Female Urogenital

Question 1

Blood supply to ovaries

Answer 1

Ovarian artery comes right off the aorta
On the right it drains to the right vena cava
On the left ovarian vein drains into the renal vein

Question 2

Vessels in fat is called

Answer 2

A vascular pedicle

Question 3

Incision for ovarian hysterectomy

Answer 3

Caudal abdomen in thirds from the umbilicus to the caudal abdomen
Dogs, you incise in the cranial 3rd
Cats you incise in the middle third
Go through lina alba

Question 4

OH surfer

Answer 4

Start left
run hook along abdominal wall as far as you go
180 degrees
Re-orient vertically
pull out

Question 5

Complications

Answer 5

dropped pedicle
clamping/ligating ureters
incisional complications (seroma, dehescense)
OVarian remnant
Uterine stump pyometra
Urinary incontenance
Fistulous tracts with non-absorbable suture.

Question 6

Pyometra bacterial causes

Answer 6

e.coli - but culture & sensitivity

Can cause toxicity (sepsis)

Question 7

Pyometra - Diagnosis/Signs

Answer 7

based on clinical signs/discharge, PU/PD, may or may not be toxic

Question 8

Pyometra occurs when?

Answer 8

dogs: 4-8 weeks post-heat
cats: 1-4 weeks post-heat

Question 9

Treatment for pyometra

Answer 9

Stabalize with fluids & antibiotics & spay

Ampicilin & enrofloxacin (fluoroquinolone)

Question 10

Spaying with pyometra

Answer 10

do not use car malts
Prevent spillage
Don't over sew (don't invert)
Can use momentum
Lavage abdomen as much as possible

Question 11

C-section - when

Answer 11

dystocia (small pelvic canal
Uterine inertia
Fatigue
Rupture
Puppies are overdue

Question 12

C-section - how?

Answer 12

Clip, prep & then induce
Ventral midline (bigger)
lift the uterus, don't pull
Pack the abdomen
Incise the uterine body, milk out puppies, break placenta
Ligate and cute the umbilical vessels
Pass to assistant
Placenta comes off easily, remove
Close in 2 layers with 2-0/3-0 absorbable monofilament, simple continuous, then inverting second layer (cushing's lembert)
Clean incision, 
Discard towels
Close
OHE--> do this after removing puppies or at a later date

Question 13

Episiotomy

Answer 13

Difficult 
Expose urethral papilla,
For reducing vagial prolapse
Openieng dorsal aspect of the vuvla
2 layers
Catheter

Question 14

vaginal mass or protrution

Answer 14

Vaginal hyperplasia
Vaginal prolapse
Neopalis
Uterine prolapse

Question 15

vaginal mass or protrution - how to differentiate

Answer 15

Age
Stage
Paplation
Size shape

Question 16

Vaginal hyperplasia - what is it, how to treat

Answer 16

Floor of the vagina
Edema/hyperplasia - due to estrogen
Lift up floor, can see the urethral papilla
May resolve after heat but can happen the next time
OHE/resection recommended

Question 17

Vaginal prolapse

Answer 17

Circumferetial
Rare, may or may not be edema
Manual reduction/purse-string sutures or surgical reduction or amputation to avoid breeding or birthing problems
Spay recommended (good prognosis)
If not removed - poor prognosis

Question 18

Peri-vulvar dermatitis

Answer 18

Estra skin that covers the vulva

Episo-plasty -remove the extra skin around the vulva and sew

Question 19

Mammary neoplasia

Answer 19

Most common tumour of female
Bening/mixed/adenocarcinoma/inflammatory carcinoma
Cats –> usually adenocarcinoma &
Treatment of cats with progesterone increases the risk
Metatstatsis & size doesn’t prognosis
Treat with ovariohysterectomy (spay before the first heat in dogs, cats under a year)

Question 20

Mammary neoplasia - work up

Answer 20

Pay attention to lymph nodes
non-specific CBC/biochem changes
Mets to lung possible
Look for iliac lymph node if caudal mamary tumours
FNA to tell between benign/malignant tumours

Question 21

Mammary neoplasia - prognosis

Answer 21

Bigger is badder for dogs
Size, speed of growth, number of nodules
Lymph node involvement, distant mets,
Ulcers

Question 22

Treatment Mammary neoplasia

Answer 22

surgery, except for inflammatory carcinoma
dogs cure = 50% (still send for histology & re-evaluate
Contraindicated for inflammatory carcinoma, metastasis or other medical issues

Question 23

Surgeries for mammary neoplasia

Answer 23

Lumpectomy or partial mamectomy (< 5mm at the edge of a gland) - include a 1cm margin and 1 fascial plane deep
2. Local mastectomy - simple (1 gland) or regional (glands that drain together) - 1,2,3 or 3,4,5 -> most
3. Unilateral mastectomy (1-5 on one side)
4. Bi-lateral (4-6 weeks apart)
(Can treat with ovariohystorectomy before removing, prevents uterine disease, and decreases size of mammary glands)

Question 24

Drainage for Mammary lymph nodes

Answer 24

1-3 sternal lymph nodes

3-5 popliteal lymph nodes

Question 25

Prognosis mammary neoplasia (dogs & cats)

Answer 25

Dogs: Malignant 1-2 years
Nodules > 3cm, lymph nodes involved, distant mets –> poorer prognosis
Cats, almost all malignant adenocarcinomas
If young, can have fibroadenomatous hyperplasia (hormone dependant, occurs at puberty and is benign)
-> rapid mastectomy including all lymph nodes
Tumours 2 cm survive 12 months