4, 5, 6: clin approach to M repro failure Flashcards
1
Q
1* cause for M repro fail?
A
management
2
Q
what is impotentia coeundi?
A
conditions that interfere w ability of M to complete copulation successfully
C - cannot do it
3
Q
what is impotentia generandi?
A
conditions resulting in conception failure after normal copulation
Gen - can do it but it is not successful
4
Q
ex of impotentia coeundi:
A
unwilling to breed
unable to copulate
5
Q
why might an animal be unwilling to breed?
A
inherently poor libido
psychogenic impotence [some kind of negative reinforcement]
6
Q
why might animal be unable to copulate?
A
non genital dz - musculoskeletal or extremely poor BCS
path problem, may or may not involve normal libido
7
Q
how common is inherently poor libido?
A
not common - very rare
over diagnosed
8
Q
causes of poor libido?
A
- abnormality of sexual development
- e2 secreting neoplasia (sertoli cell tumor)
9
Q
how does time of puberty contribute to impotentia coeundi?
A
immature, inexperienced
behavior - needs time and practice to figure out how to do it
also new Mm and Nn used in process of mating/copulation
10
Q
examples of social cues importance for impotentia coeundi?
A
- take stud dog to FM territory
- old, dominant hembra may not kush for novice M
- young boar may not breed of older or dominant boar is around
11
Q
how can psychogenic impotence impede M ability to breed?
A
- negative reinforcement for sexual behavior display [often in show animals]
- overuse
- inadequate facilities: slippery floor, roof too low, etc
12
Q
come musculoskeletal issues making M unwilling or painful when mounting?
A
- hind feed : abscess, white line dz, interdigital fibroma in bulls
- hocks : poor conformation - joint pathology, chronic high demands physically
- back issue: vertebral spondylosis in old bulls
13
Q
ex of neuro issues making M unwilling to mount or unable to mount?
A
neurologic
- equine protozoal myelitis
- wobbler’s dz [stallions]
- degenerative myelopathy
- dog; lumbosacral dz
14
Q
why not able to achieve intromission?
A
failure to achieve erection
erectile dysfunction (abnormal erection)
lesions of penis / prepuce
15
Q
what does erection require?
A
- neuro output
- occlusion of venous outflow from cavernous spaces by contraction of ischiocavernosus Mm (ICM)
- ICM contraction -> inc blood flow into penile Aa and cavernous spaces -> inc CCP pressure -> erection
16
Q
mechanism of erection failure, possible issues?
A
failure of neuro input
lack of blood flow into CCP
leakage of blood from CCP
17
Q
MC neuro or blood flow issue to penis pathology?
A
neuro issues are more common
18
Q
what may occur if there is a rent in the corpus spongiosum penis of the stallion?
Tx?
A
- small rent: normal erection
- hemospermia
- No Tx
19
Q
how does hemospermia affect stallion and dog sperm?
A
stallion - kills sperm
dog - okay, no effect
20
Q
what happens when broken penis occurs in bull?
where is MC site?
why does it occur?
A
- ruptured tunica albuginea (TA) allows blood to escape from CCP and form hematoma
- MC site: just distal to sigmoid flexure, near insertion of retractor penis M
- there is a drastic pressure change from non erection to erection
- if an unnatural force bends penis during erection
- typical story: heifer collapses during mating and breaks penis of bull
21
Q
clin signs of broken penis in bull?
acute and chronic presentation?
A
- preputial swelling just Cr to scrotum
- abscess of hematoma site
- prolapse of internal preputial lamina and penis
- secondary trauma to prolapsed tissue
acute: hematoma
chronic: abscess
22
Q
dx broken penis in bull?
Tx?
A
clin signs
u/s - see disrupted TA, hematoma or abscess
u/s guided needle aspiration to differentiate hematoma from abscess
Tx? acute: drain and lavage abscess
chronic: poor prognisis - salvage semen if valuable bull
23
Q
MC reason M fails to achieve intromission due to abnormal erection? bulls
A
penis deviations
24
Q
what is corkscrew penis in bulls?
can be repaired? heritable?
