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Small Animal Surgery > Ovaries and Uterus > Flashcards

Ovaries and Uterus Flashcards

1
Q

What are the clinical signs associated with functional ovarian cysts?

A
  • prolonged estrus
  • vaginal bleeding
  • attractiveness to males
  • standing heat
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2
Q

What is meant by a “functional” ovarian cyst?

A

hormone secreting cyst

  • follicular: estrogen
  • luteal: progesterone
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3
Q

How are ovarian cysts diagnosed?

A
  • vaginal cytology
  • hormone levels
  • abdominal ultrasound
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4
Q

How are ovarian cysts treated?

A
  • OHE is curative

- for breeding animals: GnRH, HCG, cyst removal, unilateral OVE

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5
Q

What is the likelihood of metastasis for ovarian neoplasia?

A

20-30%

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6
Q

What are the possible tissues of origin and associated neoplasms of ovarian neoplasia?

A
  • epithelial: adenoma/carcinoma
  • stromal: granulosa cell tumor, functional hormone producing tumor
  • germ cell: dysgerminoma, teratoma
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7
Q

What are common clinical signs/results of granulosa cell tumors?

A
  • persistent proestrus

- pyometra

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8
Q

How is ovarian neoplasia diagnosed?

A
  • radiographs

- ultrasound

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9
Q

How is ovarian neoplasia treated?

A

OVE

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10
Q

What is Ovarian Remnant Syndrome?

A

recurrence of estrus following OHE/OVE

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11
Q

What is the cause of Ovarian Remnant Syndrome?

A

failure to remove all ovarian tissue

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12
Q

Why is Ovarian Remnant Syndrome more common in cats?

A

ectopic tissue has been reported in the pedicle

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13
Q

How is Ovarian Remnant Syndrome treated?

A

surgical removal of the remnants

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14
Q

Where is the remnant usually located in Ovarian Remnant Syndrome?

A

caudal pole of the kidney

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15
Q

Describe the pathogenesis of cystic endometrial hyperplasia

A
  • excess/prolonged progesterone
  • endometrial cells become hyperplastic
  • glandular tissue becomes cystic
  • uterus fills with fluid
  • can lead to pyometra
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16
Q

What are the clinical signs associated with cystic endometrial hyperplasia?

A
  • failure to conceive
  • vaginal discharge
  • PU/PD
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17
Q

How is CEH diagnosed and treated?

A
  • ultrasound

- OHE

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18
Q

What is the most common bacteria associated with pyometra?

A

E. coli

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19
Q

What is the typical signalment associated with pyometra?

A
  • middle aged intact females

- dogs more common than cats

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20
Q

What is the difference between an open and closed pyometra?

A
  • open: cervix is open and infected fluid can drain out

- closed: cervix is closed and infected fluid is trapped

21
Q

Describe the pathogenesis of pyometra

A
  • prolonged/elevated progesterone levels with no pregnancy
  • growth/secretions of endometrial glands
  • uterine drainage is inhibited and fluid accumulates
  • bacterial colonization
  • estrogen will increase/sensitize progesterone receptors
22
Q

What are the clinical signs associated with pyometra?

A
  • lethargy
  • vomiting
  • PU/PD
  • vaginal discharge
23
Q

What is seen on physical exam of a dog with pyometra?

A
  • painful distended abdomen
  • fever
  • tachycardia, tachypnea
24
Q

What are possible clinical pathology abnormalities that can be seen with pyometra?

A
  • hypoglycemia
  • azotemia, proteinuria
  • anemia
  • leukocytosis with left shift
  • increased AST and ALP
25
Q

How is pyometra treated?

A
  • stabilize patient first

- OHE

26
Q

When is medical management of pyometra indicated?

A
  • if not systemically ill
  • open pyometra
  • high breeding value
27
Q

What is the medical treatment for pyometra?

A

PGF2 alpha

antibiotics 10-14 days

28
Q

What is metritis, and when does it usually occur?

A
  • inflammation/infection of the uterus

- occurs post-partum

29
Q

What are possible causes of metritis?

A
  • dystocia
  • devitalized uterus
  • fetal/placental retention
30
Q

What are the clinical signs associated with metirits?

A
  • foul smelling red/brown discharge
  • fever
  • anorexia, lethargy
  • decreased milk production
31
Q

How is metritis treated?

A
  • antibiotics

- OHE

32
Q

What is uterine torsion and what is it usually associated with?

A
  • twisting of the uterus along the long axis

- associated with dystocia, pyometra, and CEH

33
Q

What are the clinical signs of uterine torsion?

A
  • acute abdomen
  • abdominal distension
  • shock
34
Q

How is uterine torsion diagnosed?

A
  • radiographs

- exploratory

35
Q

How is uterine torsion treated?

A
  • fluids and analgesics

- OHE

36
Q

What is the usual cause of uterine prolapse?

A

complication of parturition/dystocia

37
Q

How is uterine prolapse treated?

A
  • manual reduction
  • OHE
  • reduce edema with hypertonic agents
38
Q

What are possible causes of uterine rupture?

A
  • dystocia
  • trauma
  • post c-section
  • pyometra
  • giving oxytocin when the cervix is not dilated
39
Q

What is the difference between dogs and cats in respect to uterine neoplasia?

A
  • cats are more likely to metastasize
40
Q

What is dystocia?

A

inability to expel a fetus through the birth canal

41
Q

What are the possible causes of dystocia?

A 
maternal:
- primary or secondary uterine inertia
- birth canal obstruction
fetal:
- malposition or malformation
- oversize
- secondary uterine inertia
42
Q

What is primary uterine inertia?

What are the causes?

A
  • parturition fails to proceed

- due to over or undersized litters

43
Q

What is secondary uterine inertia?

What are the causes?

A
  • normal delivery or part of the litter, then develops uterine fatigue
  • due to fetal or pelvic obstruction, fetal malposition, or fetal size
44
Q

What is found on physical exam of an animal with dystocia?

A
  • lochia without delivery
  • obstructed canal on palpation
  • lack of uterine contraction in response to Ferguson’s reflex
45
Q

How is dystocia treated?

A
  • primary uterine inertia can be treated medically with oxytocin
  • manual manipulation of fetus
  • C-section
46
Q

What are the indications for a C-section?

A
  • secondary uterine inertia
  • primary uterine inertia that failed medical treatment
  • systemic signs in bitch
  • fetal distress
  • planned for high risk patients
47
Q

Where is the incision made for a c-section?

A

midway between xiphoid and umbilicus to cranial pubis

48
Q

Describe the c-section procedure

A
  • exteriorize uterus carefully
  • pack with sponges
  • perform hysterotomy
  • clamp umbilical cord
  • pass fetus to assistant
  • close with single or double layer 3/0 mono absorbable

Small Animal Surgery (26 decks)

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