CHAPTER 61

Disorders of Canine Reproduction

| Margaret V. Root Kustritz

DISORDERS OF INFERTILITY 2. Estrus, or standing heat, is defined cytologically as

complete cornification, with >50% of the cells ap-
Infer tility in the Bitch pearing anuclear.
3. Six days after ovulation, cornified cells are sloughed,
Definition and the onset of diestrus is signaled by an abrupt
I. Infertility in the bitch is defined as lack of pregnancy after return to noncornified vaginal cytology (Holst and
ovulation of normal ova into a patent, healthy reproductive Phemister, 1974).
tract and insemination with normal semen near the time of D. Ovulation timing is best performed by measurement
ovulation. of serum progesterone.
II. Normal estrous cycling is a prerequisite of normal fertility 1. Serum progesterone concentration is 2 ng/mL 2 days
in the bitch. before ovulation and 4 to 10 ng/mL on ovulation
A. Primary anestrus is the lack of obvious estrous cycling day (Box 61-1) (Johnston and Root, 1995).
by 24 months of age. 2. Luteinizing hormone (LH) can be measured using
B. Secondary anestrus is the lack of estrous cycling within a commercially available semiquantitative assay
12 months of a previous estrous cycle. (Status-LH; Synbiotics, San Diego, Calif.).
C. Normal interestrous interval (number of days between 3. Serum LH concentration >1 ng/mL occurs (on
onset of proestrus and the subsequent proestrus) average) 2 days before ovulation.
averages 5 to 8 months in dogs but may range from III. Subclinical uterine infection is a reported cause of infertility
4.5 months (German shepherd dogs, rottweilers) to 12 in bitches.
months (basenjis, wild dog crosses). A. Infection may cause conception failure by creating a
hostile environment for the ova and spermatozoa, or
Causes and Clinical Signs
I. Primary or secondary anestrus may arise from malnutri-
tion, stress, lack of exposure to cycling bitches, systemic Box 61-1
disease, previous ovariohysterectomy, silent heat (normal
Use of Serum Progesterone Concentration to
ovarian activity without external signs), or chromosomal
Determine Ovulation Day in the Bitch
abnormalities (Johnston, 1991).
II. Improper breeding management (mistimed or inadequate Serum Progesterone
number of breedings), the most common cause of apparent Concentration (ng/mL) Event, Recommendation
infertility in bitches that are cycling normally, is reported in <1.0 Well before ovulation—recheck in
40% to 50% of infertility cases (Johnston et al., 1994). several days
A. The average bitch ovulates about 12 days after first signs 1.0-1.9 ±3 days before ovulation—
of vulvar swelling and exudation of serosanguineous recommend recheck
vaginal discharge; however, ovulation may occur as 2.0-2.9 2 days before ovulation
early as 3 to 4 days or as late as 25 to 26 days after 3.0-3.9 1 day before ovulation
proestrus onset. 4.0-10.0 Ovulation day
B. Breeding by day of the cycle alone yields pregnancy NOTE: Optimal breeding day is
rates as low as 78% (England, 1992). 2 days after ovulation
C. Secretion of estrogen from the mature preovulatory >10.0 with cornified 1-5 days after ovulation—breed
follicle stimulates division of vaginal epithelial cells. vaginal cytology immediately
1. Cytological specimens contain an increasing per- >10.0 with noncornified Diestrus—too late to breed this
centage of cornified cells as dogs progress through vaginal cytology season
proestrus.
603
604 SECTION 8 | Reproductive System

by causing early embryonic death (see Pregnancy Loss

Box 61-2
later in this chapter).
1. Because the canine uterus is inaccessible to most Diagnostic Scheme for Infertility in Bitches
practitioners without performing laparotomy and Is Normal Estrous Cycling Occurring?
hysterotomy, culture samples taken from the cranial
vagina during estrus have traditionally been used No Yes
to infer the presence of uterine infection (Bjurstrom 1. Evaluate husbandry 1. Assess fertility of male dog.
and Linde-Forsberg, 1992; Bjurstrom, 1993). and nutrition. 2. Obtain serum chemistry
2. Requesting quantitative culture results, with the as- 2. House with cycling profile, complete blood
sumption that heavy growth of a single organism bitches. count, urinalysis to assess
is indicative of reproductive tract infection, may 3. Obtain serum chemistry general health.
enhance accuracy. profile, complete blood 3. Perform serologic testing for
3. Some breeders require negative vaginal cultures of count, urinalysis to canine brucellosis (see
breeding bitches before introduction to the male, assess general health. Table 61-1).
but this is an illogical practice and is discouraged. 4. Evaluate thyroid 4. Optimize breeding
B. Canine brucellosis is a specific uterine infection asso- hormones: concurrent management with
ciated with infertility (see Pregnancy Loss later in this measurement of free measurement of serum
chapter). thyroxine by dialysis progesterone.
IV. Hypothyroidism has been associated with infertility in the and canine thyroid- 5. Perform quantitative anterior
bitch. stimulating hormone vaginal culture during
A. It may cause primary anestrus, prolonged or irregular for assessment of proestrus. Treat with
interestrous intervals, prolonged proestrus, decreased hypothyroidism appropriate antibiotic therapy
intensity or duration of estrous cycles, galactorrhea, (Panciera, 1994; throughout proestrus and
and increased incidence of spontaneous abortion. Peterson et al., 1997). estrus if necessary.
B. Many dogs with reproductive dysfunction secondary 5. Perform serial vaginal
to hypothyroidism exhibit no extrareproductive clinical cytology to monitor
signs (Reimers, 1983; Johnson et al., 1997). for silent heat.
V. Hypoluteoidism is a proposed cause of infertility and 6. Consider karyotyping.
pregnancy loss in dogs. 7. Perform serologic testing
for canine brucellosis
Diagnosis (see Table 61-1).
I. The recommended diagnostic tests depend on the presence
Modified from Johnston SD, Olson PN, Root MV: Clinical approach to infertility in the
or absence of normal estrous cycling in the bitch (Box 61-2). bitch. Semin Vet Med Surg (Small Anim) 9:2, 1994.
II. Cases refractory to standard diagnostic tests may benefit
from the following tests:
A. Uterine biopsy via laparotomy and hysterotomy to
look for cystic endometrial hyperplasia, an age-related C. Measure canine thyroid-stimulating hormone and free
change in the uterine lining that may interfere with im- thyroxine in serum to assess for hypothyroidism.
plantation and placentation and predispose the bitch D. Perform vaginal cytological examination weekly and/or
to uterine infection progesterone assays monthly to identify silent heat.
