Lecture 23: Reproductive 2 Flashcards
List the main anatomical structures of the female reproductive tract
ovary: from bipotential gonad, makes ovums
uterine tube - from paramesonephric duct
uterine horn - bicornate (mainly) from paramesonephric duct
uterine body and cervix: formed by fuson of the paramesonephric duct
vagina: for semen deposition and protection from environment
- cranially from fused paramesonephric duct
- caudally from urogenital sinus
vestibule from urogenital sinus
clitoris from external tuberacle
What are common female DSDs
normal chromosomal/phenotypic and gonadal but with XXSRY ovarian DSD
aplasia
failure to fuse
failure to fuse with urogenital sinus
What is an example of aplasia as a DSD in females
segmental aplasia of the paramesonephric duct (any part)
What is an example of a failure to fuse DSD in females
uterus didelphys
no fusion of the paramesonephric duct resulting in 2 cervixes and 2 uterine bodies
What is an example of a ‘failure to fuse with urogenital sinus’ DSD in females
persistant hymen
the paramesonephric duct fails to fuse with the urogenital sinus
can cause hydrometra/mucometria (fluid production with no outflow
What is the function of ovaries? What are the 2 main consequences of dysfunction?
function: develop and release ova and produce hormones that potentiate pregnancy
if dynsfunctional = impacts on fertility and hormone production
What are the relevant anatomical structures of the ovary
surface epithelium is smooth
-except in dogs (invaginated = form subsurface epithelium)
1 > 2 > 3 follicles > corpus hemorrhagicum > corpus luteum > corpus albicans
What is a differentiating feature of the horse ovary compared to other species
the medulla and cortex are inverted
- medulla on outside
- cortex on inside
ovulation fossa releases very large follicles
What are 2 types of disorders that can affect ovaries
cysts (peri or intra ovarian)
neoplasia
What are periovarian cysts? What species are they most common in? What is their significance?
cysts that form external to the ovary
- usually remnant of the paramesonephric or mesonephric ducts
common in horses
incidental
List 3 types of intraovarian cysts
epithelial inclusion cysts
cystic rete ovarii
cystic ovarian follicle/ovarian cysts
What animals are epithelial inclusion cysts most common? How do they form?
horses
form around ovulation fossa when surface epithelium pinches off in ovulation and embeds in stroma
- it accumulates with fluid and interferes with ovulation
differentiate it from a follicle because it doesn’t regress
What animals are most affected by cystic rete ovarii
dog, cat, guinea pig
What is the rete ovarii
remnant of the mesonephric tubules
What is the significance of cystic rete ovarii? What is a common differential?
mainly incidental but can be very large in guinea pigs and may need to be removed
ddx = cystic ovarian neoplasm
What are cystic ovarian follicles? What animals are they common in?
anovulatory follicles
dairy cows and sows
How do you differentiate an ovarian cyst from a tertiary follicle?
ovarian cysts are usually
- larger than follicles
- will persist
- will accompany changes in estrus
What is cystic ovarian disease? What animals does it affect? What are the clinical signs?
dairy cows
> 2.5cm cystic ovarian follicle for over 10 days
clinically
- nymphomania (hyperestrogenism)
- anestrus = common sign
- prolonged post-partum period
What causes cystic ovarian disease
failure of preovulatory LH surge
What are the gross characteristics of cystic ovarian disease
single or multiple cysts either uni or bilateral
may have partial luteinization
List 3 types of neoplasms that commonly affect the ovaries
they are usually primary tumors (metastasis to ovaries is rare)
germ cell
sex cord stromal
epithelial (carcinoma or adenoma)
What are 2 examples of germ cell tumors. Provide notable characteristics about the tumor(s)
dysgerminoma
teratoma: rare/benign
- multiple germ layers
- can have hair/teeth/bone/cartilage
What is an example of a sex cord stromal tumor
granulosa cell tumor
What is the most common ovarian tumor of large animals?
granulosa cell tumor (sex cord stromal tumor)
What is the clinical presentation and gross features of granulosa cell tumors
clinically: 3 patterns
1. nymphomania due to high estrogen
2. stallion-like behaviour due to high testosterone
3. anestrus due to inhibin
these manifest because it is hormonally active
gross
- unilateral
- cystic on cut section with red-brown fluid
benign
What animals are commonly affected by ovarian carcinomas?
