Clinical Disease Repro Tract Dog and Cat Flashcards
1
Q
What are the common reproductive diseases affecting the ovary, uterus and vagina in the dog and cat?
A
Ovarian Neoplasia
Pyometra, Mucometra
Dystocia
Vaginal Hyperplasia/prolapse
Vaginal neoplasia
Vaginal trauma
Ambiguous genitalia
2
Q
What is important to know about vulvar discharge when examining female patient?
A
Color
Whether its coming from uterus or urethra
Stage of reproductive cycle (diestrous, pregnancy)
3
Q
What are the causes of creamy white vulvar discharge?
A
Vaginitis
Early metestrous
Open pyometra
4
Q
What are the causes of bloody vulvar discharge?
A
Proestrous
Estrous
Persistent ovarian follicle
Ovarian tumor (estrogen-secreting)
Vaginal trauma
Vaginal FB
Cystitis
Urethral neoplasia
Coagulopathy
Placental separation
Sub-involution post partum
Vascular malformation
5
Q
What are the causes of clear mucoid discharge?
A
Normal
6
Q
What are the causes of clear watery discharge?
A
Amniotic/alantoic fluid
7
Q
What are the causes of greeny black discharge?
A
Normal parturition
Dystocia
8
Q
What are the causes of Brown/Red –> Black discharge?
A
Metritis
9
Q
What are the causes of yellow discharge?
A
Incontinence
10
Q
What is vaginitis?
A
Inflammation of the vagina
10
Q
How does vaginitis usually present in the bitch?
A
Purulent discharge
10
Q
What is the difference between juvenile and adult vaginitis?
A
Juvenile (prepubertal) vaginitis
- Secondary to bacterial contamination and excess vaginal secretion
- Usually resolves spontaneously with first season
- Do not give ABX
Adult vaginitis
- Less common, aim to ID cause and treat
- May respond to exogenous estrogens (topical/oral)
10
Q
What is pyometra? What animals does this affect?
A
Uterus fills with pus, can result in life-threatening illness (treat as emergency)
Affects both dogs and cats
10
Q
What is the difference between open and closed pyometra?
A
Open - cervix associated with mucopurulent vaginal discharge and a mild-moderately enlarged uterus
Closed - cervix not associated with vaginal discharge, uterus is usually grossly enlarged and animal systemically ill
10
Q
How many weeks within the last estrous does pyometra usually present?
A
Within 8 weeks
10
Q
What are the factors which increase the risk of an animal developing pyometra?
A
Cystic endometrial hyperplasia
Bacterial infection (E. coli)
Progesterone
Open Cervix
10
Q
What are the common clinical signs associated with pyometra?
A
Depression, lethargy, mucopurulent vaginal discharge (open), pyrexia, PU/PD, vomiting, collapse, shock
11
Q
What are the common pathological changes you will see with pyometra (Bloodwork)?
A
Neutrophils with left shift (degenerate)
Possible azotemia (renal)
Acidosis
Endotoxemia
Hypyglycemia
Anemia
Coagulopathies
12
Q
How do you diagnose pyometra?
A
Ultrasound or radiography
13
Q
How do you commonly treat pyometra?
A
Surgical - most common (OVH)
Medical - recurrence possible, reserved for dogs with breeding value
14
Q
How common is vaginal trauma? How does this usually happen?
A
Uncommon - usually iatrogenic (Ex. perforation during contrast study)
Forced separation of mating dogs
Malicious wounding (welfare issue)
15
Q
How should you investigate/treat vaginal trauma?
A
Confirm origin of bleeding
Provide conservative/supportive treatment (usually all that is required until bleeding stops)
16
Q
What is happening here? (Hint - vagina)
A
16
Q
What is happening here? (Hint - vagina)
A
17
What are the most common tumors in the bitch?
Smooth muscle tumor of vagina/vestibule - leiomyoma/leiomyosarcoma (slow growing smooth muscle tumor)
18
What is the typical signlament of dogs presenting with vaginal neoplasia? What are the clinical signs?
65% bitches entire, usually elderly
May present with visible mass, bulging perineum or dysuria/dyschezia
19
How do you diagnose vaginal/vestibular neoplasia?
History/PE
Endoscopy
Radiography
Biopsy
20
What is the treatment for vaginal/vestibular neoplasia?