B. Direct uterine culture via laparotomy and hysterotomy E. Submit whole blood or tissue for a karyotype to
(often performed at the time of uterine biopsy) determine if the bitch has a normal chromosome
C. Abdominal ultrasonography to assess the uterus complement.
1. The normal, nonpregnant canine uterus is not F. Attempt estrus induction.
visible as a distinct entity on ultrasonography. 1. Diethylstilbestrol 5 mg PO SID for 6 to 9 days or
2. If the uterus is visible, and especially if the uterine until proestrus is induced
lining can be visualized as a fluffy gray layer, then 2. Cabergoline 5 mg/kg PO SID for 7 to 10 days or
cystic endometrial hyperplasia is present. until proestrus is induced
3. Efficacy of estrus induction protocols: variable in
Treatment dogs
I. Attempt to convert primary and secondary causes of II. Minimize improper breeding practices by optimizing the
anestrus. time of breeding.
A. Ensure the bitch is on a proper plane of nutrition and A. Optimal breeding time is 2 days after ovulation.
is not stressed by the environment in which she is B. If dogs are to be bred by natural service, then they are
housed or by overwork. mated every other day while the bitch allows the male
B. Perform a complete blood count, serum chemistry to mount.
profile, and urinalysis to assess for treatable systemic C. If the number of breedings by natural service is limited
diseases. in number, or if artificial insemination with fresh or

chilled semen is intended, then vaginal insemination
is performed 2 and 4 days after ovulation.
D. If frozen-thawed semen is to be used, then intrauterine
insemination is undertaken 3 or 4 days after ovulation.
III. Institute appropriate antibiotic therapy for subclinical
uterine infection.
A. Retrieve a culture specimen from the anterior vagina
of the estrous bitch early in proestrus; moderate to
heavy growth of a single organism is significant.
B. Treat with an appropriate antibiotic based on sensitiv-
ity testing until the bitch enters diestrus, as evidenced
by lack of vulvar discharge and standing behavior, or
abrupt onset of noncornified vaginal cytology.
C. Empiric antibiotic treatment without culture is not
recommended.
IV. Canine brucellosis is not curable in dogs; no recom-
mended treatment exists for infertility caused by Brucella
canis.
A. Euthanize Brucella-positive bitches housed in a kennel
situation.
B. Individually housed bitches may be treated by per-
forming ovariohysterectomy and administering tetra-
cycline 30 mg/kg PO BID for 28 days and streptomycin
20 mg/kg IM SID for 14 days.
1. Oral enrofloxacin may be used to treat canine
brucellosis, but no specific dose regimen has been
described.
2. Antibiotic therapy induces remission, but does not
eradicate the organism.
C. Canine brucellosis is a zoonotic disease; therefore
caution owners of Brucella-positive bitches of possible
human transmission, especially if pediatric, geriatric,
or immunosuppressed persons live in the household.
V. Start thyroid supplementation.
A. Supplement with l-thyroxine 0.01 to 0.02 mg/kg PO
BID.
B. Recheck serum concentration of thyroxine 4 to 6 weeks
after treatment is instituted.
C. Hypothyroidism may be hereditary in dogs, so advise
owners that bitches with hypothyroidism are not good
candidates for breeding.
VI. Bitches with apparently normal reproductive tracts, nor-
mal estrous cycling, no evidence of intrauterine infection,
negative brucellosis serology, and normal thyroid hormone
status may benefit from intrauterine insemination.
A. Intrauterine insemination is performed surgically or
with endoscopy.
B. Surgical intrauterine insemination requires general
anesthesia and laparotomy.
1. Exteriorize the uterine body and horns, and inject
semen through the uterine wall with a 22-gauge
needle or catheter and syringe.
2. Hold off the injection spot briefly, and close the
abdomen routinely.
C. Endoscopic intrauterine insemination requires neither
general anesthesia nor sedation.
1. Pass a long, narrow-diameter, rigid endoscope the
length of the vagina to visualize the cervix.
CHAPTER 61 | Disorders of Canine Reproduction 605
2. Pass a polypropylene urinary catheter through the
cervix and into the uterus, and inject the semen
through the catheter.
Monitoring of Animal
I. Prognosis for return to fertility varies with the cause.
A. Proper breeding management, with collection of serial
vaginal cytology specimens and measurement of serum
progesterone concentrations, is corrective of apparent
infertility in 40% to 50% of cases.
B. Diagnosis and treatment of subclinical uterine infec-
tion with appropriate antibiotic therapy is the next
most common corrective therapy for infertility.
C. Brucellosis is an irreversible cause of infertility in
bitches.
D. Hypothyroidism may be a reversible cause of infer-
tility with proper supplementation with thyroxine;
however, bitches with hypothyroidism are not good
candidates for breeding.
E. Abnormal chromosome complement is an irreversible
cause of infertility in bitches.
II. The owner may benefit from a discussion regarding poten-
tial heritability of the cause of the animal’s infertility, as
well as the wisdom of removing subfertile animals from the
breeding program.
Infer tility in the Male Dog
Definition
I. Infertility in the male dog is defined as complete inability
to effect pregnancy in normal females bred multiple times
near the time of ovulation (Ellington, 1994).
II. Subfertility is defined as the siring of litters infrequently or
the siring of litters containing few pups for that particular
breed.
Causes and Clinical Signs
I. Lack of normal breeding behavior and poor libido
A. Inability to copulate
1. Failure of normal copulation in dogs may have
behavioral or physical causes.
2. Behavioral causes include introduction to a non-
receptive female, attempting to breed to a dominant
female that will not allow the male to mount, and
inexperience or apprehension (Root Kustritz, 2005).
3. Intact male dogs that have been disciplined through-
out their lives whenever exhibiting mounting and
thrusting behavior are unlikely to show normal
breeding behavior at the desired time.
4. Physical causes for failure of normal copulation
include prostate disease and any painful condition
of the spine or hind limbs that prohibits the male
from mounting, thrusting, and maintaining the
copulatory lock.
B. Inability to ejaculate
1. Lack of ejaculation may have behavioral or physical
causes.
