Ketonemia and ketonuria without glucosuria often accompany the hypoglycemia. Because hypocalcemia presents with similar signs
and can occur in term bitches, serum calcium level should also be evaluated. Treatment of hypoglycemia is with slowly administered
Nutritional supplementation will be needed in bitches that do not voluntarily eat. Termination of pregnancy may be necessary
in severe cases. Pregnant bitches that are maintained on diets deficient in carbohydrate may develop hypoglycemia in the last
two weeks of gestation. This resulted in a significant increase in stillborn puppies and in neonatal death in the first three
days of life.
Pre-existing subclinical diabetes mellitus may be aggravated by pregnancy. Sensitivity to insulin is decreased as early as
35 days of gestation and continues to decrease as pregnancy progresses. Insulin should be given if indicated by carefully
monitored blood glucose levels.
The varying demands and hormonal alterations during pregnancy and parturition may make glucose control difficult to obtain.
Hypoluteodism Although uncommon, failure to maintain an appropriate serum progesterone level throughout pregnancy is a potential cause of
fetal loss. Monitoring of the serum progesterone level allows accurate diagnosis of this problem. Serum progesterone levels
above 2 ng/ml are required to maintain pregnancy.
In a normal pregnancy, serum progesterone reaches peak levels of 15-90 ng/ml by 15-30 days post luteinizing hormone (LH) peak.
During the last trimester, serum progesterone concentrations decrease to 4-16 ng/ml before dropping below 2 ng/ml approximately
one day before parturition. Monitoring of serum progesterone levels can be performed weekly if the levels are 20-50 ng/ml
or daily if they are 5-10 ng/ml.
Treatment of hypoluteodism can be performed with injections of progesterone in oil (2-3 mg/kg IM every 24 hours). Alternatively,
ally-trenbolone (Regumate, Hoechst-Roussel Agri-Vet Co.) at 0.088 mg/kg PO daily can be given.
Ultrasonographic monitoring of fetuses can be helpful in assessing fetal viability. Fetal heart rates less than 160 bpm indicate
fetal distress, as does decreased fetal movement. Exact timing of ovulation, and, therefore, parturition date, is necessary
so that progesterone supplementation can be stopped about 72 hours prior to expected parturition, allowing for an approximation
of normal decline of serum progesterone.
Canine herpesvirusThe fatal form of canine herpesvirus infection results from exposure of the puppies during the last three weeks of gestation
and the first three weeks of life. Canine herpesvirus is most commonly spread as a mild respiratory infection between adult
dogs. Titers to canine herpesvirus can be measured in the bitch prior to breeding to determine if she has had previous exposure.
A naive bitch is at risk for infection during pregnancy, as a previously exposed bitch is not. The puppies are still at risk
after birth in either situation. No vaccination is currently available. Unfortunately, no successful treatment is available
if the puppies become infected.
Drug administration Administration of any medication is best avoided in the pregnant bitch. Some drugs have proven to be relatively safe, while
others are definitely dangerous to the developing fetus (see lists). Many other drugs carry potential risks that have not
been researched or established. The safest course is to avoid any medication of questionable safety and to only administer
medication if absolutely necessary.