Bilateral segmental aplasia with unilateral uterine horn torsion in a pomeranian bitch

Bilateral segmental aplasia of the uterine horns with unilateral pyometra and uterine horn torsion were diagnosed in a Pomeranian bitch that presented with chronic abdominal distension and an acute onset of anorexia and lethargy. Because radiographic and ultrasonographic findings revealed the presence of markedly enlarged bilateral uterine horns filled with fluid in the caudal abdomen, a tentative diagnosis of either pyometra or hydrometra with uterine horn torsion was made. Exploratory laparotomy showed bilateral, segmentally distended uterine horns with unilateral uterine horn torsion. Ovariohysterectomy was performed, and bilateral segmental aplasia of the uterine horns with the development of unilateral uterine horn torsion was diagnosed histopathologically. To the authors' knowledge, this is the first report of uterine horn torsion in conjunction with segmental aplasia of the uterine horn in a bitch.     

Prolonged foetal retention in a bitch resulting in trichogranulomatuous panmetritis and re-establishment of fertility after unilateral ovariohysterectomy.

This case report describes the clinical course, the diagnostic and therapeutic management as well as histopathological findings in a case of foetal retention for about 5 months in a 5-year-old Boxer. Clinical symptoms included mucosanguinous vaginal discharge and a firm ovoid mass of about duck egg size palpable in mid abdomen. Sonographic examination was not suitable to visualize uterine contents, while radiography revealed a conglomeration of foetal bones focally visible in the right uterine horn, which was surgically removed together with the ipsilateral ovary in order to maintain the fertility of the bitch. After lancing the uterine wall the osseous skeleton as well as parts of hairy skin and muscles of the foetus attaching the uterine wall were detected. Histologically a unilateral necrotizing panmetritis with almost complete destruction of the endometrial structures was diagnosed. Furthermore, the endometrium, the myometrium as well as the serosa revealed a severe trichogranulomatuous inflammation with numerous foetal hairs visible within the inflammatory alterations. After treatment of the bitch with prostaglandin F(2alpha) and an antibiotic agent she became pregnant in the second heat after surgery and gave birth to two healthy puppies. This is the first report on foetal retention for several months followed by unilateral ovariohysterectomy with subsequent recovery of fertility. Furthermore, this case report describes for the first time the histomorphological diagnosis of a unilateral trichogranulomatuous panmetritis in a bitch.     

Focal cystic endometrial hyperplasia in a bitch

Rapid abdominal enlargement and weight gain occurred in a four-year-old Rhodesian ridgeback bitch in late oestrus. The bitch was nulliparous. Severe cardiovascular dysfunction followed and an exploratory laparotomy was performed. A large, single, spheroid mass weighing 17 kg was located in the middle section of the left uterine horn. A diagnosis of sterile, focal, cystic endometrial hyperplasia was made from gross pathology, histopathol-ogy and bacteriology. The bitch made a complete recovery following an ovariohysterectomy.     

The Use of Epostane in an Attempt to Reproduce Cystic Endometrial Hyperplasia in the Bitch

The aetiology and pathogenesis of spontaneous cystic endometrial hyperplasia (CEH) in the bitch is not yet completely understood. Recent research based on the expression of uterine sex hormone receptors in spontaneous cases of CEH suggested that a temporary progesterone deficiency during late oestrus-early metoestrus may be responsible for the onset of CEH development. In the present study a temporary progesterone deficiency during late oestrus–early metoestrus was experimentally created using an inhibitor of progesterone synthesis, epostane. At day 49 of metoestrus, there was a significant reduction in the size of the uterine wall, mainly due to endometrial atrophy, and there was also a significant increase in the mucus-filled uterine lumen in the bitches that had been treated with epostane compared to the control bitches. No significant differences in the expression of sex hormone receptors was observed between the two groups. As no CEH developed in the epostane-treated bitches, an additional oestrogenic stimulus may be required to stimulate endometrial proliferation. Therefore, it is suggested that deficient luteinization of the corpus luteum may be the trigger in the pathogenesis of CEH, as the secretion of varying amounts of sex steroids depends on the degree of luteinization.     

