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RUSVM Small Animal Surgery I > SASx Exam II Material - Reproductive > Flashcards

SASx Exam II Material - Reproductive Flashcards

1
Q

T/F: Surgical excision is curative for ovarian cysts

A

True

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2
Q

Pyometra can occur due to persistent __________ secretion from granulosa cell tumors of stromal origin

A

progesterone

Pyometra can occur due to persistent _progesterone_ secretion from granulosa cell tumors of stromal origin

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3
Q

How is Ovarian Remnant Syndrome (ORS) diagnosed in the dog?

A

Vaginal cytology

  • Mimics normal heat cycle
  • Must be done in standing heat
  • Vaginal cytology in cats is inconsistent
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4
Q

With regard to Ovarian Remnant Syndrome (ORS), where should you look for the remnant?

A

caudal pole of kidney

  • Remnant at caudal pole of kidney
    • Identification easier during estrus/diestrus
    • Follicles or corpora lutea present
  • Proximity to ureter
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5
Q

What are the indications for medical treatment for metritis?

A

Medical treatment is only indicated if all of the following are true:

  • Valuable breeding animal
  • Good response to initial therapy
  • No devitalized tissue/retained placenta or fetus

Otherwise, surgical exploration is indicated

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6
Q

Ovarian neoplasia is most commonly of ________ or ________ origin

A

Ovarian neoplasia is most commonly of epithelial or stromal origin

  • Epithelial: adenoma or adenocarcinoma
  • Stromal: granulosa cell tumor
    • Usually functional – estrogen, progesterone, both
    • Pyometra with persistent progesterone
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7
Q

T/F: With regard to ovarian neoplasia, metastatic disease is fairly uncommon in dogs

A

True

Metastatic disease is much more common in cats

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8
Q

What is the most common bacteria that you will see associated with pyometra?

A

E. coli

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9
Q

Which of the following sets of clinical signs would be most typical of a case of pyometra?

  • Palpable uterus, fever, anemia, neutropenia, lymphocytosis
  • Palpable uterus, fever, eosinophilia, neutrophilia, azotemia
  • Palpable uterus, anemia, polyuria, neutrophilia with left shift
  • Palpable uterus, vomiting, pulmonary congestion, anuria
A

Palpable uterus, anemia, polyuria, neutrophilia with left shift

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10
Q

What is the treatment protocol for closed pyometra in a dog?

  • Immediate ovariohysterectomy - this is a surgical emergency, like GDV
  • Ovariohysterectomy within a few hours, after rehydration, IV antibiotic therapy and sometimes blood transfusion.
  • Drainage of the uterine contents by catheterization per vagina, antibiotics, ovariohysterectomy when the patient is healthy
  • Evacuation of uterine contents with prostaglandin therapy, antibiotics, ovariohysterectomy when the patient is healthy
  • Replacement of fluid deficits, IV antibiotics for 2 days followed by oral antibiotics for 2 weeks - the dog should be bred at the next estrus to prevent recurrence
A

Ovariohysterectomy within a few hours, after rehydration, IV antibiotic therapy and sometimes blood transfusion.​

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11
Q

T/F: OHE does not affect milk production

A

True

Milk production is based on prolactin, which is produced by pituitary, so spaying a dog has no effect on milk production

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12
Q

T/F: What are the anatomical indications for an episiotomy approach?

A

vestibular and vaginal lesions

  • Incision limited dorsally due to rectum​
  • Position for perineal surgery
  • Incise on midline from vulvar opening
  • Moderate hemorrhage
    • Electrocautery
    • Noncrushing clamps
  • Close in 3 layers
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13
Q

This is a surgical procedure used to open the vulvar orifice to allow access to the vestibule and caudal vagina:

A

episiotomy

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14
Q

T/F: Vaginal tumors are most common in young, large-breed dogs in estrus

A

False

  • Most common in older, intact female dogs
    • > 10 years old
    • Intact suggests hormonal influence
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15
Q

What is the most common vaginal neoplasia in dogs?

