Ovaries and Uterus Flashcards
What are the clinical signs associated with functional ovarian cysts?
- prolonged estrus
- vaginal bleeding
- attractiveness to males
- standing heat
What is meant by a “functional” ovarian cyst?
hormone secreting cyst
- follicular: estrogen
- luteal: progesterone
How are ovarian cysts diagnosed?
- vaginal cytology
- hormone levels
- abdominal ultrasound
How are ovarian cysts treated?
- OHE is curative
- for breeding animals: GnRH, HCG, cyst removal, unilateral OVE
What is the likelihood of metastasis for ovarian neoplasia?
20-30%
What are the possible tissues of origin and associated neoplasms of ovarian neoplasia?
- epithelial: adenoma/carcinoma
- stromal: granulosa cell tumor, functional hormone producing tumor
- germ cell: dysgerminoma, teratoma
What are common clinical signs/results of granulosa cell tumors?
- persistent proestrus
- pyometra
How is ovarian neoplasia diagnosed?
- radiographs
- ultrasound
How is ovarian neoplasia treated?
OVE
What is Ovarian Remnant Syndrome?
recurrence of estrus following OHE/OVE
What is the cause of Ovarian Remnant Syndrome?
failure to remove all ovarian tissue
Why is Ovarian Remnant Syndrome more common in cats?
ectopic tissue has been reported in the pedicle
How is Ovarian Remnant Syndrome treated?
surgical removal of the remnants
Where is the remnant usually located in Ovarian Remnant Syndrome?
caudal pole of the kidney
Describe the pathogenesis of cystic endometrial hyperplasia
- excess/prolonged progesterone
- endometrial cells become hyperplastic
- glandular tissue becomes cystic
- uterus fills with fluid
- can lead to pyometra
What are the clinical signs associated with cystic endometrial hyperplasia?
- failure to conceive
- vaginal discharge
- PU/PD
How is CEH diagnosed and treated?
- ultrasound
- OHE
What is the most common bacteria associated with pyometra?
E. coli
What is the typical signalment associated with pyometra?
- middle aged intact females
- dogs more common than cats
What is the difference between an open and closed pyometra?
- open: cervix is open and infected fluid can drain out
- closed: cervix is closed and infected fluid is trapped
Describe the pathogenesis of pyometra
- 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
What are the clinical signs associated with pyometra?
- lethargy
- vomiting
- PU/PD
- vaginal discharge
What is seen on physical exam of a dog with pyometra?
- painful distended abdomen
- fever
- tachycardia, tachypnea
What are possible clinical pathology abnormalities that can be seen with pyometra?
- hypoglycemia
- azotemia, proteinuria
- anemia
- leukocytosis with left shift
- increased AST and ALP
How is pyometra treated?
- stabilize patient first
- OHE
When is medical management of pyometra indicated?
- if not systemically ill
- open pyometra
- high breeding value
What is the medical treatment for pyometra?
PGF2 alpha
antibiotics 10-14 days
What is metritis, and when does it usually occur?
- inflammation/infection of the uterus
- occurs post-partum
What are possible causes of metritis?
- dystocia
- devitalized uterus
- fetal/placental retention
What are the clinical signs associated with metirits?
- foul smelling red/brown discharge
- fever
- anorexia, lethargy
- decreased milk production
How is metritis treated?
- antibiotics
- OHE
What is uterine torsion and what is it usually associated with?
- twisting of the uterus along the long axis
- associated with dystocia, pyometra, and CEH
What are the clinical signs of uterine torsion?
- acute abdomen
- abdominal distension
- shock
How is uterine torsion diagnosed?
- radiographs
- exploratory
How is uterine torsion treated?
- fluids and analgesics
- OHE
What is the usual cause of uterine prolapse?
complication of parturition/dystocia
How is uterine prolapse treated?
- manual reduction
- OHE
- reduce edema with hypertonic agents
What are possible causes of uterine rupture?
- dystocia
- trauma
- post c-section
- pyometra
- giving oxytocin when the cervix is not dilated
What is the difference between dogs and cats in respect to uterine neoplasia?
- cats are more likely to metastasize
What is dystocia?
inability to expel a fetus through the birth canal
What are the possible causes of dystocia?
maternal: - primary or secondary uterine inertia - birth canal obstruction fetal: - malposition or malformation - oversize - secondary uterine inertia
What is primary uterine inertia?
What are the causes?
- parturition fails to proceed
- due to over or undersized litters
What is secondary uterine inertia?
What are the causes?
- normal delivery or part of the litter, then develops uterine fatigue
- due to fetal or pelvic obstruction, fetal malposition, or fetal size
What is found on physical exam of an animal with dystocia?
- lochia without delivery
- obstructed canal on palpation
- lack of uterine contraction in response to Ferguson’s reflex
How is dystocia treated?
- primary uterine inertia can be treated medically with oxytocin
- manual manipulation of fetus
- C-section
What are the indications for a C-section?
- secondary uterine inertia
- primary uterine inertia that failed medical treatment
- systemic signs in bitch
- fetal distress
- planned for high risk patients
Where is the incision made for a c-section?
midway between xiphoid and umbilicus to cranial pubis
Describe the c-section procedure
- 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
