Vaginal disorders

Chronic vaginitis is the most common vaginal disorder. Dogs with vaginitis show no signs of systemic illness but often lick at the vulva and have purulent or hemorrhagic vaginal discharges. Vaginitis is most commonly secondary to a noninfectious inciting factor such as congenital vaginal anomalies, clitoral hypertrophy, foreign bodies, trauma to the vaginal mucosa, or vaginal tumors. Inspection of the caudal vagina and vestibule both visually and digitally will often reveal the source of vaginal irritation. Vaginal cytology is used to establish the stage of the estrous cycle as well as distinguish uterine from vaginal sources of discharge. Vaginal cultures are used to establish the predominant offending organism associated with vaginal discharges and may be used as a guide for selection of a therapeutic agent. Vaginitis is best managed by removing the inciting cause and treating the area locally with antiseptic douches. Congenital malformations at the vestibulovaginal or vestibulovulvar junction may prevent normal intromission. Affected bitches may be reluctant to breed naturally because of pain. Such defects are detected best by digital examination. Congenital vaginal defects may be corrected by digital or surgical means. Prolapse of tissue through the lips of the vulva may be caused by clitoral hypertrophy, vaginal hyperplasia, or vaginal tumors. Enlargement of clitoral tissue is the result of endogenous or exogenous sources of androgens. Treatment of this condition includes removal of the androgen source and/or surgical removal of clitoral tissue. Vaginal hyperplasia is detected during proestrus or estrus of young bitches. Hyperplastic tissue will regress during diestrus. Tissue that is excessively traumatized and/or prolapse of the entire vaginal circumference may be removed surgically. Ovariohysterectomy may be used to prevent recurrence. Vaginal tumors are detected most often in older intact bitches. Such tumors are generally of smooth muscle or fibrous tissue origin and benign. Surgical excision of the tumor combined with ovariohysterectomy is usually curative.     

Vaginourethroplasty for Treatment of Urethral Obstruction in the Bitch

Vaginourethroplasty was performed in six bitches with infiltrative, obstructive urethral disease. The initial clinical signs included dysuria, hematuria, pollakiuria, and stranguria. Diagnosis was based on the clinical signs, plain radiography and contrast vagino-urethrogram examination, and urethral biopsy. Five dogs were diagnosed as having urethral neoplasia; the sixth dog had granulomatous urethritis. In all six dogs, up to 50% of the urethra and the urethral tubercle were resected to ensure adequate surgical margins. One dog was euthanatized 4 months after surgery for recurrence of a transitional cell carcinoma at the surgical site. Long-term resolution of the problem (minimum of 12 months) was achieved in the other five dogs. The frequency of serious complications, including urinary incontinence and ascending lower urinary tract infections, was low.     

Vaginal leiomyofibromatosis and goiter in a goat

A mature nulliparous Saanen-type goat examined for episodes of vulvar hemorrhage had coalescing nodular vaginal masses. The histopathologic diagnosis from a biopsy specimen was leiomyofibromatosis. Because of the relationship of these tumors in bitches to cystic ovaries and the nonrecurrence in bitches after excision and ovariectomy, abdominal exploration was performed. Bilaterally cystic ovaries were removed, and the vaginal tumors slowly regressed over the subsequent year, although transvaginal adhesions formed because of the extensive superficial necrosis originally present.     

Use of exfoliative cytology for diagnosis of transmissible venereal tumour and controlling the recovery period in the bitch

Transmissible venereal tumour (TVT) is a rare vaginal tumour that can be treated surgically or cryosurgically as well as by radiotherapy or chemotherapy. Vincristine has been found to be very effective for treating TVT. Since vaginal secretion or discharge may contain neoplastic cells, the cytological identification of TVT cells is possible. The present study was carried out in 12 bitches. Vaginal smears were obtained with cotton swab from the anterior vagina and TVT suspected structures. The smears were stained according to Papanicolaou and assessed by light microscopy. Additionally the general condition of the patients was evaluated by haematological and radiographic examinations. In bitches with TVT vincristine sulphate was administered intravenously at weekly intervals. The total treatment period was three to six weeks until no atypical cells were found in the smear. This was the case after an average of 3.2 +/- 1.3 applications. Tumour masses became smaller and by this non-visible from the rima vulva after 4.2 +/- 0.7 applications. During the treatment, two of the 12 bitches (16.7%) suffered from vomiting and diarrhoea while three (25%) showed neutropenia. Twelve months after completion of treatment, the bitches were examined again and vaginal smears were taken in order to control the recovery process or a possible recurrence of TVT. No atypical cells were found in any vaginal smear. By this exfoliative cytology has proved to be a safe and easy method for TVT diagnosis and for observing the recovery process.     

