Comparison of short-term complications following Cesarean section or Cesarean section with concurrent ovariohysterectomy in bitches and queens: a pilot study   Comparison of short-term complications following Cesarean section or Cesarean section with concurrent ovariohysterectomy in bitches and queens: a pilot study Margaret V. Root Kustritz College of Veterinary Medicine, University of Minnesota, St. Paul, MN Abstract Cesarean section is a common treatment for canine and feline dystocia. Ovariohysterectomy may or may not be recommended concurrently. There are apparently no data in the literature providing evidence to guide decision-making regarding the advantages and disadvantages of performing these procedures concurrently. Animal signalment, history upon presentation, medical and anesthetic management of dystocia, and incidence of short-term complications were compared between bitches and queens undergoing Cesarean section alone and those undergoing concurrent Cesarean section and ovariohysterectomy. Short-term complications were defined as those happening after recovery from anesthesia and extubation and within several days after patient discharge. Complete data were available for two queens undergoing Cesarean section alone and two queens undergoing concurrent Cesarean section and ovariohysterectomy, and for 20 bitches undergoing Cesarean section alone and 22 bitches undergoing concurrent Cesarean section and ovariohysterectomy. No short-term complications were reported in any of these patients. An important limitation was small sample size; therefore, further investigations, perhaps by pooling data from several institutions, would be beneficial. Keywords: Cesarean section, dystocia, ovariohysterectomy, spay, bitch, queen Introduction Reported incidence of dystocia is 2.0-5.0% and 3.3-5.8% in dogs and cats, respectively, with a predisposition in some breeds.1-9 Cesarean section (C-section) is performed in 54-66% of dogs and in 74- 79% of cats with dystocia.1,4-6,10 Reported complications of C-section include hemorrhage, infection or dehiscence of the incision, and peritonitis.2,11,12 Complications may occur due to underlying disease in the animal or surgeon error.12 Mortality rate for the bitch or queen during or immediately after C-section is 0- 2%.11,13 It is not uncommon for veterinarians to recommend or for clients to request ovariohysterectomy (OHE) at the time of C-section. Reasons to conduct the two procedures concurrently include: the bitch is spared a subsequent anesthetic episode (assuming she will be spayed later); bitches that require C-section should not be rebred, which may or may not be true depending on the cause of the dystocia and the reason for the C-section; uterine pathology, e.g. uterine rupture or infection; and this is an opportunity to perform OHE for population control.10,14 Some argue that risks of concurrent C-section and OHE are excessive. It is not difficult to expect increased morbidity and potentially increased mortality in bitches and queens undergoing two invasive surgical procedures concurrently. Blood pressure rises when the linea alba is incised and as ovaries are manipulated in healthy bitches undergoing OHE.15-17 Commonly reported complications of OHE include: hemorrhage at the ovarian pedicle or from other intra-abdominal vessel; inadvertent ligation of the distal ureter; trauma to other intra-abdominal organs; persistent bloody vulvar discharge; and infection or dehiscence of the incision.17-28 Reported concerns specific to concurrent C- section and OHE are: lack of milk production due to dehydration, anemia, or uncontrolled pain post- surgically; hemorrhage; and decreased mothering responses.29 Other possible