Disease of reproductive tract in the cat and dog - female

Question 1

Common problems

Answer 1

neutering
stopping season
suspected pregnancy
misalliance (unwanted pregnancy)
calling
false pregnancy
lactation
dystocia
mating time
fertility problems
vulval discharge
vulval mass
vulval abnormalities
abdominal distension
systemic illness

Question 2

vulval discharge

Answer 2

age, neutered status important
stage of repro cycle - meteoestrus, prenant
colour of discharge

Question 3

white vaginal discharge

Answer 3

vaginitis
early metoestrus
open pyometra
cystitis

Question 4

red vagina discharge

Answer 4

pro/oestrus
persistent ovarian follicle
ovarian tumor
trauma
cystitis
neoplasia
coagulopathy
placental seperation
vascular malformation

Question 5

clear vaginal discharge

Answer 5

normal

Question 6

clear watery vaginal discharge

Answer 6

amniotic/allantoic fluid

Question 7

greeny black vaginal discharge

Answer 7

normal parturition

dystocia

Question 8

brown/red-black vaginal discharge

Answer 8

metritis

Question 9

yellow vaginal discharge

Answer 9

incontinence

Question 10

vaginitis

Answer 10

usually purulent discharge
may cause irritation
juvenile - 2ndary to bacterial contamination + excess vaginal secretion. usually resolves spontaneously
adult - less common, aim to find cause, may respond to exogenous oestrogens

Question 11

pyometra

Answer 11

v.important in small animal practice
dogs + cats
uterus fills with pus, can cause life threatening illness
usually presents within 8 weeks of last oestrus
can be open or closed (cervix) - closed worse

Question 12

pyometra - causes

Answer 12

cystic endometrial hyperplasia
bacterial infection
progesterone
open/closed cervix

Question 13

pyometra - clinical signs

Answer 13

depression
lethargy
mucopurulent vaginal discharge
pyrexia
PU/PD
vomiting
collapse
shock

Question 14

pyometra - haematology

Answer 14

neutrophilia with L shift
possible azotaemia
acidosis
endotoxaemia
hypoglycaemia
anaemia
coagulation abnormalities

Question 15

pyometra - diagnosis

Answer 15

radiography

ultrasound

Question 16

pyometra - treatment

Answer 16

medical

surgical (more common)

Question 17

vaginal trauma

Answer 17

uncommon
may bleed severely
investigate and treat

Question 18

vaginal mass

Answer 18

age, entire?
stage of repro cycle
size, shape, consistency of mass

Question 19

vaginal/vestibulo neoplasia

Answer 19

smooth muscle tumors of vaginal/vestibule = commonest tumor in bitch
typically slow growing (leiomyoma)
65% of bitches entire
mass may be visible

Question 20

vaginal/vestibulo neoplasia - diagnosis + treatment

Answer 20

Hx, PE
Radiography, endoscopy, biopsy
surgical with OVH

Question 21

vaginal hyperplasia + prolapse

Answer 21

excessive response of vaginal mucosa to oestrogens in follicular phase - vaginal oedema/ prolapse
exposed tissue can be damaged

Question 22

vaginal oedema/hyperplasia - diagnosis + treatment

Answer 22

diagnosis - Hx, PE
treat with vulvar sutures or surgical excision
tendency to recur

Question 23

ambiguous genitalia

Answer 23

indication of presence of androgens therefore testicular material +/- ovarian tissue
enlarged clitoris/underdeveloped penis
evaluate pelvic anatomy
genotype?

Question 24

ambiguous genitalia - treatment

Answer 24

remove gonads
partial/full penile amputation
treat other abnormalities associated with clinical signs

Question 25

dystocia

Answer 25

``` problems during birth common in dog + cat fetal fluids pass but no birth in 2-3h straining for 20-30 mins with no births greenish (bitch)/reddish brown (queen) vulval dicharge but no birth 2-4h weak/irregular straining 2-4h since last birth second stage labour > 12h ```

Question 26

dystocia - maternal causes

Answer 26

``` narrow birth canal disturbed labour - uterine inertia (most common cause) or spasm uterine abnormalities prolonged pregnancy psychogenic status extra uterine problems premature birth ```

Question 27

dystocia - foetal causes

Answer 27

increased foetal size - litter size, gestation length, breeds foetal malpresentation - most common abnormal foetal development

Question 28

primary uterine inertia

Answer 28

most common uterus fails to respond to foetal signals many causes (litter sizes, nutrition, age) can be complete (uterus doesn't contract) or partial

Question 29

secondary uterine inertia

Answer 29

due to exhaustion of myometrium | secondary to obstruction of birth canal

Question 30

medical management of dystocia

Answer 30

only when there's NO evidence of obstruction exercise the dam feather roof of vaginal floor (fergasons reflex) give oxytocin caesarean if not possible

Question 31

oxytocin

Answer 31

repeat small doses | can cause stillbirths

Question 32

vulval vaginal abnormalities

Answer 32

can be congenital or acquired

Question 33

congenital abnormalities

Answer 33

veulval stenosis anovulvar cleft rectovaginal fistula vestibulovaginal stricture

Question 34

acquired abnormalities

Answer 34

vulval hypertrophy recessed vulva trauma neoplasia

Question 35

abdominal mass/distention - causes

Answer 35

pyometra retained foetus ovarian/uterine neoplasia segmental aplasia + mucometra

Question 36

ovarian neoplasia

Answer 36

relatively uncommon often present with large mass +/- ascites may be endocrinology active surgical excision

Question 37

hydrometra/mucometra

Answer 37

sterile accumulations of fluid in uterus rare often present with large fluid filled viscus in abdomen