A
spiraling of penis that normally occurs after intromission takes place prematurely, px intromission from occurring
progressive - may have low preg rate 1st season then worse rates 2nd season
heritable - no repair - soln is to cull
25
```
persistent penile frenulum:
what is it?
what species?
how does it affect breeding ability?
Tx?
```
- fibrous attachment of lamina interna to free portion of penile tip
- penis fails to protrude fully and may deviate ventrally
- bull, dog, boar, camelids
- frenulum normally disrupted at puberty
- heritable in angus
- surgically disrupt for commercial stock production ONLY; NOT for seedstock offspring
- or cull
26
what species may experience congenital "shortness" of the penis?
cause?
associated w other issues?
bull, buck and boar
- bull may get heifers preg but not cows b/c can't reach cows
absence of sigmoid flexure - penis cannot extend so cannot reach
may be assoc w split scrotum
27
what is hypospadias?
species MC seen in?
how does it affect breeding?
associated w other issue?
- varying location of urethral orifice [penile, scrotal, perineral]
- lack of penile protrusion so inability to achieve intromission
- MC in dog and buck but all species can have it
- assoc w cleft scrotum
28
penile paralysis def:
no feeling in penis
| impotentia coeundi
29
paraphimosis def:
internal lamina of prepuce is outside of sheath and cannot be retracted into penis
impotentia coeundi
30
priapism def:
erection in absence of sexual arousal or prolonged erection after
impotentia coeundi
31
phimosis def:
impotentia coeundi
penis cannot get out of sheatl
32
lesions of prepuce that potentially px protrusion and intromission?
- congenital preputial stenosis
- adhesions btwn penis and prepuce OR internal lamina / sheath
- trauma w 2* inflammation, infection
33
balanitis def:
penis inflammation
34
posthitis
prepuce inflammation
35
balanoposthitis def?
how does it affect ability to breed?
penis and prepuce inflammation
impotentia coeundi - px protrusion and intromission
36
balanoposthitis in stallion:
predisposition?
resolve issue?
cause / concurrent path?
- excessive sheath cleaning may predispose
- normal flora is good
- hard to resolve
- consider SCC, equine coital exanthema (EHV3)
- may be sign of something worse
- secondary infections may occur
37
balanoposthitis in dog:
cause?
Tx? prognosis?
disruption of normal flora - opportunistic infection
- tx: preputial lavage and intramammary abx
- maybe systemic abx
- okay prognosis
38
balanoposthitis in bull:
cause?
Tx?
- infectious pustular vulvovaginitis virus (genital BHV1)
- venereal dz
- ulcerations, erosions, sloughing of penile mucosa, 2* bacT infection
- adhesions if severe => can cause phimosis if severe
- Tx: sexual rest
- prophylactic intra preputial abx infusion to px 2* bacT infections
39
```
balanoposthitis in sheep:
MC in ram or wether?
common name?
etiology?
predisposition?
Tx?
```
- MC wether over ram
- aka pizzle rot
- cause: corynebacterium renale
- high protein intake -> inc urea in urine -> inc bacT conversion to ammonia -> urine scalding of prepuce -> necrosis, blockage of preputial orifice -> urine retention
- ulceration and adhesions of penis
- Tx: dec protein intake and shear underside of ram/wether
40
phimosis:
- cause?
- how does it affect breeding?
- Tx/prognosis
- congenital: persistent penile frenulum or preputial stricture
- trauma
- chronic inflammation and or infection
- px protrusion
- tx depends on casue: Sx maybe
congenital better prognosis than acute trauma better prognosis than chronic inflammation/infection
41
preputial eversion:
| when is physiological and when is pathological?
physio: bulls and stallions when urinating; post breeding in macho
- 'hanging out' - predisposes to internal lamina trauma
42
Tx preputial eversion?
| prognosis?
- fast to px 2* trauma and necrosis
- clean: dec edema w hydroscopic agent -> replace -> purse string suture
- abx, anti inflammatories
- sexual rest
- good prognosis
43
extended penis anatomy: distal to proximal?
preputial ring or reflection
free portion of prepuce or lamina interna
external preputial orifice
sheath
44
equine pathology of penile paralysis and paraphimosis?
