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how to increase progesterone in your bitch
How to Increase Progesterone in Your Bitch -
(to maintain a healthy pregnancy, to prevent resorption and to increase litter size )
There are many hormones working together, impacting each other to make dogs come in to and go out of the heat. While, no one is required to understand complicated interactions between them, there are three significant hormones influencing heat cycle in dogs. During first days of the heat, there is a significant rise of a hormone, called oestrogen. Humans also have similar (but not identical) hormone and this is just one of many reasons why a human gynaecologist would not fully understand canine reproduction and get it wrong ! It is responsible for swelling of the vulva and creates the bloody discharge from lining of the uterus to lubricate it Other important hormone when dog is in heat is luteinizing hormone also known as LH. This hormone, similarly to oestrogen, starts climbing at the beginning in the heat, but with much, much slower rate. Then it peaks suddenly, usually two days after the peak of oestrogen, and then drops back down, and it causes the ovulation.. LH peak not only causes ovulation, but start climbing of the hormone called progesterone, as well. Progesterone makes the uterus receptive to implantation and supports the growth of the foetus. Progesterone is also used in medication to stop the heat cycle, as it, if we want to keep it short, stops production of oestrogen. Progesterone levels stay higher than normal for about two months, no matter if the bitch got pregnant or not. LH and oestrogen hormones are backing down before the heat is over.
Throughout the adult reproductive years of the female, the structural composition and hormonal activity of the ovaries are continually changing. Hormones, called gonadotropic hormones, produced by the anterior pituitary gland within the brain initiate such changes. The bitch has two ovaries that will produce the ova (eggs). Within the ovaries, the ova are contained within follicles that grow toward the surface of the ovary. When FSH and LH from the pituitary gland begin to be secreted in high quantities during onset of sexual maturity, the ovaries and the follicles within them will begin to grow. Within these follicles, a follicular fluid hormone, secreted by the ovary, called oestrogen, surrounds the ovum. This hormone is a biologic chemical that produces physiologic and social/behavioural effects within the bitch that will signal a readiness to mate.
Two days prior to ovulation, there is a surge in the secretion of LH by the pituitary gland proceeded by rapid swelling of the follicle. This LH surge is of critical importance because in its absence, even with the other hormonal physiologic effects taking place, ovulation will not occur. Additionally, the LH surge causes the ovarian cells to switch over to secreting progesterone hormone rather than oestrogen. As a result, there is an increase in progesterone levels, and a decrease in oestrogen levels. Within two days of the LH surge, the follicle reaches the surface of the ovary and bursts, thereby releasing the ovum into a capsule that surrounds the ovary. This process is referred to as ovulation. If the bitch is bred, then sperm will subsequently fertilize each of the released ova. The ova will then move down the oviducts, which connect each ovary to each of the two uterine horns, and the fertilized ova will eventually implant in the walls of the uterus where they will develop into foetuses. In the meantime, the ruptured follicles from which each ovum was developed will begin to produce a rapidly dividing mass of cells called luteal bodies, which will make up the corpus luteum. In addition to producing progesterone, which will maintain the pregnancy, the corpus luteum will also produce inhibin, the hormone that will signal the pituitary gland to decrease production of FSH and LH. When enough inhibin has eventually been secreted, this will end the mating period.
Though the above explanation mainly describes the mating stage of the bitch, the normal reproductive cycle of the bitch is comprised of four stages: pro-oestrus, oestrus, dioestrus, and anoestrus.
Pro-oestrus: (average duration = 9 days; range = 3-17 days) Swelling of the vulva, the external tissue of the vaginal opening, and bloody discharge marks the beginning of the pro-oestrus stage, also known as the follicular stage. During pro-oestrus, the ovarian follicles, each containing ova, increase in size. Increasing amounts of oestrogen hormone, secreted by the ovarian follicles, cause the cells of the vaginal walls to take-on a distinctive shape, a process known as cornification. Both the level of oestrogen and vaginal cornification are useful indicators of pro-oestrus.