606 SECTION 8 | Reproductive System

2. Behavioral causes for an ejaculation include lack of 3. The normal percentage of progressively motile sper-
sexual maturity, inexperience, and apprehension. matozoa is >70%.
3. Conversely, some very experienced stud dogs will C. Calculate the total number of spermatozoa in the
not ejaculate in the absence of an estrous teaser ejaculate. The hemacytometric method described is
bitch. more accurate than computer-assisted systems (Kuster,
4. Subordinate males may refuse to mount a bitch they 2005).
perceive to be dominant. 1. Measure concentration of spermatozoa by dis-
5. Physical causes for lack of ejaculation include pensing semen with the capillary pipette into the
prostate disease, any painful condition of the spine diluent container provided with the white blood
or hind limbs, or retrograde ejaculation (ejaculation cell Unopette kit. Dispense the diluted semen into a
of semen into the urinary bladder instead of hemacytometer chamber.
antegrade, through the penile urethra). 2. The number of spermatozoa in one of the nine large
II. Poor semen quality (Table 61-1) squares of the hemacytometer grid visible under the
III. Prostate disease μ10 objective of the light microscope is the con-
A. Benign prostatic hypertrophy, prostatitis, and prostatic centration in millions (millions of spermatozoa per
neoplasia may be associated with pain during prostatic milliliter).
contraction. 3. The total number of spermatozoa is the more valua-
B. Prostatic contraction occurs whenever the male is ex- ble number, because concentration varies with the
cited and throughout ejaculation (Olson et al., 1987). amount of prostatic fluid collected in the ejaculate.
a. The total number is calculated by multiplying
Diagnosis concentration (millions of spermatozoa per milli-
I. Collect historical data. liter) by volume collected (milliliters per ejaculate).
A. Determine whether normal copulation is occurring. b. The normal total number of spermatozoa is
1. Causes of abnormal copulation include pain in the 300 million to 2 billion.
spine or pelvic limbs and prostate disease.
2. Behavioral incompatibilities between the bitch and
male dog may also preclude normal copulation.
B. Determine whether normal ejaculation is occurring. Box 61-3
1. Causes of abnormal ejaculation include pain in the Diagnostic Scheme for Infertility in Male
spine or pelvic limbs, prostate disease, and appre- Dogs
hension on the part of the male.
2. Retrograde ejaculation of semen into the urinary Are Normal Copulation and Ejaculation Occurring?
bladder may appear as lack of ejaculation. Yes No
a. Diagnosis requires collection of a urine sample 1. Measure serum thyroid 1. Investigate the prostate by
by cystocentesis after semen collection. hormones: concurrent rectal palpation,
b. Compare the numbers of spermatozoa in the measurement of free quantitative culture of
antegrade ejaculate and in the urine sediment. thyroxine by dialysis seminal fluid, and
II. Perform a complete physical examination. and canine thyroid- ultrasonography and
A. Evaluate the dog for any evidence of systemic disease stimulating hormone radiographic imaging, with
and clinical signs of hypothyroidism, such as weight for assessment of possible fine-needle
gain and bilaterally symmetrical alopecia (Box 61-3). hypothyroidism aspirate or biopsy.
B. Prostate disease is diagnosed by rectal palpation of the (Panciera, 1994; 2. Investigate sites of pain in
prostate, culture of seminal fluid, and imaging of the Peterson et al., 1997). the spine or hind limbs by
prostate, either by retrograde urethrography or ultra- 2. Perform serological testing complete physical
sonography (see Chapter 53). for canine brucellosis examination and
III. Collect and evaluate semen. (see Table 60-3). radiography.
A. Note color and turbidity of sample. 3. Collect and evaluate 3. Assess for behavioral
1. Normal semen is milky white. semen (see Table 60-3). problems described in text.
2. Red or brown discoloration indicates contamina- 4. Investigate the prostate 4. Assess for retrograde
tion with fresh or old blood, and yellow discoloration by rectal palpation, ejaculation by collection of
indicates contamination with urine. quantitative culture of a urine sample by
3. A clear sample is indicative of azoospermia. seminal fluid, and cystocentesis after breeding
B. Evaluate percentage of progressive motility of sperma- ultrasonography and or semen collection.
tozoa. radiographic imaging,
1. Examine an unstained, undiluted drop of semen with possible fine-needle
under the μ10 objective of a light microscope. aspirate or biopsy.
2. Make a subjective assessment of percentage of sper-
matozoa moving forward. Data from Meyers-Wallen (1991), Olson (1991), and Olson et al. (1992).

TA BL E 61-1
Types of Semen Abnormalities Described in the Dog
DEFINITION
Azoospermia: ejaculation of
seminal fluid containing
no spermatozoa
Oligozoospermia: a total
number of spermatozoa in
the ejaculate <300 million
Dogs with a low number of
spermatozoa in the ejaculate
are not necessarily infertile
A total of 250 million normally
shaped spermatozoa must be
introduced into the bitch over
the fertile period from 3 days
before to 4 days after ovulation
to reliably effect pregnancy
(Mickelsen et al., 1993)
Teratozoospermia: <80%
normally shaped spermatozoa
in the ejaculate
Asthenozoospermia: <70%
progressively motile
spermatozoa in the ejaculate
CHAPTER
CAUSES
Pretesticular causes include
hypothyroidism, fever (as may be
seen with illness), drug therapy
Testicular causes include intersex
states, bilateral cryptorchidism,
direct testicular injury, indirect
testicular injury following increased
intrascrotal temperature as may
occur with testicular neoplasia or
inguinal hernia, orchitis
Post-testicular causes include outflow
obstruction of the epididymes
Prostate disease
Orchitis
Orchitis
Testicular neoplasia
Contaminated semen collection
equipment
Prostate disease
As for oligozoospermia
61 | Disorders of Canine Reproduction 607
DIAGNOSIS
Physical examination findings: abnormally small,
soft, or firm testes may have been damaged and
may not regain function
Measurement of alkaline phosphatase in seminal
fluid: concentration of >5000 IU/L indicates
complete ejaculation with no outflow obstruction
(Frenette et al., 1986)
Measurement of thyroid hormones: concurrent
measurement of thyroxine by dialysis and canine
thyroid-stimulating hormone for assessment of
hypothyroidism (Panciera, 1994; Peterson et al.,
1997)
Serologic testing for canine brucellosis:
The rapid slide agglutination test (Synbiotics, San
Diego, Calif.) is a good screening test that is
accurate as early as 8-12 weeks after infection
Negative results with this test are accurate; positive
tests must be rechecked with a nonagglutination
method
The preferred nonagglutination method in the
United States is the agar gel immunodiffusion
(AGID) test available at Cornell University
Ultrasonography of the scrotum
Culture of seminal fluid: quantitative culture is
performed and finding of >10,000 bacteria/mL of
a single organism is considered significant
Perform serum chemistry profile, complete blood
count, and urinalysis to assess for systemic diseases
Prostate diagnostic tests (see Box 61-3)
Culture of seminal fluid
Serology for canine brucellosis
Measurement of serum thyroid hormones
Serum chemistry profile, complete blood count, and
urinalysis to assess for systemic disease
Culture of seminal fluid
Ultrasonography of the scrotum
Re-collection with different equipment
Prostate diagnostic tests
As for oligozoospermia
608 SECTION 8 | Reproductive System
D. Evaluate the percentage of morphologically normal
spermatozoa.
