A Logical Aproach To Clinical Repro Disease Flashcards
What are common ‘female’ problems that owners consult the vet about?
Neutering Stopping a season Suspected pregnancy Misalliance - accidental mating Calling - cats in oestrus, owner confusion False pregnancy Lactation Dystocia Mating time Fertility problems Vulval discharge Vulval mass Vulval swelling Abdominal distension Systemic illness
What are the common ‘male’ problems that owners consult the vet about?
Neutering Behavioural modification Testicles missing Testicles of different sizes Difficulty defecating Systemic illness Preputial discharge Penis sticking out Penile mass Penile/testicular injury
What is the first question you should consider when presented with a repro case?
Is it a manifestation of normal reproductive physiology?
OR
Is there clinical disease?
What history should you take for a repro case?
Define owners problem / reason for coming in Age, Breed, Sex Neutered/entire Females - Last season: when?, normal? - Breeding history Current/planned use of animal Previous illness/surgeries Additional general information
How would you perform a (repro) clinical exam on a female patient?
General PE Vulva Mammary glands \+/- vaginal examination \+/- rectal examination Response to behavioural stimuli- pressure on rump
How would you perform a (repro) clinical exam on a male patient?
General PE Scrotum and testes Prepuce and penis \+/- mammary glands Rectal examination
What should you look for when doing a general PE (repro)?
BCS
Pyrexic?
Signs of anaemia or sepsis
Lymphadenopathy
What should you look for when doing an abdominal examination (repro)?
Abdominal mass Uterine enlargement Fluid thrill Visceral displacement Pain
What should you look for when checking mammary glands (repro)?
Enlargement/masses
Lactation/discharge
Pain
What should you look for when checking the vulva/prepuce (repro)?
Check skin, shape, position
Look for skin abnormalities
Check for discharge
Check mucous membranes and mucocutaneous junctions
Extrude penis and examine - shaft and external urethral orifice
What should you look for when checking the scrotum (repro)?
Check skin
Presence of TWO testicles
Testicular size, shape, consistency, mobility and pain
What can be checked during rectal examination?
Anal sacs Urethra Prostate/Vagina (ventral) Enlarged dorsal lymph nodes Pelvic diameter
What are the signs of oestrus?
Vulval enlargement
Standing on rump pressure +/- displacement of the tail
Haemorrhagic/straw coloured discharge
Characteristic smell
Why are several reproductive problems rare in neutered animals?
Because they are hormonally driven
What might haematology and biochemistry be useful for?
Allow detection of many changes including those that are suggestive of:
- Infection/sepsis
- Azotaemia
- Hypo/Hyper calcaemia
- Anaemia
Why are urinalysis and urine bacteriology important diagnostics?
Reproductive and urinary tract intimately associated
- infection in one closely related to infection in the other
Why can hormonal assays be useful?
Helpful for:
- Detecting incompletely excised gonadal tissue
- To aid pregnancy diagnosis
- Predict ovulation and optimal mating time
What hormone assays are available?
Testosterone Oestrogen Progesterone Anti-Mullerian Hormone (AMH) Relaxin
What are the most useful diagnostic imaging techniques for repro problems?
Radiography (plain and contrast)
Ultrasound
CT of increasing importance
When might ultrasound be useful?
- Imaging parenchymatous organs
- Distinguishing fluid from soft tissues
- Allowing image guided centesis and biopsies to be performed
- Assessing viability of pregnancy
- detecting free abdominal fluid
- Determining origin of organ enlargement
- Abdominal pathology/ change
What is ultrasound not good at?
What imaging can be used to compensate for this?
Imaging intrapelvic structures
Detecting bony change
Radiography
What is radiography most useful for?
Imaging bony changes e.g.
- foetal mineralisation and number
- pelvic anatomy
- injury to os penis
Contrast techniques can demonstrate extent and location of luminal abnormalities e.g vagina and urethra
Thoracic radiography for detection of pulmonary metastasis
How can endoscopy be useful for reproductive exams?
Vaginal mucosa changes in appearance - stage of oestrus cycle
Detection of sepsis, septa’s, neoplasia, foreign bodies
Biopsy and collection of discharge
(Less common in cats)
What categories of biopsy can be taken?
Incisional
Excisional
Needle (core biopsy)
Grasping forceps
