Episode 133: Pseudopregnancy

Dr. Cristina Gobello, a reproductive veterinarian and researcher of pseudocyesis joins us today to talk about pseudopregnancy. Learn more about this perplexing condition that leads dogs to behave as if they are pregnant! Read more about Dr. Gobello's research here.

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Transcript

Mikel Delgado [0:28] Hello, everybody, and welcome to this week’s episode of the Good Dog Pod! I am Dr. Mikel Delgado, your host this week. Today we’re here with Dr. Cristina Gobello. Dr. Gobello is an MV, which is a Medical Veterinario. She is a DRVM, which is an equivalent to a PhD, and she is a board-certified European diplomat in animal reproduction and a member of the American Society of Theriogenology. Dr. Gobello is a professor at the Faculty of Veterinary Sciences in Buenos Aires, Argentina. She has published several scientific papers about several fascinating topics related to canine and feline reproduction, including research about mammary gland tumors, treatment of pyometra, and the estrous cycle. We invited her here today because she has extensive expertise on canine pseudocyesis, more commonly known as false pregnancy or pseudo pregnancy. This is a topic we see a lot of questions about on our social media and in emails, so we’re really excited to discuss this topic with Dr. Gobello today. Dr. Gobello, welcome to the Good Dog Pod.

Dr. Cristina Gobello [1:41] Well, good morning here in Argentina!

MD [1:45] Thank you so much for joining us. Let’s start by just defining false pregnancy or pseudocyesis. Can you tell us what it is?

CG [1:54] Yeah. Pseudocyesis is a rather frequent syndrome observed in non-pregnant, intact bitches after estrous. It is categorized by different degrees of maternal behavior, mammary gland enlargement, and lactation. As you have said, it is also called pseudopregnancy or false lactation. Pseudopregnancy, for we vets, is a misleading term because it is used in different species, including the human species, with different senses. So it usually, for students, makes a mess to figure out what pseudopregnancy is in each species. I am prone to use PSE. It’s also a rather modern term, I think because of all that I’ve been explaining. Basically, history in this species reveals that there was a hint, an estrous, 6-12 weeks ago. Of course, there was no ensuing pregnancy. Post-estrous bitches usually suffer this syndrome after each estrous cycle, even becoming worse after the cycle.

MD [3:22] Okay, so it’s clearly after the estrous cycle, and it looks like pregnancy? 

CG [3:28] Yes, in a way. The good news is that in most of the cases, pseudocyesis resolves spontaneously within a few weeks after, 2-3 weeks from the onset of the previous cycle. However, it can occasionally persist in some prone bitches, even until the next estrous cycle, which is really too much.

MD [3:58] Yeah, that’s a long time. Can you tell me a little bit about why you chose to study this topic? Was it in response to what you were seeing in your hospital? I didn’t know that other species also experienced it, so perhaps it didn’t even start with dogs.

CG [4:13] In fact, it was the topic of my PhD thesis. It is very interesting from our point of view, because it involves behavioral and endocrine components. In South America, Spain, it’s not so frequent, at least as it used to be in the States. Now the paradigm of Spain has been changing all over the world, even in the States and all the other countries—it’s not so frequent as it used to be in Spain. It has been known that to live without ovaries, it’s not so healthy as we used to say. This was the situation in South America. Not because we knew it was not healthy. Because Spain was not so frequent because of other local problems. But the fact was that we saw many, many cases of PSE. It was a good place to study this syndrome. 

MD [5:21] You kind of hinted at some of this when we talked about what pseudocyesis is, but what are some of the signs that a dog owner or breeder can be looking for for pseudopregnancy? 

CG [5:30] Females could present a covert syndrome, which usually does not require any treatment. Some owners don’t recognize it. But other females show overt signs. Those overt signs can be so severe that they could become a clinical problem. We are talking about a clinical PSE. The chief complaint in these females are, of course, mammary problems, which are engorgement, lactation, licking of the glands by the own female, maternal behavior such as nesting, digging, adoption of animals or any other object in the place. Sometimes the bitch may even have depression, anxiety, or anorexia. Sometimes the only sign that the owners perceive is excessive whining. It’s crazy that you don’t know what happens with the female. You have to be very attentive to any post-estrous bitch. The owners and the vet. 

MD [6:49] Why would this occur? From an evolutionary perspective or a medical perspective, why would dogs go through this false pregnancy when they’re not pregnant?

CG [7:01] This is very, very interesting. Allomaternal care of puppies in a pack is quite frequent. Allopaternal means that subordinate females in a pack (those females that don’t have their own puppies) have to lactate the puppies of the dominant females that are the ones that whelp puppies and are the ones that are maybe hunting at the time. What was once a logical, useful thing has become now bothersome/tiresome for a bitch living in a flat or a house.

