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Vaginal Congenital Abnormalities in the Bitch 1027

Client Education SUGGESTED READING AUTHOR: Marnin A. Forman, DVM, DACVIM
Most dogs with VH secondary to hyperadre- Sepesy L, et al: Vacuolar hepatopathy in dogs: 336 EDITOR: Keith P. Richter, DVM, MSEL, DACVIM
VetBooks.ir the hepatopathy. 252, 2006. Diseases and Disorders
nocorticism do not require specific therapy for
cases (1993-2005). J Am Vet Med Assoc 229:246-

Vaginal Congenital Abnormalities in the Bitch

BASIC INFORMATION • Any type of vestibulovaginal stricture can TREATMENT
interfere with breeding due to pain produced
Definition during penetration by a male dog. Treatment Overview
Malformations that reduce the diameter of • Anatomic abnormalities of the vestibulovagi- Remove obstruction/narrowing at vestibulo-
the vestibulovaginal junction (bands) and may nal junction can inhibit drainage of vaginal vaginal junction.
cause secondary infertility, vaginitis, or cystitis; secretions, which can lead to vaginitis or
include incomplete dissolution or fusion of the ascending UTI. Acute General Treatment
paramesonephric ducts (müllerian), hymenal • Digital dilation of vestibulovaginal junction:
remnants, and hypoplasia of the vestibulovaginal DIAGNOSIS effective for treatment of hymenal remnants
junction. or mild (membranous) vestibulovaginal
Diagnostic Overview stenosis
Epidemiology Clinicians should suspect vestibulovaginal • Sharp resection of dorsoventral parameso-
SPECIES, AGE, SEX abnormalities in bitches with a history of dif- nephric duct remnants or bands if present;
Congenital vaginal abnormalities are present ficult or unsuccessful breeding. The diagnosis can use scissor or laser excision
at birth but usually are undetected until the is usually made during vaginal exam. • For severe (fibrous) vestibulovaginal stenosis:
appearance of clinical signs. Young-adult female resection and anastomosis of vestibulovaginal
dogs are most commonly affected. Differential Diagnosis junction by an extended episiotomy
• Behavioral abnormalities in breeding bitches
GENETICS, BREED PREDISPOSITION in estrus who are reluctant to stand for a Chronic Treatment
Large-breed dogs may be overrepresented. male After manual or surgical dilation, antibiotic
• Other causes of chronic UTI are more therapy (based on culture and susceptibility
ASSOCIATED DISORDERS common. [C&S] testing) may have to be extended up
Female dogs with ectopic ureters often have • Vaginal discharge may be associated with to 6 weeks for treatment of ascending UTI
coincident congenital vaginal abnormalities. juvenile-onset vaginitis or pyometra. if present.
Clinical Presentation Initial Database Behavior/Exercise
DISEASE FORMS/SUBTYPES Digital vaginal exam Bitches with previous painful breeding episodes
• Double vagina may be reluctant to accept a male after treat-
• Hypoplasia of the vaginal vault Advanced or Confirmatory Testing ment of vestibulovaginal abnormalities. Use of
• Imperforate hymen • Vaginoscopy using a flexible or rigid endo- an experienced breeding male may be helpful.
• Vaginal stenosis scope (p. 1184), for which heavy sedation
• Vaginal stricture or general anesthesia is necessary Possible Complications
• Contrast radiography: retrograde vaginog- • Stricture secondary to resection and anasto-
HISTORY, CHIEF COMPLAINT raphy mosis
• Unsuccessful breeding attempts, obvious pain
during breeding, avoidance of male during
breeding attempts
• Purulent, often recurrent vaginal discharge
• Persistent or recurrent urinary tract infection
(UTI), urine dribbling

PHYSICAL EXAM FINDINGS
• Vaginal discharge may be present.
• Narrowing of vestibulovaginal junction
may be apparent during manual vaginal
exam.
Etiology and Pathophysiology
• Incomplete fusion of the paramesonephric
ducts can result in persistent dorsoventral A B
bands.
• Vestibulovaginal hypoplasia causes concentric VAGINAL CONGENITAL ABNORMALITIES IN THE BITCH A, Vaginoscopic view of the vestibule of
narrowing of the vestibulovaginal junction. a female dog. Paramesonephric band (long arrow) spans the vaginal opening. Urethral orifice (short arrow)
• Incomplete dissolution of the hymen can is unaffected by the paramesonephric band. B, Postoperative vaginoscopic view of the vestibule immediately
compromise the vestibulovaginal junction. after the paramesonephric band was excised using a holmium-YAG laser.

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