dogs in their subsurface epithelium
What is the presenting complaint of ovarian carcinomas?
presenting complaint = ascites due to impaired lymphatic drainage
- vessel obstruction in the peritoneum and diaphragm
What are the gross features of ovarian carcinoma
multifocal and bilateral (independently develop - not metastasis)
papillary projections = shaggy appearance of ovary
What is the tumor behaviour of ovarian carcinomas
cause transcoelomic spread and carcinomatosis in abdomen
can also metastasize to lymph nodes and organs
What causes ovarian carcinoma
unknown
What are the layers of the uterus
endometrium
- glands
myometrium
- longitudinal and circular smooth muscle
serosa/perimetrium
List 4 non-inflammatory lesions of the uterus
cystic endometrial hyperplasia
mucometria/hydrometria
uterine prolapse
subinvolution of placental sites
What animals are most affected by cystic endometrial hyperplasia? What causes it?
sheep: estrogenic clover ingestion (phytoestrogen)
dog/cat: response to uterine diestrus
- progesterone primes endometrium, if there is an added irritation it results in hyperplasia
What is the gross appearance of cystic endometrial hyperplasia
cystic and distended endometrial glands
What is cystic endometrial hyperplasia associated with?
pyometra
CEH + pyometra syndrome
because CEh can provide a good environment for bacteria
What is hydro/muco metria? Why does it occur?
thin watery or thick fluid in uterus
not pyometra
due to
- endometrial hyperplasia
- obstruction of uterus/ vagina/cervix
What animals are prone to uterine prolapse?
ruminants and sows
What are the clinical signs and consequences of uterine prolapse?
clinically:
- tenesmus (dystocia/retained placenta/postpartum hypocalcemia)
- uterine inertia
reduced venous outflow = congestion/edema
- concurrent trauma/infection/drying = necrosis
- shock = death
What animals are affected by subinvolution of placental glands? What is it?
dogs only
placental sites/trophoblasts don’t completely regress
- normally it should involute in 12-15 weeks
What are the clinical signs and consequences of subinvolution of placental sites?
clinically:
- lots of bloody discharge for months (normal = 1-6 weeks)
can lead to…
- regenerative anemia
- if the animal has a coagulopathy = exsanguination
- secondary metritis
List 3 inflammatory uterine conditions in the order of severity
endometritis < metritis < pyometra
What is endometritis and what is a common condition causing this?
endometrial inflammation
post mating endometritis in mares
What causes post mating endometritis in mares?
failure to clear semen
- impacted by anatomic conformation
- some inflammation after insemination is common but usually cleared
What are the consequences of post mating endometritis in mares? What are the gross lesions/how is it evaulated?
chronic inflammation leads to edema and fibrosis = infertility
- conceptus cannot attach
no gross lesions
endometrial biopsy can be used to grade
- breeding soundness exams
What is metritis and what is a common condition causing this?
inflammation of the myometrium
post partum endometritis/metritis in cows
What is the most important uterine lesion/disease in cows
post partum endometritis/metritis
What causes post partum endometritis/metritis in cows
abnormal parturition
failure of uterine involution = prolonged lochia
- lochia is good for bacterial growth
What are the gross features of post partum endometritis/metritis in cows
dark/red-brown uterus
chocolate brown fluid
What is pyometra? List 2 conditions in which it commonly occurs
pus in the uterine lumen
post partum endometritis/metritis in cows
dogs with cystic endometrial hyperplasia-pyometra syndrome
What is the common signalment of an animal with cystic endometrial hyperplasia and pyometra syndrome
intact female dogs older than 5yo
4-6 weeks post estrus (will be in diestrus because there will be high progesterone and a CL present)
What are the clinical signs of CEH-pyometra syndrome
extragenital lesions
- depression
- dehydration
- anorexia
- vomit
- PU/PD (because bacterial endotoxins disrupt ADH)
- vaginal discharge if the cervix is open
- immune complex glomerulonephritis
- subclinical UTI
clinical signs are secondary to endotoxemia and bacteremia
What is a common bacterial cause of CEH-pyometra syndrome
E. coli
What does genital herpes in female animals cause
vulvovaginitis
self limiting
- abortion
latent/reoccuring
What are the types of genital herpes affecting female animals + respective species
cattle = BHV1 (infectious pustular vulvovaginitis)
horse = EHV3 (coital exanthema)
cat = FHV1
dog = CHV1
How is genital herpes transmitted and what are the gross lesions
venereal transmission
gross
- vesicular = erosion and ulcers
- depigmentation without healing
List 5 tubular genitalia neoplasms in females
leiomy (-ome/sarcoma)
uterine carcinoma
cattle lymphoma
canine transmissible venereal tumor
squamous cell carcinoma
What animals are leiomyoma/leiomyosarcomas most common in
dogs
- smooth muscle of uterus/vagina/cervix
What is the appearance of leiomyoma/leiomyosarcomas? What is their behaviour?
