The organism can be
demonstrated in uterine
discharges and fetal stomach
contents using a modified
Ziehl-Neelsen stain
• Serology – ELISA & IFA
Linklater & Smith
• Producers should burn or bury the placenta
• Isolate the aborted animals
• Oral tetracycline similar to chlamydophila
during out break
• Tetracycline in the feed (400-500
mg/head/day) in last 4-6 weeks of gestation
• LA OTC every 72 hours for 3 to 5 treatments
Leptospirosis
• Small ruminants not often affected by Leptospirosis
– Goats are more susceptible than sheep
• Leptospira interrogans serovars icterohemorrhagiae, grippotyphosa,
pomona, hardjo, bratislava all have been reported
• Caused by exposure to environments contaminated by cattle, pigs,
wildlife, rodent urine
• Secreted in the urine
• Transmission – skin, ingestion
• Causes abortion, renal disease, anemia, hemoglobinuria
Leptospirosis
• Diagnosis – dark field microscopy, FA on the
kidney, silver stains on the placenta, PCR on
the urine and paired sera
• Treatment and Prevention – multivalent
cattle vaccine, tetracycline in the feed
• Zoonotic
Salmonellosis
• Salmonella typhimurium, S. dublin, S.
montevideo, S. arizonae, S. abortus-ovis
• Infection may cause abortion, metritis,
diarrhoea and systemic illness – precipitated
by stress
• Sources of infection include birds, cattle,
wildlife
• Route - oral
• Diagnosis – culture abortuses &discharge
Brucellosis
• Brucella melitensis – causes abortion, weak
kids, mastitis in goats – historically not in U.S.,
but there has been recent outbreaks
• Brucella ovis – rarely causes abortion, more
commonly causes epididymitis in rams –
widespread in sheep in western U.S.
• Brucella abortus can cause abortion in ewes
and does.
• Zoonotic – Malta fever
Listeriosis
• Meningoencephalitis, abortion, septicemia
• Listeria monocytogenes and L. ivanovii
• Caused by ingestion of organism found in soil,
silage, hay, forage in boggy areas, pH >5.5
• Bacteria ► injury or infection in the mouth - ►
facial nerves carry to the brain.
• Encephalitis, abortion and mastitis
• Diagnosis – culture from abortus or vaginal
discharge
• Treatment – Tetracyclines
• Zoonotic
Listeriosis - Pathology
 Infection of the
placenta leads to acute
placentitis – thickened,
leathery placenta
 Fetal death may result
in autolysis in utero
 Small necrotic foci may
be found in the liver
and other organs
 Culture – fetal
stomach, liver and
placenta
 FA - placenta
Linklater & Smith
Mycoplasma
• Causes abortion in goats
• Can cause other conditions like mastitis,
arthritis, keratoconjunctivitis
• Mycoplasma mycoides, M. agalactia
• Diagnosis – culture cotyledon, fetal liver,
spleen. Serotyping
• Treatment – Tetracyclines
• Cull
Akabane virus and Cache Valley
virus
• Abortions in sheep and goats
• Transmission by culicoides and
mosquitos.
• Infection early in pregnancy –
deformities like head defects,
arthrogryposis and muscle
atrophy.
• Late pregnancy – abortions and
stillbirths.
• Cache Valley virus is common in
the U.S
• Serology – doe, precolostral
fetal serum for AB
Linklater & Smith
Bluetongue Virus
• Infectious, noncontagious disease of ruminants, especially
sheep
– cattle may serve as reservoirs
– goats frequently serology positive, but clinical
signs rare
• Caused by an orbivirus transmitted by Culicoides spp. gnats
• Clinical signs – infected ewes febrile, swollen discolored
tongue (blue), mucosal ulcerations, lameness
• Fetal infection – abortion, hydranencephaly, skeletal defects
• Diagnosis – Sera from the aborted fetuses for AB, VI and PCR
Caprine Herpes Virus
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Transmission – nasal and genital routes
Latent infection in adults
Kids – viremia and enteritis
Adults – Vulvovaginitis, balanoposthitis,
respiratory and abortions
• Multifocal necrosis in different organs of the
fetus
Bovine Viral Diarrhoea
• BVDV has been implicated in
the infection of pigs, alpacas,
sheep, goats, and wild deer
• Sheep and goats represent the
most likely chance of crossspecies infection, due to the
fact they are frequently
pastured with cattle
• BVDV outbreaks have been
reported in sheep, with
abortions and PI lambs
• It is reported that infection in
goats results more in abortion,
only very rarely with PIs
BVDV in pregnant goats study – Dr C. Broadus
• Objectives:
– (1) Can BVDV cause goat abortions under “natural”
conditions?
– (2) Can BVDV infection in goats result in PI kids?
• 24 goats: 6 groups of 4 goats each
• Exposed at 40, 60, 80, 100, 120, 140 days gestation
BVDV natural infection study
3/4 stillborn or weak and
later died at term
4/4 normal
births, all
alive
2/4 stillborn or
weak/euthanized
4/4
aborted
d 100-120
0
20
40
2/4 stillborn or
weak/euthanized
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60
80
2/4 stillborn or
weak/euthanized
100
120
140 150
Gross pathology
• In one placenta, pinpoint
white areas scattered along
the chorionic surface of the
cotyledons
• Marked brachygnathia was
noted in one fetus
• Mild, mandibular prognathia
noted in one fetus
• Serology – ELISA or SN, PCR,
VI
Toxic plants
• V. californicum
• Broom weed, loco weed,
consumption on day 14
sump weed and tobacco causes – resorption,
can cause abortions and
cyclopia and shortening
altered fetal development.
of the metacarpal and
• Pine – Stillbirths in ewes
metatarsal bones and
• Lupinus spp – altered fetal
prolonged gestation.
development.
• Nitrate accumulators –
• Lathyrus and Sophora spp.
sweet clover, Johnson
[ limb defects]
grass, sorghum, Lamb’s
• Clover – hyper estrogenic
quarter, jimson weed, sun
flower, pigweed and oat
• Gossypol (Cotton seed)
hay – can cause abortions
Infertility
Veratrum californicum – 14 D
Deformed
Cyclopia
Linklater & Smith
Diagnosing abortions
• Frustrating
• Proper sample submission to rule out infectious.
• Dr Tom Thedford - proper tissue and serum
submitted we can get our diagnosis up to 50%, if
they are infectious.
• One serum = < 10%
Paired serum = 15 to 20%
Fresh placenta + fresh fetus + Paired serum =
25%
3 sets of serum + fetus + placenta( frozen ) = 50%
Questions?