Prediction of parturition date in the bitch and queen

Assessment of gestational age and parturition date prediction is a challenging, yet common task in clinical management of the pregnant bitch or queen. Knowing the approximate parturition date is essential for a thorough pregnancy monitoring. Radiographic and ultrasonographic methods are suitable in bitches and queens. In the bitch, moreover, ovulation timing by means of LH or progesterone assay, determination of onset of vaginal dioestrus by means of examination of vaginal cytology, and recognition of impending parturition by monitoring prepartal progesterone levels and body temperature variation are practical methods. A combination of different methods increases the accuracy of parturition date prediction.     

Diagnosis and treatment of chronic vaginitis in the bitch

The diagnosis of chronic vaginitis is made primarily on the basis of the historical and physical finding of a persistent, nonhemorrhagic vulvar discharge. Licking the vulva and pollakiuria are present in some (10%) bitches with vaginitis. The diagnosis can be confirmed with vaginal cytology and vaginoscopy. Treatment for vaginitis in bitches younger than 1 year of age is justifiably conservative, because the majority of such bitches (90%) recover with or without treatment. Chronic vaginitis in bitches older than 1 year of age most often is associated with identifiable abnormalities of the genitalia (35%) or urinary tract (26%). Resolution of the vaginitis is directly related to the resolution of the other abnormalities.     

Persistent vulvar hemorrhage secondary to vaginal hemangioma in dogs

Two young female dogs were presented with a chronic history of persistent vulvar hemorrhage. Vaginoscopy was ultimately used to locate bleeding vaginal masses near the urethral papilla. In both cases, episiotomy was performed to resect the mass, and hemangioma was diagnosed histologically. These tumors caused persistent vaginal bleeding; they were difficult to diagnose without vaginoscopy and lavage; and surgical excision was curative in at least one case.     

Vaginal cytology and cervicovaginal mucus arborisation in the breeding management of bitches

Fifty bitches were mated on the basis of results of vaginal cytological and cervicovaginal mucus arborisation examination. When these were compared with a control group of 50 bitches mated on days 10 and 12 after the onset of proestrus there was a significant increase in pregnancy rate from 78 to 92 per cent. The litter size and bitch productivity was also increased, although this was not statistically significant. Forty-two per cent of bitches had two peaks of anuclear epithelial cells in the vaginal smear, separated by a mean of 3–6 ± 1–5 (SD) days. For these bitches, the maximum percentage of anuclear cells at the second peak was between 57 and 98 per cent, and the mean interval between the calculated day of the surge in plasma luteinising hormone (LH) and the second peak of anuclear cells was 4-4 ± 2-0 days. In bitches with one peak of anuclear epithelial cells, the maximum percentage of anuclear cells was between 43 and 94 per cent and the mean interval between the calculated day of the LH surge and the peak of anuclear cells was 1–9 ± 2-1 days. Arborisation of mucus collected from the anterior vagina was noted in all bitches; the mean interval between the calculated day of the LH surge and the peak of ferning was 2–3 ± 2-1 days. The collection of exfoliative cells by aspiration from the cranial vagina and the assessment of the anuclear cell index, may allow the identification of the fertile period after the surge of plasma LH. The anuclear cell index offers advantages over other methods of classification of exfoliative vaginal cells. When used in combination with examination of arborisation of cervicovaginal mucus this method can improve the breeding management of bitches.     

Endometrial cytology of the normal bitch throughout the reproductive cycle

Samples for endometrial cytology were collected both from live bitches using transcervical uterine cannulation (n=48) and postmortem (n=10). The cells identified were endometrial epithelial cells, leucocytes, erythrocytes, spermatozoa, bacteria and cervical or vaginal cells. The endometrial epithelial cells varied morphologically throughout the reproductive cycle and had signs of degeneration during late dioestrus and during early and mid-anoestrus following dioestrus and postpartum. Neutrophils were the most common leucocytes observed during pro-oestrus, oestrus, dioestrus and early pregnancy, and lymphocytes during anoestrus. Macrophages were frequently seen during anoestrus. Erythrocytes were found in variable numbers at all stages of the reproductive cycle. Spermatozoa were detected in samples collected during oestrus and early pregnancy in bitches which had their last mating one to three days previously. Bacteria were commonly observed during pro-oestrus and oestrus. Cornified cervical or vaginal cells were present during pro-oestrus and oestrus. This study demonstrated that the numbers, types, proportions and morphology of ceils in endometrial cytological samples from normal bitches varied throughout the reproductive cycle.     

Colliculus seminalis as a cause of a urethral filling defect in two dogs with Sertoli cell testicular neoplasms

A urethral filling defect in the proximal portion of the pelvic urethra, suggestive of a mass, was detected by positive-contrast retrograde urethrography in 2 dogs with prostatic disease and Sertoli cell neoplasms. Extension of prostatic neoplasia into the urethra or primary urethral neoplasia were considered as explanations for the radiographic finding of an intraluminal filling defect in the pelvic urethra. Masses were visualized and biopsied during prostatic surgery. Masses were nonneoplastic and represented enlargement of the colliculus seminalis.     