Oestrus: (average duration = 9 days; range =3-21 days) Receptivity to mating marks the beginning of the oestrus stage. Physiologically, oestrus coincides with the predominant presence of cornified vaginal epithelial cells and an increase in serum progesterone levels to 2 ng/ml. Ovulation usually occurs 2 days following this increase in progesterone and hence, monitoring the levels of progesterone is an excellent indicator for timing breeding.
Dioestrus: (average duration = 2 months) Approximately 6 days after ovulation, the cornified vaginal epithelial cells will revert to a non-cornified state. This condition marks the beginning of dioestrus. This stage ends when progesterone levels fall to less than 1 ng/ml just prior to whelping in the pregnant bitch or approximately 2 months after ovulation in the nonpregnant bitch.
Anoestrus: (average duration = 4-4.5 months) The beginning of this stage is marked by the drop in serum progesterone levels to less than 1 ng/ml. The beginning of pro-oestrual bleeding marks the end of this stage. Duration of anoestrus is quite variable among bitches and may be governed by both genetic and environmental variables. 
Currently ultrasound is the best method for determining and staging pregnancy in the bitch and is becoming routinely used by many breeders. Ultrasound technology utilizes the safe and non-invasive method of soundwave imaging for detection of embryos/foetuses. Though the expert can detect embryonic vesicles as early as 19 days following breeding, typically screening is performed at or after Day 25 when the actual embryos can be visualized. Additionally, by this time, heartbeats are also usually discernible.
Ultrasound is particularly helpful for differentiating between pyometra and pregnancy in bitches. Furthermore, in addition to diagnosing pregnancy, ultrasound is currently being assessed for its ability to detect foetal distress during pregnancy, which would be indicated by decrease in the heartbeat rate of foetuses (normal rates reported at 200 to 255 beats per minute)
Pregnancy Hormones
Progesterone, considered colloquially as the pregnancy hormone is an androgen produced by the corpus luteum of bitches. In non-pregnant dogs, progesterone levels progressively decrease during the extended luteal regression (up to 1 - 3 months), dropping to < 1 ng/ml at anoestrus
Normally present in low doses in non-pregnant bitches, its level rises during the dioestrus phase
Unlike humans and horses that produce a pregnancy-specific gonadotropic hormone that can be quantitated by assay and thus utilized as an indicator of pregnancy, no similar such hormone has yet been found in the dog. Recently, however, a hormone, known as relaxin, which is secreted by the placenta of the dog and functions to relax the pelvis before whelping, has been evaluated as specific marker for canine pregnancy. Serum relaxin is not present in non-pregnant dogs; however, concentrations of relaxin increase to detectable levels in the pregnant bitch approximately 25 days following breeding and peak at Day 40 to 50.
Synbiotics (Malvern, PA) has developed an ELISA test, called ReproCHEK, for detection of serum relaxin for the purpose of pregnancy testing in the bitch. For routine testing, a blood sample is obtained from the bitch 25 days after breeding or between days 22 to 26 after the LH surge if ovulation testing has been performed. Antibodies specific for relaxin will detect presence of the hormone in the blood sample. In preclinical studies, the relaxin ELISA was specific and sensitive for detecting pregnancy in bitches without the occurrence of false-positive results. Additionally, the relaxin assay is quite effective at distinguishing pseudopregnancy from actual pregnancy since relaxin hormone is absent in pseudo-pregnant bitches. Other applications for this assay include pregnancy monitoring, since sudden decrease in relaxin is an indicator of spontaneous abortion in the bitch.
Plasma Proteins
Testing of plasma proteins as indicators of pregnancy in the bitch have included assessment of fibrinogen and C-reactive proteins, which are commonly elevated in pregnancy and some other conditions. Serono Diagnostic (United Kingdom) offers one test for measurement of fibrinogen, which is elevated 25 to 30 days after breeding and as such may be used as an indicator between days 30 and 50 of pregnancy, after which levels decline. Testing for C-reactive protein also has indications for ability to diagnose pregnancy in that levels of this protein also increase between days 30 and 50 of pregnancy. However, because inflammatory responses associated with infection as well as placental development within the uterus may also lead to elevation of these proteins, there is a high incidence of false-positives when utilizing these indicators for determination of pregnancy.
TABLE 1. Drugs Considered Safe in Pregnancy
TABLE 2. Some Drugs to be Avoided in Pregnancy
Amoxicillin with clavulanic acid
Pyrantel pamoate
Milbemycin oxime





