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PAPERS & ARTICLES

Intrauterine device for contraception

in dogs
P. VOLPE, B. Izzo, M. Russo, L. IANNETTI

A new intrauterine device for contraception was tested on nine bitches. After it had been implanted, the
bitches were mated but none of them became pregnant. Over a two-year period no side effects were
observed, except in a bulldog bitch in which signs of oestrus persisted until the device had been removed.

THE mismating of a bitch is a common problem for dog at random but to provide subjects ranging in weight from 3
owners. Ovariohysterectomy is the most obvious solution to to 70 kg. They were all able to mate and maintain a pregnancy
avoiding unwanted pregnancies, although it is often rejected (they had all had litters after natural mating), and ranged in
by owners. Alternatively, there are drugs which prevent the age from three to six years.
implantation of the embryo, or induce abortion, or suppress The stage of the oestrous cycle was monitored by taking
normal ovarian cyclicity. vaginal smears and measuring plasma progesterone concen-
Oestrogens prevent implantation by inhibiting the trans- tration. The vaginal smears were prepared from the beginning
port of oocytes in the uterine tubes and by a direct embryotoxic of proestrus until oestrus, and progesterone was assayed at the
action (Concannon and Meyers-Wallen 1991), but they can beginning and at the end of the oestrous cycle. The animals
also have two serious side effects: the increased likelihood of were selected when they were in proestrus or oestrus, so that
pyometra subsequent to cystic endometrial hyperplasia and the implantation of the IUD would be fairly straightforward.
bone marrow suppression (Olson and Johnston 1993). The dalmatian, great dane and beagle were in proestrus, and
Moreover, they are often far from 100 per cent effective, espe- the others were in oestrus. Only the bulldog had undergone
cially when they are administered at inadequate dosage (Bowen a hysterotomy two years previously by caesarean section,
and others 1985). Recently, an injectable preparation of a low because it had 13 puppies.
dose of oestradiol benzoate has become commercially available
for veterinary use. This drug minimises side effects, but it The intrauterine device
requires two or three injections after mating to be effective. The IUD was made of plastic material formed into a 'Y'-shaped
Prostaglandin F2a induces luteolysis, reduces serum prog- body which could fit in the uterus (Fig 1 a). The body was cov-
esterone concentration and induces abortion, but it cannot ered with electrolytic copper and had two flexible arms. Each
be used before the 30th day of pregnancy. Moreover, its effi- arm had a block appendix attached at its end, to prevent the
cacy depends on it being injected more than once a day, device from moving. Two nylon threads were attached to the
because of its short half-life, and it can have unpleasant side- body's lower extremity, so that it could be removed if needed.
effects, particularly at high dosage, including emesis, diar- The device's contraceptive activity is due both to its mechan-
rhoea, hypothermia, salivation, lethargy and tachypnoea. ical disruptive effects and to the spermaticidal activity of the
Cabergoline can induce abortion owing to its strong metallic ions released by the electrolytic copper (Nagle and
antiprolactin activity, without obvious side effects (Post Turin 1997). The IUD is sterilised with ethylene oxide and sup-
1995). However, neither cabergoline nor prostaglandin F2a plied in a sealed plastic bag, it is available in two sizes: 'L' for
are licensed in the UK for inducing abortion in dogs. multiparous bitches weighing over 12 kg and 'S' for nulli-
Other contraceptives include various steroid hormones parous bitches or those weighing under 12 kg. The package
which prevent the synthesis and release of gonadotrophins also contains a cervicoscope and a cervical distender (Fig lb,
through feedback inhibition, resulting in the suppression of c). The small device weighs 0 8 g and the large device weighs
the oestrous cycle. Unfortunately, they also have side effects. 11 g.
They include medroxyprogesterone acetate and megoestrol
acetate; proligestone has been developed more recently and is Implantation technique
thought to be less likely to cause side effects than the otherAfter a gynaecological examination, each animal was anaes-
progestagens (Evans and Sutton 1989). thetised and positioned in dorsal or ventral recumbency with
In the past. mechanical contraceptives have been devel- the genital plane on the edge of the table; the perineal region
oped in the form of blocks to copulation in bitches, but theywas then prepared aseptically and draped. The cervicoscope
have always had a high failure rate (Concannon and Meyers- (Fig lb) was inserted with the plastic tube used for a pen lamp
Veterinary Record (2001) Wallen 1991). Intrauterine devices (IUD) have been used suc- turned towards the floor; a pen lamp did not provide enough
149, 77-79 cessfully in humans, even for long periods, and have proved light to view the cervix and a fibreoptic lamp with a flexible
to be a safe and effective method of contraception (Lete and arm was used instead.
P. Volpe, PhD, DVM, others 1998, Bonacho and others 1999). Devices of this sort The IUD bag was then opened on the side of the nylon
B. Izzo, DVM, MRCVS, have always been considered impractical in bitches because ofthreads, because the threads had to be pulled to make the two
M. Russo, DVM, PhD, the difficulty of introducing them (Concannon and Meyers- arms of the 'Y' enter the applicator tube (Fig 2a, b). The two
MRCVS, Wallen 1991). Recently a new IUD (BIOTUMER Argentina SA)for rubber rings on the applicator tube (Fig lc), which made it
L. Iannetti, DVM, bitches has been marketed, and this paper describes tests of easier to introduce into the cervix, were set 1 cm apart for
Department of Clinical its efficacy in bitches of different breeds and ages. small bitches, and 2 cm apart for large bitches. Having
Sciences, Section of enlarged the cervix with the cervical distender, the applica-
Clinical Obstetrics, tor tube with the IUD inside was introduced through the cer-
Faculty of Veterinary MATERIALS AND METHODS vicoscope. It was fairly easy to insert because in the applicator
Medicine, University of tube there was a syringe-like piston (Fig lc) which was pushed
Naples'Federico II', Animals (Fig 2c), so that each arm of the 'Y' fitted into the corre-
F. Delpino 1, 80137 - Nine bitches of different breeds, sizes and ages were studied sponding horn of the uterus (Fig 2d). The copper-covered
Naples, Italy over a period of two years (Table 1). They were not chosen body of the device was then placed in the body of the uterus.