1. Place a drop of undiluted semen on one end of a
glass slide, smear it out as for a blood smear, and
allow it to air dry.
2. Examine the slide under oil immersion (μ100 objec-
tive of the light microscope) and evaluate 100 sper-
matozoa.
3. The normal percentage of morphologically normal
spermatozoa is >80%.
IV. Perform serological testing for canine brucellosis (see Table
61-1).
V. Cases refractory to standard diagnosis and therapy may
benefit from testicular fine-needle aspirate or biopsy.
A. Testicular fine-needle aspiration requires that the dog
be sedated.
1. Using a 20-gauge needle on a 10-mL syringe, insert
it on the testicular midline, and apply suction while
the needle is directed in several directions (Dahlbom
et al., 1997).
2. Submit the sample for histological examination.
3. Ongoing spermatogenesis, inflammation, and neo-
plasia may be identified.
4. Because testicular architecture is not maintained,
complete information about spermatogenesis is not
obtained with this technique.
B. Testicular biopsy is performed with the animal under
general anesthesia.
1. Exteriorize the testis through a prescrotal incision.
2. Incise through the tunica albuginea with a scalpel
blade, and shave off the tissue that bulges through
the incision.
3. Place the tissue in modified Bouin’s or Zenker’s
fixatives rather than formalin.
4. Evaluate for the presence of the hierarchy of sper-
matogenesis within the seminiferous tubule, as well
as for inflammation and neoplasia.
Treatment
I. Behavioral causes of poor libido may be overcome.
A. Administer gonadotropin-releasing hormone (GnRH)
at 1 to 2 mg/kg IM 1 hour before attempted breeding
or semen collection (Purswell, 1994).
B. This method is not to be used routinely in valuable
stud dogs, because frequent artificially enhanced serum
testosterone concentrations may exert negative feed-
back on the pituitary, producing an eventual decline in
serum testosterone concentration and reduced sper-
matogenesis.
II. Retrograde ejaculation is treated with sympathomimetic
drugs (e.g., pseudoephedrine 4 to 5 mg/kg PO 1 and 3
hours before attempted breeding or semen collection) to
effect antegrade ejaculation (Root et al., 1994).
III. Treatment of prostate disease varies with the specific
abnormality present (see Chapter 53).
IV. Canine brucellosis is not curable in dogs, and no recom-
mended treatment exists for infertility caused by B. canis.
A. Euthanize Brucella-positive male dogs housed in a
kennel situation.
B. Individually housed dogs may be treated by performing
castration and administering tetracycline 30 mg/kg PO
BID for 28 days and streptomycin 20 mg/kg IM SID
for 14 days.
C. Antibiotic therapy induces remission but does not
eradicate the organism.
D. Canine brucellosis is a zoonotic disease, so caution
owners of Brucella-positive dogs of possible human
transmission, especially if pediatric, geriatric, or im-
munosuppressed persons live in the household.
V. Start thyroid supplementation.
A. Supplement with thyroxine 0.01 to 0.02 mg/kg PO
BID.
B. Recheck serum concentration of thyroxine 4 to 6 weeks
after treatment is instituted.
C. Hypothyroidism may be hereditary in dogs, so advise
owners that dogs with hypothyroidism are not good
candidates for breeding.
Monitoring of Animal
I. Prognosis for return to fertility varies with the cause.
A. Behavioral causes of lack of normal copulation or ejacu-
lation may be overcome with administration of GnRH
(as described previously) or circumvented by use of
artificial insemination.
B. The prognosis is better for dogs with poor semen
quality than for dogs with azoospermia.
C. The prognosis is better for dogs with normal testicular
size and consistency than for dogs with testicular
atrophy or fibrosis.
II. A definitive prognosis for future fertility may be made after
testicular biopsy. If spermatogenic cells are absent from
the seminiferous tubules, or if a significant percentage of
the seminiferous tubules are atrophied or fibrotic, then
infertility is irreversible in that animal.
III. Brucellosis is an irreversible cause of infertility.
IV. Hypothyroidism may be a reversible cause of infertility
with proper supplementation with thyroxine; however,
dogs with hypothyroidism are not good candidates for
breeding.
DISORDERS OF PREGNANCY
Pregnancy Loss
Definition
I. Early embryonic death (death of the fetuses with subse-
quent resorption in the first half of gestation) is indistin-
guishable from lack of conception.
II. Abortion (fetal death with expulsion of the fetus and
placental tissues) occurs in the second half of gestation.
III. Birth of stillborn pups or retention of nonviable pups in
the uterus without onset of parturition can also be defined
as pregnancy loss.

Causes
I. Bacterial causes
A. Brucella canis may cause pregnancy loss
1. Transmission usually occurs by ingestion of aborted
tissues or urine excreted from infected males or
females (Carmichael and Joubert, 1988).
2. Transient lymphadenopathy and colonization of
many tissues occurs, especially in the reproductive
tract (Johnson and Walker, 1992).
3. The classic presentation is abortion late in gestation.
4. Birth of stillborn or weak pups and persistent dis-
charge of purulent vaginal discharge may also be
seen.
5. Infertile bitches infected with canine brucellosis
may be asymptomatic.
B. Miscellaneous bacteria implicated in canine preg-
nancy loss include Campylobacter spp., Salmonella spp.,
Escherichia coli, and Streptococcus spp. (Johnston and
Raksil, 1987).