[The above Tables are from:  Freshman JL. Current therapeutic recommendations for pregnant dogs. In Kirk's Current Veterinary Therapy XIII, Bonagura, J.D. (ed.), W.B. Saunders Co., Philadelphia, 1999. pp. 931-933.]
False-Pregnancy (Pseudopregnancy)
Occasionally following the oestrus cycle, a bitch that was either bred or not bred during oestrus develops overt signs associated with pregnancy and lactation. If the bitch was bred, these signs may misguide the breeder to confirm a successful mating. Complicating the situation further, around day 60 of the "suspected" pregnancy, the bitch will often experience a decrease in body temperature and will display the familiar nesting, restless, panting behaviour typical of a bitch about to whelp. However, no puppies will be delivered because the bitch is experiencing a condition known as pseudo-pregnancy.
During oestrus, the surge in LH that results in ovulation also stimulates the ruptured follicles, from which the ova are released, to secrete progesterone. At this point the follicular cells become the corpus luteum. If the bitch becomes pregnant, the corpus luteum is preserved and continues to produce progesterone, which is required to maintain the pregnancy. If the bitch is not bred or mating is unsuccessful, a hormone produced by the uterus called prostaglandin F2a will cause the corpus luteum to regress, progesterone levels will decrease, and dioestrus will follow oestrus.
In bitches that experience pseudopregnancy, the corpus luteum does not regress despite the fact that conception has not taken place. As a result, increased progesterone levels are maintained bringing about the signs consistent with pregnancy. Around day 60, progesterone levels will abruptly drop as is observed at the end of gestation in pregnant bitches. This drop in progesterone results in elevation of the hormone prolactin, which is responsible for the typical nesting-behaviour in pregnant bitches. As such, the pseudo-pregnant bitch will display the same behaviour as a bitch that is actually pregnant.
How to Increase Probability Of Larger Litters
In bitches there is a preovulatory increase in progesterone above basal anoestrous levels. This initial rise in progesterone coincides with the LH surge. Because progesterone assays are readily available and because the LH surge lasts for only about 24 hours, which necessitates daily sampling, progesterone is often determined instead of LH. Knowing the LH surge, one can make the necessary arrangements to breed in 3-5 days, which is the estimated fertile period. There is a sharp increase in serum progesterone concentration after ovulation. Studies from AI programs have shown that pregnancy rates are best when insemination is performed on days when progesterone concentrations are between 30-80 nmol/L (about 10-26 ng/ml). The recommendation is to breed twice, 48 hours apart. If progesterone concentration was already nearly 60 nmol/L (19 ng/ml) at the first breeding, the second is performed in 24 hours. Pregnancy rates and litter size are greater with 2 breedings during the fertile period than with 1. Three breedings during the fertile period do not improve pregnancy rates above 2 breedings, but there is a trend toward larger litters.
The semen factors thought to be most important to fertility are the number, the morphology and the motility of the spermatozoa. The total number of sperm in the ejaculate should be 300 million to 2 billion. At least 70% of the sperm normally have rapid, steady forward progression. At least 80% of the sperm should have normal morphology. A minimum of 200 million motile sperm per insemination is usually recommended. Freshly ejaculated sperm remain viable and capable of fertilization for at least 4-6 days in the oestrous female tract. Frozen-thawed semen has a life span of about 24 hours and it does not penetrate cervical mucus very well. Pregnancy rates achieved with vaginal insemination using frozen-thawed semen of good quality have been about 30%, whereas pregnancy rates of 50% to 80% have been achieved when intrauterine insemination has been performed. It has been shown that intrauterine artificial insemination with fresh and chilled semen also improves pregnancy rates over intravaginal artificial insemination. Overall, the best results for pregnancy rates and litter size are achieved when bitches ≤ 6 years old are inseminated twice during the fertile period with semen of good quality from dogs ≤ 8 years old.
The incidence of abortion and resorption of canine foetuses is extremely difficult to assess because pregnancy cannot often be confirmed until about the 28th day. There are five known causes of both foetal resorption and abortion: foetal defects, resulting in early foetal death and resorption; abnormal maternal environment, usually resulting in the loss of the entire litter; infectious agents, i.e., Brucella; canine herpes virus infection, which may not affect the litter as a whole, but reabsorb or abort one or more foetuses; and trauma, which is extremely unlikely. All of these factors may cause both abortion and resorption, the biochemical dissolution or loss of tissue, in this case the foetus.
Abdominal ultrasonography is a reliable means of not only diagnosing pregnancy, but confirming the viability of the foetuses
Antioxidants like vitamin C may increase and intensify the effects of progesterone. Vitamin C has also been shown to raise progesterone levels and resolve luteal phase defects, resulting in improved fertility.
I often recommend 1,000 mg daily of vitamin C to my patients because it raises progesterone. Or, you can try these high-vitamin C foods: Citrus fruits, strawberries, mango, papaya, watermelon, tomatoes, broccoli. Brussels sprouts, cauliflower, cabbage, and spinach.
These methods have been shown effective for increasing progesterone levels:
750 mg vitamin C per day (increased progesterone 77% and improved fertility)
600 mg vitamin E (increased progesterone in 67% of patients)
6 g L-arginine (increased progesterone in 71% of patients)
Increasing beta carotene (boosts progesterone levels in dogs and goats)
Increasing vitamin B6 
Supplementing with Vitex Agnus Castus (increases progesterone and fertility)
120 mg Black Cohosh on days 1 to 12 (increases progesterone and fertility)
Supplementing with selenium
Consuming dairy products (shown to raise progesterone in men)
Weight loss
Avoiding overeating
Improving insulin sensitivity (metformin increases progesterone levels 246%)
Replacing saturated fat in the diet with unsaturated fat
80mg progesterone cream (shown to be as effective as 200 mg oral progesterone prescription)
Eating a high protein, low carbohydrate diet
Lowering TSH levels in subclinical hypothyroidism
When we look at canine health we usually crossover fields to that of human medicine as both have very similar physiology in disease etc.
750 mg Vitamin C increases progesterone levels by 77%, improves fertility
The concentration of ascorbic acid is reported to be much higher in human follicular fluid than in blood serum. This suggests that vitamin C may play a role as an antioxidant vitamin during folliculogenesis. After one cycle of Vitamin C(750 mg/day until positive pregnancy test) treatment, serum progesterone levels were significantly elevated in the treatment group but not in the control group (From 7.51 to 13.27 ng/mL in the treatment group vs. 7.95 to 8.73 ng/mL in controls). Nineteen patients (25%) in the vitamin C supplementation group and 5 patients (11%) in the control group became clinically pregnant.  All pregnancies occurred in patients in whom the luteal phase defect resolved, whether spontaneously or as a result of vitamin C supplementation. We found that vitamin C supplementation caused improvement in 53% of luteal phase defect cases, whereas 22% of patients with luteal phase defect had spontaneous improvement.

