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Reproduction > Clinical Disease of SA Repro Tract 1 > Flashcards

Clinical Disease of SA Repro Tract 1 Flashcards

1
Q

What are the 4 most important questions to ask when investigating vulval discharge?

A
  • age, neuter status
  • stage of repro cycle (esp metoestrus and pregnancy)
  • colour
  • discharge from uterus or urethra?
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2
Q

What does greeny black discharge in the bitch indicate?

A

placental separation

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3
Q

What colour is discharge seen associated with placental separation in the queen?

A

red/brown

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4
Q

What are the causes of white vaginal discharge?

A
  • vaginitis
  • early metoestrus
  • open pyometra
  • cystits
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5
Q

What are the causes of red vaginal discharge?

A
  • proestrus/oestrus
  • persistent ovarian follicle
  • oestrogen secreting ovarian tumour
  • vaginal trauma
  • vaginal FB
  • cystits
  • urethral neoplasia
  • coagulopathy
  • placental separation
  • subinvolution post partum
  • vascular malformation
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6
Q

What are the causes of clear vaginal discharge?

A

normal

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7
Q

What are the causes of clearn wateryvaginal discharge?

A

amniotic/allantoic fluid

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8
Q

What are the causes of greeny black vaginal discharge?

A
  • normal parturition
  • dystocia
  • separated placental membranes (may be normal or adnormal)
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9
Q

What are the causes of brown/red -> blackvaginal discharge?

A

Metritis

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10
Q

What are the causes of yellow vaginal discharge?

A

Inconcitnence

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11
Q

What are the 2 forms of vaginitis and how do they present?

A
  1. Juvenile/ prepubertal
    - common in practice
    - 2* to bacterial contamination and excess vaginal secretion
    - usually resolves SPONTANEOUSLY at 1st season
    - AVOID Abx `
  2. adult
    - less common
    - ID specific casue
    - may respond to exogenous oestrogens (topical or oral)
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12
Q

When does pyometra usually preent?

A

Within 8 weeks of last season (associated with open cervix at season)

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13
Q

What are the 2 forms of pyometra?

A
  • Open: open cervix -> mucopurulent vaginal discharge, mildly enlarged uterus
  • Closed: closed cervix -> no discharge,uterus grossly enlarged, systemic illness
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14
Q

What factors are assicated with formation of pyometra/

A

Bacteria usually GIT (E. COli) , cystic endometrial hyperplasia, progesterone, open cervix

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15
Q

What clinical signs are seen associated with pyometra?

A
  • depression, lethargy
  • mucopurulent discharge
  • pyrexia
  • PUPD
  • V+
  • Collapse and shock
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16
Q

What would be seen on haem and biochem with pyometra?

A
  • Neutrophilia with L shift
  • Possible azotaemia
  • Acidoisis
  • Endotoxaemia
  • Hypogylcaemia
  • Anaemia
  • Coagulation abnormalities
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17
Q

How is pyometra diagnosed?

A
  • ultrasound

- radiography (cannot distinguish from mid-stage pregnancy)

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18
Q

What is the most common treatment for pyometra?

A 
Surgical excision (overiohysterectomy) 
- medical trtmt possible
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19
Q

What are common causes of vaginal trauma?

A
  • iatrogenic (contrast injection etc.)
  • forced separation of mating dogs
  • malicious wounding
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20
Q

What is the treatment for vaginal trauma?

A
  • investigate and confirm origin
  • supportive treatment (pack vaginal with swabs etc.)
  • +- BS Abx
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21
Q

Are vaginal masses most common in neutered or unneturtered?

A

Most common in UN-neutered

22
Q

What questions should be asked in relation to vaginal masses?

A
  • contain a hole?
  • within wall or within lumen?
  • where in relation to external urethral orifice?
23
Q

What are the commonest vaginal/vestibular neoplasia? Which dogs is this usually seen in?

A

Lyeiomyoma or leiomyosarcoma

- elderly entire bitches

24
Q

How may vaginal masses present?

A
  • visbale mass
  • bulging perineum
  • dysuria/dyschezia
25
Q

What is the treatment for vaginal/vestibule neoplasia?

A

> surgical excision and OVH
- vie episiotomy (open vestibule)
- via pubic symphisiotomy and vaginal excision
chemo for TVT (transmissible venereal cell tumour, seen 3rd world countries)

26
Q

What are the causes of tissue prolapsing out of the vagina? How may they be differentiated?

A
  1. Vaginal hyperplasia (excessive response of vaginal mucosa to oestrogens during follicular phase of oestrus cycle -> vaginal oedema and prolapse) Seen as a section of tissue ballooning out of vagina
  2. Vaginal prolapse - hole in the centre, vagina bulging out on all sides
    > actually a difference?? look up
27
Q

Which breeds are predisposed to vaginal hyperplasia and prolapse?