II. Viral causes
A. Canine herpesvirus
1. Canine herpesvirus can be transmitted by aerosol,
via licking, or venereally.
2. Most infected adult animals are asymptomatic or
have mild vesicular lesions of the genitalia.
3. Animals at greatest risk are naive bitches exposed to
the virus in the last 3 weeks of gestation.
4. Necrotizing placentitis develops, with subsequent
birth of stillborn, macerated, mummified, or weak
pups of various sizes, often all within the same litter
(Poste and King, 1971).
B. Other viruses: parvovirus and canine distemper virus
III. Mycoplasma spp. and Ureaplasma spp.
A. Mycoplasma spp. and Ureaplasma spp. are ubiquitous
organisms that lack a rigid cell wall.
B. They have been associated with infections of the repro-
ductive tract and pregnancy loss and also are part of the
normal vaginal flora (Doig et al., 1981).
IV. Protozoal causes (Toxoplasma gondii)
A. Toxoplasmosis infection is uncommon in dogs and is a
very uncommon cause of pregnancy loss.
B. Pups have been experimentally infected with toxo-
plasmosis transplacentally.
C. Dogs that lose pregnancies from toxoplasmosis may
be clinically ill from systemic disease (Dubey et al.,
1990).
V. Hypoluteoidism and hypolutemia
A. Hypoluteoidism is a hypothesized cause of pregnancy
loss in dogs.
B. The corpora lutea are the sole sources of progesterone,
which is required throughout pregnancy.
C. If the corpora lutea fail prematurely, then progesterone
concentrations decline and pregnancy loss occurs.
Clinical Signs
I. Most bitches have nonspecific clinical signs, including
anorexia, lethargy, and fever.
CHAPTER 61 | Disorders of Canine Reproduction 609
II. Signs specific to the reproductive tract include exudation
of purulent or bloody vaginal discharge from the vulva.
Diagnosis
I. Diagnostic testing both of the bitch and any pups is bene-
ficial in determining the cause of pregnancy loss (Box 61-4)
(Purswell, 1992).
II. Mycoplasma spp. and Ureaplasma spp. are difficult to grow
in culture, and differentiating pathologic from non-
pathologic isolates is also difficult.
III. Hypoluteoidism is diagnosed by measurement of serum
progesterone concentrations during pregnancy.
A. Weekly measurement of serum progesterone concen-
tration is recommended in bitches with a history of
possible hypoluteoidism, for the first 6 to 8 weeks after
breeding.
B. If serum progesterone falls to <10 ng/mL, then daily
monitoring of serum progesterone concentration is
recommended.
C. Treatment is instituted with progesterone supplemen-
tation if serum progesterone concentration falls to
<5 ng/mL.
Treatment
I. Canine brucellosis is not curable in dogs.
A. Antibiotic therapy can be tried, but the infection
usually persists and the dog may exhibit bacteremia
when stressed months to years after therapy.
B. Brucellosis is a zoonotic disease and may be reportable
in the state or country where the disease is diagnosed.
C. Neutering minimizes shedding of the organism in
urine.
D. Eradication of canine brucellosis in a kennel may re-
quire euthanasia of affected animals.
II. Treatment of the bitch for a bacterial cause of pregnancy
loss often is not useful at the time she is aborting.
A. Even if the cause can be identified, the pups are not
viable; therefore pregnancy loss is allowed to continue,
with monitoring to ensure its completion and normal
uterine involution.
B. Antibiotic therapy to prevent sepsis in the bitch is
instituted as needed.
C. Mycoplasma spp. and Ureaplasma spp. infections can
be treated with tetracycline, which is contraindicated
during pregnancy, and with enrofloxacin, which is not
approved for use during pregnancy.
III. Treatment of the bitch with canine herpesvirus rarely is
necessary.
A. Treat viremic pups by increasing environmental tem-
perature to decrease replication of the virus within the
pups.
B. An infected bitch should not lose more than one litter
to canine herpesvirus, apparently because she retains
enough memory cells to allow an adequate immune
response if she is reexposed to the virus.
IV. Bitches with documented hypoluteoidism are treated with
progesterone (in oil) 2 mg/kg IM every 3 days, or with
610 SECTION 8 | Reproductive System
Box 61-4
Diagnostic Scheme for Pregnancy Loss in Dogs
Is the Bitch Pregnant and, If So, Are the Pups Viable?
Abdominal ultrasonography is the diagnostic method of choice for this assessment, but radiographs may be used after 45 days from
breeding to give some idea of fetal viability.
Yes
1. Serological testing for canine brucellosis is performed (see
Table 60–3).
2. Serum progesterone concentration is measured. Serum
progesterone concentration of <10 ng/mL at midgestation,
and <5 ng/mL anytime before the last 2 to 3 days of
gestation, is suggestive of poor luteal function.
3. A sample of the vaginal discharge of the bitch is submitted for
aerobic culture, and empirical treatment is instituted with
amoxicillin-clavulanate at 14 mg/kg PO BID.
4. Continuing viability of the pregnancy is monitored weekly,
preferably with abdominal ultrasonography.
5. If nonviable pups are passed, they are submitted for necropsy.
altrenogest (Regumate) 0.088 mg/kg PO SID (Purswell,
1991; Eilts, 1992).
A. Therapy must be withdrawn (to mimic the normal de-
cline in progesterone) in the last 2 to 3 days of gestation.
B. Bitches receiving altrenogest may have poor milk
production in early lactation.
Monitoring of Animal
I. All breeding bitches are tested for canine brucellosis twice
yearly, even if they are not actively being bred.
II. The poor antigenicity of canine herpesvirus and the varia-
bility of titers because of environmental and host factors
preclude regular serologic testing as a means of defining
naive and exposed dogs (Ronsse et al., 2004).
III. In dogs with a history of pregnancy loss from bacterial
infections, obtain quantitative culture of the cranial vagina
early in proestrus, with administration of appropriate anti-
biotic therapy throughout proestrus and estrus while the
cervix is open.
IV. Cleanliness of the environment must be assessed.
V. Bitches with a history of hypoluteoidism are monitored
via weekly serum progesterone assays during subsequent
pregnancies.
A. Serum progesterone concentrations of <10 ng/mL at
midgestation or <5 ng/mL anytime before the last 2 to
3 days of gestation are suggestive of poor luteal func-
tion.
