Whelping management in a bitch with vaginal beta-haemolytic streptococci

Clinical case. The clinical case concerns a 24 months old, second parity German Shepherd bitch with a history of neonatal mortality at the first parturition at the age of 18 months. The owner reported a sharp increase in uninvestigated neonatal mortality involving all the kennel during the last two years. The dogs in this kennel are regularly vaccinated against HCV according to the manufacturer’s protocol. Despite the vaccination program, the neonatal loss continued and the considered bitch lost all the 6 puppies of the first litter during the first 3 days after whelping. The bitch was conducted to the clinical examination seven days after the beginning of vaginal proestrous bleeding. At the clinical examination the bitch appeared in good nutrition, healthy and with no signs of illness. The mammary glands and the external genitalia were normal. The trans-abdominal palpation of the uterus and the ultrasound examination of the genital system revealed the typical findings of the estrous phase of the cycle. Cranial vaginal bacteriology was investigated by swabbing and, in the purpose of estrous monitoring, a blood sample was collected for an initial plasma progesterone measurement and a vaginal smear collected for cytology. The vaginal cytology confirmed the estrous phase with >80% keratinization index and plasma progesterone (P4) concentration was 40 ng/ml. According to the owner’s request, the bitch was immediately submitted to a single natural mating with a male of proven fertility. The bacteriological exam revealed a mild presence of Streptococcus faecalis, not treated. Thirty days after the single mating, pregnancy and viable embryos were detected by ultrasound and the day of parturition predicted (1). Another vaginal swab confirmed a mild presence of Streptococcus faecalis. No treatment was planned. About a week before the expected day of whelping, a clinical exam of the bitch was scheduled with the main purpose of a further vaginal swab. This time a high number of -haemolytic streptococci developed and, according to the antibiotic sensitivity test, the bitch was immediately submitted to treatment with enrofloxacin (5mg/kg/24 hours) and a Caesarean section (CS) planned on the base of the predicted day of parturition, but performed only when P4 was <2 ng/ml and body temperature <38°C. Three hours before the beginning of CS, an additional injection of enrofloxacin was performed in the bitch. Six healthy, mature and viable puppies were born by CS and injected with 5 mg/kg/24 hours enrofloxacin within 60 min after birth. The puppies were allowed to nurse by the bitch, but protected from the possible contamination with maternal vaginal fluids by the use of pants for dogs. Both the bitch and the puppies were treated with enrofloxacin for 7 days after parturition. Contamination from vaginal fluids was avoided by the usage of dog pants for 4 weeks following birth, until the puppies started the nutritional weaning and the vaginal swab was negative for -haemolytic streptococci. Discussion. Group B Streptococcus (GBS) is recognized as a cause of early neonatal mor¬bidity and mortality in humans and maternal colonization with GBS in the genito-urinary system considered as the primary risk factor for newborns that can be contaminated during passage through the birth canal. Prevention is of paramount importance and the most effective tool for prevention is maternal intravenous administration of antibiotics during labour. Some studies evidenced that CS performed before the onset of labor with intact amniotic membranes, strongly reduces the risk for early-onset GBS disease in newborns. Haemolytic GBS are recognized as a major cause of neonatal mortality also in dogs (2), with no effective possible treatment for newborns. Prevention represents the only possibility for survival of the puppies and assisted parturition is mandatory for bitches with vaginal GBS. Prepartum and intrapartum antibiotic administration, aimed to reduce bacterial numbers, could also be helpful for treatment of possible prepartum fetal, or after birth newborn, contamination.