Urethropexy for the management of urethral sphincter mechanism incompetence in the bitch

Urethropexy was performed on 100 bitches for the management of urethral sphincter mechanism incompetence (SMI). The dogs ranged in age from 12 months to nine years (mean 4.5 years). Diagnosis of the condition was based upon clinical, laboratory and contrast radiographic examinations, and clinical response to medical management. In all bitches, incontinence developed in the adult individual and in the majority (89 bitches) after spaying. Radiographic findings were unremarkable in 22 bitches, apart from the presence of an intrapelvic bladder neck. Follow-up periods ranged from 12 months to seven years (mean 2.9 years). Fifty-six bitches were completely cured by surgery, 27 became less incontinent and 17 either failed to respond (nine animals) or showed an initial improvement in urinary function, but then relapsed (eight animals). Nine of these 17 animals underwent a second urethropexy procedure, resulting in a cure in six and an improvement in three cases (follow-up 12 to 41 months, mean 22.2 months). A deterioration in the response rate was observed over time. Postoperative complications were seen in 21 bitches and included an increased frequency of micturition (14 bitches), dysuria (six bitches) and anuria (three bitches).     

Long-term study of aerobic bacteria of the genital tract in breeding bitches.

The aerobic bacterial flora of the genital tract was characterized in 59 bitches in an 18-month study. The bitches represented 4 breeds and were from 3 kennels. Collection of vaginal swab specimens for bacterial culturing was performed every month, except during estrus when specimens were collected every week (n = 826). The capsule of the swab containing transport media was broken before specimen collection to moisten the tip, which helped to reduce the number of negative cultures. All bitches helped at least once during the study and, thus, had known reproductive functions. Pregnancy rates, litter sizes, and pup mortality were within normal limits. Pasteurella multocida, beta-hemolytic streptococci group G, and Escherichia coli were the most common bacteria isolated. Although these species generally were isolated from mixed cultures, pure cultures were obtained from 18% of the specimens. There was a tendency for the various breeds to differ in their vaginal bacterial flora. The flora also varied during the reproductive cycle. Pasteurella multocida was isolated significantly more often during proestrus, estrus, metestrus, and pregnancy, than during anestrus and the postpartum period, and beta-hemolytic streptococci were isolated significantly more often during proestrus than during estrus, pregnancy, or the postpartum period. Staphylococcus intermedius was almost exclusively found after parturition. Culture results were negative for only 5.2% of specimens cultured. On the basis of our findings, bacterial culturing of vaginal swab specimens from bitches without signs of genital disease is of little value.     

Vaginal position and length in the bitch: relationship to spaying and urinary incontinence

A study was undertaken to determine if the vagina might be a suitable site for the measurement of intra-abdominal pressure during cystometry in the bitch. The position of the cranial vagina and vaginal length were measured radiographically and the effects of spaying and urinary incontinence on these variables were evaluated in 30 continent and 30 incontinent bitches. The study used retrograde vaginourethrograms which had been obtained from animals used in a previous study. The cranial vagina was intra-abdominal on 36 of the vaginourethrograms, being least commonly intra-abdominal in incontinent bitches (11/30). Vaginal position was related linearly to vaginal length and continence status (P < 0.01), while its length was related to bodyweight (P < 0.01). Allowing for bodyweight, neutered animals had significantly shorter vaginas than entire bitches (P < 0.01). Measurement of intra-abdominal pressure with concomitant measurement of intravesical pressure is essential if accurate assessment of detrusor pressure is to be determined during cystometry. The vagina is unlikely to be a useful location from which to measure intra-abdominal pressure since any pressure-measuring catheter inserted into it may fall outside the abdominal pressure zone. This is particularly true of neutered and/or incontinent bitches, the groups in which urodynamic investigations of urinary incontinence are most frequently indicated.     

Vaginal lactic acid bacteria in healthy and ill bitches and evaluation of in vitro probiotic activity of selected isolates

The concentrations of lactic acid bacteria (LAB) in 42 vaginal samples from healthy and ill bitches were determined. Eight isolates belonging to the genera Lactobacillus and Enterococcus were selected and identified and their in vitro antimicrobial activity against canine pathogens and their ability to adhere to canine vaginal epithelial cells were determined. There was no correlation between the concentrations of vaginal LAB and clinical status, body temperature, vaginal pH, or age. Although the animals were either well or suffering from various illnesses, LAB were found in almost every sample, and the selected isolates showed promising probiotic-related features. These findings are significant for the design of strategies for the modulation of vaginal microbiota by vaginal LAB isolates.     