A

Brachycephalic breeds

28
Q

How should vaginal prolapse be managed? What should owners be made aware of?

A
  • conservative measures ie. keep moist, vulvar sutures to keep it in place
  • surgical excision via episiotomy
  • likely to reoccour next oestrus
    > neuter or control pharmacologically
29
Q

What is the cause of ambiguous genitalia?

A
  • manifestation of intersexuality due to presence of androgens from testicular tissue +- ovarian tissue
30
Q

What is the treatment for ambiguous gonads? What other investigation may be performed?

A
  • removal of gonads (+ histopath)
  • karyotyping (chromosomes)
  • SRY gene testing (sex determining regionof Y)
  • treatment of other abnormalilities if causing problems eg. reflux of urine into a uterine structure
  • amputation of penis
31
Q

When should partuition be a cause for concern?

A
  • fetal fluids passed 2-3hrs, no birth
  • dam straining 30mins, no birth
  • greenish/reddish brown vulval discharge apparent with no birth 2-4hrs later
  • weak/irregular straining 2-4hrs, no birth
  • > 2-4hrs since last pup delivered no birth
  • second stage labour lasting > 12hours
  • dam sick
32
Q

Give possible maternal causes of dystocia

A 
> narrow birth canal 
- soft tissue
- oseus
> Disturned labour
- uterine inertia
- uterine spasm/tetany
- inadequate abdo force
> uterinae abnormalities 
- torsion
- rupture
- malformation
- adhesions 
> prolonged pregnancy
> psychogenic causes 
> extrauterine problems 
- sepsis
> premature birth
> prolonged parturition 
> idiopathic
33
Q

What is the most common cause of dystocia?

A
  • maternal

- uterine inertia

34
Q

Which foetal causes may cause dystocia?

A 
>^foetal size
- litter size
- genstational length
- breed factors 
> foetal malpresenation [most common]
> abnormal foetal development
- hydrocephalus
- foetal death
35
Q

What are the 2 forms of uterine inertia? Which is most common?

A
  • 1*: uterus fails to respond to foetal signals [most common]
  • 2*: exhaustion of myometrium due to obstruction of birth canal
36
Q

What are the causes of 1* inertia?

A
  • small or very large litter
  • systemic disease of the dam
  • inherited predisposition
  • nutrition
  • obesity
  • age
  • failure neuroendocrine due to low levels of oxytocin
37
Q

What medical management of partuition should be implemented and when?

A
  • should only be implemented when NO EVIDENCE OF OBSTRUCTION
  • exercise
  • feathering the roof of the vaginal floor
  • oxytocin (multiple small doses. NOT SINGLE LARGE DOSE)
  • hypocalcaemia/hypoglycaemia trtmt
  • tocospasmolytic drugs in combo with OT in Europe
38
Q

What should be carried out if medical intervention in dystocia is unsusccessful?

A

C section

39
Q

How much and how often should oxytocin be dosed?

A

30-40mins

- 0.2-0.4IU/kg

40
Q

Why shuodl a single large dose of OT not be given?

A
  • ^ no. stillbirths due to hypoxia

- placental compression and compromise

41
Q

Give examples of congential abnormalities

A
  • vulval stenosis
  • anovolvular cleft
  • rectovaginal fistula
  • vestibulovagional stricture/band
42
Q

Give examples of acquired abnomaltities

A 
> vulval hypertrophy 
- juvenile prolonged proestrus
- endogenous/exogenous oestrogens 
> recessed vulva
> trauma
> neoplasia
43
Q

What are the potential pathological cuases of abdominal mass/distension?

A
  • pyometra
  • retained foetuses
  • ovarian/uterine neoplasia
  • segmental aplasia and mucometra (congenital abnormalilty, presents around time of first season due to build up of sterile mucous proximal to stricture)
44
Q

Is ovarian neoplaisa common in the dog and cat?

A

No

45
Q

What types of ovarian neoplasia are possible?

A
  • granulosa cell
  • cystadenoma
  • adenocarcinoma
  • teratoma
46
Q

What clinical signs are seen associated with ovarian neoplasia?

A
  • large mass
  • +-ascites
  • signs of proestrus if endocrinologically active (-> oestrus production)
  • peritoneal cavity metastasis
47
Q

What is the treatment of ovarian neoplasia? What does prognosis depend on?

A

Surgical excision, depends on pathology and stage of disease.

48
Q

Is hydrometra/mucometra common? What type of pathology is this?

A
  • rare
  • congential
  • often found incidentally
49
Q

How is hydrometra diagnosed?

A

imaging and surgery

50
Q

What reproductive pathology may cause systemic illness?

A
  • closed pyometra

- uterine torsion or rupture

Reproduction (30 decks)

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