Identification of focal adenomyosis as a uterine lesion in two dogs

A focal uterine adenomyosis is described in two bitches. In both cases, the uterus showed knobbly enlargements of 4 to 8 cm in diameter, which resulted in distinct clinical symptoms. Other pathological changes of the uterus were not present. One bitch was presented because of a history of vaginal discharge of several months' duration. Radiographs, as well as ultrasonography, revealed a soft tissue lesion at the cervix. The other bitch showed a marked reduction in its general condition and a sudden onset of a tense abdomen. Radiologically, a lesion of soft tissue opacity was observed in the mid-abdomen and was seen to originate from the left uterine horn during exploratory laparotomy. A torsion of the lesion was present, which explained the clinical signs in this second case.     

CYSTIC ENDOMETRIAL HYPERPLASIA AND BACTERIAL ENDOMETRITIS ASSOCIATED WITH AN INTRAUTERINE FOREIGN BODY IN A GUINEA PIG WITH OVARIAN CYSTIC DISEASE

A 3-year-old, 920 g intact female guinea pig presented with a 4-month history of nonpruritic hair loss on the ventral abdomen. The physical examination revealed flank and ventral abdominal alopecia, mucoid vulvar discharge, and abdominal distension. Bilateral rounded masses just caudal to the kidneys and structures consistent with enlarged uterine horns were detected on abdominal palpation. Abdominal ultrasound revealed bilateral ovarian cysts, thickened uterine horns, and multiple circular hypoechoic and anechoic structures in the uterine wall. The patient underwent ovariohysterectomy. Gross examination of the uterus revealed a piece of hay in the left uterine horn. A final diagnosis was hormonally active ovarian follicular cysts, cystic endometrial hyperplasia, and purulent bacterial endometritis caused by Escherichia coli, Fusobacterium nucleatum, and Arthrobacter spp. Cystic endometrial hyperplasia is infrequently reported in guinea pigs, and this report describes an associated bacterial endometritis and uterine foreign body with concurrent ovarian cysts.     

Co‐existing monophasic teratoma and uterine adenocarcinoma in a female dog

Ovarian teratomas are occasionally reported in dogs; the rarest type is the monophasic teratoma, composed of tissues originating from only one germ layer. Canine endometrial adenocarcinomas are also rare in dogs and mainly affect geriatric females. This report describes the case of co‐existing ovarian teratoma and uterine adenocarcinoma in a 10‐year‐old nulliparous female Boxer presented with lethargy, anorexia and purulent vaginal discharge. Abdominal ultrasonography evidenced pyometra and a mass in the left ovary. This was composed of a uniform whitish tissue with multiple cystic structures. The histology revealed an atrophy of the ovarian parenchyma, compressed by a proliferation of well‐differentiated nervous tissue staining positively to vimentin, S100 and neuronal specific enolase (NSE), and negatively to keratin and inhibin. The left uterine horn, whose diameter was markedly increased, showed foci of endometrial cellular atypia, evident nucleoli and mitoses, at light microscopy. To our best knowledge, this is the first report of a co‐existing ovarian monophasic teratoma and endometrial adenocarcinoma, two rare reproductive neoplasia in dogs.     

Equine Endometrial Gland Density and Endometrial Thickness Vary among Sampling Sites in Thoroughbred Mares

The secretions of the equine endometrial glands are essential for the survival, growth, and development of the conceptus in early pregnancy, and endometrial gland density is directly related to successful pregnancy outcome. Endometrial biopsy is routinely used to assess the reproductive potential of broodmares. Some previous studies have shown that equine endometrial glands are uniformly distributed throughout the uterus; however, other work has shown variation of the endometrial architecture between biopsy sites, suggesting that a single biopsy is not representative of the entire endometrium. The aims of this study were to assess and compare the endometrial gland density and thickness at four sampling sites in the uterus (the central segment of each uterine horn, the uterine horn-body junction, and the caudal portion of the uterine body). Endometrial samples from five nulliparous Thoroughbred mares in diestrus were obtained at necropsy and used for subsequent histomorphometric analysis. The caudal uterine body had a significantly lower endometrial gland density and endometrial thickness than the other sites. This may result in nutrient deprivation and reduced survival of embryos or fetuses in this region of the uterus. The endometrial gland density and endometrial thickness did not significantly differ between the other regions sampled, indicating that they are similarly suitable for embryonic implantation and fetal development. Our results suggest that the endometrial structure of the caudal uterine body of the mare is not representative of the endometrial morphology at other sites. Thus, the caudal uterine body is not a suitable site for routine endometrial biopsy.     

