SASx Exam II Material - Reproductive Flashcards
T/F: Surgical excision is curative for ovarian cysts
True
Pyometra can occur due to persistent __________ secretion from granulosa cell tumors of stromal origin
progesterone
Pyometra can occur due to persistent _progesterone_ secretion from granulosa cell tumors of stromal origin
How is Ovarian Remnant Syndrome (ORS) diagnosed in the dog?
Vaginal cytology
- Mimics normal heat cycle
- Must be done in standing heat
- Vaginal cytology in cats is inconsistent
With regard to Ovarian Remnant Syndrome (ORS), where should you look for the remnant?
caudal pole of kidney
-
Remnant at caudal pole of kidney
- Identification easier during estrus/diestrus
- Follicles or corpora lutea present
- Proximity to ureter
What are the indications for medical treatment for metritis?
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
Ovarian neoplasia is most commonly of ________ or ________ origin
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
T/F: With regard to ovarian neoplasia, metastatic disease is fairly uncommon in dogs
True
Metastatic disease is much more common in cats
What is the most common bacteria that you will see associated with pyometra?
E. coli
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
Palpable uterus, anemia, polyuria, neutrophilia with left shift
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
Ovariohysterectomy within a few hours, after rehydration, IV antibiotic therapy and sometimes blood transfusion.
T/F: OHE does not affect milk production
True
Milk production is based on prolactin, which is produced by pituitary, so spaying a dog has no effect on milk production
T/F: What are the anatomical indications for an episiotomy approach?
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
This is a surgical procedure used to open the vulvar orifice to allow access to the vestibule and caudal vagina:
episiotomy
T/F: Vaginal tumors are most common in young, large-breed dogs in estrus
False
-
Most common in older, intact female dogs
- > 10 years old
- Intact suggests hormonal influence
What is the most common vaginal neoplasia in dogs?
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
What is the most common malignant vaginal tumor in dogs?
leiomyosarcoma
-
Leiomyosarcoma most common malignancy
- Relatively low risk of metastasis
- Locally invasive
- Aggressive resection necessary
- Vulvovaginectomy
- Also requires perineal urethrostomy
What is the most common neoplasm in intact female dogs?
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
What breed of dog is presdisposed to developing malignant mammary tumors?
German Shepherds
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
Regional caudal mastectomy
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.
Closure of the resulting wound may be difficult or impossible
What are the most common sites of metastasis for canine mammary tumors (CMT)?
Lung, Bone, Kidney, Spleen, Liver, Distant lymph node
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
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
T/F: Surgical treatment is recommended for inflammatory carcinoma
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
T/F: Mammary tumors are more common in the cat than the dog
False
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
Are usually (>80%) adenocarcinoma
You have a cat with a mammary tumor on the left 3rd mammae.
T/F: Simple mastectomy is indicated in this cat
False
For any mammary tumor in cats, chain mastectomy should be done on the affected side (regardless of tumor size, number)
What’s going on with these weird cat boobs?
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
At what age do the testicles usually descend in dogs?
30-40 days
Diagnosis of cryptorchidism can be made after 6 months
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
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
Hyperestrogenism is a common paraneoplastic syndrome seen with sertoli cell tumors. What is the clinical significance of this to the patient?
Bone marrow suppression may be irreversible and determines prognosis
T/F: Vasectomy has no effect on testosterone
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
Incomplete formation of the penile urethra is termed:
hypospadias
- Most common developmental anomaly of the external male genitalia
- Most common in Boston Terriers
-
Signs depend upon location
- Minimal signs
- Urine scalding
How do you treat hypospadias?
Urethrostomy proximal to the abnormality
Excision of exposed mucosa, penile remnants
Inability to retract the penis into the prepuce is termed:
paraphimosis
-
Congenital causes
- Narrowed orifice
- Shortened prepuce
-
Acquired causes
- Trauma
- Infection
- Priapism
How do you treat this condition in the dog?
amputate the penis
What procedure is shown below?
penile amputation
What is the most common neoplasia in the prepuce?
mast cell tumor (MCT)
more malignant than other sites
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
Prostatic neoplasia
What is the most common organism associated with prostatic abscess?
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
What is the surgical treatment of choice for prostatitis?
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
T/F: With regard to prostatic neoplasia, castration is neither palliative nor protective
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
-
Usually malignant
T/F: Episiotomy is commonly performed to facilitate removal of a fetus from the vagina in the dog or cat with dystocia.
False
To which lymph node do these mammary glands drain?
inguinal lymph node