B. Empiric administration of progesterone to pregnant
dogs is not desirable, because progestogens are terato-
genic and nonviable pups need to be expelled.
No
1. If the pups are not viable, expulsion of the pups is allowed
to continue, and the bitch is monitored with abdominal
ultrasonography and/or abdominal palpation to ensure
complete loss of the pregnancy and normal involution of the
uterus. Expulsion of uterine contents may be augmented
with oxytocin or prostaglandin F2a.
2. A sample of the vaginal discharge of the bitch is submitted
for aerobic culture.
3. Serologic testing for canine brucellosis is performed.
4. Any nonviable pups passed or stillborn pups are submitted
for necropsy. Pups that died from canine herpesvirus have
pathognomonic hemorrhagic lesions on the major
abdominal organs. Contents of the stomach can be cultured
to identify what organisms were in the pup’s amniotic fluid.
5. Serologic testing for canine herpesvirus may be performed
on the bitch, but the antigenicity of the virus is poor, so low
titers do not indicate lack of exposure.
Dystocia
Definition
Dystocia comes from the Greek words dys, meaning abnormal,
and tokos, meaning birth, and is abnormal parturition.
Causes
I. Maternal causes
A. Uterine inertia
1. Primary uterine inertia is lack of initiation of
second-stage labor by the bitch.
2. Secondary uterine inertia is the lack of progression
of second-stage labor as the uterine muscle fatigues.
B. Obstruction of passage, as might be seen in a bitch with
an artificially narrowed birth canal after pelvic fracture
C. Abnormality of pregnancy, such as uterine torsion
II. Fetal causes
A. Developmental abnormality, such as hydrocephalus
B. Obstruction of passage from relative or absolute over-
size of the pup
C. Malpresentation
1. Both cranial (head and extended forelimbs) and
caudal (tail and extended hind limbs) presentation
is normal in the dog.
2. Examples of malpresentation include breech presen-
tation (caudal presentation with the hind limbs
flexed) and cranial presentation with only one or
neither forelimb extended.
III. Breeds at increased risk for dystocia: Pekingese, Chihuahua,
Scottish terrier, dachshund, Yorkshire terrier, miniature

poodle, Pomeranian, and English bulldog (Gaudet and
Kitchell, 1985)
Clinical Signs
I. An obvious malpresentation is present.
II. The bitch has been in first-stage labor for >12 hours, in
weak and intermittent second-stage labor for >4 hours,
or in hard second-stage labor for >30 minutes before
delivering any pups.
III. It has been >2 hours since the last pup was born.
IV. Abnormal vaginal discharge is present.
A. Frank blood indicates hemorrhage.
B. Black or green discharge indicates placental separation
and is most valuable as an indicator before the first
pup is born.
V. The pregnancy is a high-risk one (e.g., former pelvic
fracture, predisposed breed, known single-pup litter).
Diagnosis
I. At the minimum, diagnosis of dystocia requires a good
history, a physical examination including a digital vaginal
examination, and a lateral abdominal radiograph.
II. Abnormalities that may be noted on physical examination
are as follows:
A. The bitch appears systemically ill.
B. Abnormal vaginal discharge is present (see previous
discussion).
C. Digital vaginal examination findings are abnormal (no
pup in the birth canal or vagina, very large pup palpable
in birth canal or vagina, obvious malpresentation).
III. Abnormalities are found on radiography.
A. Extremely large pup(s)
B. Dead pups: gas within or around fetuses, collapse of
axial skeleton and/or skull
C. Large number of pups remaining in a fatigued bitch
IV. Obtain an abdominal ultrasound if viability of the pups
is in question.
A. Fetal heart rate of <150 beats per minute is indicative
of fetal distress.
B. Lack of visible movement or heart beats at term is
indicative of fetal death.
V. Measure serum calcium.
A. Serum calcium <7 mg/dL is diagnostic of hypocalcemia.
B. Hypocalcemia causes dystocia by prohibiting normal
muscle contraction.
VI. Evaluate labor with an external whelping monitor, which
may suggest a decrease in fetal viability or show an abnor-
mal pattern of uterine contractions (Whelp Watch; Vet
Watch Corporation [888-200-8044]).
Treatment
I. Manipulation
A. If a pup is palpable within the birth canal, then manip-
ulation may allow it to pass.
B. Use caution when manipulating pups, because limb
dislocation and skin tearing may occur.
C. Clamps, forceps, and other instruments have been de-
scribed for relief of dystocia but must be used with
extreme caution.
CHAPTER 61 | Disorders of Canine Reproduction 611
II. Pharmacological therapy
A. Oxytocin causes uterine contractions and contributes
to cervical dilatation.
1. It also promotes placental separation.
2. Oxytocin is not to be used unless the cervix is open
(pup or significant vaginal discharge passed) and
no present obstruction exists (as determined by
abdominal radiography).
3. The recommended dose is 2 to 5 IU SC, IM.
4. If no response to oxytocin is seen after three doses
(administered at 20- to 30-minute intervals), then
institute some other form of therapy (Wallet Darvelid
and Linde-Forsberg, 1994).
B. Hypocalcemic bitches with no signs of eclampsia other
than dystocia may benefit from parenteral calcium
gluconate at 5 to 10 mL SC, IM.
C. Oxytocin and calcium are often given together, because
calcium may potentiate the effects of oxytocin.
D. Some reports suggest that bitches in dystocia may re-
spond to parenteral dextrose; however, hypoglycemia
has not been reported as a cause of dystocia in the
bitch.
III. Surgical therapy
A. Surgical treatment of dystocia is via cesarean section.
B. Use anesthetic agents with a short half-life and agents
that can be reversed in the pups.
1. Premedicate with atropine 0.04 mg/kg IM.
2. Examples of suitable induction agents include thio-
pental 4 to 8 mg/kg IV (to effect) or oxymorphone
0.1 to 1.0 mg/kg IV (to effect).
3. Intubate and maintain on inhalant anesthesia; iso-
flurane is the inhalant anesthesia of choice.
C. No contraindications exist to ovariohysterectomy at
the time of cesarean section.
D. Ovariohysterectomy at the time of cesarean section is
recommended if uterine rupture has occurred or if the
owner has no further plans to breed the bitch.
Monitoring of Animal
I. The prevention of dystocia requires good client education.
II. Feed the bitch a well-balanced diet and provide consistent
exercise throughout pregnancy.