Estriolum Treatment in the Bitch: A Risk for Uterine Infection?

Purulent vaginal discharge in a bitch in which ovariohysterectomy has been performed is often caused by inflammation of the uterine stump. The inflammation is due to either cystic endometrial hyperplasia (CEH) induced primarily by progesterone from remnant ovarian tissue or exogenous progestagens, or it is due to the presence of unabsorbed suture material. This report describes a 9-year-old Irish setter with hemopurulent vaginal discharge and non-pruritic symmetrical alopecia, which had undergone ovariohysterectomy 3.5 years ago and which had been treated with estriolum daily for the past 2.5 years because of urinary incontinence. Vaginoscopy revealed hemopurulent discharge throughout the vagina and vestibule. Cytological examination of ultrasound-guided fine-needle aspiration biopsies of a large mass in the hypogastricum, which appeared to be the uterine cervical stump, revealed septic purulent inflammation. The concentration of plasma progesterone was low and the concentration of plasma 17-ß oestradiol did not increase after gonadotrophin-releasing hormone administration. No remnant ovarian tissue was found by abdominal ultrasonography, laparotomy, or histological examination of mesovarian pedicles. Laparotomy revealed uterine stump empyema. Histological examination of the surgically removed mass excluded both CEH and unabsorbed suture material as the cause of the stump empyema. Instead, it is hypothesized that the long-term treatment with estriolum was a causative factor. This suggests that bitches treated with estriolum should be examined regularly.     

The development of cystic endometrial hyperplasia in the bitch following serial uterine biopsies

Serial uterine biopsies were performed on two bitches during three oestrous cycles. The uterus was biopsied once in one other bitch and twice in another case following exteriorization and palpation of the uterine horn on four occasions earlier in the cycle. Following the serial biopsies both bitches developed a vulval discharge for a duration of 8-21 days. This first appeared between metoestrus days 14 and 30. By the 5th week after oestrus the uteri of both bitches developed cystic endometrial hyperplasia with inflammatory cell infiltration which regressed spontaneously. This lesion did not develop in the two other bitches, and it may have been caused by the surgical interference with the endometrium during the period of luteal development.     

Is Mechanically Induced Cystic Endometrial Hyperplasia (CEH) a Suitable Model for Study of Spontaneously Occurring CEH in the Uterus of the Bitch?

Cystic endometrial hyperplasia (CEH) was experimentally reproduced by the intraluminal insertion of a silk wire in the uterus of metestral bitches to obtain a model for the study of spontaneously occurring CEH in the bitch. This mechanically reproduced CEH corresponded histologically very well to spontaneously occurring CEH. With respect to sex hormone receptor expressions, however, there was no similarity. In the mechanically induced CEH, progesterone receptor expression was reduced in the epithelial cells (surface epithelium and endometrial glands) and slightly increased in the stromal fibroblasts and myometrium as compared with the normal metestrus uterus. The oestrogen receptor expression in mechanically induced CEH was reduced in the epithelial cells (surface epithelium and endometrial glands) and more or less unchanged in the stromal fibroblast and myometrium as compared with the normal metestrus uterus. This is in contrast to the increased sex hormone receptor expressions in all uterine cell types, observed in spontaneously occurring CEH. The mechanically induced CEH model corresponds immunohistochemically more to early placentation and to pyometra in the bitch. Thus this experimental CEH model is not suitable for pathogenic studies of spontaneously occurring CEH in the bitch.     

Endometrial Adenocarcinoma and Mucometra in a 6-year-old Alaska Malamute Dog

A 6-year-old female Alaska Malamute dog was presented for evaluation of abdominal enlargement referred by a local veterinarian. On the history, the owner complained of chronic abdominal enlargement initiated more than 4 months ago, reduced appetite, occasional vomiting and general dullness. He also complained of greenish mucous intermittent vaginal discharge starting 10 days ago. The bitch was chronically treated with medroxiprogesterone acetate. A laparatomy was performed and fluid in the abdomen was found and aspirated during the surgery. Also a very fluid-filled distended uterus and a mass in the distal part of the left uterine horn were found. The mass was encapsulated by the omentum, but areas of necrosis and calcification were identified. Histopathological diagnosis was endometrial adenocarcinoma.     