concerns with concurrent OHE and C-section are physiologic responses in the dam, including: changes in blood pressure or hematologic parameters secondary to removal of the blood-filled uterus and associated placental tissues; increased duration of anesthesia and surgery if procedures are performed concurrently, with associated complications such as hypothermia and tissue damage; and ethical concerns for the bitch. Veterinarians, breed clubs, and others interested in ensuring optimal health of breeding bitches rely on scientific literature to help them make decisions. In one retrospective study, number of days hospitalized and complications were reportedly higher in 10 bitches that had undergone both C-section and OHE than in those that had undergone C-section alone.1 Complications were not described in that 409 Clinical Theriogenology • Volume 10, Number 4 • December 2018   study. Other studies described overall complications of populations of animals undergoing either C- section or OHE, some of which likely underwent both procedures, but again without comparing complications between C-section or OHE alone and the two surgeries performed concurrently.4,6,10,19 The author is unaware of any published studies specifically evaluating short-term complications of C-section versus C-section with concurrent OHE. The goals of this pilot study were to identify reported short-term complications associated with C- section alone versus C-section with concurrent OHE and to identify trends in patient signalment or medical and anesthetic management of these cases that may have contributed to development of complications. Materials and methods The electronic medical record was searched for the procedure code for C-section. Complete records were either available electronically or hard copies were retrieved to ensure that the author had all available data. Data recorded included signalment, history upon presentation, and medical and anesthetic management. Breed but not weight was recorded, as weight varies in late gestation (due to litter size). Similarly, body condition score was not reported because it can be difficult to assess in late-gestation bitches. Short-term complications were defined as those happening after recovery from anesthesia and extubation and within several days after patient discharge. Results The electronic medical record was searched from 2001 through 2017. Fifty-four medical records were identified. Five records were incomplete. Three bitches were presented for hysterotomy due to pregnancy loss of undefined cause (n = 1) or for removal of a non-viable fetus and fetal membranes (n = 2). Of the remaining cases, four were queens, two of which underwent C-section alone and two that underwent C-section with concurrent OHE, and 42 were bitches, 20 of which underwent C-section alone and 22 that underwent C-section with concurrent OHE. History and management of the queens are shown (Table 1). Anesthetic protocol was only reported in detail for the two queens that underwent C-section with concurrent OHE; one queen received midazolam and butorphanol and was maintained on sevoflurane, whereas the other was induced with propofol and maintained on sevoflurane. Reason for the concurrent OHE was not reported in either queen. All kittens were born alive and discharged with the dam. No short-term complications were reported for any queens. History and management of the 20 bitches that underwent C-section alone are shown (Table 2). Mean + SD age at the time of presentation was 4.2 + 1.8 years. Breed was variable, with no breed over- represented. Three bitches were of toy breeds and one was of a giant breed. Anesthetic protocol was reported in detail for 10. Two were