The Pharma Innovation Journal 2019; 8(3): 309-311

ISSN (E): 2277- 7695 ISSN (P): 2349-8242 NAAS Rating: 5.03 Comparative efficacy of , cloprostenol and TPI 2019; 8(3): 309-311 © 2019 TPI dinoprost along with vaginal application of misoprostol www.thepharmajournal.com Received: 13-01-2019 in whelping induction Accepted: 16-02-2019

Raheema S Raheema S, Jayakumar C, Kurien MO and Amritha A MVSc Student, Department of Animal Reproduction, Gynaecology and Obstetrics, Abstract College of Veterinary and Animal Small litter size is considered high risk pregnancy in dogs from a probable dystocia due to prolonged Sciences, Mannuthy, Kerala gestation, uterine inertia and foetal oversize contributing to high neonatal mortality. Studies on medical Veterinary and Animal Sciences induction of whelping are few and hence this study aims to investigate the efficiency and safety of University, Thrissur, Kerala, medical induction of whelping in full term canine high risk pregnancies using antagonist, India mifepristone; prostaglandin analogue, cloprostenol and natural prostaglandin, dinoprost tromethamine in

combination with anterior vaginal application of PGE1, misoprostol. A high number of puppies born alive Jayakumar C at birth, a decreased medical and surgical assistance for completing the whelping process and the Assistant Professor, Department advantage of oral suggests induction of whelping using mifepristone with anterior vaginal of Animal Reproduction, administration of misoprostol a better choice than cloprostenol and dinoprost tromethamine. Gynaecology and Obstetrics, College of Veterinary and Animal Sciences, Mannuthy, Kerala Keywords: High risk pregnancies, canine, mifepristone, cloprostenol, dinoprost, misoprostol Veterinary and Animal Sciences University, Thrissur, Kerala, Introduction India Low fecundity with three or fewer foetuses is usually a high-risk pregnancy in the dog. In pregnancies with small litter size, inadequate stimulus to initiate the parturition cascade result Kurien MO Professor and Head, Department in extended duration of pregnancy and possible dystocia from relative foetal oversize and [8, 9] of Animal Reproduction, primary uterine inertia . Therefore, induction of whelping becomes inevitable for a Gynaecology and Obstetrics, successful outcome.Consequently it becomes mandatory to make sure that the foetus has College of Veterinary and Animal accomplished but not exceeded its required gestational age before delivery [6]. Ideally, the Sciences, Mannuthy, Kerala treatment provided should induce parturition with a greater efficiency and within an expectant Veterinary and Animal Sciences time frame and must be safe for the dam and the neonates.Mifepristone, being a synthetic University, Thrissur, Kerala, India with high affinity towards progesterone receptors, could bind with those receptors and interfere endogenous progesterone from employing its biological effects and induces [5] Amritha A parturition . A decrease in luteal progesterone secretion occurs after exogenous PGF2α Assistant Professor, Department administrations, identical to the changes occurring prior to normal parturition [11]. of Animal Reproduction, Gynaecology and Obstetrics, Prostaglandin E1, misoprostol accelerated the cervical dilatation soon after using antiprogestin, [1] College of Veterinary and Animal aglepristone in bitches treated for termination of pregnancy . Vaginal misoprostol Sciences, Mannuthy, Kerala administration had a higher bioavailability and sustained serum level which is prerequisite for Veterinary and Animal Sciences regular uterine contractions. This advantage of intravaginal misoprostol administration over University, Thrissur, Kerala, oral administration of misoprostol was proved in human pregnancy termination [10]. The India present study hence aimed to determine the efficacy of three treatment protocols in medical

induction of whelping in canine high risk pregnancies with small litter size with respect to its success rate and safety for the dam and the neonates.