- EMP, EHV, spinal cord injury occurs
- dec retractor penis M tone
- penile paralysis
- penile swelling
- paraphimosis
- out: swells worse, inc intra preputial pressure
- paraphimosis, swelling, M fxn compromise - cycle continues and worsens
45
do not give what drug to stallions to px paraphimosis?
ace
46
Tx paraphimosis?
mechanical: hydroscopic agents (glycerol, epsom salt soak), massage distal to proximal, assess tissue health
medical: hydrothearapy to dec edema, clean gross area, NSAIDs, abx (systemic and topical)
mgmt: assess urination, retraction, forced exercise, cold water 15 mins BID, avoid sexual arousal
- may use compression bandage, topical tx for lubrication and abx
-
47
methods of retention for tx paraphimosis?
- purse string suture (local anesthetic)
- penis retainer (homemade)
- probang penis repulsion device (PCV pipe anchored to ventral body wall, holds penis)
- towel clamps
48
indications for urinary catheter placement?
- penile paralysis
- paraphimosis
- rare: spinal cord lesion (stallion)
- preputial injury NOT commonly effect urination so NOT an indication
49
chronic paraphimosis options for bull, stallion, gelding, dog?
bull: semen collection if wanted and if possible - cull
others:
phallectomy
perineal urethrostomy
castration (if intact)
50
paraphimosis prognosis in stallion?
good if Tx before 24 hours
prognosis worsens with time
51
paraphimosis prognosis in bull?
better if Tx in acute phase
2* infection, adhesion make prognosis worse
52
dog paraphimosis: etiology?
Tx?
prognosis?
emergency!!!
abnormal preputial orifice (lax, stenotic) or too short prepuce
failure to replace penis into prepuce after breeding
trauma
intra perputial messes (TVT)
Tx - same idea: clean, hydroscopic agents, lubricate, catheter if needed, abx
prognosis: Tx in 24 hrs improves prognosis
may need Sx to enlarge preputial orifice or amputate penis
castrate
53
priapism MC affects what species?
stallion / gelding
then dog
then bull, ram, buck
54
t/f: priapism is not an emergency
FALSE
| emergency in any species
55
etiology and pathophysiology of priapism in equine:
- lesions of spinal cord, nematodiasis, neoplasia
- dec venous drainage from CCP
- persistent erection and penile protrusion
- edema at preputial reflection
56
how to differentiate priapism from edema in equine?
priapism: firm core of penis to shaft - cannot be reduced back into sheath
NOT priapism: edema and can be put back into sheath
57
edema prominent in priapism?
| where is it found?
little edema present
| if so, MC loc at preputial reflection
58
priapism in dog:
| etiology?
- trauma post mating
- neuro disorder [distemper, spinal cord]
- penile thromtoembolism
- UTI
- constipation
- idiopathic
59
distinguish priapism from paraphimosis in dog?
priapism: proximal area will be engorged (bulbis glandis)
paraphimosis NOT engorged
60
Tx of priapism in equine:
maintain penile and preputial mucosa
apply compression bandage
provide support w/o replacement
refer
61
if you cannot refer equine priapism case, what to do?
- benztropine mesylate - IV w/in few hrs onset, monitor for ileus and colic
- massage
- irritagion of CCP under anesthesia
- emollient application
- replacement and retention
62
if priapism in equine does not resolve in 6-8 hours, what is option?
phallectomy
63
Tx priapism in dog?
- ID and Tx inciting cause
- symptomatic Tx to support penile mucosa
- phallectomy
- castration alone NOT effective
64
fibropapilloma lesions MC in what species?
bull
then stallion
then dog
65
presentaion of bull w fibropapilloma lesion?
- young
- at skin / mucocutaneous jxn, free portion of penis, internal lamina
- pedunculated [stalk] or sessile [more attached] - single or multiple
66
complications of bull w fibropapilloma?
- hemorrhage
- ulceration, 2* infection
- dec libido
- preputial prolapse due to enlargement
67
Tx fibropapilloma in bull?
BSE prognosis?
self cure by 3 yo
remove - pull w hemostat
sx
autogenous vacc option
good prognosis
68
presentation of fibropapilloma in stallion?
Tx?
