Diagnostic Efficacy of a Single Progesterone Determination to Assess Full-Term Pregnancy in the Bitch

Assessment of Vcheck® analyzer for rapid progesterone concentration measurement including recommendations for achieving the optimal breeding time in bitches

Background and Aim

Serum progesterone concentration plays critical role in determining the optimal breeding time in bitches and diagnosing reproductive-related issues. This study aimed to conduct a comparative analysis of serum progesterone results obtained from commercial point-of-care immunological analyzers, namely, Vcheck®, with those obtained using chemiluminescent microparticle immunoassay (CMIA). Our overarching goal was to evaluate these analyzers' accuracy and establish standardized guidelines for optimal breeding timing.

Materials and Methods

Ninety-four serum samples from bitches were analyzed using the Vcheck® analyzer and compared with CMIA. Thorough documentation included the mean, standard deviation, 95% confidence interval (CI), and minimum and maximum values of serum progesterone concentrations. Furthermore, Pearson's correlation coefficient, Lin's concordance correlation coefficient, and the bias correction factor were meticulously recorded.

Results

The mean progesterone concentration measured using the Vcheck® analyzer was significantly lower than that measured using CMIA, with a mean difference of 1.26 ng/mL of serum. The Bias correction factor was 0.935, which was nearly 1.00, indicating that the line of best-fit was on the perfect line of agreement, providing insight into the measurement accuracy. Pearson's correlation coefficient, a measure of precision, was also close to 1 (0.939), confirming the reliability of the data. Furthermore, Lin's concordance correlation coefficient was 0.877, indicating a fair overall agreement between the Vcheck® and CMIA methods. These results support the validity of the Vcheck® analyzer's results. The present study was developed by aligning with established CMIA guidelines and adapting them using the range and 95% CI derived from each set of results, ensuring a standardized and rigorous approach.

Conclusion

The Vcheck® analyzer provides a rapid assessment of serum progesterone concentration in bitches, with results comparable to those measured using the CMIA technique. However, when considering the use of the Vcheck® analyzer, it is recommended that the results should be interpreted carefully and the interpretation guidelines should be followed. In conclusion, Vcheck® provides a reliable and convenient method for veterinarian practitioners to measure canine progesterone levels in a clinical/hospital setting.

A Precision Assessment of a Point-of-Care Immunological Analyzer for Swift Progesterone Measurement and Guidance for Determining the Optimal Breeding Time in Bitches

The measurement of serum progesterone often varies due to different laboratory methodologies and individual canine characteristics. In this investigation, serum progesterone outcomes obtained from a commercial point-of-care immunological analyzer, designed for efficient serum progesterone assessment in bitches, were compared with results derived from chemiluminescent microparticle immunoassay from reference laboratories in Thailand. Our thorough documentation encompassed various parameters: mean, standard deviation, 95% confidence interval, and minimum and maximum serum progesterone concentration values. Additionally, we meticulously recorded the Pearson's correlation coefficient, Lin's concordance correlation coefficient, and the bias correction factor. Interestingly, there was no significant difference (p > 0.05) in the means obtained by the point-of-care immunological analyzer and chemiluminescent microparticle immunoassay. The Pearson's correlation coefficient between the point-of-care immunological analyzer and chemiluminescent microparticle immunoassay stood at 0.957, with Lin's concordance correlation coefficient for point-of-care immunological analyzer recorded as 0.949. Furthermore, the bias correction factor was established at 0.991. This investigation followed established chemiluminescent microparticle immunoassay guidelines, modified to incorporate the mean and 95% confidence interval as criteria for optimal breeding time using the point-of-care immunological analyzer. In conclusion, the commercial point-of-care immunological analyzer emerges as a valuable tool, aiding in precisely determining the optimal timing for natural mating or artificial insemination in bitches.