Surgical excision of mass + OVH
Chemotherapy - option for some tumors
21
How does vaginal edema/prolapse occur?
Excessive response of vaginal mucosa to estrogens during follicular phase of estrous cycle = vaginal edema (hyperplasia) and vaginal prolapse
22
Which breeds are predisposed to vaginal edema/prolapse?
Brachycephalics
23
What is important to check before reducing prolapsed vaginal tissue?
Check for lesions as exposed tissues may get traumatized
24
How do you diagnose and treat vaginal edema/prolapse?
Diagnose through history and PE
Majority of treatment is conservative (keep moist, place sutures)
Surgical excision (episiotomy)
25
How common is recurrence of vaginal edema/prolapse? What can you do to reduce chances of recurrence?
Common (tends to recur)
Must control estrous and recommend neuter
26
What is ambiguous genitalia a manifestation of? What does it indicate?
Intersexuality
Indicates presence of androgens and therefore testicular material +/- ovarian tissue
27
How do you investigate ambiguous genitalia?
28
What is the management for ambiguous genitalia?
Removal of gonads
Possible partial penis amputation/removal of penis via episiotomy
Treatment of other abnormalities if associated with other clinical signs
29
What is dystocia?
Disturbance during parturition when normal delivery of fetus through birth canal is interrupted
30
Is dystocia more common in the dog or the cat?
Dog
31
What are the 3 factors involved in dystocia?
Maternal
Maternofetal
Fetal
32
What are causes for concern during parturition (signals that you might need to intervene)?
33
What are the maternal causes for dystocia?
34
What is the most common cause for dystocia?
Maternal - Uterine inertia
35
What are the fetal causes for dystocia?
Fetal malpresentation
Increased fetal size
- Increased size, litter number, gestational length, genetic/breed factors
Abnormal fetal development
- Hydrocephalus, other congenital abnormalities, fetal death
36
What is the most common cause of fetal dystocia?
Fetal malpresentation
Fetal oversize (brachycephalics over-represented)
37
What is uterine inertia? How is it classified?
Uterine muscle is unable to contract and expel fetus
Primary - uterus fails to respond to fetal signals
Secondary - exhaustion of myometrium, secondary to obstruction in birth canal
38
What are the most common causes of primary uterine inertia?
Small litter, large litter
Systemic disease
Obesity, age, nutritional imbalance
Inherited predisposition
39
What is the medical management protocol for dystocia? When should this be considered? What do you need to rule out first?
Need to rule out obstruction first
Management may include:
- Excercisind dam
- Feathering roof of vaginal floor
- Treatment with oxytocin
- Treatment of hypocalcemia/hypoglycemia
40
If medical treatment of dystocia is unsuccessful what should you consider next? How quickly do you need to make this decision?
If medical treatment unsuccessful or deemed inappropriate C-section required
Need to complete IMMEDIATELY after decision is made
41
How should you administer oxytocin to dystocia patient? What is the dosing protocol and how often should you dose?
Repeated small doses
Single large dose associated with prolonged myometrial contraction = placental compression and compromise
Dose at 30-40 min intervals
42
What is treatment with oxytocin alone associated with?
Stillborn and hypoxic pups
43
What are these 2 conditions?
44
List the common congenital abnormalities found in the dog?
Vulval stenosis
Anovulvar cleft
Rectovaginal fistula
Vestibulovaginal stricture/band
45
What is atresia ani? What kind of congenital abnormality does this associate with?
Atresia ani - hindgut does not communicate properly with anus, does not form an opening, feces needs to go somewhere so creates a pathway through vulva, leading to infection
Needs surgery to correct
46
What is vulval hypertrophy? What hormone is this influenced by? What are the 2 types/causes?
Enlarged and inflamed vaginal lining (influenced by estrous)
Juvenile prolonged proestrous
Endogenous/exogenous estrogens
47
What is a recessed vulva? What 2 conditions can cause this to occur? What is the common name for this condition?
"Hooded vulva" - skin folds around vulva which can build up infection
Predisposed:
- Dermatitis, Chronic inflammation
48
What are the main pathological causes of abdominal distension that relate to the reproductive tract?
Pyometra
Retained fetus
Ovarian/Uterine neoplasia
Segmental aplasia and mucometra
49
How common is ovarian neoplasia in dogs and cats?