maintained on isoflurane and also received propofol (n = 1) and alfaxalone (n = 1). Eight were maintained on sevoflurane and also received hydromorphone and propofol (n = 4); hydromorphone, diazepam, and propofol (n = 2); fentanyl and propofol (n = 1), or diazepam and propofol (n = 1). Two bitches suffered transient hypotension under anesthesia that responded to medical therapy. All pups were born alive and sent home with the dam for 13 bitches; all pups were stillborn, could not be resuscitated, or had congenital defects incompatible with life at the time of C-section for four bitches; and there was a combination of live and stillborn pups for three bitches. No short-term complications were reported for any bitches that underwent C-section alone. One bitch on a raw, homemade diet had a poor appetite and was not attentive to the pups the first day after surgery; however, that resolved after she was fed a commercial diet. History and management for the 22 bitches that underwent C-section and concurrent OHE are shown (Table 3). Mean age at the time of presentation was 4.2 + 2.0 years. Breed was variable, with no breed over-represented. Five bitches were of toy breeds and one was of a giant breed. Reason for the concurrent OHE was unreported in 21 bitches, whereas a uterine tear was present in one bitch. Anesthetic protocol was reported in detail for 13. Seven were maintained on isoflurane and also received alfaxalone (n = 2); propofol (n = 2); atropine, midazolam, hydromorphone, and propofol (n = 1); diazepam, 410Clinical Theriogenology • Volume 10, Number 4 • December 2018   hydromorphone, and propofol (n = 1); hydromorphone and propofol (n = 1). Six were maintained on sevoflurane and also received hydromorphone and propofol (n = 2); atropine, hydromorphone, and propofol (n = 2); diazepam, hydromorphone, and propofol (n = 1); and fentanyl and propofol (n = 1). One bitch with aspiration pneumonia in late gestation had a prolonged capillary refill time and a decline in PCV from 35 to 19% intra-operatively; she responded to transfusion with packed RBCs. One bitch with pregnancy toxemia had an unreported decline in PCV intra-operatively; she responded to transfusion with blood products. One bitch with respiratory distress had low oxygen saturation and could only maintain normal oxygen saturation after intubation and oxygen therapy; however, this resolved after surgery, and she had a prolonged but uneventful recovery. All pups were born alive and sent home with the dam for 13 bitches; all pups were stillborn, could not be resuscitated, or had congenital defects incompatible with life at the time of C-section for three bitches; and there was a combination of live and stillborn pups for six bitches. No short-term complications were reported for any bitch that underwent C-section with concurrent OHE. Discussion In this study, no short-term complications were noted either for C-section alone or for C-section with concurrent OHE. All cases were managed in a referral hospital where the receiving clinician had immediate access to a board-certified theriogenologist and all procedures were completed by board- certified anesthesiologists and surgeons. This, coupled with availability of pharmaceuticals and monitoring equipment that may not be available at all facilities, may have decreased the likelihood of complications. One limitation of this study was the limited number of cases. This is a referral hospital in a large metropolitan area with many clinics that offer high-quality small animal reproductive services, which limits such cases presenting to the author’s institution. Another limitation was a lack of complete follow- up on all cases, as some undoubtedly were