Pathology of the female genital tract

Question 1

ascending infections

Answer 1

at oestrus
postpartum infections
of equine placenta during pregnancy

Question 2

haematogenous infection

Answer 2

specific infections during pregnancy

Question 3

descending from ovary

Answer 3

rare, some viral, chlamydial,ureaplasma infections

Question 4

transneural infection

Answer 4

rare recrudescence of herpesvirus

Question 5

defence mechanisms - innate immunity

Answer 5

allows for sterile environment for foetus but allows entry of semen
vaginal epithelium
cervical barrier
conformation external genitalia
myometrial tone + contraction of uterus
drainage of secretions
neutrophils, macrophages, complement, cytokines

Question 6

defence mechanisms - adaptive immuntiy

Answer 6

response to pathogens but tolerate spermatozoa + foetus
humoral immunity - antibodies
cellular immunity - T-lymphocytes

Question 7

influence of hormones on immunity

Answer 7

better drainage through open cervix at oestrus
pro-inflammotory activity of oestrogen
uterus more susceptible to infection during progestational or luteal phase incl pregnancy
infl with epithelial + mucosal surface loss results in decr PGF2a (no CL lysis)

Question 8

developmental anomalies/intersex/sexual ambiguity

Answer 8

true hermaphrodism
pseudohermaphrodism
chimerism
tract anomaly
ovarian anomaly
most infertile

Question 9

tract anomaly

Answer 9

segmental aplasia
persistent hymen
duplication

Question 10

ovarian anomalies

Answer 10

agenesis
hypoplasia
duplication - significant when part of ovarian remnant syndrome
vascular hamartoma
developmental cysts

Question 11

acquired ovarian lesions

Answer 11

cysts - follicular, anovulatory luteinised cysts, cystic corpora lutea

Question 12

follicular cysts/cystic ovarian follicles

Answer 12

failure of mature follicle to ovulate - persistence for >10 days without functional CL
anovulation without luteinisation due to abnormal hypothalamo-hypophyseal-ovarian axis
lack of LH peak - low GnRH or receptors
can be stress/infection
anoestrus or nymphomania

Question 13

anovulatory luteinised cyst

Answer 13

anovulation with luteinisation of theca

mostly anoestrus

Question 14

cystic corpora lutea

Answer 14

normal ovulation
ovulation papilla on surface
no infertility
can be confused with luteal cysts

Question 15

acquired ovarian lesions

Answer 15

cysts - follicular, avonvulatory luteinised, cystic CL
haemorrhages
adhesions
infl - rare

Question 16

germ cell neoplasia

Answer 16

rare
dysgerminoma - from primative germ cells, smooth surface + commonly areas of haemorrhage/necrosis, mostly benign + undifferentiated
teratoma - from totipotent germ cell with elements of 2-3 germ layers, mostly benign + well differentiated

Question 17

gonadal stromal neoplasm

Answer 17

granulosa cell tumour - granulosa-theca cell tumours often make steroids, smooth surface with solid or cytic cut surface
thecoma
luteoma

Question 18

epithelial neoplasm

Answer 18

cytadenoma + cystadenocarcinoma - often bilateral + shaggy surface
esp in bitches
may spread by implantation on peritoneal surfaces ( all ovarian neoplasms)

Question 19

secondary tumours

Answer 19

lymphomas
mammary carcinomas - bitch
intestinal carcinoma - cow

Question 20

fallopian tubes - uterine tubes - salphinx - oviduct

Answer 20

hydrosalphinx (congenital or acquired)
phyosalphinx
salpingitis

Question 21

uterus - physical

Answer 21

torsion
rupture
prolapse

Question 22

endometrial growth disturbance

Answer 22

Atrophy – Loss of trophic ovarian function, normal atrophy in seasonal anoestrus 
Polyps 
Hyperplasia (ewe, bitch, queen)– cystic endometrial hyperplasia in bitch; CEH-pyometra syndrome
Mucometra/ Hydrometra – Obstruction (congenital or acquired), excessive fluid production (e.g. with endometrial hyperplasia) 
Pseudopregnancy - Exaggerated form of physiologic process 
Subinvolution of placental sites in the bitch - longer than normal persistence of placental sites (> 12 weeks)