III. Stress good breeding management to optimize litter size.
A. Vaginal cytological examination and measurement of
serum progesterone concentration allow determination
of ovulation day.
B. Optimal litter size is achieved by breeding 2 days after
ovulation.
IV. Provide the bitch with a stress-free, sanitary whelping
environment.
Pseudocyesis
Definition
I. Pseudocyesis is mammary development, lactation, and be-
havior typical of whelping, nursing, and mothering in
nonpregnant bitches at the end of diestrus.
II. The term false pregnancy is a misnomer.
612 SECTION 8 | Reproductive System
A. All bitches undergo a hormonal false pregnancy, with
luteal production of progesterone for an approximately
2-month diestrus, regardless of breeding or pregnancy
status.
B. The terms pseudocyesis or false whelping more accu-
rately describe this phenomenon.
III. Pseudocyesis is a normal reproductive phenomenon in
dogs and is not associated with reproductive tract disease.
Causes and Clinical Signs
I. All bitches produce luteal progesterone for approximately
2 months after ovulation, which causes mammary devel-
opment.
II. The abrupt decline in serum progesterone at the end of
diestrus stimulates release of prolactin from the anterior
pituitary, with subsequent mothering behavior and lacta-
tion.
III. Onset of pseudocyesis can be triggered by withdrawal of
exogenous progestogen therapy or by a decline in en-
dogenous progesterone after ovariohysterectomy during
diestrus.
IV. Physical changes of pseudocyesis include distention of the
mammary glands and exudation of serous fluid or normal
milk from the mammae.
V. Behavioral changes include nesting behavior, mothering of
inanimate objects, and possible aggression.
Diagnosis
I. Diagnosis of pseudocyesis is based on a history of having
been in estrus approximately 2 months before presenta-
tion, as well as the presence of the previously mentioned
clinical signs.
II. If breeding occurred, or if the owner is unsure if the bitch
was bred, then perform abdominal radiography to rule out
pregnancy and imminent whelping.
III. Diagnose secondary mastitis if the mammary glands are
enlarged, hot, and painful (see Chapter 60).
Treatment
I. Spontaneous remission occurs in most cases within 2 to
3 weeks of onset of clinical signs.
A. Do not milk out the mammary glands, because in-
creased intramammary pressure inhibits prolactin re-
lease and continuing milk production.
B. Wrapping the mammary glands with an elastic bandage
may hasten this pressure effect and protects the dis-
tended glands from trauma.
II. Megestrol acetate (Ovaban) at 2.5 mg/kg PO SID for 8 days
is the only therapy approved for treatment of pseudo-
cyesis in dogs.
A. Signs resolve with treatment but very often recur when
the drug is withdrawn.
B. Side effects of progestogen therapy include increased
appetite and changes in temperament.
C. Progestogens are not given to bitches with a history of
mammary neoplasia, diabetes mellitus, or pyometra.
D. The author does not recommend the use of megestrol
acetate for treatment of pseudocyesis in dogs.
III. Testosterone cypionate at a dose of 0.5 to 1.0 mg/kg IM
may decrease milk production in dogs.
IV. Prolactin inhibitors decrease milk production in dogs.
A. Bromocriptine is administered at a dose of 30 mg/kg
PO SID for 16 days, with the most common side effect
being emesis.
B. Cabergoline is administered at a dose of 1.5 to 5.0 mg/kg
PO SID for 2 to 8 days, with emesis as a rare side effect.
V. Ovariohysterectomy is not curative of a given episode of
pseudocyesis but prevents subsequent episodes.
VI. Short-term tranquilization may be necessary in aggressive
animals.
A. Diazepam is the drug of choice.
B. Phenothiazine tranquilizers (e.g., acepromazine) and
butyro-phenone tranquilizers (e.g., haloperidol) are
not recommended, because they may stimulate pro-
lactin release and worsen clinical signs.
Monitoring of Animal
I. Pseudocyesis is not associated with uterine disease and may,
in fact, be a historical indicator of normal ovarian function
in the bitch.
II. Age at onset of pseudocyesis is variable, and a given bitch
may not exhibit signs of pseudocyesis after every estrous
cycle.
III. Increased incidence of pseudocyesis in a given bitch may
be associated with predisposition to malignant mammary
neoplasia, presumably because of inflammatory changes
and release of free radicals within the distended mammary
tissue (Verstegen and Onclin, 2003).
POSTPARTUM DISORDERS
Eclampsia
Definition
I. Eclampsia is hypocalcemia arising from inadequate stores
of usable calcium in the extracellular compartment.
II. Eclampsia is also known as postpartum hypocalcemia and
puerperal tetany.
Causes and Pathophysiology
I. Hypocalcemia occurs most commonly in small breed dogs
nursing large litters, especially at peak lactation (2 to 3
weeks postpartum) (Kaufman, 1986).
II. Eclampsia can also occur during parturition and may
precipitate dystocia.
III. The disorder develops because the bitch’s body is incapa-
ble of drawing enough calcium from intracellular sources,
such as bone, and cannot ingest enough oral calcium to
meet the excessive demands of lactation.
IV. Supplementation with oral calcium during pregnancy may
predispose bitches to eclampsia during peak lactation.
V. Excessive calcium intake during pregnancy causes down-
regulation of the bitch’s own calcium regulatory system and
subsequent clinical hypocalcemia when calcium demand is
high.

Clinical Signs
I. Eclampsia is characterized by progressive neurologic changes,
with initial tremors followed by ataxia and disorientation,
collapse with seizures, and, finally, coma and death (Drobatz
and Casey, 2000).
II. Elevated body temperature (>40.5° C [105° F]) may be
present.
Diagnosis
I. Putative diagnosis is made by signalment (small breed dog,
nursing large litter), history (2 to 3 weeks postpartum),
and clinical signs as described previously.
II. Confirmatory diagnosis requires demonstration of total
serum calcium concentration <7 mg/dL.
Differential Diagnosis
I. Differential diagnoses for seizures in dogs include idio-
pathic epilepsy, meningoencephalitis, and toxicities (see
Chapter 22).
II. Evaluate dogs for hypoglycemia that do not respond to
empiric treatment with calcium.
Treatment
I. Mild tremors, ataxia, and disorientation in the lactating
bitch
A. Provide 10% calcium gluconate 0.2 to 0.4 mL/kg IM,
SC.