Relatively uncommon
50
How does ovarian neoplasia typically present?
large mass +/- ascites
51
What hormone do ovarian neoplasias typically produce?
Estrogen
52
What is the treatment for ovarian neoplasia?
Surgical excision
53
What is hydrometra/mucometra? What is it usually secondary to?
Sterile accumulations of fluid within uterus
Usually secondary to congenital abnormalities such as segmental aplasia or acquired abnormalities
- Ex. uterine neoplasia
54
What are some reproductive causes of systemic illness?
Closed pyometra
Uterine torsion
Uterine rupture
55
What is the term for missing testicle(s)?
Cryptorchidism
56
What is the most common congenital defect in male dogs?
Cryptorchidism
57
What are retained testicles more susceptible to?
Torsion
Neoplasia
58
What procedure is advised to prevent future problems with cryptorchidism?
Castration
59
What are 2 other extremely rare conditions that can occur with the testicles?
Anorchia
Monorchism
60
What are the common causes for testicles of different sizes?
Neoplasia - most common
Orchitis/Epididymitis
Torsion
61
How common are tumors of the testicles reported in male dogs?
Second most common site for tumors reported in male dogs
Rare in cats, but can occur
62
What are the 3 most common tumors of the testicles?
Seminoma
Interstitial cell tumor
Sertoli cell tumor
63
Are tumors affecting scrotal testicles usually benign or malignant? What about cryptorchid testicles?
Scrotal testicles - generally benign
Cryptorchid testicles - more likely to be malignant
64
Where do malignant tumors of the scrotum usually metastasize to?
Usually go to lymph nodes, rarely viscera
65
What hormones can Leydig tumors vs. Sertoli tumors vs. Seminomas produce?
Leydig - may produce testosterone
Sertoli - may produce estrogen = feminization
Seminomas - may rarely be associated with feminization
66
How can tumors lead to infertility?
Production of hormones
Replacement of functional tissue
67
What is Orchitis? What is epididymitis?
Orchitis - inflammation of one or both testicles
Epididymitis - inflammation of epididymus
68
How does orchitis/epididymitis usually present? What are the typical signs?
Usually occur together
Signs include (normal signs of inflammation)
- Epididymal enlargement
- Testicular pain
- Tenseness and scrotal edema
- May abcessate via scrotum
- Animal may be systemically ill
69
Chronic orchitis/epididymitis (infection) may result in WHAT to occur to scrotum/testicle?
Small and firm testicle with epididymal enlargements
Adhesions between tunics and scrotum may reduce testicular mobility
70
Where do infections in orchitis/epididymitis originate from?
May originate from urinary tract, via direct penetrations or via hematogenous spread
71
What is testicular torsion? How common is it? What are the presenting signs?
Testicular torsion occurs when a testicle rotates, twisting the spermatic cord that brings blood to the scrotum
Unusual, more common in retained testicles
Presenting signs can be variable and confused with disease of other body systems
72
What are the presenting signs associated with a protruding penis?
Low grade irritation
Pain, bleeding, trauma
Social problem for owner
73
What are the diagnoses that could be associated with a protruding penis?
Paraphimosis
Priapism
Trauma
74
What is paraphimosis?
Non-erect penis protrudes from prepuce and cannot be retracted or retained in its normal position
75
What can cause paraphimosis?
Cause can be congenital or acquired
Narrowed preprutial orifice
Penile enlargement preventing retraction
Failure of penis to stay in prepuce
- Abnormally short prepuce
- Weak prepucial muscles or retractor penis muscle
- Contracture following wound
76
How do you treat paraphimosis?
Treatment dependent on severity and cause
Symptomatic treatment
Enlargement of preputial opening, preputial lengthening
Phallopexy if indicated - Partial penile amputation
77
What is Priapism? How common is priapism?
Persistent erection of >4 hours not associated with sexual excitement
Uncommon in dogs and cats
78
What can be associated with priapism?
Trauma in both dogs and cats
Perineal abscess
Neurological disease - most common
Neoplasia
79
What kind of exam is a good starting point for an animal with priapism?
Neurological
80
What kind of exam is a good starting point for an animal with priapism?
Neurological
81
What are the 2 classifications for priapism?
Ischemic (veno-occlusive, low flow)
Non-ischemic (arterial, high flow)
82
How can you differentiate ischemic from non-ischemic priapism?