presented solely because emergency service was available and they subsequently completed follow-up with their regular veterinarian. For many cases, complete analysis of records permitted the author to access information from telephone conversations with clients in the days following surgery. A final limitation, common in retrospective studies, was the lack of consistent data in medical records. For example, surgical reports often did not clarify if OHE had been performed post-hysterotomy or if an en bloc OHE had been performed. This could have affected incidence of short- term complications. In one study describing en bloc OHE as a treatment for dystocia, examples of post- surgical complications included: anemia requiring blood transfusion in three queens; disseminated intravascular coagulation (DIC) in a queen; bloody vulvar discharge in a bitch; uroperitoneum in a bitch; and death of a queen.30 As another example, use of pre- or intra-operative antibiotics was variably recorded. For many cases, antibiotic use was identified by the author reviewing the anesthesia record, the surgical record, the pharmacy request screen, or the final bill. Consequently, there was limited ability to determine when the antibiotic had been administered. Presumably some bitches received antibiotics and it either was not recorded or was not retrieved. Consequently, use of pre- and intra-operative antibiotics could not reliably be reported. Data regarding dispensed antibiotics were consistent in the record, as described above. Use of antibiotics generally is not required unless there is systemic infectious disease, ongoing uterine pathology in bitches or queens left intact, or contamination of the peritoneal cavity with uterine contents during either C-section or OHE.11 The rationale for using or withholding antibiotics was not consistently apparent. Two studies evaluating post-surgical complications in dogs and cats based on retrieval of hard copy or electronic records demonstrated under-reporting in computer records.19,23 Both hard copies and electronic records had some deficiencies in this study, more likely due to lack of training and tracking of record completion, rather than variation in the medium used. Most studies in dogs and cats identify uterine inertia as the most common cause of dystocia.1,4,10,30 In a study describing 510 C-section procedures in 453 bitches, lack of progression of labor was the 411 Clinical Theriogenology • Volume 10, Number 4 • December 2018   reported cause of dystocia in 73.1% of cases.2 However, in the present study, specific causes of dystocia were difficult to identify from the medical record. Variability of breed and range of age of bitches and queens in this case series matched those reported in the literature.2,13 Increased body weight was associated with increased incidence of complications of OHE in several studies.17,20 That was not supported by data in this study, although weight of the bitches and queens in this case series was not retrieved from the medical record, due to concerns regarding inability to differentiate lean body weight from pregnancy weight, with varying litter size. Various anesthetic protocols were used, consistent with the literature.2,13 The lack of short-term complications precluded making associations with medical or anesthetic management. However, the variability of medical and anesthetic management protocols suggests that such associations would be unlikely unless sample size or the effect were large. The author looks forward to other publications with larger sample sizes, perhaps as a collaborative effort from several institutions, to provide more definitive evidence. References 1. Gaudet DA: Retrospective study of 128 cases of canine dystocia. J Am Anim Hosp Assoc 1985;21:813-818. 