Assessment of the optimal age for a preventive ultrasonographic screening of the uterine health in bitches

Studies about prevalence of uterine pathologies in bitches are scarce. Although correlation between age and uterine disorders was documented, the most suitable age for a preventive sonographic screening has not been proposed yet. Present study aimed to estimate the eligible age for an ultrasonographic screening of uterine abnormalities in dogs. Data regarding ultrasound examination and clinical records of non‐pregnant intact females were retrospectively analysed. The age of each bitch was expressed as age ratio (actual/maximum age expected for the respective breed). The cut‐off age ratio was determined by a ROC curve for overall uterine abnormalities. Frequencies of different abnormalities below and over the cut‐off derived from the ROC curve were calculated and statistically analysed by chi‐Square and OR. Prevalence of three categories of ultrasonographic findings was as follows: cystic endometrial hyperplasia (CEH) 18%; uterine collections (UC) 10.5%; masses (M) 1.3%. By the cut‐off age ratio (0.325), derived by ROC curve (AUC = 0.91; SP 84.23%; SE 79.2%; PPV 83.4%; NPV 80%), 228 cases were divided into two subgroups: bitches over (exposed group: n.83) and below cut‐off (control group: n.145). All abnormalities resulted more frequent in exposed group: OR was 24.96 (p < 0.0001: 71.1% over vs. 9% below cut‐off) for overall abnormalities; 13.68 (p < 0.0001: 40.9% vs. 4.8%) for CEH; 6.13 (p < 0.002: 21.7% vs. 4.1%) for UC; 12.65 (p = 0.09: 3.6% vs. 0%) for M. Cystic endometrial hyperplasia represents the most common finding in adult bitches, followed by UC. A preventive sonographic screening for uterine abnormalities should start from 33% of expected longevity to preventively select animals requiring further evaluations.     

脂多糖对小鼠子宫内膜Toll样受体4介导的炎性信号通路的影响

革兰阴性菌感染可引起子宫内膜炎,机体的Toll样受体4(TLR4)可接受革兰阴性菌的细胞壁主要成分脂多糖(LPS)的刺激引发一系列炎症反应。为了研究LPS对TLR4介导的炎性信号通路的影响,本试验以小鼠为模型,分别用不同浓度的LPS对小鼠进行在体子宫灌注和处理体外培养的子宫内膜上皮细胞系。组织学观察显示,灌注不同浓度LPS后子宫内膜组织中炎性细胞增多。通过RT-PCR对各组中TLR4和核转录因子κB(NF-κB)、IL-6的mRNA表达水平进行检测,发现LPS刺激能够增强TLR4和NF-κB、IL-6 mRNA表达,影响TLR4介导的炎性信号通路。     

In this issue – October 2011

AVA Policies · Unilateral uterine torsion in a bitch · Q fever in dogs in Townsville · Purchase price and racing performance of Thoroughbred yearlings · Review of genetic neurological defects in cattle · Bovine salmonellosis and antibiotic sensitivity · Chlamydial load and infectious disease in koalas · History of endemic disease regulation in Australia     

Pyometra in an Inguinal Hernia in a Bitch

Pyometra in an inguinal hernia was diagnosed in a 10‐year‐old intact cross‐bred bitch which had had dysorexia, depression and inguinal distension. The hernia contained caudal portions of the two uterine horns, uterine cervix and cranial part of the vagina. As the organs were enlarged and full of pus, manual attempt to push back the uterine horns and the vagina in the abdominal cavity through the inguinal canal was unsuccessful. Herniated uterine horns were ligated and cut in their median portion, so it became possible to remove the cervix and the caudal portion of the horns through the hernial orifice, and the ovaries and the cranial part of the horns through a peritoneal midline incision. This bitch was not intended for breeding purposes and, given the presence of a huge pyometra associated with an inguinal hernia, an ovario‐hysterectomy was recommended. Uterine herniation should be considered as a differential diagnosis of a caudal lateral inguinal mass. When pushing the uterus back in the abdominal cavity is impossible, a surgical procedure should be performed to detect ischemia–reperfusion injury and/or a septic risk.     