Materials and methods The study was carried out in eighteen dogs of different breeds presented to the University

Veterinary Hospital, Kokkalai and Mannuthy, Thrissur, KVASU with a history of not Correspondence exhibiting any impending signs of parturition. The animals were subjected to detailed clinico- Raheema S gynaecological examination and abdominal radiographic evaluation to record the pregnancy MVSc Student, Department of status with three or fewer foetuses. Trans-abdominal sonography was performed to assess the Animal Reproduction, foetal viability and gestational age of the foetus based on the foetal head diameter and foetal Gynaecology and Obstetrics, College of Veterinary and Animal organ development. Pregnant bitches with foetuses having foetal heart rate (FHR) of more than Sciences, Mannuthy, Kerala 200 beats per minute (bpm) and with a gestational age of at least 61±1 days determined by Veterinary and Animal Sciences sonographic measurements of foetal head diameter were selected for medical induction of University, Thrissur, Kerala, parturition. India ~ 309 ~ The Pharma Innovation Journal

Out of 18 bitches, 6were distributed into three treatment for initiation of whelping (24.5 h) was noticed in mifepristone groups of different therapeutic protocols for induction of and misoprostol combination group while the maximum time whelping. Dogs in Group I was treated with mifepristone @ for initiation of whelping (48 h) was noticed in the 5mg/kg body weight twice daily, orally for two consecutive cloprostenol and misoprostol combination group. The time days; Group II dogs were treated with a single subcutaneous interval (mean ± SE) from initiation of whelping to the administration of cloprostenol @ 2.5 μg/kg body weight and delivery of the entire litter in group I was 152.50±49.66 min, Group III dogs were treated with subcutaneous administration in group II it was 78.00±12.90 min and in group III, it was of dinoprost tromethamine @ 0.1mg/kg body weight. Twenty 102.00±21.06 min. The shortest duration of whelping four hours following the institution of treatment, misoprostol (78±12.90 min) was observed in group II and the reason @ 400μg was administrated in anterior vagina (Fig 1) of all attributable to the lowest litter size. A beneficial effect of the dogs in the three treatment groups. Glycopyrrolate @ 0.01 combination therapies in termination of pregnancies has been mg/kg bodyweight was subcutaneously administered 15 proved in human beings [2] and also in dogs [1]. Out of 18 minutes prior to prostaglandin administration. If the process bitches subjected to medical induction of whelping, 66.7 per of parturition was not initiated upto 72h after the cent bitches whelped normally, 27.7 per cent bitches required commencement of treatment, medical induction of parturition assistance in whelping and in 5.5 per cent bitches emergency was considered as a failure and was immediately subjected to caesarean section was performed. The assistance for delivery caesarean section. Suitable medical management was carried was provided in the form of manual traction and / or medical out on failure of foetal expulsion within two hours of management with 25% dextrose, 10% calcium gluconate and initiation of whelping or between expulsions of pups. Serum oxytocin. The reduced incidence of dystocia encountered in progesterone and concentrations were estimated by the treatment groups could be attributed to the reduced foetal ELISA technique before treatment and on initiation of size as well as combined uterotonic effects provided by the whelping.The data obtained during the study were subjected combination of different drugs used for the induction. No to statistical analysis using SPSS 24.0 version software. maternal side effects for any drug used in the treatment protocols were noticed in any of the groups. Results and Discussion A decrease in serum progesterone concentration was noticed Treatments with mifepristone, cloprostenol and dinoprost after treatment in all the dogs of treatment groups indicating tromethamine in association with misoprostol successfully the efficiency of the drugs in initiating the parturition. induced whelping with a great efficiency as substantiated by However, in mifepristone treated dogs the circulating the overall induction response of 100 percent within 72 hours progesterone at whelping was still higher (2.71±0.41 ng/ml) of treatment in group I, II and III.The mean (±SE) rectal when compared to group II and group III (0.60±0.14 ng/ml temperature of the dogs in group I, II, and III before