Clinical use of the canine foetal kidney formula in dogs of different maternal sizes during the last ten days before parturition

Data concerning the use of the canine foetal kidney length (L) formula in the prediction of parturition timing are still lacking. In our study, we aimed to evaluate the accuracy of the L formula in predicting the parturition date during the last 10 days of pregnancy. Twenty-five clinically healthy pregnant bitches, aged 2-9 years and weighing 3.5-52.2 kg, were ultrasonographically monitored from -11 to 0 days before parturition (dbp). Kidney L was measured for the three most caudal foetuses, and the parturition day was estimated using the kidney formula, whose accuracy was calculated as the percentage of cases estimated (ranges of ± 1 or ± 2 days) on the actual parturition date. A K-proportions test was performed to identify differences in the accuracy among maternal sizes and the sex ratio of pups, and a two-proportions z-test was performed to identify differences between litter size classes (≤ 7 vs. > 7 pups) and time ranges (-11/-5 and -4/0 dbp). An accuracy of 35% within ± 2 days was found in the range of -11/-5 dbp and an accuracy of 30% within ± 2 days was found in the range of -4/0 dbp. The accuracy differed between small (53% ±1 day and 60% ±2 days) and large (10% within ± 1 and ± 2 days) bitches (P = 0.019 within ± 1 day, and P = 0.007 within ± 2 days). For small litter sizes, the accuracy was 38% within ± 1 day and 44% within ± 2 days, and for large litter sizes, it was 14% within ± 1 and ± 2 days. A threshold value was found between litter size classes within ± 2 days. The use of the L formula during the last ten days of pregnancy did not seem to warrant good accuracy in the prediction of parturition date. Further studies on different maternal sizes should be performed.

Use of a Point-of-Care Progesterone Assay to Predict Onset of Parturition in the Bitch

An assay of circulating progesterone (P4) is commonly used to estimate progress through late gestation in the bitch. Point-of-care assays provide rapid results, a major advantage over laboratory-based assays. This study aims to compare P4 levels determined by the Catalyst® Progesterone point-of-care assay with those determined by chemiluminescent immunoassay (CLIA) and to identify the expected distribution of Catalyst P4 levels at time intervals 3 days prior to the onset of parturition in pregnant bitches. Twenty-eight pregnant bitches carrying two or more fetuses were admitted to a specialist veterinary reproduction hospital 53 days after the onset of cytological diestrus or, when that date was not known, 57 days after the last mating. Vaginal speculum examinations were performed every 6 h until the onset of cervical dilatation (TCD). Serum samples were collected twice daily (08h00 and 18h00) until TCD. For most samples, fresh serum was assayed for P4 immediately using the Catalyst assay (CatP4), then frozen until assayed by CLIA (IMMULITE 2000; ImmP4). However, for some samples, CatP4 was not analyzed prior to freezing. For these data points (n = 33), CatP4 for fresh serum was estimated from CatP4 assayed on frozen-thawed serum, based on a comparison between CatP4 on fresh vs. frozen-thawed sera. In comparison to ImmP4, CatP4 levels up to and including 7 nmol/L appear to have a constant bias of −1.69 nmol/L (limits of agreement −4.91 to 1.52), while levels >7 nmol/L appear to have a proportional bias of −17.9% (limits of agreement −68.6% to 32.7%). Bootstrapped percentiles of CatP4 results spanned 0.4–9 nmol/L within 12 h of TCD, 0.9–11 nmol/L 12–24 h from TCD, and 2.2–13.5 nmol/L 24–36 h from TCD. A CatP4 >9 nmol/L indicates a bitch that is unlikely to reach TCD within 12 h. Bitches with CatP4s below 3.5 nmol/L are likely to reach TCD within 36 h and bitches with a CatP4 below 2.2 nmol/L are likely to reach TCD within 24 h. In conclusion, the Catalyst Progesterone assay provides rapid assessment of circulating P4 in the bitch, with clinical application in the monitoring of late term pregnant bitches.

