Review: SA Diseases

Question 1

Pathophysiology of CEH

Answer 1

Cystic Endometrial Hyperplasia
Chronic/Repeated progesterone exposure (normal cycle or exogenous)
Uterine glands increase in # and Size, increased secretion, cystic dilation +/- luminal fluid accumulation
Irreversible

Question 2

Incidence of CEH in dogs:

Answer 2

2/3 of all female dogs > 9y with normal estrus cycles will have CEH
Inc risk with exogenous progestagen

Question 3

Consequences of CEH:

Answer 3

Often an incidental finding on ultrasound
Infertility/Subfertility, Decreased Litter Size
Hydrometra, Mucometra, Endometritis, Pyometra

Question 4

Tx of CEH:

Answer 4

OHE

Question 5

Pyometra:

Answer 5

Suppurative bacterial infection of the uterus with accumulation of inflammatory exudate in the uterine lumen

Question 6

When does Pyo commonly develop due to CEH? Independent of CEH?

Answer 6

Young dogs- independent of CEH
Older dogs- occurs together

Question 7

Pathophysiology of pyometra:

Answer 7

Due to progesterone influence (1-3 mo after heat, in diestrus)
During proestrus & estrus, cervix is open
During Diestrus, progesterone decreases uterine defense mechanisms

Question 8

When can vaginal cytology be used to diagnose pyometra:

Answer 8

OPEN pyos
Does not confirm alone, must also demonstrate fluid accumulation in uterus

Question 9

Surgical Treatment of Pyo:

Answer 9

OHE
Abx- Clavamox, enro, or combo
Supportive care- fluids, antiemetics, analgesia

Question 10

When is medical treatment considered okay for pyos:

Answer 10

Young breeding bitches
In good general condition
NO other uterine or ovarian pathologies
No repro cycle abnormalities
OPEN pyo
Specific cases with high anesthetic risks

Question 11

Medical management of pyometra:

Answer 11

PGF2a (dinoprost or clorprostenol)- uterine contractions, luteolysis, cervical opening
Algepristone- cevical opening, decreases progesterone’s effect on the uterine musculature
Prolactin inhibitors (cabergoline)- Luteolysis

Question 12

Consequences of a non-treated pyometra:

Answer 12

Sepsis, uterine rupture, death

Question 13

Puppy Vaginitis:

Answer 13

Mucopurulent vulvar discharge, spontaneous resolution after 1-2 heats
DO NOT SPAY until resolved

Question 14

Differentials for Primary vaginitis in intact bitches:

Answer 14

canine herpesvirus, brucella canis, opportunistic normal flora

Question 15

Differentials for secondary vaginitis in intact bitches:

Answer 15

Anatomical abnormalities, vaginal neoplasia/FB/Trauma, UTI, Concurrent uterine dz, Endocrine disposition

Question 16

Adult onset vaginitis in spayed bitches:

Answer 16

Secondary to vaginal atrophy following spay due to lack of estrogen influence, usually chronic
Tx- incurin (estradiol) +/- abx, probiotics

Question 17

Risk factors for perivulvar dermatitis in dogs:

Answer 17

Spayed, (usually prepubertal spays)
Recessed vulva, skin folds, obesity, vaginitis, UTI, incontinence

Question 18

Other diseases of the canine vagina

Answer 18

Vaginal hyperplasia & prolapse
Vaginal tumors (mostly benign & hormone dependent)

Question 19

Benign prostate hyperplasia pathophysiology

Answer 19

Increasing age-> decreasing testosterone-> inc relative estrogen-> upregulates prostate androgen receptors
5a reductase converts T to DHT
DHT-> prostate=> BHP

Question 20

Clinical signs and exam findings of BHP:

Answer 20

bloody/sanguinous preputial discharge, hematuria, stranguria, dysuria, bad poopies, Hematospermia, blood in 3rd fraction
Enlarged, symmetric, smooth, non-painful prostate on rectal palp

Question 21

Two treatment options for BHP

Answer 21

Castration (50% decrease in 3wks)
Finasteride (50+% decreased in 8-12 wks)

Question 22

Cause of Prostatitis, and what are the potential presentations:

Answer 22

Sequella of BHP
Acute (w/systemic signs), Chronic, Prostate Abscess (complication)

Question 23

Prostatitis palpation findings:

Answer 23

Painful if acute
Enlarged, firm, symmetric (unless abscess)

Question 24

Prostate neoplasia

Answer 24

Presents like Prostatitis/BHP but also weightloss, weakness,
Terrible prognosis, sx isnt worth it
Androgen-independent

Question 25

Squamous metaplasia of the prostate

Answer 25

Due to estrogen influence (E2 secreting tumor or exogenous estrogen)

Question 26

If cryptorchidism is unilateral in small animals which side is it usually

Answer 26

Right

Question 27

What does cryptorchid predispose?

Answer 27

neoplasia, torsion

Question 28

Testicular tumor types:

Answer 28

Sertoli cell
Leydig cell
Seminoma

Question 29

Testicular tumor symptoms:

Answer 29

Signs of hyperestrogenemia

Question 30

What is always a r/o for orchitis/epididymitis?

Answer 30

B. canis

Question 31

Causes of balanoposthitis in dogs:

Answer 31

Normal floras
Canine Herpes Virus
Atopic Dermatitis, Foreign body

Question 32

Prepartum deworming in the dog:

Answer 32

Fenbendazole at day 41-43 (T. canis & A. caninum)

Question 33

Infectious causes of resorption/abortion in Small animals:

Answer 33

E. coli, staphs, streps, Campy jejuni, Salmonella, Mycoplasma, Ureaplasma, B. canis
CHV-1, parvos, distemper, FIV, FeLv, FIP, Feline calicivirus
Toxo

Question 34

Non-infectious causes of SA abortion/absorption

Answer 34

CEH, hypoleuteoidism, endocrine disorders, drugs, toxins, nutrition, trauma

Question 35

SA Uterine Torsion:

Answer 35

Uncommon

Hem. Vulvar Discharge, Acute abdomen, Asymptomatic until dystocia

OHE

Question 36

Medical tx of early mismating:

Answer 36

<21 days
Algepristone 7-14 days after mating

Algepristone & friends for 22-40 days

> 40 - carry to term to OHE

Question 37

Feline mammary fibroepithelial hyperplasia:

Answer 37

Benign fibroglandular proliferation
Young intact cats- pregnant or pseudopregnant
Spay or allow cat to have kittens
Medical tx will cause abortion if preg (PGF2a & Algepristone)