2. Ayres SE, Thomas PGA: Population characteristics of 453 bitches undergoing 510 cesarean section procedures between 1999 and 2009 – a retrospective study. Clin Therio 2012;2:451-465. 3. Evans KM, Adams VJ: Proportion of litters of purebred dogs born by caesarean section. J Small Anim Pract 2010;51:113-118. 4. Ekstrand C, Linde-Forsberg C: Dystocia in the cat: A retrospective study of 155 cases. J Small Anim Pract 1994;35:459-464. 5. Gunn-Moore DA, Thrusfield MV: Feline dystocia: Prevalence, and association with cranial conformation and breed. Vet Rec 1995;136:350-353. 6. Munnich A, Kuchenmeister U: Dystocia in numbers – Evidence-based parameters for intervention in the dog: Causes for dystocia and treatment recommendations. Reprod Domest Anim 2009;44 (Suppl 2):141-147. 7. Bergstrom A, Nodtvedt A, Lagerstedt A-S, et al: Incidence and breed predilection for dystocia and risk factors for Cesarean section in a Swedish population of insured dogs. Vet Surg 2006;35:786-791. 8. Humphreys J: Dystocia in cats. Vet Rec 1974;95:353. 9. Linde-Forbserg C, Eneroth A: Abnormalities in pregnancy, parturition, and the periparturient period. In: Ettinger SJ, Feldman EC, editors, Textbook of veterinary internal medicine, 5th Edition, Philadelphia; WB Saunders; 2000. P. 1527- 1538. 10. Walett Darvelid A, Linde-Forsberg C: Dystocia in the bitch: A retrospective study of 182 cases. J Small Anim Pract 1994;35:402-407. 11. Sammarco J, Kahn A: Cesarean section in dogs: Indications, techniques. Available at: http://veterinarynews.dvm360.com/cesarean-section-dogs-indications-techniques?id=&sk=&date=&pageID=3. Accessed 04-04-18. 12. Baltodano LA, Memon MA, King C: Incidence of post-surgical complications of ovariohysterectomy and orchiectomy in field conditions. Clin Therio 2013;5:37-43. 13. Moon PF, Erb HN, Ludders JW, et al: Perioperative management and mortality rates of dogs undergoing cesarean section in the United States and Canada. J Am Vet Med Assoc 1998;213:365-369. 14. Gilroy BA, DeYoung DJ: Cesarean section. Anesthetic management and surgical technique. Vet Clin North Am 1986;16:483-494. 15. Hoglund OV, Olsson K, Hagman R, et al: Comparison of haemodynamic changes during two surgical methods for neutering female dogs. Res Vet Sci 2011;91:159-163. 16. Tallant A, Ambros B, Freire C, et al: Comparison of intraoperative and postoperative pain during canine ovariohysterectomy and ovariectomy. Can Vet J 2016;57:741-746. 17. Berzon JL: Complications of elective ovariohysterectomies in the dog and cat at a teaching institution: clinical review of 853 cases. Vet Surg 1979;8:89-91. 18. Burrow R, Batchelor D, Cripps P: Complications observed during and after ovariohysterectomy of 142 bitches at a veterinary teaching hospital. Vet Rec 2005;157:829-833. 19. Pollari FL, Bonnett BN, Bamsey SC, et al: Postoperative complications of electives surgeries in dogs and cats determined by examining electronic and paper medical records. J Am Vet Med Assoc 1996;208:1882-1886. 20. Muraro L, White RS: Complications of ovariohysterectomy procedures performed in 1880 dogs. Tierarztliche Praxis 2014;42:297-302. 21. Adin CA: Complications of ovariohysterectomy and orchiectomy in companion animals. Vet Clin North Am 2011;41:1023-1039. 412Clinical Theriogenology • Volume 10, Number 4 • December 2018   22. Roberts ML, Beatty JA, Dhand NK, et al: Effect of age and surgical approach on perioperative wound complication following ovariohysterectomy in shelter-housed cats in Australia. J Feline Med Surg Open Reports 2015; 1. doi:10.1177/2055116915613358. 