SA Reproductive disease in the female Flashcards
What are some common diseases associated with the vulva and vestibule
Congenital abnormalities, persistent hymen, occluded vulva etc, intersex, breeding issues
Vestibulitis
Clitoral disease- tumours, hypertrophy
Vestibulitis
Inflammation of vestibule but not vagina, associated with alkalkine urine- check urine/diet/treat with topicals/E collar etc
Racing greyhounds can be seen with what vaginal disease
Hypertrophy as they may be on androgens to suppress heat
What are some diseases associated with the vagina
Vaginitis- juvenile vaginitis, adult vaginitis
Vaginal hyperplasia and prolapse
Vaginal polyps
Vaginal tumours
Juvenile Vaginitis
Common, prepubescent bitches from 8 weeks onwards, mucoid to mucopurulent vulvar discharge, otherwise OK but licking vulva, usually no bacterial growth on culture, usually resolves spontaneously in >80% cases after 1st oestrus
A/bs can help but not curative
Vaginitis in mature bitch is caused by
- Viral (herpes)-rare,
- Secondary to underlying defect anatomically, e.g., ectopic ureter, persistent hymen etc,
- Other disease process such as pyometra, trauma
- FB (grass awns)
- Neoplasia
- Endocrine disease-DM, HAC
Outline staging of Vaginal hyperplasia and Prolapse and treatment for each
Stage 1 should resolve at end of oestrus, then OVH,
Stage 2 &3-controversial-proligestone (discontinued anyway adds pyometra risk, surgical removal of prolapsed tissue in dioestrus, keep tissue viable(moisten, E collar) until dioestrus/OVH,
Stage 3-surgical removal, OVH or will recur (manual reduction and purse string sutures not recommended)
What is true vaginal prolapse
NOT caused by oestrogen, can occur after parturition, or if dogs forcibly separated during mating-may be able to replace or may require surgical resection
What are some common diseases associated with the uterus
Endometritis
Cystic endometrial hyperplasia
Pyometra
Mucometra (hydrometra)
Uterine tumours
Uterine serosal inclusion cysts
Miscellaneous-adenomyosis, segmental endometrial hyperplasia
Uterine torsion
What is cystic endometrial hyperplasia
Hyperplasia of endometrium and dilatation of the endometrial glands, plasma cell infiltration and endometrial ulceration.
What is pyometra
Pyometra is the presence of purulent contents within the uterus, a progession of 2nd stage CEH.
Pyometra- Clinical Signs
Canine and feline > 6 years old
Typically within 4-8 weeks of a season or after exogenous estrogens/progestins (synthetic progestogens to prevent oestrogens)
PU/PD
Vomiting, Anorexia, Depression
+/-Vulval discharge
+/-Pyrexia
+/- Abdominal distension
Difference between open and closed pyometra
Open pyometra occurs when the cervix is open and therefore the pus is able to drain from the uterus and out through the vagina (in which case a vaginal discharge will be noted). Closed pyometra occurs when the cervix is closed and it is the more life-threatening of the two types.
Diagnosis of pyometra
Clinical signs
Haematology & Biochemistry
- Neutrophilia with left shift
- +/- leukopaenia, thrombocytopaenia
- Mild/moderate normocytic normochromic anaemia
- Hyperglobulianaemia, Increased Urea, Creatinine, Hypoglycaemia
Ultrasound (and/or Radiography)
Describe what I can see of an ultrasound of a patient with pyometra
Will show an anechoic and hypoechoic fluid-filled organ with variable wall thickness and proliferative changes (3 bladders!)-fluid +/- flocculant material, sandy appearance
Pyometra- Management
intravenous fluids and a/bs (broad spectrum-potentiated amoxicillin)
With Alizin (Aglepristone) – progesterone antagonist-UK and Europe
Common diseases associated with ovaries
Ovarian cysts
Ovarian tumours
Hyperoestrogenism
Hyperoestrogenism is most commonly caused by what tumour
granulosa theca cell tumour
Clinical signs of hyperestrogenism
Bilaterally symmetrical alopecia beginning in the perineal, inguinal, ventral and flank regions
Enlargement of the vulva
Enlargement of nipples, Comedones on ventral alopecic skin.
Mammary hypertrophy
Abnormalities of the oestrus cycle
Secondary seborrhoea and hyperpigmentation of all affected regions in chronic cases.
Increased risk of pyometra or endometritis.
Diagnosis of hyperestrogenism
Elevated blood oestrogen levels
Chest radiographs are indicated if an ovarian tumour is suspected.
Rule-out of other endocrine dermatoses
Treatment of hyperestrogenism
Ovariohysterectomy.
Prognosis of hyperestrogenism
The prognosis is good if no ovarian malignancy is found.
Treatment of Pseudopregnancy
Many cases undergo spontaneous remission
Can treat with cabergoline (or bromocriptine)
-usually treat for 5-7days and clinical signs resolve
Transmissible Venereal Tumour risk factors
in 4-5-year-old dogs with increased risk in free roaming dogs
How is Transmissible Venereal Tumour transmitted
viral aetiology is unlikely. transmitted by contact with genital mucous membranes during coitus (and can be oral)
Transmissible Venereal Tumour treatment
Wide surgical excision + chemotherapy
