ISSN 2398-2985      

Pregnancy toxemia

6guinea pig

Synonym(s): Pregnancy ketosis, Metabolic toxemia


Introduction

  • Cause: metabolism imbalance ocurring in late pregnancy or shortly after parturition.
  • Signs: lethargy, anorexia, dehydration followed by collapse, convulsions, death.
  • Diagnosis: compatible clinical signs in late pregnancy or shortly after parturition. Urinalysis shows ketonuria, proteinuria, aciduria.
  • Treatment: agressive supportive care: fluids (warmed dextrose/saline), oral feeding, vitamin C. Caesarean section.
  • Prognosis: guarded to poor depending on how early the disease is treated, whether hepatic lipidosis has progressed, and if the sow is obese.
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Pathogenesis

Etiology

  • Several factors can predispose or lead to pregnancy toxemia.
  • One main factor is compression of arteries irrigating the uterus, producing uterine ischemia and metabolic changes in fetuses and dam. This leads to hypertension and the need of emergency caesarean section Caesarean section.
  • The other main factor is that gastric compression during pregnancy produces anorexia, and the high metabolic needs of the dam and fetuses cannot be met. This leads to fatty liver (hepatic lipidosis Hepatic lipidosis), particularly in obese animals, and other metabolic changes.
  • The metabolic imbalances then produce ketoacidosis and pregnancy toxemia.
  • In sows, it has been proposed that this syndrome may include:
    • Vitamin K deficiency due to poor quality feed.
    • Hepatic dysfunction secondary to pressure from gravid uterus.
    • Calcium deficiency affecting the clotting cascade resulting in disseminated intravascular coagulation.
  • Anorexia Anorexia contributes to the negative energy balance, and contributes to the development of hepatic lipidosis Hepatic lipidosis and ketoacidosis.

Predisposing factors

General

  • Obesity.
  • Pregnancy, particularly with large litters that require large nutritional demands as well as compression of abdominal viscera leading to anorexia that in turn leads to development of hepatic lipidosis and ketoacidosis.
  • Proposed: poor diet lacking in vitamin K, calcium.
  • Hereditary predisposition has also been reported.

Specific

  • Lack of exercise.
  • Change in diet and/or environment.
  • Heat stress Heat stress.
  • Primiparity.
  • Chronic lack of vitamin C Vitamin C deficiency is associated with fatty liver disease.

Pathophysiology

  • Gravid uterus may compress either the uterine vascular supply or the supply to the kidneys, GI tract which leads to tissue ischemia and hypertension.
  • Negative energy balance of the sow due to the demands of a large number of fetuses.

Timecourse

  • In sows, 2 weeks prior to parturition to 2 weeks after parturition generally; most cases occur 7-10 days prior to parturition to 7-10 days after partruition.
  • In fatal cases, clinical signs last for 24-72 h before death.

Diagnosis

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Treatment

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Prevention

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Golden J G, Hughes H C & Land C M (1980) Experimental toxemia in the pregnant guinea pig (Cavia porcellus). Lab Anim Sci 30 (2), 174-179 PubMed.
  • Seidel D C, Hughes H C, Bertolt R et al (1979) True pregnancy toxemia (preeclampsia) in the guinea pig (Cavia porcellus). Lab Anim Sci 29 (4), 472-478 PubMed.
  • Gangway J R & Allen A M (1971) Obesity predisposes to pregnancy toxemia (ketosis) in guinea pigs. Lab Anim Sci 21 (1), 40-44 PubMed.
  • Foley E J (1942) Toxemia of pregnancy in the guinea pig. J Exp Med 75 (5), 539-547 PubMed.

Other sources of information

  • Hawkins M G & Bishop C R (2012) Disease Problems of Guinea Pigs. In: Ferrets, Rabbits, and Rodents Clinical Medicine and Surgery. 3rd edn. Eds: Quesenberry K E & Carpenter J W. Elsevier. pp 295-310.
  • Harkness J E, Turner P V, Vandewoude S & Wheler C L (2010) Harkness and Wagner’s Biology and Medicine of Rabbits and Rodents. 5th edn. Wiley-Blackwell. pp 366-367.
  • Johnson-Delaney C (2010) Guinea Pigs, Chinchillas, Degus and Duprasi. In: BSAVA Manual of Exotic Pets. 5th edn. Eds: Meredith A & Johnson-Delaney C. British Small Animal Veterinary Association. pp 28-62.

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