Infertility in the Bitch & Queen

Question 1

What are some reasons why breeding attempts fail?

Answer 1

Female, male, environment or management

Question 2

What is the major pathogen causing pyometra?

Answer 2

E. Coli

Question 3

What causes pyometra?

Answer 3

Progesterone causes development & secretion of endometrial glands, suppressed endometrium motility, cervix closure and decreased immune function in uterus.
These all predispose to pyometra.
This is in dioestrous

Question 4

What are the common presenting complaints for a pyometra patient?

Answer 4

Cystic endometrial hyperplasia, mucometra, endometritis and infertility.
Get depression, PU/PD, anorexia, vomiting, dehydration, fever.
Entact bitch showing non-specific signs of illness.

Question 5

How do you diagnose pyometra?

Answer 5

Vaginoscopy and vaginal cytology. ultrasound, radiography.

Question 6

What will you see with clinical pathology of pyometra?

Answer 6

Severe leukocytosis with left shift neutrophilia.
Hyperglobulinaemia.
Hypoalbuminaemia.
Increased ALP, cholestrol & bilirubin, glucose, potassium, creatinine & urea.
Low concentration of urine, proteinuria, glucosuria, renal casts.

Question 7

What is your preferred treatment method for pyometra?

Answer 7

Ovariohysterectomy.
Can use Lutalyse to cause luteolysis & increase uterus motility combined with antibiotics (Penicillin) - only do this is very valuable breeding bitch.

Question 8

Why is transmissible venereal tumour so highly contagious?

Answer 8

Neoplastic cells get transferred during coitus, sniffing and licking.
More prevalent in free roaming intact dogs in warm humid climate.

Question 9

Describe the diagnosis and treatment of TVT.

Answer 9

Diagnose with impressoin smear, biopsy or vincristine response.
Treatment with chemotherapy (vinristine) weakly, surgery, local irridiation and desex asap.

Question 10

Dog presents with vulvar discharge, pollakiruia and high male dog interest. What is your main DDx?

Answer 10

Vaginitis

Question 11

What’s the difference between juvenile puppy vaginitis and adult onset vaginitis?

Answer 11

Juvenile puppy vaginitis - 1yo, primary (brucella), secondary (urine pooling, foreign body, neoplasia, UTI)

Question 12

What is the risk of using oestrogen to treat vaginitis?

Answer 12

Too much oestrogen is toxic (bone marrow suppression)

Question 13

What are common causes of vaginitis?

Answer 13

E. coli, Strep, Staph, Pasteurella

Question 14

List some congenital causes of non-infectious female infertility.

Answer 14

Segmental aplasia
Vulvar hypoplasia
Vaginal hyperplasia & prolapse
Vestibulovaginal structures

Question 15

What are the three grades of vaginal hyperplasia and prolapse?

Answer 15

Grade 1- Swelling caudal vagina & vestibule
Grade 2- Large mass protruding from vulva
Grade 3- Whole vaginal circumference protrudes
Associated with pro-oestrous increase in oestrogen

Question 16

How would you treat a vaginal prolapse and hyperplasia?

Answer 16

Elizabethian collar
Purse string suture
Ovariohysterectomy

Question 17

How would you differentiate vaginal hyperplasia and vaginal neoplasia?

Answer 17

Hyperplasia - young, from vaginal floor cranial to opening, varies with oestrous cycle
Neoplasia - old, arises anywhere in vagina, does not vary oestrous cycle

Question 18

What are the clinical signs, diagnosis and treatment of vestibulovaginal stricture?

Answer 18

Clinical signs: inability to breed, vaginitis, UTI, dystocia
Diagnosis: Vaginoscopy, Vaginography, Intersex test, vaginal exam
Treatment: Ovariohysterectomy, Manual dilation, small vaginal septae, Surgical reconstruction.

Question 19

Dog presents with nymphomania and on examination you find her in anoestrous. What do you suspect?

Answer 19

Cystic ovarian degeneration.
Diagnose via ultrasound or ex. lap.
Treat with drainage or ovariectomy or ovariohysterectomy.

Question 20

List some causes of vulva discharge.

Answer 20

Puppy vaginitis 
Normal oestrous cycle
Urinary incontinence
Coagulopathy
Foetal loss
Metritis
Ovarian remnant treatment
Uterine stump infection
Whelping

Question 21

List some causes of an abnormal oestrous cycle.

Answer 21

Delayed puberty.
Prolonged anoestrous.
Prolonged oestrous.
Split oestrous.

Question 22

How do you deal with pseudopregnancy?

Answer 22

Just leave, it will subside in 1-3 weeks. Can prevent teat licking with an elizabethian collar (avoid lactation).
Happens to every bitch in non-pregnant dioestrous phase.

Question 23

What is ovarian remnant syndrome?

Answer 23

Residual ovarian tissue left after spay.

Get signs of oestrous basically after ovariohysterectomy.

Question 24

What do you do when you spay a bitch and the owner insists that she’s on heat again?

Answer 24

Confirm it’s really oestrous.

Vaginal cytology, ultrasound, ex lap, serum progesterone levels.

Question 25

What do you do with anovulatory cycle?

Answer 25

Do nothing - the dog will ovulate next year or you can induce ovulation with GnRH or hCG.

Question 26

What are the three types of ovarian neoplasia?

Answer 26

Epithelial tumours (from surface epithelium) eg. adenoma
Sex cord stromal tumours eg. granulosa thecal cell tumour
Germ cell tumour eg. dysgerminomas, teratomas

Question 27

What are some types of uterine neoplasia?

Answer 27

Leiomyoma, Fibroma, Leiomyosarcoma

Question 28

Describe mammary neoplasia in dogs and cats.

Answer 28

Dog - most common, 50/50 likelihood being benign
Cat - more likely to be malignant
Risk is reduced if spayed before first oestrous.

Question 29

What is mammary hypertrophy in the cat?

Answer 29

Benign fibroglandular enlargement of mammary gland.
Associated with progesterone exposure.
More in

Question 30

Why would you do a vaginal swab and culture?

Answer 30

Good for identifying which antibiotics you need.