MD [7:49] That’s so interesting. So the roots of it are really in shared caring for offspring. Even though dogs in a home may not be living with other dogs and caring for their offspring, that behavior still retains. 

CG [8:00] Yeah, there is a hierarchy within a pack. Not all the females were 

MD [8:08] So you mentioned there are some hormonal changes that are happening when a dog exhibits false pregnancy. Can you maybe make it simple so that those of us who are not veterinarians can understand: what hormonal changes are happening during this presentation?

CG [8:24] It’s not casual. It’s at certain times of the estrous cycle, as I have said. In fact, after estrous, there’s usually an increase of the hormone, called prolactin, that is the main cause of all these changes. Also, at that point, there is the decrease of progesterone and other hormones. It seems to be that this combination of increase in prolactin and decreasing progesterone triggers all the signs, with different severity, in some bitches. It’s very interesting that in the past, veterinarians were using the treatment of PSE and now it is known that they have to be avoided because they only postpone the problem. When you inject progestin, it seems that the bitch is better, but as far as progesterone begins to decrease, it simulates this scenario and the signs appear again. It has to be avoided, at least in prone bitches.

MD [9:40] Okay, that’s good to know. 

[Good Dog Mailbag Break]

MD [14:04] One thing that we hear is that people suspect their dog has pseudocyesis, but they can’t get a diagnosis from a veterinarian, so they’re not sure what’s going on. How can people find out? What are veterinarians looking for, or what would they rule out to determine, “Yes, your dog is experiencing this condition”?

CG [14:28] One important aspect is that the vet and the owner have to recognize this, which is to a certain degree, physiological. But it’s important to know. The diagnosis of this syndrome could be suspected in any post-estrous that is after heat, non-pregnant bitch that is presented with mammary enlargement, either with a milksac region or not and any kind of abnormal behavior. Not only maternal behavior, but any kind of abnormal behavior. The bitch is doing weird things. Which is very important! Because pregnancy should be ruled out in all the cases. It could be dangerous, as many treatments used nowadays, could cause abortion.

MD [15:24] So the first thing is to make sure the dog is not actually pregnant. 

CG [15:28] Sometimes the owner doesn’t know there was a mating. So don’t believe only what the owner says. Also, rule out pregnancy before treating an apparent pseudopregnancy. If you look carefully, as I have said, you will see some degree of mammary enlargement, which could be very, very mild. For example, in some bitches, only the nipples are . Some other bitches have a painful engorgement and lactasis, which means that the milk is produced in great quantity and it is retained in the mammary glands, and it is very high discomfort for the female. Important that the mammaries that are more evident with this change. So look at the pectoral region. Look at the pectoral region. Sometimes even skin over the mammary glands could be dermatitis, maybe because the bitch licks their own milk/mammary glands. One final important thing is that this syndrome could coexist with other problems, like pyometra, mastitis, or mammary tumors. To diagnose one of these (any of the four I have mentioned) does not rule out that the others aren’t co-existing at the same time. So be careful—the vet and the owner. Diagnose or rule out any one of these, because they usually appear at the same time after heat, so it can be confused, and it’s frequent to say, “Ah, I have diagnosed one of them. The others are not.” No, no, no. You have to diagnose or rule out any one of these four at least.

MD [17:47] Very good to know. It sounds like the signs of pseudocyesis will just wax and wane. Does it need treatment, or can people just let their dog ride it out and wait? 

CG [18:04] In other cases, the mild ones, it may not be necessary. What is important in all the cases is to discourage maternal behavior. Sometimes people do just the opposite. They give toys. No, no, no. You have to discourage that behavior. It may be useful, for example, walking the dog and trying to distract her. Avoid any kind of stimulation of the mammary glands, either by the dog or by the owner. They were all treatments that indicated padding, either hot or cold, on the mammary gland, which is severely contradictory because any kind of stimulation will be worse because it will perpetuate the problem—let alone touching or milking! If you milk, it will never stop. It’s that simple. Sometimes, for example, bitches will need collars to prevent self-milking or licking. Another important aspect is to avoid the administration of any tranquilizer. Some tranquilizers increase prolactin. The owner will have to be very careful and ask the vet what kind of tranquilizer they can use if the bitch is anxious because you can also be worsening the thing. In chronic, unresponsive cases, the only treatment is spaying the bitch. As I have said, it comes after each cycle again. You can’t control it anymore. The only solution is to take out the ovaries and not to have cycles anymore. It’s very important that the surgery should be carried out when the problem is solved, not in the middle of the problem. You have to solve it, perhaps medically. And then you spay the bitch. The first time of the cycle is in estrus, which is more or less 3 months after the last heat. Not before. Because you can make things worse if you are too close to the heat. Again, the good news is that we have rather new drugs that can manage the problem very well. Those drugs are dopamine in some countries. There are some problems with veterinary presentation. But in all the countries, they are present in at least in human medicine. The problem could be that human medicine sometimes is difficult to split for a small dog and to be very careful because they are very safe drugs, but if you overdose trying to split a pill and you give a small bitch a big dose, it could cause vomiting and a lot of problems. Sometimes, you say, “No, no, no. This treatment doesn’t work.” No. It works, if used correctly. You have to administer the correct dose, preferably with the biggest meal of the day with the female so there will probably be no problems.