- uncommon
- occur w balanoposthitis
- no tX
- cause of SCC maybe
69
dog fibropapilloma presentation?
- poorly circumscribed
- slow developing
- ulcerative
70
MC penile/preputial neoplasm of stallion / gelding?
SCC
| on glans penis, internal lamina
71
complications of SCC?
- red smegma
- prolapse
- 2* infection, trauma, ulceration
- slow to met to regional lnn
72
Tx of SCC in stallion / gelding?
cryotherapy
5 FU (topical)
aldara (topical)
sx excision - reefing or phallectomy
73
less common equine penile neoplasms?
Tx?
- sarcoid (of sheath or internal preputial lamina)
- melanoma (internal lamina)
Tx - sx excision
74
canine MC penile neoplasm?
presentation?
Tx?
prognosis?
TVT - transmissible venereal tumor
spread via coitus (genital) or sniffing (nose, mucocutaneous jxn)
young animal
grey nodular mass invading prepuce and/or penis
firable, ulceratibe
Tx: sx debluking, chemo (vincristine), laser therapy
recurrence high rate
75
complete ejaculatory failure - some causes?
- ejaculatory reflex disrupted
damage to sensory nn of glans penis
dorsal N of penis damaged 2* to stretching (from paraphimosis)
compression of spinal root by exostoses (old bull)
- localized pain: lumbosacral, peritonitis in Cd abdomen (bulls w seminal vesiculitis)
76
ejaculatory failure MC in what species?
dog
77
what is incomplete ejaculate?
- omission of sperm rich fraction from ejaculate during semen collection
azoospermia - look at alk phos
78
what is ejaculatory mixing of fractions?
| pathology?
alternation btwn sperm rich and prostatic fractions
NOT pathologic
79
what is outside tie?
natural mating, dog fails to achieve intromission - ties w external preputial orifice and ejaculates
80
what is slip mating?
dog achieves but does NOT maintain intromission - breeding may NOT result in pregnancy
81
what is impotentia generandi?
| what are organs of concern?
failure of fertilization despite normal copulation
testes, epididymis, scrotum, accessory sex glands
82
when considering impotentia genreandi, r/o:
- pathology or subfertility of FM
| - management issues
83
components of evaluation for impotentia generandi:
- exam scrotal contents, acc sex glands
| - collect and eval semen
84
what is low # sperm?
oligozoospermia
85
what is no sperm?
azoospermia
86
what is abnormal sperm motility?
asthenozoospermia
87
what is abnormal sperm morphology?
teratozoospermia
88
leukospermia def?
WBC in semen
| NTs
89
hemospermia def?
RBC in semen
90
what species is cryptorchidism MC?
stallion, dog and boar MC than
| bull, ram or buck
91
can unilateral cryptorchids impregnate FM?
yes
92
possible mechanisms of cryptorchidism?
- abnormal / insufficient development of the gubernaculum
- inadequate dev of epididymal tail -> fail to dilate internal inguinal ring
- insufficient intra abdominal pressure to distend vaginal process
- testicular teratoma
- aberrations of repro hormonal environment
93
unilateral retention in horse - common location?
- sub Q tissue
- inguinal canal
- abdomen: left testis more frequently retained
94
bilateral retained in horse - common location?
- both in abdomen or both in inguinal area
| - mixed locations are uncommon
95
what is risk for malignant neoplasia from cryptorchidism in horse?
very low
teratoma is benign
96
goal of cryptorchid evaluation:
- confirm presence of fxnl testicular tissue
| - locate occult gonad
97
what to palpate for during scrotal PE if cryptorchidism is suspected?
- lack of scrotal testis
| - ID testis at superficial aspect of inguinal canal
98
for rectal palpation to ID cryptorchid testes?
- deeper into inguinal canal - feel ductus deferens entering inguinal ring
- intra abdominally retained testis: epididymal tail and testis often identifiable in area of internal inguinal ring
99
how to confirm presence of testis that were palpated?
trans rectal u/s
100
greatest use for transcutaneous u/s when cryptorchid testicle is suspected?