23. Pollari FL, Bonnett BN: Evaluation of postoperative complications following elective surgeries of dogs and cats at private practices using computer records. Can Vet J 1996;37:672-678. 24. Pearson H: The complications of ovariohysterectomy in the bitch. J Small Anim Pract 1973;14:257-266. 25. Okkens AC, van de Gaag I, Biewenga WJ, et al: Urological complications following ovariohysterectomy in dogs. Tijdschr Diergeneeskd 1981;106:1189-1198. 26. Harris KP, Adams VJ, Fordyce P, et al: Comparison of surgical duration of canine ovariectomy and ovariohysterectomy in a veterinary teaching hospital. J Small Anim Pract 2013;54:579-583. 27. Kennedy KC, Tamburello KR, Hardie RJ: Peri-operative morbidity associated with ovariohysterectomy performed as part of a third-year veterinary surgical-training program. J Vet Med Educ 2011;38:408-413. 28. Bowlt Blacklock KL, Langer P, Halfacree Z, et al: Canine ovariohysterectomy: A survey of surgeon concerns and surgical complications encountered by newly graduated veterinarians. J Vet Med Educ 2016;43:184-189. 29. Traas AM: Surgical management of canine and feline dystocia. Theriogenology 2008;70:337-342. 30. Robbins MA, Mullen HS: En bloc ovariohysterectomy as a treatment for dystocia in dogs and cats. Vet Surg 1994;23:48-52. 413 Clinical Theriogenology • Volume 10, Number 4 • December 2018   Ta bl e 1. S ig na lm en t a nd c as e m an ag em en t d at a fo r q ue en s u nd er go in g Ce sa re an se ct io n al on e or C es ar ea n se ct io n w ith c on cu rre nt o va rio hy ste re ct om y. PR O CE D U RE BR EE D / A G E PR ES EN TI N G H IS TO RY RA D IO G RA PH S / U LT RA SO U N D O X Y TO CI N TH ER A PY ? PR E- A N ES TH ET IC BL O O D W O R K A N TI BI O TI CS D IS PE N SE D A T D IS CH A RG E C- se ct io n on ly A by ss in ia n / 4 y ea rs Le th ar gy , va ria bl e an em ia ov er th e la st w ee k Ra di og ra ph s a nd ul tra so un d N o PC V 2 3% N o C- se ct io n on ly D SH / 1 ye ar Pr ol on ge d la bo r, on e sti llb or n ki tte n bo rn a t ho m e Ra di og ra ph s Y es – tw o liv e ki tte ns b or n PC V 3 8% N o C- se ct io n w ith co nc ur re nt O H E Si am es e / 3 ye ar s Pr ol on ge d la bo r Ra di og ra ph s a nd ul tra so un d N o PC V 3 9% , H G B 13 .3 g m /d L N o C- se ct io n w ith co nc ur re nt O H E D SH / 4 ye ar s Pr ol on ge d la bo r, hi sto ry o f p el vi c fra ct ur e Ra di og ra ph s N o PC V 2 9% , pl at el et n um be r no rm al (e sti m at e) N o 414Clinical Theriogenology • Volume 10, Number 4 • December 2018   Ta bl e 2. S ig na lm en t a nd c as e m an ag em en t d at a fo r b itc he s u nd er go in g C- se ct io n al on e. BR EE D / A G E PR ES EN TI N G H IS TO RY RA D IO G RA PH S / U LT RA SO U N D O X Y TO CI N TH ER A PY ? PR E- A N ES TH ET IC BL O O D W O R K A N TI BI O TI CS D IS PE N SE D A T D IS CH A RG E En gl ish b ul ld og / 2 y ea rs Pr ol on ge d la bo r, gr ee n vu lv ar di sc ha rg e U ltr as ou nd N o PC V 4 4% , H G B 15 .2 g m /d L N o En gl ish b ul ld og / 2 y ea rs G re en v ul va r d isc ha rg e 4 da ys pr io r t o pl an ne d C- se ct io n Ra di og ra ph s N o PC V 4 1% , H G B 13 .9 g m /d L Y es St an da rd po od le / 2 ye ar s Pr ol on ge d la bo r N on e re po rte d Y es – n o ef fe ct PC V 3 6% , H G B 12 .4 g m /d L, pl at el et n um be r 38 9, 00 0 N o A m er ic an bu lld og / 2 ye ar s Pr ol on ge d la bo r N on e re po rte d Y es – n o ef fe ct N on e re po rte d N o Be rn es e m ou nt ai n do g / 3 ye ar s Pl an ne d C- se ct io n as b itc h en te re d la bo r Ra di og ra ph s N o PC V 5 2% , H G B 17 .8 g m /d L, pl at el et n um be r 32 6, 00 0 N o En gl ish c oc ke r sp an ie l / 3 ye ar s Pr ol on ge d la bo r Ra di og ra ph s Y es – n o ef fe ct PC V 2 9% , H G B 9. 