Diagnostic Methods in the Bitch and Queen Flashcards
What is the physiology of the bitch cycle?
- Mono-oestrus
- Non-seasonal
- Pre-ovulatory luteinsation
- Spontaneous ovulator
- Polytocous
- Long non-pregnant luteal phase with normal pseudopregnancy (physiologic pseudopregnancy (silent) vs overt pseudopregnancy (clinical))
What is the physiology of the queen cycle?
- Poly-oestrus
- Seasonal
- Induced ovulator
- Polytocous
- No luteal phase if not ovulating (=interoestrus)
- Non-pregnant luteal phase longer than other species
- Pregnancy similar to bitch
- Waves of follicle growth which cause this cyclicity
list the diagnostic methods that you might use to investigate this bitch?
Smell the discharge (is it odorous?)
Vaginal endoscope
Vaginal cytology
Progesterone measurement
Ultrasound exam to rule out pyometra
Physical exam: HR, RR, temperature (trying to decide if it is sick or well), mammary development (repro exam), BCS
History: any signs of oestrus behaviour, has she been mated, any previous history of this discharge, has the discharge changed, how long has it been there, is it neutered?, is the animal systemically ill (PD/PU, inappetant?, any weight loss)
This can be a common discharge in pregnant dog and sometimes in luteal phase. A non-odorous creamy discharge and systemically well. If not systemically well then highest d/dx is pyometra.
What repro tract exams can we do in the bitch/queen? (5)
- Clinical history
- Previous breeding records
- Venereal pathogen screening
- General clinical examination
- Specific reproductive examination
What questions should we ask when taking a clinical history? (7)
- Previous cycles (normal / abnormal)?
- Normal mating?
- Ovulation confirmed?
- Previous pregnancy confirmed?
- Pregnancy to term?
- Reproductive tract discharge?
- Behavioural manifestations?
What would you find on routine bacteriology of the vagina and vestibule?
•The vestibule and vagina have a normal commensal flora which changes daily
–Many bacteria are present: Staphs., Streps., E.coli
–Ureoplasma and mycoplasma are also normal
–Often there is a mixed flora
–Pseudomonas is not commonly isolated
–Brucella canis is a veneral pathogen in some countries but not the UK (causing abortion, stillbirth, fading pups)
What would you find in the uterus when undertaking bacteriology?
usually sterile
–Vaginal bacteria may enter the uterus at oestrus
When may a vaginal discharge be normal? (2)
- Proestrus/oestrus
- Common during pregnancy
How do we interpret bitch vaginal swabs? (7)
- Most swabs are taken from the vestibule
- Swabs should be expected to contain commensal bacteria
- There is no evidence that isolation of bacteria is pathological
- A single species may be more significant than a mixed culture
- The only known venereal pathogen is Brucella canis
- Routine screening of the clinically normal bitch is pointless
- Routine antibiotic use is not appropriate
- Don’t lavage the vagina with antiseptic as may end up with a yeast/fungal infection and have made a problem.
What canine virus can be found with venereal pathogen screening?
How can we prevent?
•Canine herpes virus
–A known venereal pathogen causing vesicular lesions in the genital tract of dogs and bitches
–Appears to be increasingly common but no studies on prevalence in UK
–Infection can be venereally or via the respiratory tract
–Some viral recrudescence occurs as with many herpes viruses
–A vaccine (Eurican Herpes) is available for bitches and is given twice during pregnancy to protect that litter
What may canine herpes cause in the bitch? (3)
–In bitches it may cause resorption, abortion, stillbirths; depending upon when infection occurs
What ther viral infections are there during pregnancy, that can cause pregnancy loss– but are not venereal pathogens? (3)
–Canine parvovirus
–Canine adenovirus
–Canine distemper virus
What is seen on normal bacteriology of the vagina and vestibule of the queen?
•The vestibule and vagina have a normal commensal flora which changes daily
–Many bacteria are present: Staphs., Streps., E.coli
–Often there is a mixed flora
–Bacteria are commonly isolated from stillborn kittens and likely are opportunistic commensals
What is seen on bacteriology of the uterus of the queen?
•The uterus is normally bacteriologically sterile
–Vaginal bacteria may enter the uterus at oestrus
What virus may we find in the queen on venereal pathogen screening?