single or multiple
benign
hormonally dependent
What animals are uterine carcinomas common
rabbit = very common
cattle
What is the clinical effects and tumor behaviour of uterine carcinoma?
it causes a marked scirrhosis reaction
- increase fibrous tissue resulting in constriction
it causes transcoelomic spread and metastasis to lymph nodes and lungs
What causes cattle lymphoma
BLV
What is the critical barrier to the mammary glands
The ostium/opening of the papilla
blocked by a keratin plug
What is the most common causes of mastitis
main cause = ascending bacterial infection via the teat canal/papillary duct
second most common is blood borne infection
mainly bacterial in origin
List the common bacterial types that cause mastitis and where they are found?
obligate mammary pathogens (direct contact transmission)
- Strep agalactiae
- Staph aureus
- Mycoplasma
environmental
- E. coli
- Klebsiella
both enviro and mammary
- Strep. uberis
- Strep. dysgalactiae
List 3 types of mastitis
severe necrotizing/gangrenous mastitis
suppurative mastitis
mycoplasma mastitis
What is the causative agent(s) of severe necrotizing/gangrenous mastitis
coliform bacteria (e. coli or highly virulent staph aureus)
What are the clinical signs of severe necrotizing/gangrenous mastitis
toxemia resulting in
- fever
- anorexia
-hot firm mammary glands
What are bloodwork changes associated with severe necrotizing/gangrenous mastitis
hyperfibrongenemia
leukopenia
What are the gross lesions associated with severe necrotizing/gangrenous mastitis
srtaw coloured/watery/bloody fluid
blue - black cold and soft tissue (gangrene)
if she lives = the affected tissue will slough off
What is the causative agent(s) of suppurative mastitis
pyogenic gram (+)
- low virulence staph aureus
- strep dysgalactiae
- truperella pyogenes
How do you compare suppurative mastitis with severe necrotizing mastitis
there is less necrosis/vascular injury and systemic impact
What are the gross lesions associated with suppurative mastitis
increased pus in the lactiferous sinus
fibrosis if it is chronic
What is the causative agent(s) of mycoplasma mastitis
M. bovis is the most importnat cause
via ascending infection of blood borne
What are the gross lesions associated with mycoplasma mastitis
yellow/tan well demarcated areas of caseus necrosis
A calf presents to you with enzootic pneumonia and otitis media, what should you consider?
mycoplasma mastitis in the dam
What are the common features of mammary neoplasias affecting dogs?
common
benign
How does OHE change the risk of mammary neoplasia and hyperplasia in dogs and cats?
dogs: OHE will reduce the risk of neoplasia
- if spayed after the 2nd estrus there is an increased risk compared to spaying earlier
cats:
- hyperplasia: spay can cure/resolve
- neoplasia: there is mixed/inconclusive evidence
What are the 3 classifications of canine mammary neoplasias
epithelial tumors
complex tumors
- epithelial and myoepithelial
mixed tumors
- epithelial and mesenchymal (bone/cartilage)
What is the common signalment for an animal presenting with mammary fibroadenomatous hyperplasia
a young (<2yo) intact female cat
they may or may not be on progestin therapy
- progesterone can induce
What are the clinical signs of mammary fibroadenomatous hyperplasia
single or multiple glands
large
swollen
firm
What is the common signalment for a cat with mammary carcinoma
old ~11yo
with a single mass that may or may not be ulcerated
What is the most common type of mammary carcinoma affecting cats? What is the prognosis?
90% malignant
poor prognosis if >3cm
very metastatic