The Veterinary Record, July 21, 2001 77

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PAPERS & ARTICLES

FIG 1: (a) Intrauterine

device. (b) Cervico-
scopes (sizes 'L' and 'S)
and the pen lamp.
(c) Applicator tube and
the cervical distender.
(d) X-ray examination;
the IUD'S copper-
covered body is
indicated by an arrow

When the applicator tube was pulled out (Fig 2e) two nylon RESULTS
threads protruded from the lips of the vulva and had to be cut
5 cm inside the vagina (Fig 2f). The introduction of an IUD The bitches which had been fitted with the IUD were exam-
took from 10 to 20 minutes. ined clinically and by ultrasound on the 15th, 20th, 25th and
30th day after mating, and none of them was pregnant.
Tesng the conbtaceptive efetveness of the IUD During the two years (three oestrous cycles) during which the
The position of the IUD was checked by x-ray examination IUDs remained in the bitches none of them showed any signs
(Fig ld), and the bitches were examined clinically and by of pain in relation to their presence and there were no signs
ultrasound, and a vaginal smear was taken every 30 days to of any pathological process. However, in the bulldog the signs
monitor the state of the reproductive tract. of oestrus persisted. Examinations by x-ray and ultrasound
After implantation the IUDS were left in the bitches for two showed that the IUD was in the correct position, and vaginal
years and they were removed after the onset of the third smears and progesterone and oestrogen assays indicated that
oestrous cycle. The manufacturer recommends leaving the the bitch was in oestrus. On the 15th day after implantation
IUD for at most two years because this is the effective life of the concentration of progesterone was 4-6 ng/ml and of
the electrolytic copper. oestradiol-17. 35 pg/ml; on the 17th day the concentration
At the first oestrus after the device had been introduced of progesterone was 4*5 ng/ml and oestradiol-17J 30 pg/ml.
each bitch was mated to one or more male dogs four times on On the 20th day proligestone was administered, but the signs
alternate days, in the presence of a veterinary surgeon. The of oestrus persisted. On the 24th day after implantation the
chosen dogs had already proved fertile in other matings, and IUD was removed and 24 hours later the bitch stopped show-
sperm had been collected and examined 15 days before the ing signs of oestrus.
mating.
DISCUSSION
The IUD proved to be a safe and effective method of contra-
ception, none of the bitches showed any signs of pain or any
pathological process, and none became pregnant.
The persistence of oestrus in the bulldog was associated
with a slightly high serum progesterone concentration on the
15th day after implantation (4-6 ng/ml) suggestive of immi-
nent ovulation. However, the signs of oestrus persisted and a
hormone assay on the 17th day showed little change. Vaginal
smears taken during this period contained many superficial
anucleate cells, presumably owing to the high serum levels of
oestrogens. The proligestone administered on the 20th day
failed to have the expected effects and the IUD was therefore
removed. The rapid disappearance of the signs of oestrus sug-
gests that the persistence of oestrus was due to the presence
2001
78
21.