•Feline leukaemia virus (FeLV)
–Implicated in infertility, resorption and abortion
–The most common cause of infectious infertility
–Screening of queens prior to breeding is important
What other viruses that can cause pregnancy loss associated with infection during pregnancy in the queen – but are not venereal pathogens (2)
What signs do these cause?
–Feline herpes virus
- Uncommon
- Late abortion
- Vaccination effective in prevention
–Feline panleukopenia virus
- Uncommon
- Abortion, stillbirth, cerebellar hypoplasia
What are you looking at on a pre breeding general clinical exam?
- Looking for maturity, adult body size, systemic disease
- Ruling out hereditary disease
- Considering specific DNA tests
- Carefully considering suitability for breeding based on temperamental assessment
What do you look at when examining the perinema and vulva? (2)
•Normality or abnormality
–Presence of a discharge
- Normal in oestrus etc
- Normal muco-purulent discharge in early pregnancy
–Assess clitoris and vestibule
•Stage of the oestrus cycle
What does this show?
Normal vulval anatomy
What does this show?
Intersex pup with clitoral enlargement
What does this show?
Vaginal tumour
What does this show?
Abnormal purulent discharge in bitch
What do you asses with the mammary glands in a physical exam? (2)
- Normal or abnormal
- Stage of the oestrus cycle
–Mammary enlargement under influence of progesterone
What does this show?
Normal mammary enlargement of pseudopregnancy in bitch
(uncommon in the queen)
What does this show?
Mammary carcinoma in queen (in the queen 80% are malignant adeno-carcinoma; in the bitch 50% are malignant)
Vaginal strictures and dorso-ventral bands are common; what might we need to do prior to breeding?
–May need to be transected prior to breeding
What are these 3 pictures showing?
Note they are respresenting the vagina.
A: thin band
B: broader band with length to it creating almost double vagina
C: constricted
What may the effects of vaginal hyperplasia during oestrus be? (2)
–May prevent breeding
–May progress and ultimately prolapse
What does this show?
Stages of vaginal hyperplasia
Why do we use vaginal endoscope? (2)
- Assessment of stage of the cycle
- Documentation of normality or abnormality
How might we assess the stage of cycle with a vaginal endoscope?
•Changes in size, colour, moistness and contour of mucosal folds. Under influence of oestrogen the vaginal wall changes and becomes rounded and swollen
What is this?
Complex vaginal band at vestibulo-vaginal junction
What is this?
Herpes virus papules
What is this?
Trans-cervical insemination
How can we collect a sample for vaginal cytology?
–Collection by aspiration
–Collection by swab
–Use of haematology stains
•Look for large anuclear cells
–[Use of stains for keratinisation not necessary and takes some time]
What does Elevated plasma oestrogen cause cytologically?
Epithelial proliferation
Surface cells are collected for vaginal cytology - what does the relative number reflect?
Degree of epithelial proliferation
How does the epithelium change, and how is this seen on cytology?
Cuboidal to stratified squamous
How many cornflake cells would be present for the animal to be in oestrus on cytology?
75%
Other than cornflake cells, what else can we look at to determine where in the cycle a bitch is from cytoloty?
WBCs
What is this?
Vaginitis demonstrating the presence of many nondegenerate to degenerate neutrophils and scattered epithelial cells (Wright-Leishman stain).
Vaginitis is often secondary to foreign body, polyp, neoplasia but rarely is it a primary bacterial problem except in bitches with pre-pubertal vaginitis.
What is this?
Transitional cell carcinoma. The epithelial cells exhibit anisocytosis, anisokaryosis, nucleolar rings, basophilic cytoplasm, and have an increased N/C ratio (Wright-Leishman stain).
The most common tumour of the caudal urethra is TCC.
Where is the uterus postioned?
•The uterus is positioned dorsal to the bladder
–Tubular in sagittal plane
–Circular in transverse plane
What changes the U/S appearance of the uterus?
Oestrus cycle
What is this?
CEH: Multiple cysts within uterine body. Common disease process in aging animals
What is this?
Mucometra: Small volume fluid within uterine lumen. Fluid abnormal in uterus
What is this?
Early Pyometra: Thickening of uterine wall and fluid accumulation
What is this?
Pyometra: Gross distension of uterus with pus
When can we diagnose pregnancy in the bitch and queen via U/S?
•From day 20 after ovulation bitch
–Normally undertaken 28 days from mating as day of ovulation not always known
•From day 18 after ovulation in queen
What does this show?
Bitch: 21 days from ovulation – embryo visible within anechoic yolk sac
What is this?