- find loc of testicle after confirmation of retention using endocrine assays
sequential image: inguinal area, cd ventral abdomen to flank fold, lateral aspect of flank
101
what endocrine assays exist for cryptorchid?
- T
- AMH
- estrone sulfate
102
describe baseline T test for cryptorchid in horse?
- get baseline T conc: if less than 100-250, the NO testicular tissue
- if high, means cryptorchid
- if low, then he may still be too young (less than 18 mos)
103
describe T stim test for cryptorchid in horse?
- baseline T conc
- give hCG -> LH like activity on leydig cells
- should see inc by 2-3x in T conc after hCG if testicular tissue in horse
- give horse 48 or 72 hrs to respond
better than baseline test
104
what is estrone sulfate test for cryptorchid?
- leydig cells produce estrone in quantities greater than T
- take single serum sample in horse over 3 yo
- it is conjugated in soluble water and is inactive -> blood vessel
NOT used in donkey jack or mule
105
AMH test for cryptorchid equine?
- AMH = glycoprotein sec by sertoli cells in lg quantities
- prod by testis -> stim regression of paramesonephric duct system in M fetus via supression of leydig cell differentiation and steroidogenesis
- levels remain high in M until puberty
- at puberty, the blood testis barrier evolves and AMH sec into seminiferous tubule lumen and into seminal plasma
- dec in prod BUT prod in cryptorchid testes, Sertoli cell tumors and intersex gonads
gelding: little/none
stallion: little bit
cryptorchid: a lot
should work in donkeys, mules too
106
cryptorchid dog - what age descent?
8 wks old
107
heritability of cryptorchidism in dog?
sex limited autosomal recessive trait
108
breeds at inc risk?
toy, minis
boxer
old eng sheepdog
109
dx cryptorchid in dog?
- PE
- u/s of inguinal region and abdomen
- endo assays: baseline T, LH serum conc
110
how does LH serum conc test determine cryptorchid dog?
- castrated dogs lack neg feedback loop so have high LH
| - presence of cryptorchid testicle -> prod T so low LH b/c of feedback loop
111
Tx cryptorchid in dog?
unethical and questionable efficacy anyways
- medical: hCG injections, GnRH analog injections, T [not effective]
- orchiopexy - tack testis into scrotum
MUST BILATERALLY CASTRATE
112
dog risk for malignant neoplasia in retained testicles?
VERY HIGH
113
how does thermal induced testicular degeneration occur?
thermal induced testicular degeneration reversible?
insulation: spermatic cord insulated by fat, varicoele, inguinal hernia, hydrocele
inc temp: fever or environmental
inflammation from frost bite or dermatitis
infection: periorchitis, orchitis, epididymitis
yes
114
irreversible causes of testicular degeneration:
toxins (gossypol, cotton seed in bulls)
inc corticosteroids - dec LH sec (endogenous or exogenous)
dec FSH and/or dec LH sec - ant pit lesion or sertoli cell tumor
age related / senile
idiopathic
115
clin signs of testicular degeneration?
- dec testicle size
- prominent epididymis
- altered testicle consistency: soft if acute or firm if chronic
- normal libido
- abnormal spermiogram (few/no sperm) OR teratozoospermia
116
dx testicular degeneration?
- clin signs
- spermiogram
- testicular bioopsy (rare)
- hormone conc NOT good dx tool
117
prognosis testicular degeneration depends on?
- etiology
- duration of insult
- bilateral or unilateral
118
testicular hypoplasia:
reversible?
causes?
signs?
- irreversible
- indaequate # germinal cells
- bilaterally small testes AND epididymis
- few to no sperm and abnormal morph
- etiology: family predisposition/sporadic
chromosome abnormalities (XXY - bull, ram, boar, dog)
M tortoise shell and calico cats
119
orchitis?
etiology?
route of infection
- inflammation of testis
- unilateral MC than bilateral
- infection or autoimmune
- infection via: direct inocluation or hematogenous spread or ascending from epididymis
120
MC causes of orchitis:
- ubiquitous bacT (e coli or staphylococcus)
- mycoplasma
- brucella
- pyogenic organisms common to that species
less common: dog - distemper virus, autoimmune
tom cat: FIP virus
121
Tx of orchitis:
abx not successful
salvage breeding of unilateral infection - abx and anti inflammatories
guarded future breeding soundness
cull if brucella!
