Female Clinical Disease of Repro Tract

Question 1

What are some potential causes of a white vulval discharge?

Answer 1

Vaginitis, early metoestrus, Open pyometra, Cystitis.

Question 2

What are some potential causes of a red vulval discharge?

Answer 2

Prooestrus/oestrus, persistent ovarian follicle, ovarian tumour, vaginal trauma, vaginal FB, cystitis, urethral problems, placental separation

Question 3

What are some potential causes of a clear mucoid vulval discharge?

Answer 3

Normal discharge

Question 4

What are some potential causes of a clear watery vulval discharge?

Answer 4

Amniotic/allantoic fluid

Question 5

What are some potential causes of a green/black vulval discharge?

Answer 5

Normal parturition, dystocia

Question 6

What are some potential causes of a brown/red or black vulval discharge?

Answer 6

Metritis

Question 7

What are some potential causes of a yellow vulval discharge?

Answer 7

Incontinence

Question 8

What historical findings are usually found in vaginitis?

Answer 8

Juvenile vaginitis about 3-5 months. Usually a purulent white discharge in an otherwise healthy dog.

Question 9

What causes Juvenile Vaginitis? How is it treated?

Answer 9

Causes by bacterial contamination and excess secretions usually at 3-5m. Usually resolves spontaneously with first season, usually try to avoid Abx.

Question 10

What historical findings are usually found in Pyometra?

Answer 10

Usually within 8 weeks of last oestrus. Obviously unneutered bitches.

Question 11

What causes Pyometra?

Answer 11

It is multifactorial. Often it is a combination of bacterial infection, cystic endometrial hyperplasia, progesterone (decreasing mucosal immunity) and an open cervix.

Question 12

What clinical signs might you expect with pyometra?

Answer 12

Depends on open or closed. May have depression lethargy, mucopurulent vaginal discharge, pyrexia, PU/PD, vomiting, collapse, shock.

Question 13

What clinical pathology (blood) might you expect with pyometra?

Answer 13

Depends on open or closed. May have neutrophilia with left shift, azotemia, acidosis, endotoxaemia, hypoglycaemia, anaemia

Question 14

What is an open pyometra vs. a closed pyometra?

Answer 14

Open pyometra the cervix is open, get discharge, mild/moderate enlarged uterus. Closed pyo’s are not associated with discharge, and are often systemically ill with a very enlarged uterus.

Question 15

How is pyometra diagnosed?

Answer 15

Ultrasound preferred, can use radiography.

Question 16

How is pyometra treated?

Answer 16

Most often surgically (OHE), may be done medically (reduce progesterone e.g. PGF2A) but difficult.

Question 17

When investigating a vaginal mass, what is it important to know about the dog/mass to narrow down?

Answer 17

Age and neutered status very important, stage of reproductive cycle (esp oestrus or pregnancy), size, shape and consistent of the mass (does it contain a hole? Is it in the wall or the lumen? )

Question 18

What historical findings are usually found in vaginal neoplasia? How might they present?

Answer 18

Usually elderly entire bitches, that are not in season. May have a visible mass, bulging pernieum or dysuria/dyschezia.

Question 19

What is the most common type of vaginal neoplasia in bitches? How is this treated?

Answer 19

Smooth muscle tumour (leiomyoma, leiomyosarcoma), but can get other types (e.g. transmissable venereal tumour) . Treatment by surgical excision and OVHE, TVT usually needs chemotherapy.

Question 20

What is vaginal hyperplasia and vaginal prolapse? What predisposes to them?

Answer 20

Excessive response of vaginal mucosa to oestrogens during follicular phase of oestrus cycle. Predisposition of brachycephalic breeds, most commonly young bitches during oestrus.

Question 21

How can you tell the difference between vaginal oedema and vaginal prolapse?

Answer 21

Vaginal oedema is excessive swelling of the mucosa (usually ventral), often there is no hole to the vagina. Vaginal prolapse has a hole into the vagina.

Question 22

What is a common way for intersexuality to present in bitches? What does this indicate?

Answer 22

Many different phenotypes, but a common clinical presentation is an enlarged clitoris/underdeveloped penis in a ‘female’ puppy. This indicated androgens being present, which may indicate there is some testicular tissue.

Question 23

What can be done to investigate ambiguois genitalia?

Answer 23

Evaluate pelvic anatomy (contrast radiography good), remove gonads, karyotyping, SRY gene testing

Question 24

What is the treatment for ambiguous genitalia?

Answer 24

Remove gonads, possible partial penile removal, may treat other abnormalities e.g. incontinence due to reflux into uterine structure.

Question 25

What is Dystocia? What are the three potential types of causes of dystocia?

Answer 25

Disturbance during parturition when normal delivery
of the foetus through the birth canal is interrupted. It can be caused by maternal factors, foetal factors, or maternofoetal factors.

Question 26

When should you worry about dystocia during parturtition?

Answer 26

Foetal fluids 2-3hrs, no birth, vigorous straining for 20-30 mins, no birth, greenish-brown discharge not followed by birth, weak irregular straining for 2-3hrs, 2-4 hours since last baby, second stage labour >12 hours.

Question 27

What is primary uterine inertia? What are some potential causes?

Answer 27

Uterus fails to respond to foetal signals. Potential causes: small litter, v. large litter, inherited, nutritional, obesity, age. It can be complete or partial.

Question 28

What is secondary uterine inertia?

Answer 28

Exhaustion of myometrium due to blockage of the birth canal.

Question 29

What are some maternal factors/causes of dystocia?

Answer 29

Narrow birth canal, inertia (primary or secondary), uterine abnormalities, prolonged labour, premature birth, extra uterine problems e.g. sepsis. Maternal causes are most common, and most common is inertia.

Question 30

What are some foetal factors/causes of dystocia?

Answer 30

Increased foetal size (litter size, breed), malpresentation, abnormal foetal development. Most common foetal cause is malpresentation.

Question 31

What medical management is indicated for dystocia?

Answer 31

ONLY CONSIDER WHEN NO OBSTRUCTION. May excercise the dam, treat with oxytocin (repeated small doses every 30-40 mins), may treat for hypocalcaemia/hypoglycaemia

Question 32

How common is ovarian neoplasia in cats and dogs? What types of tumours can occur?

Answer 32

Relatively uncommon, types of tumours include granulosa cell tumour, teratoma, cystadenoma, adenocarcinoma, teratoma.

Question 33

How does ovarian neoplasia often present?

Answer 33

Often a large mass with ascites, may show signs of prooestrus if endocrinologically active.

Question 34

What is hydrometra/mucometra?

Answer 34

Sterile accumulations of fluid in the uterus.

Question 35

What causes hydrometra/mucometra? How common are they?

Answer 35

Usually secondary to congenital abnormalities such as segmental aplasia or neoplasia. Rare, and may be incidental. May not be a problem until large accumulations occur.

Question 36

What types of reproductive disease in the bitch might cause systemic illness?

Answer 36

Closed pyometra, uterine torsion, uterine rupture. IMPORTANT TO REMEMBER AS A CAUSE OF ACUTE ABDOMEN.