3 Follicles present within ovary Can also see caudal border of kidney to the left
What is this?
3 CLs present within ovary
What does this show?
Homogenous ovary in mid luteal phase
What is the most common ovary abnormality?
Ovary neoplasia
What does this show?
Multicystic Granulosa Cell tumour in bitch.
There is marked enlargement, visible on radiography only as a soft tissue opacity. Often produce oestrogen so clinical signs produced by this overproduction
When might we do radiogrpahy of repro tract? (2)
What radiography might we do? (2)
- Usually conducted to determine pregnancy or fetal number / fetal death
- Otherwise less commonly used to examine the reproductive tract as been replaced by ultrasound
- Plain radiographs
- Contrast studies
When does mineralisation of the skeleton happen?
Day 45
How do we document fetal number on radiographs?
Counting skull numbers
How can we detect fetal death several days after death? (3)
–Loss of normal posture
–Overlapping of skull bones
–Accumulation of gas in fetus / uterus
Radiograph: Can see a lot of gas present in the uterus and in one of the fetus due to dead fetus that is putrefying this has taken 3-4 days after fetal death has occurred. US exam would have shown death immediately
When would we see ovaries an uterus on x ray?
- Normal ovaries and uterus are not normally visible in plain radiographs
- Detection of enlargement may be possible in some cases; usually this is a soft tissue opacity mass causing displacement of other structures where location is suspicious of the reproductive tract
What is this?
Soft tissue opacity mass within the cranio-dorsal abdomen causing caudal and ventral displacement of small bowel and cranial compression of stomach
What is this?
Tubular soft tissue opacity mass within the caudo-ventral abdomen causing cranial and dorsal displacement of small bowel
What is this?
Pseudo-hermaphrodite
What is this?
Double-vagina caused by dorso-ventral vaginal band not regressing
How can we use endocrine testing?
•Progesterone rises before and throughout ovulation
–Common test is the elisa kit
What happens to progesterone prior to parturition?
Falls
How can we endocrine test for pregnancy? (3)
- Not progesterone e.g could use relaxin
- Acute phase proteins (yes I know its not a hormone)
- Plasma relaxin
What test do we use for Confirmation of functioning (presence) of the ovary?
hCG stim
What test do we use for Confirmation of functioning (presence) of the ovary and pituitary?
GnRH stim
How can we confirm prescence of ovaries in cats? (2)
–In Oestrous Cats by induction of ovulation
- hCG Stimulation Test
- GnRH Stimulation Test
–Both will induce ovulation so that elevation of progesterone can then be detected
What is the commenest cause of infertility in the bitch?
Mating at incorrect time
What is the commenest cause of infertility in the queen?
mating insufficient number of times on the correct day (not mated enough times at the right time so they do not ovulate)
What are the common endocrine repro disorders in the bitch? (3)
–Pseudopregnancy
–Cyclical problems at puberty
–Ovulation failure
What are the common endocrine repro disorders in the queen? (2)
–Failure to ovulate (number and time of mating)
–Failure to cycle
What are the common mating difficulties in the bitch? (4)
–Attempting mating at wrong time
–Female or male behaviour including inexperience
–Size differences
–Pain at coitus (strictures / hyperplasia)
What are the common mating difficulties in the queen? (2)
–Female dominance
–Lack of time for social interaction
What are the common infectious repro problems in the bitch? (5)
–Mis-conceptions about normal vaginal commensal organisms
–Pre-pubertal vaginitis
–Pyometra (NB underpinned by endocrine environment)
–Canine herpes virus
–Post-partum metritis
What are the common infectious repro problems in the queen? (1)
–Feline leukaemia virus
What are the common pregnancy related problems in the bitch? (3)
–Failure to get pregnant
–Dystocia
–Pregnancy loss
What are the most common pregnancy relaed problems in the queen? (3)
–Dystocia
–Failure to ovulate and get pregnant
–Infectious pregnancy loss
What are the most common post partum problems in the bitch? (5)
–Fading puppies
–Concerns about retained placenta
–All the others (haemorrhage, metritis, mastitis, hypocalcaemia, hypoglycaemia)
–Poor nursing behaviour
–Sub-involution of placental sites
What are the most common post partum problems in the queen? (2)
–All the others (haemorrhage, metritis, mastitis, hypocalcaemia, hypoglycaemia)
–Poor nursing behaviour