Evaluation of surface plasmon field-enhanced fluorescence spectroscopy for rapid measurement of progesterone concentration in bitches

OBJECTIVE

To compare progesterone (P4) concentrations measured with surface plasmon field-enhanced fluorescence spectroscopy (SPFS) and chemiluminescence immunoassay (CLIA) in serum and plasma samples of client-owned bitches of various ages and breeds and to determine reference ranges for P4 concentrations at various stages of the estrous cycle.

SAMPLES

102 serum samples and 104 plasma samples.

PROCEDURES

In experiment 1, 1 aliquot each of serum and plasma was analyzed for P4 concentration by use of SPFS incorporated in a veterinary-specific point-of-care immunologic analyzer and CLIA. In experiment 2, serum collected from bitches in various stages of the estrous cycle was analyzed for P4 concentration by use of SPFS to establish reference ranges for each stage.

RESULTS

In experiment 1, P4 concentrations measured by SPFS and CLIA were highly correlated (serum, r = 0.966; plasma, r = 0.968). In experiment 2, ranges of serum basal (proestrous) P4 concentrations (n = 114) and P4 concentrations at the estimated time of ovulation (76), during pregnancy or diestrus (107), and during the prepartum period (50) measured with SPFS were 0.42 to 1.46 ng/mL, 3.69 to 7.85 ng/mL, 11.73 to 28.24 ng/mL, and 1.54 to 3.22 ng/mL, respectively.

CONCLUSIONS AND CLINICAL RELEVANCE

Because serum and plasma P4 concentrations measured with SPFS were highly correlated with those measured with CLIA and ranges of serum P4 concentrations measured with SPFS for each of phase of the estrous cycle were well-defined for the large sample size, veterinarians may be able to accurately use this veterinary-specific point-of-care immunologic analyzer with SPFS methodology to determine P4 concentrations of bitches in their daily practice.

Usefulness of Maternal and Fetal Parameters for the Prediction of Parturition Date in Dogs

An accurate parturition timing is of key importance for breeders and veterinarians in order to give professional assistance to parturition in dogs. However, pregnancy length calculated from the breeding date has a wide variability. Different parameters and formulas have been described and calculated, as well as their accuracy which is affected by various factors: stage of pregnancy, litter and maternal size. Therefore, the selection of the most appropriate parameter panel poses the challenge of weighing their influences and impact on the overall accuracy. The aim of this review is to analyze the parameters useful for parturition timing, especially their accuracy, and to propose the addition of fetal maturity and criteria for its evaluation to detect readiness for parturition. Parameters, as described in literature, are classified as: (i) maternal parameters, (ii) fetal parameters, (iii) ultrasonographic assessment of maternal and fetal heart rate and blood flow, (iv) parameters indicating fetal maturity. A focus on recently described parameters-such as fetal gastrointestinal motility and fetal lung development detected by quantitative ultrasound-is reported. Currently, the most accurate way to predict parturition day is represented by a prepartum progesterone drop, but the identification of a panel of ultrasonographic parameters combining their significance and their accuracy throughout pregnancy is still needed.

Accuracy and precision guidelines for optimal breeding time in bitches using in-house progesterone measurement compared with chemiluminescent microparticle immunoassay

Background and Aim:

The concentration of serum progesterone is commonly used to determine the optimal mating time in bitches, and to diagnose reproductive-related abnormalities. This study aims to compare the serum progesterone results obtained by rapid fluorescence immunochromatography assay (RFICA) with those obtained by chemiluminescent microparticle immunoassay (CMIA) from the same serum samples to develop a standard guideline for optimal breeding time.

Materials and Methods:

Serum progesterone levels were measured in 124 bitches using RFICA and CMIA. Simple linear regression and correlation analyses were performed to analyze the data. The percentage difference between the maximum and minimum progesterone values in the same serum sample in the same assay was compared using Wilcoxon’s rank-sum test.