MD [21:39] It sounds like there are treatment options. Maybe compounding the medication into the right dose.

CG [21:44] Yes. It's a short treatment if you use it correctly. In 5-7 days, the treatment is going on working after stopping it. You can do it for 5 days, and it will for sure resolve the problem in a week, for example. It works very well, fortunately.

MD [22:08] Does the dog being pregnant cure a tendency towards pseudocyesis in the future, or no?

CG [22:14] No! Just the opposite. A dog can’t be pseudopregnant and pregnant at the same time. It has to be one of them. It’s pregnant or pseudopregnant. Pregnancy has to be ruled out very carefully at the time of the consult. Of course, if you spay the dog, the dog will not have cycles anymore, and you will not have pseudopregnancies anymore. 

MD [22:49] Right, but if the dog has been pregnant, and you don’t spay them, will they still be susceptible to this in the future heat cycles?

CG [22:55] Yes. That’s a very good question, because there is a tendency to anthropomorphize. There’s always a feeling in the owner, “Poor bitch. I want her to have a litter before spaying,” as if the bitch will remember in the future that she has already had a litter. It’s a dilemma that also appears at the time of spaying. The fact is that she will not remember. The important thing is how many cycles the bitch has had before spaying. That’s the only thing for the future health of the female. But anyway, coming back to our topic, repeated pregnancy will not prevent future episodes. Of course, if you mate the bitch in heat, she will be pregnant, she will whelp. But if she’s prone, she will come back to her problem the next cycle. 

MD [23:58] Is this condition more common in some breeds of dogs than others, or can it happen to any dog breed?

CG [24:04] Yes, it has been observed in all the countries all over the world that there are some breeds that are more prone. What I can say is, of course, in my area—you have to be careful in the national publication because all the others will say the same; we will say our frequency according to the most popular breeds in our geographic area. I can see in the nation, it’s quite frequent in Basset Hounds and Pointers. Keep in mind that it can vary in your country. What is really important are the breeds that don’t seem to be prone to this. For example, I never saw a pseudopregnant German Shepherd. Never. Beagles are also quite infrequent. Beagles are very calm, because they’re dogs used in many investigations. If it would be frequent, we’d know everywhere all over the world, because we have all worked at some time with Beagles. In fact, they are not prone at all. There were some studies in Beagles, and one of the drawbacks of those studies is they don’t use the Beagle to describe pseudopregnancy because they are not prone to it, so it’s not a good model to study this syndrome. 

MD [25:37] Good to know. Beagles don’t seem to be prone. 

CG [25:42] Each breed has its own hormone pattern. Even within each, there are their own hormone patterns. This is quite related to that.

MD [25:55] Very interesting. Well, Dr. Gobello, thank you so much for answering all of my questions about false pregnancy. I like to ask just a fun question to end our interview, so I wanted to ask you if you could be any breed of dog, which would you choose?

CG [26:08] Well, I will give a vet response. I would select to be a Pointer, in spite of the pseudopregnancy problems, because they are quite healthy in general. So I would select to be a Pointer.

MD [26:25] That’s a good choice. Where can people learn more about your work?

CG [26:30] There are many publications online. Maybe they are not adequate for a lay audience, but for example, there is a website—I don’t know if you know them. IVIS: International Veterinarian Information Service of the University of Cornell, which is open access. It’s free. You use it. It is mainly for vets. There are some topics, for example, the chapter on pseudopregnancy, that I think would be easily read by any person without problems to understand. Just in case, the web page of the IVIS: www.ivis.org. 

MD [27:30] Great. We’ll also put that in the notes for this episode, so people can access it. Well, Dr. Gobello, thank you so much for sharing your expertise on this topic. I knew you were the perfect person to talk to about this, so I really appreciate you agreeing to be on the Good Dog Pod. Thank you so much.

CG [27:44] Thanks to you! It was a pleasure for me.