Disorders of the vestibular system

Disorders of the vestibular system are common in veterinary practice and result in a clinical syndrome characterized by head tilt, asymmetric ataxia, and nystagmus. These signs may occur with lesions involving the peripheral or central vestibular structures. Careful neurologic evaluation of the animal and knowledge of surrounding neuroanatomic structures and their functions enable the clinician to differentiate between peripheral and central disorders. Conditions resulting in peripheral vestibular symptoms include idiopathic syndromes, otitis interna, trauma, neoplasia, drug-induced ototoxicity, and congenital disorders. Radiographs of the petrous temporal bone and tympanic bulla and examination of the tympanic membrane are useful in determining the specific etiology. Central vestibular dysfunction may result from inflammatory CNS diseases, neoplasia, trauma, thiamine deficiency, and storage diseases. Cerebrospinal fluid analysis, skull radiographs, and computed tomography are diagnostic tests useful in animals with central vestibular symptoms. Once the etiology is identified, specific therapy may be provided and a more accurate prognosis can be determined.     

Urethral haemangiosarcoma in a boxer

A seven-year-old, entire female boxer presented with a history of restless behaviour and inappetence. Physical examination revealed that the dog was listless and had a hunched gait. Neurological examination was normal. Abdominal ultrasonography revealed a 4 cm x 4 cm mass in the cranial pelvic canal. Neurological abnormalities were detected three days after presentation, and progressed from proprioceptive deficits to loss of deep pain sensation in the pelvic limbs over a two-day period. The dog was euthanased and postmortem examination revealed that the pelvic mass was a urethral haemangiosarcoma with metastasis to the second lumbar vertebra. This case is unusual as urethral tumours are usually transitional cell carcinomas and frequently present with signs of dysuria.     

Complete uterine prolapse without uterine mucosal eversion in a queen

A five‐year‐old female cat weighing 3 kg was presented by the owner after noticing a large pink, bilobed mass protruding through the vulva during labour. The cat was in good condition, with appropriate lactation, and the newborn kittens were nursing normally. The uterus was not reverted or invaginated at examination, and there was rupture of the mesovarium, mesometrium and uterine‐vaginal connection around the cervix. Manual reduction of the prolapsed uterus was not possible because of torn ligaments. A coeliotomy was performed to remove the ovaries, and the apex of the uterine horns was passed by the vaginal route. The remaining part of the mesometrium was disconnected, and the prolapsed uterus was removed. The queen and kittens were discharged from the hospital on the second day after surgery. An unusual feature of this case is that the prolapse was complete, without eversion of any part of the uterus through a vaginal tear.     

Fertility and whelping complications in bitches following correction of vaginal abnormalities

The fertility and whelping complications of normal bitches and of bitches that had had surgery to correct a vaginal abnormality of varying severities were compared retrospectively. Reproductive performance and whelping statistics were compared between 37 bitches that had been diagnosed with a vaginal abnormality and 37 age- and breed-matched bitches with no history of vaginal abnormalities. There were no significant differences in reproductive performance between the affected and control bitches. When analysed by the severity of the abnormality, pregnancy rates were significantly lower for the group of bitches with the most severe abnormalities compared with the group of bitches that had mild vaginal abnormalities. Furthermore, the bitches that had severe abnormalities were significantly more likely to require a caesarean section than those with mild abnormalities.     

Some observations on the aerobic bacterial flora of the genital tract of the dog and bitch

The aerobic bacterial flora from the genital tracts of 143 bitches and 51 dogs was investigated. Beta haemolytic streptococci (group G), Staphylococcus aureus and Escherichia coli were among the organisms isolated from normal bitches in heat, abnormal bitches and normal dogs. Repeated sampling of two bitches during oestrus, and the dog to which they were mated, showed that bacteria were transmitted from bitch to dog, but did not become established. Guarded swab samples taken from the vagina collected less bacteria than samples from the vestibule. Numerous bacteria were seen in vaginal smears taken from bitches during oestrus, but numbers fell rapidly with the appearance of leucocytes in the smear at the onset of metoestrus.     

A urethropexy technique for surgical treatment of urethral prolapse in the male dog

Urethral prolapse is an uncommon condition affecting young male dogs, most commonly English bulldogs. Current described techniques for surgical treatment of urethral prolapse involve manual reduction of prolapsed mucosa and placement of a temporary purse-string suture at the penile tip, or resection of the prolapsed tissue and apposition of urethral and penile mucosa. The incidence of recurrence of urethral prolapse following resection of the prolapse is not known. This report describes a technique for surgical treatment of urethral prolapse in the male dog that minimizes surgical and anesthetic time, is simple to perform, requires minimal equipment, is effective, and is not associated with significant complications or recurrence. Three cases are described.