RETAINED PLACENTA

The third stage of labour involves the passage of the placentas. The mother dog may eat the placentas and chew the umbilical cords free from the puppies. The ingested placental tissue provides extra nutrients to give the mother energy through the first few days of nursing. Most breeders, however, choose to remove the placentas and discard them.

If you don't discard them, count the placentas as they are being expelled to make sure that there is one placenta for every puppy. Retained placentas can lead to uterine infections and toxicity. If you suspect a retained placenta, contact your veterinarian.

What is retained placenta? 

The placenta is the organ that unites the developing foetus to the mother during pregnancy. The placenta normally is passed within 15 minutes of birth. Retained placenta occurs when the placenta is not expelled within 15 minutes. This condition is uncommon in dogs and rare in cats. 

What causes retained placenta? 

Retained placenta may be caused by large litter size or by abnormal labour or birth. It happens most commonly in toy breed dogs. 

What are the signs of retained placenta? 

The number of placenta must equal the number of puppies or kittens in the litter. Unfortunately, the pet guardian may not see the birth or it may be easy to lose count, especially with large litters. Normally after the birth of puppies or kittens, the mother dog (bitch) or cat (queen) will have some vaginal discharge (lochia). The discharge may be greenish or blackish immediately after the birth, but then should become reddish or brownish. The discharge normally decreases and should not have an odour. In the case of retained placenta, the discharge will continue, and the discharge frequently will be dark and will smell bad. The amount of the discharge does not decrease and it may increase. The mother dog or cat may act sick, although, cats may have a retained placenta for days without acting sick. If the pet guardian has any questions about the vaginal discharge or the potential for a retained placenta, the pet should be taken to a veterinarian. 



How is retained placenta diagnosed? 

Retained placenta is diagnosed by physical examination and by examination of the cells of the vagina. The veterinarian will want to check for infection of the uterus and for any retained foetuses. Pets with uncomplicated retained placenta will not have signs of infection. Radiographs (X-rays) and/or ultrasound (visualizing deep body structures by recording ultrasonic waves) may be needed for a definitive diagnosis. Surgical examination of the uterus may be required for diagnosis in some patients. 

How is retained placenta treated? 

Treatment of healthy animals is minimal. Medication can be given to increase the contractions of the uterus to facilitate expulsion of the placenta. At home, the pet guardian will need to observe the pet for signs of infection. Surgical removal of retained placenta is indicated if medical treatment is unsuccessful or if the animal develops infection of the uterus. Surgical removal of the ovaries and uterus (ovariohysterectomy, spay) should be considered if future breeding is not a consideration. 

What is the prognosis for animals with a retained placenta? 

The prognosis (outcome) for animals with a retained placenta varies, depending on the length of time that the placenta has been retained and the speed with which veterinary care is sought. Acute infection of the uterus can develop if the placenta is not passed. If infection does not develop, the prognosis for future successful pregnancies is good. If infection does occur, the animal's ability to become pregnant again is fair to poor. With treatment, there is a fair to good chance of recovery. 

RETAINED PLACENTA

History 

  • Retained placenta is often associated with prolonged whelping or dystocia, and is more often seen in Toy breeds.

Clinical signs

  • The persistence of greenish-black discharge for longer than 24-26 hours after parturition. 

  • Normally the discharge should be rust coloured 48 hours postpartum.

Diagnosis 

  • A diagnosis that a placenta is actually retained may be difficult, because great reliance is placed on the owner counting the placentas as they are passed. Since placentas are not necessarily passed with each pup and the bitch commonly eats the placentas, it is easy for the owner to miscount. Palpation is not reliable to diagnose a retained placenta.

  • Ultrasound may be used, but it too is very subjective in determining if a placenta is retained. 

  • Exploratory celiotomy may be used to definitively diagnose retained placenta. 

Therapy 

  • Calcium gluconate (10%) 3-10 ml IV slowly. Followed by oxytocin, 5-25 IU, IM 

  • Oxytocin (5-25 IU IM) may be given routinely to all bitches once delivery has been completed. This has been suggested to aid in the expulsion of remaining placentas, and even retained foetuses! 

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