treatment and 0.90±0.18 ng/ml respectively). An increased circulating were 101.78±0.22°F, 101.93±0.24°F and 101.88±0.20°F plasma progesterone concentration in the mifepristone treated respectively and after the treatment temperature decreased to group at the time of whelping has also been reported [4], who mean (±SE) of 99.55±0.20°F, 99.76±0.39°F and explained it on the basis of increasing binding of progesterone 99.68±0.24°F.This temporary drop of temperature before receptors by progesterone antagonists in place of natural whelping was in accordance with observation of Weyden et hormone and also due to hypothalamic effect of the agent on al. (1989) [12] who suggested that in dogs, progesterone has a GnRH neurons resulting in increased pituitary secretions of thermogenic effect within thermoregulatory centre. FSH and LH that stimulated corpora lutea cells to produce The mean gestational age on the day of treatment calculated more progesterone. An increasing trend of serum cortisol from the last day of breeding ranged between 60 to 63 days levels were noticed in all the dogs after the treatment. Similar with a mean (±SE) of 61.67±0.42 days in group I, 60 to 63 observations on the fluctuations of maternal cortisol days with a mean (±SE) of 61.17±0.54 days in group II and concentration within the normal range during the last week of 60 to 64 days with a mean (±SE) of 61.83± 0.60 days in group gestation (15-25 ng/ml) with elevated levels on the day before III. In sonographic foeto-biometry, assessment of foetal head parturition (40-80 ng/ml) was recorded [3]. diameter is the most accurate method to analyze the Number of puppies born alive in the three induced groups gestational age of the foetus in later stages of gestation by were 12 out of 13 (92.3%), 7 out of 10 (70%) and 9 out of 11 employing the formula (15 X head diameter) + 20 [6, 7]. The (81.8%) respectively. However the neonatal survival rate upto mean (±SE) gestation age determined by ultrasound two weeks of birth did not differ significantly between the measurements were 61.63±0.42 days with mean (±SE) BPD three groups. of 2.77±0.02 cm, 61.66±0.34 days with mean (±SE) BPD of 2.77±0.02cm and 62.28±0.39days with mean (±SE) BPD of Conclusion 2.81±0.02cm in group I, II and III respectively. This signifies The study revealed the merits of medical induction of that the treatment provided was without any impending signs whelping using combination of drugs in canine high risk of whelping even on sonographic GA determination of 61±1 pregnancy with small litter size as evident from a cent percent days. The disparity between the gestational age assessment induction response within a relatively short and predictable based on breeding dates and that by sonographic foetal period and also from the high puppy survival at birth. measurements highlights the need for dependence on However, a high number of puppies born alive at birth and a sonographic confirmation of foetal growth and viability, else decreased medical and surgical assistance for completing the would result in delivery of immature puppies. whelping process makes induction of parturition using The time taken for initiation of whelping in three treatment mifepristone with anterior vaginal administration of groups was comparable (35.58±3.54 h in group I, 36.00±2.79 misoprostol a better choice than cloprostenol and dinoprost h in group II and 36.58±1.22 h in group III). The earliest time tromethamine (Table 1).

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Table 1: Comparison of the efficacy of three treatment protocols in whelping induction

Parameters Group I (n=6) Group II (n=6) Group III (n=6) Mean GA assessed by ultrasound on start of treatment (days) 61.63±0.42 61.66±0.34 62.28±0.39 Mean GA assessed by last breeding date to start of treatment (days) 61.67±0.42 61.17±0.54 61.83±0.60 Mean gestational length from ultrasound measurement to date of 63.04±0.76 63.23±0.33 63.84±0.50 whelping (61 to 64 days) (61 to 63 days) (62 to 64 days) Mean gestational length from last date of breeding to date of 63.14±0.76 62.66±0.52 63.35±0.63 whelping (61 to 64 days) (61 to 64 days) (61 to 64 days) Time of delivery of first pup from start of treatment 35.58±3.54 h 36.00±2.79h 36.58±1.22 h Vaginal Vaginal delivery (n=5) Vaginal delivery (n=5) Nature of whelping delivery (n=6) Caesarean section (n=1) Caesarean section (n=1) 12 out of 13 7 out of 10 9 out of 11 Number of puppies born alive (92%) (70%) (81.8%)

Fig 1: Anterior vaginal administration of misoprostol

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