Differentiated on clinical signs
Non-ischemic - entire penis partially rigid and painful - not an emergency
Ischemic - painful rigid shaft with soft glans - EMERGENCY
83
How should you diagnose and treat priapism?
Diagnose - U/S, Blood gas analysis of aspirated blood (looking for high lactate value)
Treatment - conservative (e-collar, analgesia, topical treatment) or surgical amputation if damage severe
84
How do you confirm diagnosis of penile masses?
Clinical appearance +/- biopsy
85
What are the top 3 differentials for a penile mass?
Inflammatory disease
Neoplasia
Urethral prolapse
86
How common are penile tumors in the dog and cat?
Uncommon, occur more often in dog>cat
87
What are the potential soft tissue tumors of the penis?
Transmissible Venereal Tumor
Somatic Cell Tumor
Papilloma
Lymphoma
Adenocarcinoma
Mast Cell Tumor
88
What are the potential tumors of the os penis?
Osteosarcoma
Ossifying fibroma
Chondrosarcoma
89
How can penile injury potentially occur? What are the typical presenting signs and what is the treatment?
90
What is hypospadias? What kind of abnormality is this?
Hypospadias is a congenital developmental anomaly of the external genitalia in male animals, in which the external urethral orifice is on the ventral surface of the penis rather than at the tip of the glans.
91
How does hypospadias occur? How is it corrected?
Failure of fusion of urogenital folds and incomplete formation of penis urethra
Correction attempts historically unsuccessful - likelihood of stricture very high
92
What is this condition and how is it treated? What age group of dogs is this typically associated with?
Persistent frenulum
Treatment is sectioning of fine lines and ligation of any bleeding vessels under GA
Young animals
93
What is phimosis? How can this occur and what is the treatment?
Inability to protrude the penis beyond the preputial orifice
May be congenital or acquired
Treatment - surgical enlargement/treatment of underlying condition
94
What is normal preputial discharge vs. abnormal?
Normal - slightly creamy discharge with normal commensal flora
Abnormal - severe/blood tinged discharge - needs investigation
95
What is dyschezia? What is this an important sign of?
Difficulty pooping
Important sign of male reproductive tract disease in the dog
Usually indicates prostatic enlargement +/- perineal rupture
96
What is benign prostatic hypertrophy? What hormone is this enlargement dependent on?
Uniform enlargement of prostate (maintains same structure, just bigger)
Commonest prostatic disorder in entire male dogs
Normal aging change (can cause clinical disease)
Testosterone dependent
97
What is the treatment for BPH?
Castration
98
What are the medical treatments for BPH? How commonly are those used?
Anti-androgens
Synthetic progestagen
GnRH analogue
Estrogens
Fecal softeners
99
What is prostatitis/Prostatic abscessation? What dogs is this more likely in?
Infection/Inflammation of the prostate - more likely in entire male dogs
100
How do patients with prostatitis/prostatic abscess usually present?
Associated with UTI/may arise from hematogenous spread
May be associated with purulent urethral discharge, systemic illness, dysuria, pain, vomiting/diarrhea, PU/PD
Occasionally septic shock/collapse
101
How do you diagnose prostatitis/prostatic abscess?
Diagnosis made on PE + U/S, aspirate
Rectal exam - take care!
Medical or surgical treatment
102
What can you say from this image?
103
How common are prostatic cysts?
Not uncommon in dog, might occur in cat
104
What are the 2 types of prostatic cysts?
Prostatic/parenchymal cysts (within prostatic tissue)
Paraprostatic/periprostatic cysts (edge of prostate)
105
What is the etiology of prostatic cysts?
Probably related to secretory activity
Secondary to neoplasia, metaplasia, resolved abscess, etc.
106
How common is prostatic neoplasia in dogs and cats? What is the prognosis?
Rare in dogs and cats
Prognosis poor
107
Which tumor types are the commonest in prostatic neoplasia?
Adenocarcinoma
Transitional cell carcinoma
108
What are the signs of prostatic neoplasia? How do these tumors typically invade?
Weight loss, pain, lameness in hind legs, dyschezia/dysuria, hindleg edema
Prostate may be enlarged, irregular in contour, firm on palpation
Tend to be locally invasive and metastasize
