Successful Treatment for Subinvolution of Placental Sites in the Bitch with Low Oral Doses of Progestagen

Abstract

Subinvolution of placental sites (SIPS) is the major cause of persistent sanguineous vaginal discharge after parturition in the bitch. Spontaneous remission is common but may take several months, and hence, medical therapy to end the discharge is often requested. In this retrospective study, we evaluated the effect of treatment for SIPS with low oral doses of a progestagen. Nine bitches with SIPS, but otherwise clinically healthy, were found in the computer database of the Department of Clinical Sciences of Companion Animals. Seven of these bitches were treated with low oral doses of a progestagen (megestrol acetate, 0.1 mg/kg body weight (bw) once daily for the 1st week, then 0.05 mg/kg bw once daily for the 2nd week). The other two bitches were untreated. Treatment results were evaluated by a telephone questionnaire. Progestagen treatment was successful in all of the treated dogs; sanguineous vaginal discharge stopped within the treatment period. One of the two untreated dogs remained symptomatic until the next oestrus, approximately 120 days after parturition, and the other remained symptomatic until 6 weeks before the start of the next pro-oestrus, 270 days after parturition. No side effects of the progestagen treatment were observed. Subsequent gestations, parturitions and puerperal periods of 5 mated bitches were uneventful. One bitch did not become pregnant after mating. In conclusion, the results of this study indicate that oral administration of low doses of progestagen for 2 weeks is effective in stopping persistent sanguineous vaginal discharge in bitches with SIPS, with neither side effects nor reduced subsequent fertility.

Severe thrombocytopenia due to subinvolution of placental sites in a Maltese terrier

“…Several methods of medical management in more severe cases have been reported, but with limited success. [16][17][18]22 Surgical treatment is usually ovariohysterectomy, but hysterolaparatomy with curettage of selected sites has also been reported. 23 An underlying disorder causing a predisposition to haemorrhage and thrombocytopenia seemed unlikely in this case based on the history and response to treatment.…”

“…As SIPS is normally a self‐limiting condition, treatment is rarely required. Several methods of medical management in more severe cases have been reported, but with limited success 16–18,22 . Surgical treatment is usually ovariohysterectomy, but hysterolaparatomy with curettage of selected sites has also been reported 23…”

“…14 The incidence of PPH in dogs has not been reported in the literature, 15 but is noted to be rare. 2 The incidence of SIPS in dogs has not been documented, 16 but a case series has found 20/95 postpartum bitches to have SIPS. 17 Other differentials for PPH include coagulopathies, metritis, proestrus, vaginitis, trauma, retained or mummified fetus and neoplasia.…”

Hematometra associated with fetal death in a fennec fox (Vulpes zerda)

“…With subinvolution of placental sites, there is prolonged bloody vaginal discharge after birth, and it is also excluded, as is open pyometra [3]. Abnormal bleeding not associated with estrus or the postpartum period is called metrorhttps://doi.org/10.12729/jbtr.2021.22.4.211 rhagia [4]. Uterine hemorrhage is very rare; there are only a few reports in dogs, and it has not been reported in fennec foxes.…”