Results:

The present study showed a strong linear dependence of the results obtained by RFICA on those obtained by CMIA as R²=0.8976, with regression coefficient of 0.9474 and p<0.05, including the regression model was CMIA = (0.9483 × RFICA) − 0.761. Moreover, five critical measurement times during estrous in bitches showed statistically significant differences (p<0.05), except at the fertilizable period, which showed a non-significant difference (p>0.05).

Conclusion:

This study demonstrated that it is presumably acceptable to use the RFICA and CMIA methods interchangeably for quality progesterone measurements in serum samples from bitches. However, when considering the use of the RFICA method, it is advisable to carefully interpret the results and follow the interpretation guidelines. Finally, RFICA in the present study provides a reliable and convenient option for veterinarian practitioners to measure canine progesterone levels in-house.

Ultrasonographic analysis of fetal gastrointestinal motility during the peripartum period in the dog

The aim of this study was to investigate fetal gastrointestinal motility (FGM) of dogs using ultrasonic imaging and its association with vaginal and rectal temperature, serum progesterone concentrations and fetal heart rate. Pregnant bitches were examined after day 54 of gestation and there were determinations of vaginal and rectal temperature and serum progesterone concentrations. The fetal abdomen was evaluated for 30 s using longitudinal and transversal assessments, and FGM was scored as 0 (no peristalsis) or 1 (evident peristalsis). Number of fetuses with a 1 or 0 score were determined for each bitch (number and the percentage of fetuses with FGM). A total of 135 FGM measurements were recorded. There was FGM in 0/3, 0/6, 1/6 (16.7 %), 3/20 (15 %), 5/18 (27.3 %), 18/28 (64.3 %), 12/17 (70.6 %), 14/22 (63.6 %), 6/9 (66.7 %), 4/6 (66.7 %) fetuses from day -9 until 0 preceding parturition, respectively. In the last 5 days before parturition, 63.3 % of fetuses had FGM. Vaginal and rectal temperature were strongly and positively correlated (P < 0.001). Vaginal temperature was positively correlated with progesterone concentrations and fetal heart rate (P < 0.01), and there was a small negative correlation with FGM (r = -0.331, P < 0.05). Due to ease of data collection, the assessment of FGM is a valuable procedure for evaluation of fetal maturity in dogs. Vaginal and rectal temperatures are reliable variables to be assessed during the last week of pregnancy for estimating the time of parturition.

Comparison of progesterone assay by chemiluminescence or radioimmunoassay for clinical decision-making in canine reproduction

The Coat-A-Count® radioimmunoassay has been long and widely used to determine the concentration of progesterone in serum or plasma of bitches (progRIA), but was discontinued in 2014. The Immulite® 1000 LKPG1 chemiluminescence immunoassay has gained prominence since 2003 to determine the concentration of progesterone in serum of bitches, but the assay changed in 2012 (Immulite® 1000 LKPW1). This study assessed the feasibility of using Immulite® 1000 LKPW1 (progImm) to estimate the time of clinically relevant events during oestrus and compared progRIA and progImm 2 and 3 days after the first or only day of the luteinizing hormone surge (LH1). ProgImm first exceeded 5.1 nmol/L on the same day that progRIA first exceeded 6 nmol/L, a proxy for the occurrence of the LH surge, or the day before in 28 of 31 (90%) of oestrous periods. ProgImm first exceeded 13.6 nmol/L on the same day that progRIA first exceeded 16 nmol/L (a proxy for the day of ovulation) or the day before in 34 of 35 (97%) oestrous periods. ProgImm first exceeded 5.4 nmol/L on LH1 or the day before in 24 of 25 (95%) of oestrous periods. The median of progImm 2 days after LH1 was 1.2 nmol/L lower than the 10.7 nmol/L of progRIA (p = 0.001). The mean of progImm 3 days after LH1 was 2.2 nmol/L lower than the 19.0 nmol/L of progRIA (p < 0.001). In conclusion, the days on which progImm first exceeded 5.1 nmol/L, 13.6 nmol/L and 5.4 nmol/L effectively estimate the days on which progRIA reached 6 nmol/L or 16 nmol/L or LH1.