A

leiomyoma (LMO)

  • Most masses (80%) are benign
    • Leiomyoma (LMO) most common
    • Fibroma, polyp, cyst
  • Masses usually pedunculated, intraluminal
  • Excisional biopsy via episiotomy
  • Full-thickness resection at base
  • Electrocautery highly recommended
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16
Q

What is the most common malignant vaginal tumor in dogs?

A

leiomyosarcoma

  • Leiomyosarcoma most common malignancy
    • Relatively low risk of metastasis
    • Locally invasive
  • Aggressive resection necessary
  • Vulvovaginectomy
  • Also requires perineal urethrostomy
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17
Q

What is the most common neoplasm in intact female dogs?

A

canine mammary tumors

  • Most common neoplasm in intact female dogs
    • 70% of all tumors (benign and malignant)
    • Median age at presentation is 7-11 years
  • Mammary tumors reported in males
    • Extremely rare
    • When seen, tend to be benign
    • This is different from the situation in cats
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18
Q

What breed of dog is presdisposed to developing malignant mammary tumors?

A

German Shepherds

19
Q

A dog is brought to you with mammary tumors of the 3rd, 4th and 5th glands in the left chain. There is no evidence of metastasis. What surgery is indicated?

  • Lumpectomy of each mass
  • Local mastectomy – removal of each gland as well as each mass
  • Regional caudal mastectomy
  • Full left chain mastectomy
A

Regional caudal mastectomy

20
Q

Bilateral full-chain mastectomy in the dog is not usually recommended. Why?

  • Blood loss is excessive.
  • Length of procedure results in high risk of infection.
  • Closure of the resulting wound may be difficult or impossible.
  • Mammary tumors are usually benign, so an extensive surgery is not indicated.
  • The prognosis for dogs with bilateral tumors is very poor.
A

Closure of the resulting wound may be difficult or impossible​

21
Q

What are the most common sites of metastasis for canine mammary tumors (CMT)?

A

Lung, Bone, Kidney, Spleen, Liver, Distant lymph node

22
Q

Ovariohysterectomy is most effective in reducing the incidence of mammary tumors in the dog if done:

  • Before the first estrus cycle
  • Between the first and second estrus cycles
  • After the dog has whelped 1 litter
  • As soon as possible after diagnosis of a mammary tumor
A

Before the first estrus cycle​

  • OHE before 2 years of age reduces risk
    • 0.5% risk if spayed before 1st estrus
    • 8% risk if spayed between 1st and 2nd cycle
    • 26% risk if spayed after 2nd but before 2 y/o
23
Q

T/F: Surgical treatment is recommended for inflammatory carcinoma

A

False

  • Suspicion based on clinical signs, rapid progression
  • Usually metastatic – depends on duration
  • Median survival < 1 month
  • Treatment
    • NSAID may improve survival
    • Surgical treatment not recommended
24
Q

T/F: Mammary tumors are more common in the cat than the dog

A

False

25
Q

Which of the following is true? Mammary tumors in the cat:

  • Are usually (>80%) adenocarcinoma
  • Are most common in the 5th pair of mammae
  • Are often diagnosed in cats between 2-4 years of age
  • Are effectively treated by simple excision (lumpectomy) in most cases
A

Are usually (>80%) adenocarcinoma​

26
Q

You have a cat with a mammary tumor on the left 3rd mammae.

T/F: Simple mastectomy is indicated in this cat

A

False

For any mammary tumor in cats, chain mastectomy should be done on the affected side (regardless of tumor size, number)

27
Q

What’s going on with these weird cat boobs?

A

fibroadenomatous hyperplasia

  • Benign lesion
  • Usually occurs in young (< 2 year old) cats
  • Progesterone-dependent
    • During first estrus cycle
    • Pregnancy/pseudopregnancy
  • Reported in older and male cats
  • Complicated by trauma, infection, necrosis
  • Treatment
    • OVH/OVE
    • Flank approach recommended
    • Condition resolves over weeks to months
    • Resect of tissues that do not regress after spay
28
Q

At what age do the testicles usually descend in dogs?