Pseudo-placentational Endometrial Cysts in a Bitch

Cystic alterations of the canine endometrium compromise reproduction and fertility of the bitch and may lead to life-threatening diseases, such as pyometra. Even without clinical evidence, reduction of the uterine lumen by cysts implicates disturbances during migration, nidation and development of the embryo. Several studies point to the high variability of morphology of uterine endometrial cysts but they lack detailed analyses of alterations. In the present study, immunohistochemistry was used to investigate the expression of steroid hormone receptors (oestrogen, progesterone), proliferation activity, inflammation and infection in the cystic affected tissue regions in contrast to the normal endometrium. Oestrogen receptor expression showed a high density of receptors throughout the surface epithelial cells, crypt epithelial cells, glandular epithelial cells and stromal cells of the normal endometrium as well as the cystic affected regions. Proliferation in the cysts was verified in the middle and basal cells of the crypts. Neither in the endometrium nor in the cysts inflammatory processes or evidence of infection could be detected. Furthermore, lectin histochemistry and electron microscopic methods showed that lectin binding patterns and cell morphology of internal epithelial lining and surface epithelium of the cysts can be used to characterize and distinguish different types of cystic alterations. Analogies between epithelial cells of the glandular chambers of the canine placenta and the cystic cellular morphology, steroid hormone receptor distribution as well as lectin binding patterns of the endometrial cysts, as observed in this study, suggest to introduce the term 'pseudo-placentational endometrial cysts'.     

Uterine torsion in a Sprague Dawley rat (Rattus norvegicus)

Uterine torsion is a twisting of the uterus or uterine horn perpendicular to its long axis. We report a case of uterine torsion in an adult breeding Sprague Dawley rat. The rat died a month after her last recorded delivery. Post mortem examination of the rat revealed 270 degrees torsion of the right uterine horn. The uterus contained a single foetus. The liver was pale and enlarged. The rest of the viscera appeared normal. Histopathological examination showed acute hepatic necrosis and pulmonary congestion with mild lymphocytic infiltrates peribronchially. The acute hepatic necrosis may have been associated with septicaemia due to compromised blood vessels following the uterine torsion. The presence of a single foetus could have resulted in foeto-maternal disproportion with resultant uterine torsion. Torsion of the uterus can be accompanied by haemostatic and metabolic complications, which could have caused the death of the rat. Although uterine torsion is a rare condition in rats, it should be considered as a potential complication of gestation in animal breeding units.     

The potential function of endometrial‐secreted factors for endometrium remodeling during the estrous cycle

Uterine has a pivotal role in implantation and conceptus development. To prepare a conducive uterine condition for possibly new gestation during the estrous cycle, uterine endometrium undergoes dramatic remodeling. In addition, angiogenesis is an indispensable biological process of endometrium remodeling. Furthermore, essential protein expressions related to important biological processes of endometrium remodeling, which are vascular endothelial growth factor (VEGF), myoglobin (MYG), collagen type IV (COL4), fucosyltransferase IV (FUT4), and cysteine‐rich protein 2 (CRP2), were detected in the endometrial tissue reported in many previous studies and recently discovered in histotroph substrates during the estrous cycle. Those proteins, which are liable for provoking new vessel development, cell proliferation, cell adhesion, and cell migration, were expressed higher in the histotroph during the luteal phase than follicular phase. Histotroph proteins considerably contribute to endometrium remodeling during the estrous cycle. To that end, the following review will discuss and highlight the relevant information and evidence of the uterine fluid proteins as endometrial‐secreted factors that adequately indicate the potential role of the uterine secretions to be involved in the endometrial remodeling process.     

Uterine serosal inclusion cysts in a bitch

A six-year-old, pluriparous German shepherd dog bitch was presented with an abnormal vaginal discharge of several weeks' duration. Clinical signs and radiographic and ultrasonographic findings supported an initial diagnosis of segmental cystic endometrial hyperplasia, and ovariohysterectomy was performed. Macroscopic-ally, the uterus appeared normal except for one large and several smaller cysts attached to its antimesometrial side. These cysts were restricted to a small area of the left uterine horn. The histological diagnosis was serosal inclusion cysts. The clinical findings, gross pathology and histopathology are described and discussed.