bilateral: cull - poor soundness
122
testicular neoplasia common or rare in most species? exception is which species?
rare
| except in dog (10%)
123
MC presentation of dog testicular neoplasia?
incidental - necropsy finding
| death unrelated
124
how is testicular neoplasia classified by endocrinologic activity?
active
| inert
125
what tumors are active testicular tumors? what do they sec?
interstitial (leydig cell) - sec T
| sertoli cell tumor - sec e2
126
inert testicular tumors?
seminoma
| teratoma
127
metastasis to testicular neoplasia common?
NO
128
Tx of choice for testicular neoplasia?
sx excision
129
clin signs in dog w leydig cell tumor:
- small
- no impact on fertility
- inc prostatic dz
- inc circumanal gland adenoma
130
clin sign in dog w sertoli cell tumor?
- contra lateral testis atrophy
- prostatic squamous metaplasia
- feminization
131
seminoma clin signs in dog?
large
abdominal pain w cryptorchid
innocuous if scrotal
132
teratoma MC seen in what species?
sequelae?
Tx?
- abdominally retained testes in horse
- solid or cystic w multiple embryonic cell types
- rare met - can be lg and cause colic!
- Tx - sx removal
133
epididymitis?
MC species?
acute and chronic presentation?
inflammed epididymis
ram MC over dog, bull, stallion
acute: lg and painful epididymis, leukospermia, teratozoospermia
chronic: firm, nodular epididymis, occlusion of epididymal outflow, ipsilateral testicular atrophy
sperm granuloma can occur if BTB compromised
unilateral: few sperm
bilatersl: NO sperm
134
MC etiology of epididymitis in ram?
- brucella ovis
venereal transmission via homosexual activity or breeding infected ewes
- persistent infection
135
clin sings of brucella ovis epididymitis in ram?
- lg epididymal tail
- leukospermia if acute
- sperm granulomas
- testicular atrophy if chronic
- maybe seminal vesiculitis
136
Dx brucella ovis epididymitis in rams?
Tx?
- serology - ELISA
- semen culture
- dec prod rate and inc lambing interval
NO Tx -> cull + rams
137
ram lamb or young virgin ram epididymitis etiology?
- HPA group: histophilus, acctinobacillus siminis, pasteurella haemolytics
often sub clin infections in herds - self cure 60% of time
revealed w poor herd hygeine
138
clin signs of HPA / epididymitis ?
leukospermia
acute: swelling, heat and pain in testicles/epididymis; anorexia; hyperfibriongenemia
chronic: testicular atrophy, fibrosis and Calcification, epididymal fibrosis
139
dx of ram lamb epididymitis?
tx?
px?
semen eval and culture
NO Tx - oxy tet may help
px w clean environment and dec intensity of mgmt
140
sperm granuloma etiology?
any species
result of epididymitis or compromise of integrity of ductus deferens
unilateral: oligospermia and subfertile
bilateral: azoospermia and infertility
141
seminal vesiculitis - species?
age?
etiology?
transmission?
bulls
young MC than old - intensive mgmt w high stocking density
high feed intake, fast grower
a pyogenes commonly isolated but more also
venereal transmission to cows possible but no big issue
142
clin signs of seminal vesiculitis in bull?
| acute and chronic
acute: dec libido, pain, lg or painful vesicular glands on transrectal palpation
chronic: poor fertility despite normal libido, firm and nodular areas but no pain on palpation
143
semen of seminal vesiculitis in bulls?
- gross: flocculent, grey color
- asthenozoospermia
- teratozoospermia (2* defects especially)
- leukospermia
- inc pH
144
Tx of seminal vesiculitis?
young: abx and self resolve
re evaluate 60 days
old: bilateral = cull; unilateral = abx NOT effective, formalin injection, seminal vesiculectomy (hard sx to do), CULL if semen is poor
145
dog prostatic hyperplasia notes:
big Tx:
benign
intact get it b/c DHT accumulation
castration may help but not fix it
inhibit conversion of T to DHT - a 5a reductase inhibitor at level of prostate