A

30-40 days

Diagnosis of cryptorchidism can be made after 6 months

29
Q

You are treating an 8 month old Shar pei with a firm, non-reducible, painful, cordlike swelling extending from the inguinal region to the scrotum. The tissues have bluish-black appearance. The most likely diagnosis is?

  • Testicular torsion
  • Brucellosis
  • Scrotal hernia
  • Prepubic tendon rupture
  • Seminoma
A

Testicular torsion​

  • More common with abdominal testicles
  • Clinical signs variable
    • Mild signs (anorexia, lethargy)
    • Acute abdomen (marked pain, shock)
  • Diagnosis by ultrasound, palpation
  • Condition fatal without surgical treatment
  • Prognosis good with surgery
30
Q

Hyperestrogenism is a common paraneoplastic syndrome seen with sertoli cell tumors. What is the clinical significance of this to the patient?

A

Bone marrow suppression may be irreversible and determines prognosis

31
Q

T/F: Vasectomy has no effect on testosterone

A

True

  • No change in testosterone-dependent disease
    • Perineal hernia
    • Perianal adenoma
    • Prostatic disease
  • No change in secondary characteristics
    • Urine odor
    • Roaming
    • Agression
    • May be helpful in controlling feral populations
32
Q

Incomplete formation of the penile urethra is termed:

A

hypospadias

  • Most common developmental anomaly of the external male genitalia
  • Most common in Boston Terriers
  • Signs depend upon location
    • Minimal signs
    • Urine scalding
33
Q

How do you treat hypospadias?

A

Urethrostomy proximal to the abnormality

Excision of exposed mucosa, penile remnants

34
Q

Inability to retract the penis into the prepuce is termed:

A

paraphimosis

  • Congenital causes
    • Narrowed orifice
    • Shortened prepuce
  • Acquired causes
    • Trauma
    • Infection
    • Priapism
35
Q

How do you treat this condition in the dog?

A

amputate the penis

36
Q

What procedure is shown below?

A

penile amputation

37
Q

What is the most common neoplasia in the prepuce?

A

mast cell tumor (MCT)

more malignant than other sites

38
Q

Which of these prostatic diseases is seen in castrated as well as intact dogs?

  • Benign prostatic hypertrophy
  • Prostatic abscess
  • Prostatic neoplasia
  • None – all are diseases of intact dogs
A

Prostatic neoplasia​

39
Q

What is the most common organism associated with prostatic abscess?

A

E. coli

  • Prostatic abscess/prostatitis
    • Ascending infection from the urethra
    • E.coli most common organism
    • Middle-aged to older intact dogs
    • Pre-existing BPH required
    • Clinical signs due to prostatomegaly, infection
40
Q

What is the surgical treatment of choice for prostatitis?

A

exploratory laparotomy and omentalization

  • Omentalization consistently successful
  • Fewer complications vs. other techniques
  • Shorter hospitalization vs. other techniques
  • Recurrence if loculations not properly broken down
  • Same for treatment of benign prostatic hypertrophy
41
Q

T/F: With regard to prostatic neoplasia, castration is neither palliative nor protective

A

True

  • Prostatic neoplasia
    • Usually malignant
      • Adenocarcinoma, various subtypes
      • 80% have metastasis on necropsy
      • Similar to aggressive form of human disease
    • Effect of castration
      • Increased incidence
      • Increased risk of metastasis
      • Castration neither palliative nor protective
42
Q

T/F: Episiotomy is commonly performed to facilitate removal of a fetus from the vagina in the dog or cat with dystocia.

A

False

43
Q

To which lymph node do these mammary glands drain?

A

inguinal lymph node

RUSVM Small Animal Surgery I (15 decks)

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