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Next Generation Exam 2 > Diseases of diestrus and anestrus > Flashcards

Diseases of diestrus and anestrus Flashcards

1
Q

Cystic Endometrial Hyperplasia results from chronic/repeated __ exposure where uterine glands __ in number, size, secretion and cystic dilatation and is ___

A

progesterone, increase, irreversible

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2
Q

__ of all female dogs >9 years with normal estrus cycles will have CEH

A

2/3

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3
Q

CEH is usually an incidental finding but can affect __bitches, __,and ___

A

breeding, infertility, decreased pregnancy rate

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4
Q

therapy of choice for CEH

A

ovariohysterectomy (OHE)

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5
Q

pyometra

A

suppurative bacterial infection of the uterus with accumulation of inflammatory exudate in the uterine lumen

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6
Q

young dogs usually have pyometra __ CEH while older dogs usually have pyometra __ CEH

A

without, with

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7
Q

what species and age are most likely to have a pyometra?

A

middle to older age bitches, 20% diagnosed before 10yrs

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8
Q

progesterone is dominant during diestrus causing the cervix to be __ and uterine defense mechanisms to be __ allowing opportunistic bacteria to ascend the vagina/GI tract

A

closed, decreased

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9
Q

what is the most common opportunistic bacteria in cases of pyometra?

A

E. coli (65-90%)

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10
Q

predisposing factors to pyometra

A
  • endogenous and exogenous progesterone
  • CEH, hydrometra, mucometra
  • bacterial virulence: adhesin factors, biofilm production
  • breed predisposition
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11
Q

T/F: pyometra is a differential diagnosis in all intact female dogs

A

T

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12
Q

what diagnostics are appropriate if you suspect pyometra?

A

abdominal ultrasound
CBC, Chem
+/- Vaginal Cytology
+/- X-ray

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13
Q

in pyometra cases, purulent hemorrhagic malodorous vulvar discharge is an __ cervix while no vulvar discharge indicates a __ cervix

A

open, closed

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14
Q

clinical presentation of pyometra is very __

A

variable

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15
Q

if you decide to ultrasound a patient with pyometra what would you see?

A
  • fluid filled uterine horns
  • uterine wall often thickened
  • u/s cannot accurately differentiate between hydro/muco- or pyometra
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16
Q

pyometra lab findings

A

WBC: usually has a leukocytosis with neutrophilia and left shift, monocytosis

RBC: often mild normocytic normochromic anemia

Chemistry: azotemia, increased ALP, bilirubinemia, hypoalbuminemia, electrolyte imbalances; coagulation impairment (hypercoagulable state)

urinalysis: iso or hyposthenuria, concomittant cystitis

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17
Q

vaginal cytology is only informative in cases of __ pyometra and would show __, __, and __. what else does the patient need to demonstrate?

A

open, PMN, bacteria, vaginal epithelial cells

needs to demonstrate fluid accumulation in the uterus

18
Q

__ pyometra causes more severe signs of illness but the outcome is not poorer

A

closed

19
Q

treatment of pyometra

A
  1. OHE!!!!
  2. antibiotics (broad spec, bactericidal), amoxi-clav, enroflox or combo
  3. supportive care
20
Q

medical treatment only for pyometra cases is only attempted in __ breeding bitches with no other abnormalities and it must be an __ pyometra

A

young, open

21
Q

the goal of medical management of pyometra is to empty the uterus and decrease progesterone levels and/or prevent its actions. What drugs would you use for this?

A
  1. PGF2
  2. aglepristone: progesterone receptor blocker
  3. prolactin inhibitors: cabergoline (luteolysis)
22
Q

medical tx of pyometra needs __ until clinical improvement and has a __ recurrence rate. If it fails __

A

24-48 hours, high, OHE

23
Q

t/f: the recommendation for medical management is to breed on the next heat cycle

A

T, the pregnancy is generally considered protective for the development of pyometra but are high risk

24
Q

consequences of a non-treated pyometra

A

sepsis
uterine rupture
death

25
Q

juvenile vaginitis is in __ dogs

A

prepubertal (6wks - 8mths)

26
Q

puppy vaginitis

A
  • mucopurulent discharge
  • inflammatory vaginal cytology
  • spontaneous resolution after 1-2 heat cycles
  • treat with benign neglect
27
Q

t/f: you should spay a puppy with vaginitis before it resolves

A

F!!!!!! do not spay before vaginitis resolves because chronic vaginitis may develop

28
Q

primary vaginitis of the intact bitch is caused by __, __ or __ while secondary is __, __, etc.

A

canine herpesvirus, brucella canis, opportunistic bacteria, anatomic, neoplasia

29
Q

__ is the most common bacterial culprit for vaginitis in intact bitches and __ is the most common clinical sign at any stage of the repro cycle

A

e. coli, vulvar discharge

30
Q

intact vaginitis dx

A
  • digital palpation for bands/strictures/tumors
  • vaginal cytology and bacteriology with c/s via guarded vaginal swab
  • vaginoscopy
  • +/- urinalysis with c/s
31
Q

vaginal cytology of intact vaginitis

A

inflammatory: degen neutrophil granulocytes, epithelial cells according to cycle stage, bacteria, mucus, debris

32
Q

tx of intact vaginitis

A

correct underlying cause
- antibiotics -> start with amoxicillin- clavulanic acid
- probiotics

33
Q

vaginitis in spayed dogs is secondary to __ following spay due to lack of estrogen influence and is usually __

A

vaginal atrophy, chronic

34
Q

treatment of spayed vaginitis

A
  1. correct underlying cause
  2. estriol(incurin) tablets PO
    -short acting estrogen -> proliferation and cornification of vaginal mucosa, increases local defense mechanism
  3. antibiotics
  4. probiotics
35
Q

perivulvar dermatitis is more common in __ dogs in the __ with vaginitis, UTI and urinary inconinence common

A

spayed, skin folds (recessed vulva and obesity)

36
Q

tx for perivulvar dermatitis

A
  1. underlying cause of incontinence or UTI
  2. weight loss
  3. clean with chlorohex
  4. e-collar
  5. antibiotics
37
Q

type 1 vaginal hyperplasia

A

slight-moderate eversion of the vaginal floor just cranial to the urethral orifice. No tissue
protrudes through the vulva

38
Q

Type II hyperplasia

A

prolapse of the cranial vaginal floor and
lateral walls of the vagina through the vulvar lips
forming a pear-shaped mass

39
Q

type III hyperplasia

A

prolapse of the entire vaginal
circumference as a doughnut-shaped edematous
tissue with a lumen

40
Q

vaginal hyperplasia recurs at __ and is __. For tx, remove __ influences for regression in 1-3 weeks, place an __ and use 50%__ , cleaning and lubrication to reduce.

A

peak estrus, hereditary, estrogen , e-collar, dextrose

41
Q

vaginal tumors are usually __ and in __ dogs

A

benign, older

42
Q

dx and tx for vaginal tumors

A

palpation, vaginoscopy, FNA, biopsy, impression smear

tx with sx resection, OHE if hormone dependent and chemo

Next Generation Exam 2 (20 decks)

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