Vitamin E increases progesterone in 67% of patients with luteal phase defect; L-arginine helpful for 71%
Patients with both luteal phase defect [serum progesterone concentrations < 10 ng/ml during mid-luteal phase] and low corpus luteum blood flow were given vitamin E (600 mg/day) or L-arginine (6 g/day) as a potential nitric oxide donor. Vitamin E improved corpus luteum blood flow in 83% of patients and improved serum progesterone in 67% of patients. L-arginine improved corpus luteum blood flow in 100% of patients and improved serum progesterone in 71%. In the control group, who received no medication to increase corpus luteum blood flow, only 9% improved in corpus luteum and 18% improved in serum progesterone.

Antioxidants intensify the action of progesterone
Vitamin C and vitamin E possess progesterone-like effect and act synergistically with progesterone on rabbit endometrium, when they were given together.

Beta carotene increases progesterone in goats
The beta-carotene supplemented goats depicted both the largest values for corpus luteum total number and serum progesterone levels, with no differences for volume corpus luteum between treatments. Results suggest a higher efficiency within the cellular-enzymatic groups defining the steroidogenic pathways in the beta-carotene supplemented goats, generating a larger progesterone synthesis. The last is essential for ovulation of healthy oocytes, maintenance of uterine quiescence, nourishment and survival of the embryo around implantation; all of them of paramount significance during the maternal recognition of pregnancy process.

Beta carotene increases progesterone in dogs
Dogs fed 50 mg of beta-carotene had significantly higher concentrations of plasma progesterone between d 12 and 26 compared with unsupplemented dogs. Dietary beta-carotene did not influence plasma estrogen and total uterine proteins. Therefore, beta-carotene is absorbed into plasma, corpus luteum, and uterine endometrium of dogs. Furthermore, dietary beta-carotene increased plasma progesterone concentrations during the menstrual cycle. It is possible that dietary beta-carotene may improve reproductive function in the canine.

Vitamin B6 acts similarly to progesterone
Vitamin B6 possesses progesterone-like effect but it does not intensify the action of progesterone. On the other hand, vitamin B12 and vitamin A exhibit no progesterone-like effect and do not affect the action progesterone when they were given together.

Vitamin B6 increases progesterone
Administration of vitamin B6 at doses of 200-800 mg/day reduces blood estrogen, increases progesterone and results in improved symptoms under double-blind conditions.

Vitex increases progesterone and fertility
After three months, the FertilityBlend (Vitex) group demonstrated a trend toward increased mean mid-luteal progesterone. After three months, 26% treated  vs. 10% placebo were pregnant.

Black cohosh increases progesterone and pregnancy rate
Endometrial thickness, serum progesterone and clinical pregnancy rate were significantly higher when additional oral phytoestrogen (Cimicifuga racemosa)(black cohosh) 120 mg/day was added to infertility treatment from days 1 to 12.
Selenium supplementation increases progesterone
Selenium supplementation did not affect the length of the estrous cycle, but it did increase the concentration of plasma progesterone in the estrous cycle. These results suggest the possibility that selenium contributes to the progesterone production of corpus luteum.

