female pathology Flashcards
routes of pathogen entry into the female tract
ascending infection
haematogenous
descnd from ovary
transneural infection
4 developmental abrnomalities of the female tract
- true hermaphrodite / pseudohermaphrodite
- chimerism / free martinism
- tract anomaly (segmental aplasia, persistnet hymen, duplication)
- ovarian anomaly ( agenesis, hypoplasia, duplication, cysts, hamartoma)
what is the pathology of follicular cysts?
persist for 10d
due to lack of LH surge
become anovulatory
can be stress associated
give GnRH
how do follicular, luteal and CL affect fertility?
follicular and luteal cysts make the animal anovulatory
cystic CL still ovulate normally
name the 3 neoplasms of the ovaries
- germ cell neoplasms
- gonadal stromal neoplasm
- epithelial neoplasm
what is a germ cell neoplasm?
- dysgeminoma - from primitive germ cells, smooth, haemorrhage / necrosis, most benign
teratoma - benign
what is a gonadal stromal neoplasm?
granulosa cell tumour
thecoma
luteoma
may be active
what is an epithelial neoplasm?
cystadenoma / cystadenocarcinoma
bilateral and shaggy
esp bitch
may spread by implanting on peritoneum
name 3 pathologies of the fallopian tubes
hydrosalpinx
pyosalpinx
salpingitis
3 physical pathologies of the uterus
torsion (need a weight in uterus)
rupture
prolapse (inertia, dystocia , low calcium)
6 growth distrubances of the uterus
atrophy
polyps
hyperplasia ( can predispose to pyo)
mucometra / hydrometra
pseudopregnancy
subinvolution of placental sites
what is endometritis?
inflammatory infiltration to uterine mucosa
can become chronic and fibrous
cow endometritis pathogens
herpesvirus
tritrichomonas foetus
campylobacter
foetus ssp venerealis
mare endometritis pathogens
a haemolytic strep
klebsiella pneumonia
e.coli
taylorella equigenitalis
psuedomonas aeruginosa
what is metritis?
all layers of uterine wall affected
more severed than endometritis
haemorrhage on serosa
thickened odematus friable uterine wall
yellow-red exudate
foul odour
when is pyometra seen in the bitch?
older
nulliparous
p4 exposure
UTI
cystic endometrial hyperplasia can predispose
when is pyoetra seen in the cow?
early postpartum from endo/metritis
from venereal inf
persistent CL
high p4
always open so less severe
what causes pyometra in the sow?
truperella pyogenes
when is pyometra seen in the mare?
postpartum
always open
mare keeps cycling
3 neoplasias of the uterus
- leiomyoma
- carcinoma
- lymphosarcoma
what is a leiomyoma?
smooth muscle neoplasm
often multiple, benign, firm , pink/white
see whorled muscle
oestrogen often involved
often in the bitch
what are the characteristics of a uterine carinoma?
often in the horns
fibrous, firm, metastatic
often cow
what are the characteristics of a uterine lymphosarcoma?
enxoonotic bovine leukosis can cause it
notifiable
yellow
friable
3 pathologies of the cervix
degenerative
trauma
infectious
what can cause cervix degeneration?
oestrogenic substances
non inflammatory pathologies of the vulva and vagina
persistent hymen
vaginal septum
rupture
stricture
tumefaction
hyperplasia
prolapse
cysts
polyps
inflammtory pathologies of the vulva and vagina
trauma
vaginitis
herpesvirus
dourine
4 types of neoplasms of vulva and vagina
- leiomyoma
- fibropapilloma
- squamous cell carcinoma
- transmissible venereal tumour
what causes a fibropapilloma?
bovine fibropapilloma virus
what do you see with squamous cell carcinoma?
ulcers
mets
what are the characteristics of a transmissible venereal tumous?
transferred during mating
nodule with bizarre nuclei
mets if in poor health
cells have 59 instead of 78 chromosomes
what is this?
luteal cyst
What is this?
cystic CL
What is this?
ovarian dysgerminoma
What is this
teratoma
What is this?
granulosa theca cell tumour
produce steroids
solid / cystic
What is this?
epithelial neoplasm
cyst adenoma
or
cyst carcinom
what is this
endometritis
what is this?
metritis
what is this?
transmissible venereal tumour
what is classified as an embryo?
from developing a long axis and major structures but not complete organogenesis
what is classified as a foetus?
from complete organogenesis to birth
what is an abortion?
premature expulsion of the products of conception from the uterus
fresh and non autolysed
what do you see with rapid foetal death?
autolysed foetus
what are the characteristic of early embryonic loss?
chromosome abnormalities
inherited disorders
uterine environment
can be expelled or resorbed
can return to oestrus at normal interval
infectious causes rare
what can cause foetal loss?
non-viable
placentitis
foetal death
what infections can cause embryonic death
ureaplasma spp
tritrichomona foetus
campylobacter spp
what are the consequences fo the embryo of early embryonic death?
expulsion or resorption
what are the consequences to the foetus after foetal death?
aborted
stillborn
retained (mummified, macerated, emphysema)
what is mummification?
no bacterial infection
foetal skin is developed enough to withstand autolysis
absorption of placental and foetal fluid
no odour
closed cervix
normal future breeding
what is maceration?
liquified foetus with bacterial uterine inf
foetal bones not macerated
foetid odour
what is emphysema?
putrefactive organism ascended from the vagina
associated with dystocia or incomplete abortion
foul gas, uterine lesions, fatal to dam from toxaemia
non infectious causes of abortion
dystocia
twins
umbilical cord anomalies
placental insufficiencies
genetic
abnormal adrenal / pituitary
husbandry
seasonal
toxins
nutrition
stress
ovine infectious causes of abortion
most : chlamydophilia
toxoplasma
campylobacter
salmonella
least: listeria
also: brucella, coxiella burnetti, BDV (pestivirus), bluetongue (orbivirus), schmallenberg
bovine infectious causes of abortion
most: bacillus licheniformis
neospora
trueperella pyogenes
s.dublin
campylobacter
least: BVDv
also: brucella, salmonella, leptospira, coxiella burnettis, IBR, schmallengberg
porcine infectious causes of abortion
most: PRRS
parvo
strep
leptospira
least: pasturella
also: brucella, salmonella, aujeszkys, CSF
equine infectious causes of abortion
EHV
placentitis
salmonella
leptospira
streptococcus zooepidemicus
EVA
how do you diagnose bacterial and fungal abortion?
culture foetal stomach contents
selective bacterial culture
histopath
serology
how do you diagnose viral causes of abortion?