The VeWrinary Record, July 21, 2001

The
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PAPERS & ARTICLES

EVANS, J. M. & SUTTON, D. J. (1989) The use of hormones, especially prog-

estagens, to control oestrus in bitches. Journal ofReproduction and Fertility
39, 163-173
LETE, I., MORALES, P. & DE PABLO, J. L. (1998) Use of intrauterine contra-
ceptive devices in nulliparous women: personal experience over a 12-year
period. European Journal of Contraception and Reproductive Health Care 3,
190-193
NAGLE, C. A. & TURIN, E. (1997) Contraception in bitches by non-surgical inser-
tion of an intrauterine device (IUD). Veterinaria Argentina 14,414,416-420
OLSON, P. N. & JOHNSTON, S. D. (1993) New developments in small ani-
mal population control. Journal of the American Veterinary Medical
Association 202, 904-
POST, K. (1995) Induced pregnancy termination in dogs. Theriogenology
(a) (b) (C) Handbook C2. Hastings, Society for Theriogenology, American College of
Theriogenologists. p 1

;_ABSTRACTS
Amphotericin B in the
treatment of canine
4( leishmaniasis
(d)
I -A
e) A
lghl NINETEEN dogs with leishmaniasis were treated with
(f) amphotericin B in an emulsion prepared by mixing 50 mg of
the drug's desoxycholate with 40 ml of sterile water and 10 ml
of soya bean solution. The dogs were first infused for nearly
FIG 2: (a) and (b) The nylon threads and the syringe-like piston are pulled to make the an hour through a peripheral vein with 50 ml/kg of normal
two arms of the IUD enter the applicator tube. (c) and (d) The syringe-like piston is
pushed, so that each arm of the IUD fits into the corresponding horn of the uterus and the saline, followed by 10 ml/kg of 20 per cent mannitol, and the
copper-covered body of the device is in the body of the uterus. (e) The applicator tube is emulsion was then infused for 30 to 60 minutes by means of
pulled out. (f) The two nylon threads protruding from lips of the vulva are cut 5 cm inside a syringe pump. The emulsion was given twice a week for at
the vagina least four weeks at doses increasing from 1 to 2-5 mg/kg. All
17 dogs which received a total dose of more than 10 mg/kg
of the IUD, which had probably produced local stimulation in of the emulsion were clinically cured, and 14 of them gave a
a very sensitive subject. The bulldog was the only one of the negative result in a PCR test for the organism on bone marrow.
nine bitches which had been subjected to hysterotomy by
caesarean section. LAMOTHE, J. (2001) Activity of amphotericin B in lipid emulsion in the ini-
The costs involved in the IUD technique are fairly modest, tial treatment of canine leishmaniasis. Journal of Small Animal Practice 42,
170-175
given the low price of the device itself and the short duration
of anaesthesia. Moreover, it would be unnecessary for a vet-
erinary surgeon with extensive experience with the implan-
tation procedure to check the position of the IUD by x-ray. The
device would be particularly useful for planning pregnancies
in purebred bitches, and would avoid the unpleasant side
Dual energy x-ray
effects of contraceptive drugs. A further 10 bitches have since absorptiometry for measuring
been fitted with the IUD and after five months none has devel-
oped any problem.
bone mineral density in horses
The device could be improved if there were radiodense FORELIMBS from 12 horses were scanned in two planes at
material at the ends of the arms of the IUD, So that an x-ray six sites by dual energy x-ray absorptiometry, and the calcu-
examination could eliminate the risk of placing it in a single lated bone densities were compared with direct measure-
horn of the uterus. However, this incorrect position should ments by Archimedes' principle. There were significant
not prejudice the effectiveness of the device, which is mostly associations between the two measurements which were
due to the spermaticidal activity of the ions released by the improved by taking into account variations in age, weight and
electrolytic copper. the thickness of soft tissue. Repeated measurements had a low
coefficient of variation. The x-ray technique appears to be
References suitable for serial in vivo measurements of the bone density
BONACHO, I., PITA, S. & GOMEZ-BESTEIRO, M. I. (1999) Eight years with
of the metacarpus of horses, for example in investigations of
the same IUD. Contraception 59, 233-236 the effects of diet or drugs on bone density, and of the den-
BOWEN, R. A., OLSON, P. N., BEHRENDT, M. D., WHEELER, S. L., HUSTED, sity changes due to bone remodelling associated with stress
P. W. & NETT, T. M. (1985) Efficacy and toxicity of estrogens commonly used fractures.
to terminate canine pregnancy. Journal of the American Veterinary Medical
Association 186, 783-788 MCCLURE, S. R., GLICKMAN, L. T., GLICKMAN, N. M. & WEAVER, C. M.
CONCANNON, P. W. & MEYERS-WALLEN, V. N. (1991) Current and pro- (2001) Evaluation of dual energy x-ray absorptiometry for in situ measure-
posed methods for contraception and termination of pregnancy in dogs and ment of bone mineral density of equine metacarpi. American Journal of
cats. Journal of the American Veterinary Medical Association 198, 1214-1225 Veterinary Research 62, 752-756

The Veterinary Record, July 21, 2001 79

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Intrauterine device for contraception in dogs

P. Volpe, B. Izzo, M. Russo and L. Iannetti

Veterinary Record 2001 149: 77-79

doi: 10.1136/vr.149.3.77

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