B. Dispense oral calcium carbonate or calcium gluconate
(1 to 3 g/day) with concurrent vitamin D.
C. Puppies may continue to nurse unless signs worsen or
recur.
II. Severe tremors, ataxia or disorientation, or seizures in a
bitch at peak lactation
A. Administer 10% calcium gluconate 1 to 10 mL IV, to
effect, while ausculting the heart.
B. Stop administration of calcium if any cardiac abnor-
mality is evident.
C. If hyperthermia is present, then gradually cool the bitch.
D. Provide a depot of 10% calcium gluconate 0.2 to
0.4 mg/kg IM, SC, and dispense oral calcium carbonate
or calcium gluconate (1 to 3 g/day), with concurrent
vitamin D, when the animal is discharged.
E. Remove pups from the bitch for 24 hours, or perma-
nently if signs recur during the same lactation.
Monitoring of Animal
I. If signs worsen or recur, then the puppies are removed
from the bitch and either hand raised (<4 weeks of age) or
weaned (>4 weeks of age).
II. Bitches with a history of eclampsia may benefit from oral
calcium supplementation during lactation after subsequent
whelpings.
Metritis
Definition
I. Metritis is a primary bacterial infection of the uterus that
occurs postpartum.
CHAPTER 61 | Disorders of Canine Reproduction 613
II. Metritis is not synonymous with pyometra, which is pri-
mary cystic endometrial hyperplasia with secondary bac-
terial infection that occurs during or after diestrus.
Causes and Clinical Signs
I. Metritis is caused by an ascending infection with vaginal
aerobic organisms after normal parturition, or after abor-
tion, fetal infection, dystocia, and/or retention of placentas.
II. Clinical signs include fever, anorexia, depression, neglect
of pups, and exudation of foul-smelling purulent discharge
from the vulva.
Diagnosis
I. Cytological examination of the vulvar discharge: inflam-
mation, contains numerous polymorphonuclear leukocytes
(some of which may be degenerative) and bacteria
II. Aerobic culture and sensitivity of the vulvar discharge to
guide antibiotic therapy
III. Complete blood count to demonstrate neutrophilia with a
left shift (common)
IV. Abdominal radiographs or ultrasonography to diagnose
retention of placentas and/or fetuses
V. Serological examination for canine brucellosis
Differential Diagnosis
I. Other causes of purulent vulvar discharge in the post-
partum bitch include brucellosis and vaginitis.
II. Rule out other causes of uterine disease (see Chapter 57).
Treatment
I. Administer an appropriate antibiotic, based on culture and
sensitivity testing, for 14 days.
II. While awaiting culture results, start on a broad-spectrum
antibiotic, such as ampicillin at 20 mg/kg PO TID.
III. Evacuate the uterine contents by administration of oxytocin
at 1 IU/kg IM or prostaglandin F2a (Lutalyse) at a dose
of 0.25 mg/kg SC.
IV. Perform ovariohysterectomy on bitches that become septic
(as evidenced by worsening clinical signs, hypoglycemia,
and positive blood cultures) and on bitches that are not
intended for future breeding.
V. Bitches with mineralized retained fetal tissue may require
hysterotomy or ovariohysterectomy for its removal.
Monitoring of Animal
I. Vaginal discharge resolves within 3 weeks postpartum or
2 weeks after institution of appropriate antibiotic therapy.
II. Properly treated, metritis should have no effect on future
fertility of bitches left intact.
Subinvolution of Placental Sites
Definition
Subinvolution of placental sites (SIPS) is exudation of sero-
sanguineous, noninflammatory vulvar discharge beyond the
time normal postpartum lochia generally is present (>3 weeks
postpartum).
614 SECTION 8 | Reproductive System
Causes and Pathophysiology
I. Histological examination of placental sites in affected
bitches reveals eosinophilic protrusions of nodular epithe-
lium with necrosis and hemorrhage from failure of normal
thrombosis and occlusion of endometrial blood vessels.
II. Underlying cause is unknown.
Clinical Signs
I. SIPS is most common in young bitches after whelping
their first litter.
II. Clinical presentation is of an apparently healthy bitch with
prolonged exudation of serosanguineous vulvar discharge.
Diagnosis and Differential Diagnosis
I. SIPS is diagnosed by ruling out other causes of persistent
vulvar discharge, such as metritis and canine brucellosis.
II. Perform cytological examination of the vulvar discharge.
A. Vulvar discharge characteristic of SIPS is noninflam-
matory.
B. It contains noncornified vaginal epithelial cells, occa-
sional healthy polymorphonuclear leukocytes, and
mucoid proteinaceous debris.
III. Perform culture of the vulvar discharge.
A. Because the vagina of the normal bitch is not sterile,
ask the laboratory for a quantitative culture.
B. Moderate to heavy growth of a single organism is
significant and leads to a diagnosis of infection of the
reproductive tract, not SIPS.
IV. Perform serological examination for canine brucellosis,
which also produces persistent vaginal discharge.
V. Perform abdominal palpation, radiography, and/or ultra-
sonography.
A. Assess uterine size and evaluate for retained fetuses
or placentas.
B. The presence of excessive intrauterine fluid or retained
tissues from parturition suggest metritis is present,
not SIPS.
VI. Perform a complete blood count to assess hematocrit,
white blood cell count, and cell differential count.
A. Chronic exudation of serosanguineous discharge may
be excessive enough to cause a regenerative anemia.
B. Neutrophilia with a left shift is suggestive of metritis,
not SIPS.
VII. Definitive diagnosis of SIPS requires histopathology of
uterine tissue and is rarely, if ever, performed in the bitch.
Treatment
I. If the bitch is not intended for future breeding, then
ovariohysterectomy is performed.
II. If the bitch is to be left intact, then monitoring is recom-
mended.
Monitoring of Animal
I. Evaluate cytological findings of the vulvar discharge weekly.
A. If the vulvar discharge becomes cytologically purulent,
then perform aerobic vaginal culture.
B. Next, treat with an appropriate antibiotic (based on
culture and sensitivity testing) for 14 days.
II. Monitor hematocrit weekly, because bitches rarely become
anemic to an extent requiring transfusion of whole blood.
III. The serosanguineous vulvar discharge of SIPS may persist
until onset of the subsequent proestrus.
IV. SIPS rarely recurs after subsequent whelpings.
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