Evaluation of serum C-reactive protein concentration as a marker of impending parturition and correlation with progesterone profile in peri-partum bitches

C-reactive protein (CRP) is one of the major acute phase proteins in dogs. It is produced by the liver and rapidly increases in response to an inflammatory stimulus. The aim of this study was to measure CRP concentrations around parturition and to verify whether this protein could be useful, together with progesterone (P), to detect the onset of parturition in bitches. The CRP and P concentrations were measured in 66 serum samples from 28 healthy pregnant bitches, collected between -5 and +2 days from parturition (day of parturition = day 0). The effect of 'days from parturition', parity, and litter size on P and CRP concentration was analyzed and the correlation between CRP and P values was calculated. The P and CRP values were affected by 'days from parturition'. While P decreased during the last days of pregnancy, CRP concentration was greater than the normal range (0-1.07 mg/dl) starting the parturition day with the increase starting on day -1. The CRP concentration profiles during the days around parturition have not been previously reported in dogs. The increase in CRP very near the time of parturition and the low magnitude of the increase do not allow for it to be useful in clinical practice to assess the onset of parturition in the bitch.

Comparing the values of progesterone in the blood of bitches as measured with a chemiluminescence immunoassay and a radioimmunoassay

A ¹²⁵ I radioimmunoassay (RIA) has long been used to determine the value of progesterone in serum or plasma of bitches but was discontinued in 2014. A chemiluminescence immunoassay (CLIA) gained prominence since 2003 to determine the value of progesterone in serum of bitches but the assay changed in 2012. This study assessed the agreement between progesterone values obtained with RIA in plasma (progRIA) and with the post-2012 CLIA (progCLIA) in the serum of bitches. ProgCLIA was determined in 110 serum samples from 40 bitches in pro-oestrus or early oestrus and compared to progRIA in plasma samples collected from the same bitches at the same time, where progRIA had a uniform distribution between 0.5 and 25 nmol/L. Two replicate analyses of each serum or plasma sample were simultaneously done in the same assay. For RIA and CLIA, the intra-assay CVs were 5.85% and 6.70% and the interassay CVs 8.45% and 9.16%. For RIA and CLIA the progesterone values obtained with replicate analyses differed by as much as 11%-31% in 25% of samples. On average, the value of progCLIA was 85% of that of progRIA (95% CI 58%-112%, n = 110), with 88% of progCLIAs being lower than the progRIAs. This study shows that RIA and CLIA may yield replicate values that differ by as much as 11%-30% in about a quarter of samples analysed, necessitating replicate analyses if precise values are required. The study provides an equation by which to estimate progCLIA from progRIA.

The precision of predicting the time of onset of parturition in the bitch using the level of progesterone in plasma during the preparturient period

Precise prediction of the time of onset of parturition in the bitch is of clinical importance. Many parturition management cases in clinical practice are presented in the last two weeks of pregnancy without a reliable estimate of the parturition date. The aim of this study was to assess the value of a single progesterone level in the blood plasma from a preparturient bitch to predict the time of onset of parturition. The temporal relationship between the decrease in the plasma progesterone levels and the time of cervical dilatation (TCD)-which correlates to the onset of stage 1 of parturition-was evaluated in 25 bitches in the preparturient period. Among bitches destined to reach TCD within 12 h there is a 2% probability of having a plasma progesterone level of 15.8 nmoL/L or above and a 6% probability of having a level of 8.7 nmoL/L or above. Conversely, if the level is below 8.7 nmoL/L there is a 99% probability of reaching TCD within 48 h and if the level is below 3.18 nmoL/L there is a 100% probability of reaching TCD within 24 h. These results allow the veterinary obstetrician to make prompt decisions in the management of parturition.