Producción CyT
Capítulo de Libro
Autoría
Fecha
2006
Editorial y Lugar de Edición
Elsevier
Libro
Veterinary Clinical Advisor
(pp. 907-908)
Elsevier
Elsevier
Resumen
Información suministrada por el agente en
SIGEVA
Definition: Pseudopregnancy is a syndrome observed in non pregnant diestrus or anestrous bitches that is characterized by different degrees of maternal behavior, mammary gland enlargement and lactation. Synonyms: Pseudocyesis, false pregnancy, nervous anorexia. EPIDEMIOLOGY Species, age, sex Post-pubertal female dogs of any age. genetics and breed PREdisposition Any breed could be affected, although Dalmatian, Basset Hounds, Pointers are frequently affected. Risk factors Exogenous administratio...
Definition: Pseudopregnancy is a syndrome observed in non pregnant diestrus or anestrous bitches that is characterized by different degrees of maternal behavior, mammary gland enlargement and lactation. Synonyms: Pseudocyesis, false pregnancy, nervous anorexia. EPIDEMIOLOGY Species, age, sex Post-pubertal female dogs of any age. genetics and breed PREdisposition Any breed could be affected, although Dalmatian, Basset Hounds, Pointers are frequently affected. Risk factors Exogenous administration of progestins, diestrous ovariectomy and hypothyroidism may trigger its occurrence. ASSOCIATED CONDITIONS AND DISORDERS Pseudopregnancy can coexist with other diestrous diseases such as pyometra CLINICAL PRESENTATION DISEASE FORMS/SUBTYPEs Depending on the intensity of the clinical sings it can be classified as: covert (physiological, although recognizable from the rest of the estrous cycle) and overt pseudopregnancy which can even become a clinical problem (clinical pseudopregnancy). history, chief complaint History reveals the occurrence of estrus 6 - 12 weeks previously without an ensuing pregnancy. The chief complaints mainly focus on mammary problems (engorgement, lactation, licking of the glands) and abnormalities associated with aberrant maternal behavior (nesting, digging, adoption of animals or objects). In addition, the bitch may have depression or anxiety, anorexia and excessive vocalization (whining). PHYSICAL EXAM FINDINGS Physical exam reveals some degree of mammary enlargement which can vary from turgid nipples to an important engorgement and galactostasis. Mammary enlargement is most evident in the caudal pair of glands. Occasionally local dermatitis due to excessive licking occurs. Mastitis may also be present. ETIOLOGY AND PATHOPHYSIOLOGY The combination of high plasma concentrations of prolactin at the end of the luteal phase when progesterone concentrations are decreasing is associated with the development and maintenance of pseudopregnancy. Individual and breed sensitivity to these hormonal changes and environmental factors have been hypothesized to influence its occurrence. DIAGNOSIS DIFFERENTIAL DIAGNOSIS Pregnancy Pyometra Mastitis Mammary tumors Any other cause of anorexia, depression or anxiety should be ruled out. Pseudopregnancy can even coexist with pyometra, mastitis and mammary tumors. INITIAL DATABASE Physical findings, history and normal CBC. ADVANCED OR CONFIRMATORY TESTING Ultrasonography or radiography should be used to confirm the absence of pregnancy. TREATMENT THERAPEUTIC GOAL(S) Eliminate or treat predisposing factors such us exogenous administration of progestins and hypothyroidism. Avoid stimulation on the mammary glands e.g. padding (either hot or cold), touching or licking. Discourage maternal behavior using aversion methods. Decrease plasma prolactin with dopaminergic agonist or antiserotonergic drugs. Avoid steroid hormones (progestins/ androgens) as they usually postpone the problem and have many side effects. ACUTE GENERAL TREATMENT If necessary, Elizabethan collars can be used to prevent licking and self-milking. Dopaminergic agonists should be given with food to reduce digestive side effects: -cabergoline 5mg/kg q 24 h PO during 5- 7 days -bromocryptine 10mg/kg q 8-12 h PO during 7 days Antiserotonergic drugs: metergoline 0.1 mg/kg q12 h PO during 7 -10 days. Metergoline should not be used in anxious and restless bitches as this drug could potentiate this behavior. Refer to chapters XX and YY for the treatment of mastitis or local dermatitis, respectively. CHRONIC TREATMENT Clinical, chronic, unresponsive or recurring pseudopregnacy cases should be treated surgically (ovariectomy) after the acute phase of the syndrome has been controlled and during anestrous. DRUG INTERACTIONS Avoid using phenotiazine drugs during pseudopregnancy as they increase plasma prolactin POSSIBLE COMPLICATIONS Local dermatitis and mastitis are the most frequent complications and may have an influence in perpetuating the problem. Repeated episodes of pseudopregnancy have been hypothetically associated with the future development of mammary tumors. RECOMMENDED MONITORING Monitor the patient during treatment until the syndrome resolves. PROGNOSIS AND OUTCOME Pseudopregnancy typically resolves spontaneously within a few weeks (2 or 3) from its onset. However, occasionally pseudopregnancy can persist until the next estrous cycle. PEARLS & CONSIDERATIONS COMMENTS Pseudopregnancy is a good indicator of ovulatory estrous cycles. Predisposed bitches usually suffer the syndrome after each estrous cycle becoming more severe throughout life. PREVENTION Ovariectomize predisposed bitches. Pregnancy does not prevent future episodes. CLIENT EDUCATION Teach your client to recognize the pseudopregnancy and ask for treatment if it becomes clinically relevant.
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