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Tierarztl Prax Ausg K Kleintiere Heimtiere 2010; 38(06): 389-396
DOI: 10.1055/s-0038-1622870
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Schattauer GmbH

Luteale Insuffizienz bei der Hündin – Symptome, Diagnose, Folgen und Therapie

Eine Übersicht der LiteraturLuteal insufficicency in the bitch – symptoms, diagnosis, consequences and therapyA review of the literature
A. Becher
1   Klinikum Veterinärmedizin, Klinik für Geburtshilfe, Gynäkologie und Andrologie der Groß- und Kleintiere mit Tierärztlicher Ambulanz, Justus-Liebig-Universität Gießen
,
A. Wehrend
1   Klinikum Veterinärmedizin, Klinik für Geburtshilfe, Gynäkologie und Andrologie der Groß- und Kleintiere mit Tierärztlicher Ambulanz, Justus-Liebig-Universität Gießen
,
S. Goericke-Pesch
1   Klinikum Veterinärmedizin, Klinik für Geburtshilfe, Gynäkologie und Andrologie der Groß- und Kleintiere mit Tierärztlicher Ambulanz, Justus-Liebig-Universität Gießen
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Publication History

Eingegangen: 24 June 2010

Akzeptiert nach Revision: 24 August 2010

Publication Date:
05 January 2018 (online)

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Zusammenfassung

Die unzureichende Synthese von Progesteron (Hypoluteoidismus, luteale Insuffizienz) ist eine Infertilitätsursache bei der Hündin. Ohne Beachtung der dynamischen Veränderungen der Progesteronkonzentration im Reproduktionszyklus kann die Diagnose Schwierigkeiten bereiten. Die Hündin ovuliert bei einer Serumkonzentration von 5–10 ng/ml (15,7–31,4 nmol/l). In den folgenden 3–4 Wochen steigen die Werte bis auf über 25 ng/ml (~78,5 nmol/l) an und fallen nach einer 7- bis 14-tägigen Plateauphase allmählich ab. Bei der graviden Hündin kommt es ca. 24–48 Stunden ante partum durch Prostaglandin F2α zum abrupten Ab-fall der Progesteronkonzentration auf unter 2 ng/ml (~6,3 nmol/l) . Die Lutealinsuffizienz, charakterisiert als vorzeitige Abnahme der Progesteronsekretion der Corpora lutea, tritt häufig zwischen Tag 20 und 35 der Gravidität auf. Als kritische Grenze zur Graviditätserhaltung gilt eine Progesteronkonzentration von ca. 2 ng/ml (~6,3 nmol/l). Eine niedrigere Konzentration führt zu Fruchtresorption bzw. Abort. Bei Hündinnen mit Verdacht auf Lutealinsuffizienz sollte, beginnend ca. 5–7 Tage nach dem Deckakt, spätestens bei der Frühträchtigkeitsuntersuchung, wöchentlich eine Progesteronmessung mittels quantitativer Testverfahren stattfinden. Bei Werten unter 10 ng/ml (~31,4 nmol/l) ist das Untersuchungsintervall zu erhöhen. Werden vor dem 58./60. Graviditätstag bei lebensfähigen Feten Werte unter 5 ng/ml (~15,7 nmol/l) gemessen oder ergibt sich zwischen dem 20. und 35. Tag bei sonographisch vitalen Feten ein rapider Abfall um 10–15 ng/ml (~31,4–47,1 nmol/l), ist eine Gestagensubstitution indiziert. Zur Verfügung stehen natürliche und synthetische Gestagene , wobei Letztere insbesondere bei Applikation zwischen dem 29. und 35. Tag ein höheres Nebenwirkungspotenzial wie Maskulinisierung weiblicher Feten und Kryptorchismus bei männlichen Feten bergen. Die Substitution von natürlichem Progesteron sollte 2–3 Tage vor dem errechneten Geburtstermin eingestellt werden, da sonst aufgrund des fehlenden Progesteronabfalls eine verlängerte Tragzeit mit Dystokie und Totgeburten die Folge sein kann.

Summary

Insufficient progesterone synthesis, so called hypoluteoidism or luteal insufficiency, is one of the possible reasons for infertility in the bitch. Confirming this diagnosis may be difficult if the dynamic changes of progesterone during the reproductive cycle are not taken into account. The bitch ovulates at progesterone concentrations of about 5–10 ng/ml (15.7–31.4 nmol/L). The concentrations increase to > 25 ng/mL (78.5 nmol/L) within 3–4 weeks and then subsequently decrease after a plateau of 7–14 days. In the pregnant bitch, progesterone rapidly drops to < 2 ng/ml (6.3 nmol/L) approximately 24–48 hours before parturition induced by PGF2α secretion. Luteal insufficiency, characterized as an early decrease of progesterone secretion, is most commonly observed between days 20 and 35 of pregnancy. Progesterone concentrations of approximately 2 ng/ml (6.3 nmol/L) are thought to be necessary for maintaining pregnancy. Lower concentrations result in resorption and abortion, respectively. In bitches suspected to have luteal insufficiency, weekly progesterone determinations using quantitative tests should be performed from 5–7 days after mating or at least from the date of early pregnancy diagnosis. The frequency has to be increased in the case of progesterone concentrations below 10 ng/ml (31.4 nmol/L). Progesterone administration is indicated in the case of viable foetuses and progesterone concentrations < 5 ng/ml (15.7 nmol/L) before day 58/60 of pregnancy or after the detection of a rapid progesterone decline of about 10–15 ng/ml (31.4–47.1 nmol/L) between days 20 and 35 with viable foetuses in the sonographic examination. Either natural or synthetic progestins can be used. However, synthetic progestins have a greater risk potential for side effects (masculinisation of female puppies and cryptorchidism in male puppies), especially when administered between days 20 and 35 of pregnancy. Administration of natural progesterone should be stopped 2–3 days before expected parturition otherwise it would result in a prolonged duration of pregnancy with dystocia and stillbirth.

Schlüsselwörter

Hund - Progesteron - Abort - Hypoluteoidismus

Key words

Dog - progesterone - abortion - hypoluteoidism
 

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