Disorders of the Canine Uterus and Ovaries

Question 1

What bacteria is common in a pyo infection? Where does it invade?

Answer 1

E. coli; invades/colonizes hyperplastic endometrium during estrus and remains even thru diestrus

Question 2

What is a hormonally mediated diestrual disorder with bacterial infection with endometrium which has undergone pathological changes leading to the condition encountered

Answer 2

Pyometra

Question 3

What are the effects of high progesterone in a pyometra?

Answer 3

Closes cervix, enhances uterine gland activity, inhibits uterine defense and contractility

Question 4

Vaginal bacteria frequently flows into the _______ but rarely causes pathology without underlying cystic endometrial hyperplasia (CEH)

Answer 4

Uterus

Question 5

What is almost always a pre-req of pyo?

Answer 5

Cystic endometrial hyperplasia

Question 6

When does the uterus become fluid- filled in the pyo infection?

Answer 6

During diestrus is when uterus becomes fluid-filled

Question 7

Signalment of pyo infection patients:

Answer 7

Commonly seen in 4-8 weeks after estrus, middle aged to older bitches, intact or “partially spayed” with ovarian tissue still remaining

Question 8

Clinical signs of Pyometra are usually seen when?

Answer 8

Around4-8 weeks after estrus

Question 9

Why would a bitch be PU/PD with pyometra?

Answer 9

prerenal azotemia, dehydrated bc kidneys losing ability to concentrate urine, medullary washout

Question 10

What do we see on CBC with a pyometra?

Answer 10

Mature neutrophils, L shift bc bone marrow exhausted, non-regen anemia (if chronic)

Question 11

What do we usually see in our chemistry with a pyometra?

Answer 11

hyperproteinemia due to dehydration and elevated BUN due to pre-renal azotemia

Question 12

What is the gold standard pyo diagnostic tool?

Answer 12

Ultrasound

Question 13

Tx for Pyometra:

Answer 13

spay is preferred, stabilize very sick p BEFORE anesth./surgery. Medical management not rec. but likely to reoccur but can use prostagladnins (Lutalyse) and supportive care

Question 14

Retained placentas in bitch are _____. Seen __-__ days postpartum and occurs with this clinical sign:

Answer 14

Rare; 2-7 days; THICK vaginal discharge seen

Question 15

What RX do we give for patients with retained placenta?

Answer 15

Plastaglandins and oxytocin for their ecbolic effects and abx if clinical signs are showing

Question 16

Acute Metritis in the bitch is a….

Answer 16

Ascending infection of the uterus without underlying uterine pathology. Almost always assoc. with recent whelping.

Question 17

Acute metritis predisposing causes–>

Answer 17

prolonged delivery, dystocia, retained fetuses/placenta

Question 18

Sub involution of placental sites (SIPS)

Answer 18

dogs appear n but with bright red blood discharge, condition of post partum uterus

Question 19

What anatomical event causes SIPS???

Answer 19

Abn repairs of the endometrial placental sites (dogs have a deciduate placenta) but trophoblastic cells continue to invade the endometrium and erode blood vessels

Question 20

Sanguineous vaginal discharge for longer than 6 weeks during pp is commonly seen with what condition?

Answer 20

Sub Involution of Placental Sites (SIPS)

Question 21

SIPS TX:

Answer 21

generally resolves spontaneously without any tx, but tx options include spay or blood transfusion in worst cases

Question 22

Ovarian tumors of the bitch include which two types??

Answer 22

Epithelial tumors, sex cord tumors

Question 23

Epithelial tumors

Answer 23

most common ovarian tumor in the bitch, accounts for half of the bitch tumors. Papillary adenomas, cystadenomas, cystadenocarcinomas

Question 24

Sex cord tumors

Answer 24

second most common ovarian tumor (first is epith. tumor), granulosa cell tumor are the most common form of sex cord tumor

Question 25

Granulosa cell tumor (a sex cord tumor of the bitch) =persistent signs of ____
Functional follicular cyst has persistent signs of ____

Answer 25

estrus; proestrus

Question 26

Sex cord tumors are usually unilateral or bilateral? What is the cure?

Answer 26

Unilateral; spay

Question 27

Ovarian cysts are associated with this impt finding….

Answer 27

Persistent proestrus for long period of time

Question 28

Functional follicular cyst primarily secretes what hormone? It occurs with persistent _____ usually.

Answer 28

estrogen; proestrus

Question 29

ovarian CYST- what is the most common one?

Answer 29

Functional follicular cyst

Question 30

Ovarian Remnant syndrome diagnosis hormone profile will show…

Answer 30

Elevated anti-mullarian hormone levels, usually low LH

Question 31

Ovarian Remnant syndrome TX–>

Answer 31

remove offending tissue with surgery (usually at the pedicles), do histo on it. Medical management is GnRH analogue/antagonist like Megestrol Acetate or Mibolerone but neither are rec. bc side effects and best tx is spay

Question 32

Diagnosis of ovarian remnant syndrome

Answer 32

Vaginal cytology shows predominant cornified/superficial cells (evidence of estrus)
Vaginoscopy- vaginal edema
Rads/ Ultrasound- not helpful usually

Question 33

Clinical signs of a pyometra is associated with ______ circulation

Answer 33

endotoxins