9 gm /d L Y es La br ad or re tri ev er / 3 ye ar s St ill bo rn th e da y be fo re , n o co nt ra ct io ns si nc e. Ra di og ra ph s a nd ul tra so un d Y es – 6 p up s bo rn li ve PC V 4 2% , H G B 14 .3 g m /d L N o La br ad or re tri ev er / 3 ye ar s Pr ol on ge d la bo r, re fe rri ng D V M g av e ox yt oc in to n o ef fe ct Ra di og ra ph s Y es – 2 p up s bo rn li ve PC V 3 2% , H G B 10 .9 g m /d L N o Be rn es e m ou nt ai n do g / 4 ye ar s Fi ve p up s b or n liv e at h om e, pr ol on ge d la bo r f or fi na l p up Ra di og ra ph s N o PC V 3 8% , H G B 12 .9 g m /d L N o Si be ria n hu sk y / 4 y ea rs Pr ol on ge d la bo r Ra di og ra ph s N o PC V 3 7% , H G B 12 .9 g m /d L, pl at el et n um be r 53 1, 00 0 N o 415 Clinical Theriogenology • Volume 10, Number 4 • December 2018   Ch ih ua hu a / 4 ye ar s Pr ol on ge d la bo r, tw o pu ps b or n liv e at h om e th at la te r d ie d Ra di og ra ph s Y es – n o ef fe ct N on e re po rte d N o Pu g / 4 y ea rs Pr ol on ge d la bo r Ra di og ra ph s a nd ul tra so un d N o N on e re po rte d N o Ita lia n gr ey ho un d / 4 ye ar s Pr ol on ge d la bo r, ha d re ce iv ed de xa m et ha so ne e ar lie r i n pr eg na nc y fo r m is m at in g Ra di og ra ph s N o PC V 3 4% , H G B 11 .7 g m /d L Y es Si be ria n hu sk y / 5 y ea rs El ec tiv e C- se ct io n N on e re po rte d N o N on e re po rte d N o D ac hs hu nd / 5 ye ar s Pr ol on ge d la bo r Ra di og ra ph s Y es – 1 p up bo rn li ve N on e re po rte d N o Si be ria n hu sk y / 6 y ea rs El ec tiv e C- se ct io n fo r s in gl e, la rg e pu pp y Ra di og ra ph s N o N on e re po rte d N o Co lli e / 6 y ea rs Pr ol on ge d la bo r Ra di og ra ph s Y es – 2 p up s sti llb or n PC V 3 9% N o Iri sh W ol fh ou nd / 7 ye ar s Pr ol on ge d la bo r, bi tc h in a tri al fib ril la tio n an d he ar tw or m po sit iv e N on e re po rte d N o PC V 3 4% , H G B 12 .2 g m /d L N o Sa m oy ed / 7 ye ar s Pr ol on ge d la bo r, on e liv e pu p an d on e sti llb or n at h om e N on e re po rte d N o N on e re po rte d Y es A fg ha n ho un d / 8 ye ar s Pr ol on ge d la bo r Ra di og ra ph s Y es – n o ef fe ct PC V 4 5% , H G B 15 .2 g m /d L Y es 416Clinical Theriogenology • Volume 10, Number 4 • December 2018   Ta bl e 3. S ig na lm en t a nd c as e m an ag em en t d at a fo r b itc he s u nd er go in g co nc ur re nt C -s ec tio n an d O H E. BR EE D / A G E PR ES EN TI N G H IS TO RY RA D IO G RA PH S / U LT RA SO U N D O X Y TO CI N TH ER A PY ? PR E- A N ES TH ET IC BL O O D W O R K A N TI BI O TI CS D IS PE N SE D A T D IS CH A RG E Pu g / 1 y ea r Pr ol on ge d la bo r N on e re po rte d N o N on e re po rte d Y es Ch ih ua hu a / 1 ye a r Pr ol on ge d la bo r Ra di og ra ph s N o PC V 4 2% , H G B 14 .3 g m /d L N o Y or ks hi re te rri er / 2 ye ar s Pr ol on ge d la bo r, on e liv e an d on e sti llb or n pu p at h om e U ltr as ou nd N o PC V 3 7% , H G B 12 .6 g m /d L N o G ol de n re tri ev er / 2 ye ar s Re sp ira to ry d ist re ss in la te ge sta tio n / d ia gn os ed w ith as pi ra tio n pn eu m on ia Ra di og ra ph s a nd ul tra so un d N o PC V 3 5% , H G B 11 .9 g m /d L, pr ol on ge d CR T Y es Ro ttw ei le r / 2 ye ar s Pr ol on ge d la bo r Ra di og ra ph s N o PC V 3 9% , H G B 14 .0 g m /d L N o Po m er an ia n / 3 ye ar s Pr ol on ge d la bo r, pr io r h ist or y of p el vi c in ju ry Ra di og ra ph s N o PC V 3 4% , pl at el et n um be r in cr ea se d (e sti m at e) Y es Be rn es e m ou nt ai n do g / 3 ye ar s Pr ol on ge d la bo r U ltr as ou nd N o PC V 3 9% N o D ac hs hu nd / 3 ye ar s Ta rry st oo ls, le th ar gy / di ag no se d w ith p re gn an cy to xe m ia Ra di og ra ph s N o PC V 2 5% N o A m er ic an St af fo rd sh ire te rri er / 3 ye ar s Pr ol on ge d la bo r, tw o liv e