PCT
hyistopath
IHC
serology
what is the fungal cause of abortion? and how does it appear?
aspergillus fumigatus
thick leathery placenta covered with exudate
elevated greying plaques on foetal skin and eyelid
3 protozoal causes of abortion
neospora caninum
tritrichomonas foetus
toxoplasma gondii
how is neospora caninum spread?
persistent inf in cattle
hotizontal transmission in dog
vertical transmission in cow
how is tritrichomonas foetus spread and what does it do?
cow coitus
foetal maceration
pyometra
2-4 m in gestation
what do you see wtih toxoplasma gondii?
lots of barren ewes and late abortions
from cat faeces
zoonotic
which bacterial causes of abortion cause late abortion?
brucella
salmonella
leptospira
listeria
chlamydophila
coxiella burnetti
strep
what bacterial causes of abortion cause abortion throughout gestation?
campylobacter
bacillus
trueperlla
what are the dog causes of abortion?
brucella
salmonella
campylobacter foetus
CHV
distemper
what is this lesions in the genital tract?
- large, smooth, round vaginal mass
- microscopically smooth muscle and fibrous stroma
- benign leiomyome / fibroleiomyoma
A and B show what?
C is form a peritoneal tap from animal A/B
D is from a different species
What is diagnosis for A/B/C and what animal is D
A +B - small white masses extending over peritoneum
C - nuclear :cytoplasmic ratio increased, different sized cells with differing nuclear size
A + B +C diagnosis - malignant ovarian tumour that has spread throughout peritoneal cavity as the small gap between ovary and fallopian tube means the mets can see throughout the abdomen
D - chicken ovary
how does mastitis appear in SA?
postparum
firm swollen
painful
pyrexia
depression
inappetance
what is glactostasis?
warm, firm, swollen painful glands
no infection
self resolving
what is galactorrhea?
lactation not associated with normal pregnancy
stop food for 24 hr and self limits
who is mammary hyperplasia common in?
young entire cats 2-4 w after oestrus due to high p4
resolves
biopsy
neuter to prevent
what is the incidence of mammary neoplasia?
more common in the bitch than queen
more malignant in queen than bitch
how can mammary neoplasia be prevented?
neuter
what indicates a mammary neoplasia may be benign or non-mets?
oestrogen and progesterone receptors as better differentiated
normally has better response to treatment
risk factors for mammary neoplasia?
old age
obesity in ealry life
progestagen treatment
previous benign treatment
intact after 3rd season
what is an inflammatory carcinoma on the mammary glands?
uncommon and aggressive
presents as a diffuse swelling
repidly progresses, metastatic, systemically ill
about 1 m to live
types of mammary neoplasia?
benign - adenoma / fibro-adenoma / fibroma
malignant - carcinoma, sarcoma (worse)
how is mammary neoplasia staged?
TNM
T1 =<3cm
T2 = 3-5cm
T3 = >5cm
how can you diagnose mammary neoplasia?
Rads - mets
US
FNA
surgical biopsy
IHC (presence of hormone receptors, expensive and not really needed)
medical treatment of mammary neoplasia?
never done solely
can use chemo as adjunctive therapy
what type of mammary neoplasia can you not surgically remove?
inflammatory carcinoma
how do you operate on feline mammary neoplasia?
always remove the whole chain (unilateral mastecomy) as very high chance of recurrence
what are the 5 different surgical options for canine mammary noeplasia?
lumpectomy
simple mastectomy
regional mastectomy
unilateral mastecomy
bilateral mastectomy
what is a lumpectomy suitable for mammary neoplasia?
mass < 0.5 cm
encapsulated
non invasive
what is a simple mastectomy and for what neoplasia is it used for?
excise entire gland with 2 cm margins
when mass > 1cm and involving most of the gland
what is a regional mastectomy and what is used for?
excision of involved and adjacent gland with 2cm margins. If removing caudal 2 glands then remove inguinal LN also
multiple tumour or a tumour between glands
what is a unilateral mastectomy and what is it used for?
excision of whole chain and inguinal LN
for multiple tumours , tumour in middle of glands, cats
less trauma than individual
need tension free closure
What is a bilateral mastectomy and how do you do it?
remove both chains
masses in both chains
do staged unilateral mastectomy 2-3 w apart or else not enough skin closure
what is the SA mammary anatomy?
cats - 4 pairs of gland
dogs - 5 pairs of glands
cranial ones drain to axillary LN
caudal ones drain to inguinal LN
what should you do post op mammary surgery?
multimodal analgesia
bandage
clean drains
careful of tension
may get some hindlmib oedema from lymph disruption
dogs prognostic factors for mammary neoplasia
tumour size
histology (sarcoma worst)
differentiation
invasive
LN involvement
mets
p4 / e2 receptors (better)
fixation to tissues (worse)
non prognostic factors for mammary neoplasia?
site of tumour
type of surgery
number of tumours
doing OHE at same time
median survival with mammary neoplasia?
about 1 yr
