Infertility in the female dog

Continued

Up until now the discussion has centered on infertility of the bitch based on hormonal, metabolic, management related, genetic or anatomic (congenital or acquired) disorders/ deficiencies.  Today, we’ll look at the infections aspect of infertility.

Chronic endometritis – (CE)

This is low-grade bacterial infection that affects the internal lining of the womb.  The germs which invade the uterus (womb) usually work their way up from the vagina.  Let’s face it: the very position of the entrance of the vagina (under the anus) is tailor-made for bacteria to accumulate and enter the vagina.  Perhaps that’s why there are so many defence mechanisms in that area to prevent germs from anchoring themselves in the vaginal tissue and working their way upwards towards the womb.  Be that as it may, it doesn’t stop those obstinate germs from invading the vagina and then marching towards the uterus, via the cervix – that body which connects the vagina and the uterus (womb).

Once the germ troops have landed in the uterus, even if they are not numerous, they create an inflammatory environment that would almost surely lead to infertility.  For one thing, those germs (and their toxic products) kill sperm cells.  Dead semen cannot fertilise eggs, therefore no offspring.  And even if the fertile egg cell and the fertile sperm cell unite to begin the process of embryo development, the fertilized egg cannot nest itself in a uterus wall that is inflamed.

I should also mention that when the bitch is in heat, the vulva (that tissue at the entrance of the vagina) becomes, at the same time (during heat), very enlarged, and the pink tissue of the vagina is visible through the open lips of the vulva.  Having easy accessibility, the germs begin their journey.  Under normal (non-heat) circumstances there is a mucus plug in the cervix (that bit of tissue which is located between the vagina and the uterus, (see above).  During heat that mucus plug is dislodged (I suppose to allow the sperm free passage into the uterus.  Just as how the semen can pass through, so too can germs).  So, germs don’t even have a protective mucus plug to deal with any more.

For a veterinarian, the biggest problem associated with a chronic endometritis is the fact that one hardly recognizes the ailment when it exists at the beginning.  The number of bacteria is large enough to create an infection (therefore fertility problems), yet it is low enough not to make the animal sick, showing signs of pain, fever, depression, loss of appetite, etc.  The animal is actually quite lively and eats well, but does not breed.

We must begin suspecting a chronic endometritis when the bitch refuses to accept the advances of the male, or, having accepted the male, still does not conceive.  If there is no attraction or conception after two or more involvements of the partners, the vet should be requested to commence an investigation and possibly to institute therapy.  You may recall I had mentioned at the beginning of this overall theme (sex and reproduction) that it is advisable for your veterinarian to clinically examine the two potential breeding partners before they are brought together for mating.

In terms of tell-tale signs of CE, the delivery of stillborns or weak and sickly puppies, which die soon after birth, should make us suspect the possibility of CE.

Treatment

I am from the old school, therefore I swear by the uterine irrigation with Lugol’s solution (an Idoine based liquid).  This is also called a douche or a lavage.  It is simply the insertion of a tube pipette into the uterus and washing it out.  This method is pretty much tested and proven.

Only a skilled and experienced veterinarian should carry out this exercise.  The use of antibiotics is also very effective, and since it is relatively simple, its use is recommended – under veterinary supervision and advice.  My preference for using the douche in the first instance is that since the bacteria numbers are small, we should not introduce the heavy artillery of antibiotics right at the onset, rather we should keep the antibiotic arsenal for more serious infections.  I never believe that antibiotics are the first line of defence.
Enough of this today.

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