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to a) make sure that in early pregnancy corpora lutea are present prior to starting treatment by assaying serum P4, and b) avoid using aglepristone as the only abortifacient drug in bitches who are pregnant beyond day 40. Treatment failures are occasionally observed, therefore it is always advisable to recheck treated females at least twice at weekly intervals following
the end of treatment. Treatments with aglepristone
can be started after day 40 provided that the issue is thoroughly discussed with the owner and a prostaglandin or antiprolactinic treatment is associated to help evacuating the uterus. There is no effect on subsequent fertility although the first post-treatment estrus may be delayed. AGL is effective to induce abortion in cats. The suggested protocol is the same although most authors use a higher dosage for cats, 15 mg/kg; however the
10 mg/kg dose seems equally effective at least during the first half of pregnancy5,6. The success rate is similar
to the bitch during the first half of pregnancy, while effectiveness may drop to 66% when causing late term abortion7. Hemorrhagic vulvar discharge following abortion has been reported to occur in pregnant queens treated with aglepristone: this is a consequence of damage to maternal uterine venules with endometrial and cervical extravasation and blood loss, a feature which has not been observed in bitches4.
Planning parturition or C-Section – When used near term, AGL will induce labor. Parturition should be induced as close to spontaneous parturition as possible, therefore ovulation should have been staged previously. Whelping has been successfully induced in bitches treated on day 58 and 59 day of gestation using AGL alone at the dose of 15 mg/kg or combined with oxytocin or prostaglandin F2alpha. Gestation length is shorter in treated vs control bitches (59 vs 62 days) 8. Fontbonne and coworkers9 used a combined AGL+oxytocin treatment: one injection of aglepristone at the dose of 15 mg/kg was administered on day 59-61, and then starting 24 hrs later oxytocin was administered at the dose of 0.15 IU/kg every 2 hr. Parturition began approximately
30 hours after the Aglepristone injection (from 9:00 to 12:00-18:00 of the following day) and resulted in the birth of puppies which were alive and viable at 1 month 9. Length of parturition, expulsion time and incidence
of neonatal mortality are comparable to what happens during normal parturition. However, 2 small size treated bitches delivered some of their pups before the first administration of oxytocin9; furthermore, 4 Yorkshire terrier pups (treated group) were born premature and died at 19-29 hr after birth9.
AGL can also be used in the planning of an elective caesarean section, particularly if surgery needs to be done prior to physiological termination of pregnancy because of fetal death, or in case of prolonged singleton pregnancy. Levy et al.10 administered one injection of 15 mg/kg AGL 59-60 days post-ovulation to 37 bitches of
15 breeds. C-section was performed 20-24 hours after treatment. There were no post-operative complications and no signs of prematurity in all pups. 5/188 pups died during the first 2 weeks of life (2.6%). Serum P4 remained > 2.0 ng/ml at time of surgery, which would justify the use of AGL as a high serum P4 concentration following a C-section would delay uterine involution10.
Open and closed-cervix pyometra - Pyometra is a uterine condition characterized by accumulation of pus within the uterus and very often fever, luekocytosis, depression11. It is potentially a life threatening disease which has been treated for a long time mostly through surgical removal of the reproductive tract12. Medical treatment used to be possible only for open cervix cases while closed cervix ones could only be treated with (sometimes elaborate and dangerous) surgery13, as the only way to open the cervix was using prostaglandins with the inevitable risk of causing uterine rupture14,15.
AGL has solved this problem as cervical opening
occurs without any appreciable uterine contraction within the first 48 hrs post-treatment16,17. AGL treatment
of pyometra requires often a longer protocol than what is used for pregnancy termination; the usual dosage
of 10 mg/kg aglepristone is administered on days 1, 2, and then at weekly intervals counting from day 1 for as long as necessary. Therefore, injections are typically given on days 1, 2, 8 and then also 15 and 28 or even longer depending on the clinical situation18,19. The use
of aglepristone should be associated with antibiotics
if necessary, and may also be associated with PGF/
PGE1 provided that cervical opening has occurred. Aglepristone is as effective for the treatment of pyometra also in the queen6,20.
Feline mammary hyperplasia - Benign mammary hyperplasia is a benign fibroglandular proliferation of one or more mammary glands which typically occurs in young queens at their first luteal phase. The proliferation of the mammary gland is due to an excessive response to the action of progesterone which is present in presumably normal concentrations in affected animals. Mammary glands will start swelling rapidly and within 2-3 days
all glands become very swollen, firm and nodular. If
left untreated, the problem may disappear on its own without any complication in most cases. Treatment with prostaglandins or antiprolactinic is not effective, while removal of ovaries or administration of aglepristone is often (but not in 100% of cases) curative. When mammary hyperplasia occurs following progestogen administration, signs typically do not subside immediately following neutering or withdrawal of progestin therapy21. In such cases, surgical removal of persisting nodules should be considered in order to perform histology and rule out presence of neoplasia. Feline mammary hyperplasia may
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