Question 23

endometritis

Answer 23

Limited to uterine mucosa (endometrium) 
Post service (seminal fluid) 
Postpartum in particular when dystocia 
Inflammatory infiltrate (lymphocytes, plasma cells) into 
mucosa 
Mild cases usually self-limiting 
severe cases can become chronic and fibrous 
Persistent CL in mare and cow in chronic endometritis 
Persistent mating induced endometritis in mares `

Question 24

endometritis - common pathogens in cow

Answer 24

Herpesvirus
Tritrichomonas foetus
Campylobacter foetus ssp venerealis
Others incl. pyogenic cocci and coliformes, T. pyogenes

Question 25

endometritis - common pathogens in mare

Answer 25

α-haemolytic streptococci 
Klebsiella pneumonia 
E.coli 
Taylorella equigenitalis (CEM) 
Pseudomonas aeruginosa

Question 26

metritis

Answer 26

Infl of all layers of uterine wall
More severe + advanced than endometritis
Potentially life threatening due to toxaemia/
septicaemia
Commonly dull congested serosa with “paintbrush”
haemorrhages, thickened oedematous friable uterine wall, yellowish-dark red exudate with foul odour

Question 27

pyometra in bitch

Answer 27

see other lecture

Question 28

pyometra in cow

Answer 28

Uterine disease (endometritis/ metritis) predisposes to pyometra
Mostly early postpartum (following endometritis/ metritis)
Various times after breeding (venereal infections)
Persisting CL and high progesterone levels
Functional cervical closure but usually some discharge
few ml-several litres of thick, mucinous cream/gray coloured pus
Rarely systemic signs
haemolytic streptococci, staphylococci, coliforms, Trueperella pyogenes, Pseudomonas
sp; also Tritrichomonas foetus (venereal)

Question 29

pyometra in sow

Answer 29

trueperella pyogenes

Question 30

pyometra in mare

Answer 30

Some follow difficult parturitions with infections,
continue cycling during disease, sometimes prolonged
Hormonal influences less important
Mostly no cervical closure (commonly cervical deformity) → discharge
Seldom evidence of systemic disease
Streptococcus zooepidemicus,E.coli, Actinomyces spp, Pasteurella spp, Pseudomonas spp

Question 31

leiomyoma

Answer 31

uncommon
Mostly in the bitch and benign
– Often multiple also affecting cervix and vagina
– Oestrogens likely involved in provoking and maintaining in bitch
– Usually firm, pink or white; whorled smooth muscle cells

Question 32

carcinoma (epithelial neoplasia with glandular pattern)

Answer 32

Mainly in cow (found at meat inspection → has to be considered EBL suspect and notifiable)
Mainly in uterine horns
Scirrhous response (fibrous tissues); firm neoplasm
Metastases to regional lymph nodes, lungs and seeding in peritoneum

Question 33

lymphosarcoma (arising in lymphoid tissue

Answer 33

EBL in the cow → notifiable!
affected organs: heart, abomasum, lymph nodes, uterus
Light yellow, slightly friable

Question 34

cervix

Answer 34

Anomalies
Degenerative disease – cervix alteration in ewes
exposed to oestrogenic substances
Trauma – parturition, insemination
Infectious disease – concurrence with endometritis or vaginitis
Neoplasms – very rare

Question 35

vulva + vagina - non-inflammatory diseases

Answer 35

Persistent hymen - anomaly 
Vaginal septum - anomaly 
Ruptures 
Stricture / stenosis 
Abnormal tumefaction 
Vaginal hyperplasia/ hypertrophy 
and/ or prolapse 
Vaginal cysts 
Vaginal polyps – common in older bitches

Question 36

vulva + vagina - inflammatory diseases

Answer 36

Post partum trauma 
Granular vaginitis/ vulvitis 
IPV 
CHV-1 
EHV-3 – coital exanthema 
Dourine – notifiable!

Question 37

vulva + vagina - neoplasms

Answer 37

Leiomyoma
transmissible venereal tumour
Fibropapilloma
Squamous cell carcinoma of vulva

Question 38

transmissible venereal tumour

Answer 38

TVT cells have 59 chromosomes
instead of normal 78 in dogs
Transmission by transfer of neoplastic cells during coitus
Nodule formation beneath vaginal mucosa that enlarges
Histo: large, round neoplastic cells with occasional large bizarre nuclei
Vincristine responsive
Metastases in dogs with poor health