Dietary Changes that Increase Progesterone
Replacing saturated fat with unsaturated fat boosts progesterone
Mean plasma progesterone concentrations were higher in cows fed flaxseed (high in omega 3's) and sunflower seeds (high in omega 6's) than in those fed saturated fatty acids.
Higher protein intake, lower carbohydrate intake associated with higher progesterone. Serum progesterone levels were positively correlated with protein intake and negatively correlated with percent carbohydrate in the diet.
Progesterone is found in dairy products, but not very much
The group measured salivary progesterone levels in 17 male volunteers at baseline and 24 hours later after consuming three servings of high-fat dairy foods (2 tablespoons butter, 2 ounces cheese, and a quart of premium ice cream) between morning and afternoon. The procedure was repeated a week later. Salivary progesterone increased 22 to 116 percent in all subjects both times after 24 hours of a high-fat dairy product diet. (Average progesterone in men is 0.181 ng/ml, while the average progesterone in a healthy early pregnancy is 32 ng/ml, so an additional 0.2 ng/ml is probably insignificant). Dr. Goodson said males were chosen because their normal concentrations of progesterone are lower and less cyclic than in females and hence an effect would be easier to measure. Because progesterone dissolves readily in fat, it should be absorbed more efficiently in high-fat products. Foods that were 70% to 80% dairy fat contained 175 to 300 ng/mL of progesterone (.175 to .3 mg/liter; oral progesterone is usually prescribed in 100 mg to 200 mg doses), they found. The amount of progesterone in 200 mL of ice cream would be approximately one-one-hundredth of a pharmacological adult dose of 2 mg.
Overeating lowers progesterone
The present experiment was conducted to evaluate the effects of feeding allowance level on reproductive hormone secretion in early gestation gilts. Progesterone levels were the lowest in the high feeding group (fed 2x maintenance diet).

Weight loss increases progesterone and leads to resumed ovulation in 87% of patients
Before and after a weight loss of at least 5% of initial body weight we analyzed LHFSHestrogenprolactintestosterone, DHEA-S, oral glucose tolerance test and progesteroneweight, BMI, waist/hip ratio and total body fat percentage. The mean weight loss was 9.5 kg, which represents a weight loss of 10.96% from initial body weight, with 26 patients (86.6%) resuming spontaneous ovulation. The women's mean plasma testosterone, LH, estradiol and DHEA-S decreased significantly and there was significantly increased on progesterone.
Lower body weight associated with higher progesterone in ovulating women
Increased body weight was associated with decreased progesterone levels, even in ovulatory women.

Other Ways to Increase Progesterone
Improving insulin sensitivity increases progesterone levels 146% 
A significant negative correlation was observed between insulin and progesterone and between progesterone and LHconcentrations, and a positive correlation was observed between LH and insulin. The study further demonstrated a significant enhancement in luteal progesterone concentration (4.9 ng/ml vs 16.97 ng/ml) in PCOS women treated with metformin. The results suggest that hyperinsulinemia/insulin resistance may be responsible for low progesterone levels during the luteal phase in PCOS. The luteal progesterone level may be enhanced in PCOS by decreasing insulin secretion with metformin.
80mg/day progesterone cream is as effective as 200mg/day oral prescription in increasing progesterone
Twelve healthy postmenopausal women received 200-mg oral progesterone capsules once daily for 12 days or progesterone cream 40 mg twice daily for 12 days. At steady state (day 12 of each phase), whole-blood samples were collected over 24 hours (oral progesterone) or 12 hours (topical progesterone) and assayed for total progesterone concentration. No significant differences were found in dose-normalized 24-hour progesterone exposure comparing the cream to oral capsules (median AUC(0-24) 12.5 ng x h/mL vs 10.5 ng x h/mL, respectively). In light of the potential risks associated with long-term progesterone use, the authors question whether topical progesterone products should be available OTC.

Lowering TSH levels increases progesterone
In infertility patients found to have mild or subclinical hypothyroidism, after treatment with 50-150 micrograms l-thyroxine daily for at least 4 to 6 weeks, elevated prolactin values significantly decreased in 9 out of 12 patients and testosterone levels slightly decreased in 5 out of 8 patients. An improvement of the cyclical ovarian function could be observed by the significant increase of the average progesterone concentration in the luteal phase. From these results we conclude, that mild hypothyroidism may cause ovarian insufficiency.
I hope this allows you insight as to the IMPORTANCE of progesterone in canine reproduction .

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