pu ps bo rn a t h om e an d th en la bo r sto pp ed Ra di og ra ph s a nd ul tra so un d N o PC V 3 4% , H G B 11 .6 g m /d L N o En gl ish b ul ld og / 4 y ea rs Re sp ira to ry d ist re ss in la te ge sta tio n N on e re po rte d N o PC V 3 5% , H G B 12 .0 g m /d L N o La br ad or re tri ev er / 4 ye ar s Pr ol on ge d la bo r, co nc ur re nt sta ge II v ag in al h yp er pl as ia . Fi ve p up s b or n liv e at h om e N on e re po rte d N o N on e re po rte d N o G ol de n re tri ev er / 4 ye ar s Pr ol on ge d la bo r Ra di og ra ph s Y es – n o ef fe ct PC V 4 1% , H G B 14 .4 g m /d L, Y es 417 Clinical Theriogenology • Volume 10, Number 4 • December 2018   pl at el et n um be r no rm al Pu g / 5 y ea rs N on e re po rte d Ra di og ra ph s N o N on e re po rte d Y es A m er ic an St af fo rd sh ire te rri er / 5 ye ar s Pr ol on ge d la bo r, gr ee n vu lv ar di sc ha rg e Ra di og ra ph s N o PC V 3 9% , H G B 13 .9 g m /d L N o M in ia tu re pi ns ch er / 5 ye ar s O ve rd ue b as ed o n br ee di ng da te s, te m pe ra tu re d ro pp ed to 99 F fo ur d ay s a go , i nt er m itt en t co nt ra ct io ns Ra di og ra ph s N o PC V 4 1% , H G B 14 .5 g m /d L N o Ca va lie r K in g Ch ar le s s pa ni el / 5 y ea rs Pr ol on ge d la bo r Ra di og ra ph s Y es – 2 p up s bo rn li ve PC V 4 5% , H G B 15 .3 g m /d L N o En gl ish se tte r / 6 ye ar s Pr ol on ge d la bo r, gr ee n vu lv ar di sc ha rg e N on e re po rte d N o PC V 3 9% , H G B 13 .3 g m /d L N o Be ar de d co lli e / 6 ye ar s Pr ol on ge d la bo r Ra di og ra ph s N o PC V 4 1% N o Iri sh w ol fh ou nd / 6 y ea rs Pr ol on ge d la bo r, 2 pu ps b or n liv e at h om e Ra di og ra ph s N o PC V 3 7% , H G B 16 g m /d L, no rm al p la te le t nu m be r (e sti m at e) N o W hi pp et / 7 ye ar s Pr ol on ge d la bo r, gr ee n vu lv ar di sc ha rg e Ra di og ra ph s N o PC V 4 1% Y es Bi ch on fr ie s / 7 ye ar s Pr ol on ge d la bo r, tw o sti llb or n at h om e Ra di og ra ph s N o PC V 3 4% , H G B 11 .6 g m /d L N o Sa m oy ed / 9 ye ar s Pr ol on ge d la bo r, ga ve b irt h to 9 pu ps a t h om e Ra di og ra ph s Y es , b y ow ne r PC V 3 2% N o 418Clinical Theriogenology • Volume 10, Number 4 • December 2018 000_frontal MS_1 forematter for December 2018 MS_2 Letter1 for December 2018 MS_2 Letter2 for December 2018 MS_2 Letter3 for December 2018 MS_3 Table of contents MS_4 Therio News for December 2018_BW 2019 Therio Preview Therio Recap with pics Steiner-New officers 2018 Therio Sponsors 2018 Exhibitors-SFT Board Noms 2018 Auction donations 2019 Bartlett Nomination ACT call for noms Call for Abstracts 2019 for CTJ The Society for Theriogenology and American College of Theriogenologists issue a call for research and case abstracts to be presented at the annual Therio Conference July 24-27, 2019 in Savannah, Georgia. 1. Competitive Category: 2. Non‐Competitive Category: 3. Case Abstract Category: 4. Poster Category: General: GUIDELINES: WHAT TO SEND AND HOW TO SEND IT Abstracts not adhering to these guidelines will not be considered for presentation. DEADLINE: Abstracts must be received no later than February 15, 2019 for consideration. Call for 2019 Student Case Presentations.pdf Call for Student Case Presentations-2019 Annual Therio Conference Student Case Presentations Call for Student Case Presentations also available at www.therio.org Guidelines for Application Submission Society for Theriogenology Student Case Presentation Competition Annual Therio Conference, Savannah, Georgia, July 24-27, 2019 MS_5 Editorial 001a_MS_6 Roberts - color pictures 002_MS_7 Root Kustritz 003_MS_8 Ferrer 004_MS_9 Wiley 005_MS_10 Wallace 006_MS_11 Peterson 007_MS_12 Nobre 008_MS_13 Sidelinger 009_MS_14 Mirando