Page 2054 - Cote clinical veterinary advisor dogs and cats 4th

1028 Vaginal Hyperplasia and Vaginal Prolapse

• Inadequate resection does not resolve clinical ○ The diameter of the vestibulovaginal Client Education
signs. junction must be less than 30% of the • Breeding bitches that are reluctant to
VetBooks.ir Recommended Monitoring • Most congenital vaginal abnormalities do • Congenital vaginal anomalies may be present
diameter of the maximal diameter of the
stand for a male may have vestibulovaginal
vagina to be considered pathologic.
abnormalities that cause painful breeding.
Observe the animal for recurrence of signs.
Initial treatment may have to be repeated
not cause clinical signs.
if stricture occurs secondary to resection or • Vestibulovaginal abnormalities (parame- without causing clinical signs.
traumatic dilation. sonephric septal remnants, vaginal septa, SUGGESTED READING
double vagina) are very common in dogs Crawford JT, et al: Influence of vestibulovaginal
PROGNOSIS & OUTCOME with ectopic ureters. stenosis, pelvic bladder, and recessed vulva on
response to treatment for clinical signs of lower
• Prognosis is good if clinical signs are caused Prevention urinary tract disease in dogs: 38 cases (1990-1999).
by hymenal remnants or mild vaginal Because most vestibulovaginal abnormalities J Am Vet Med Assoc 221:995-999, 2002.
stricture. are congenital but not hereditary, there are AUTHOR: James A. Flanders, DVM, DACVS
• Prognosis for resolution of clinical signs is fair no recommendations against breeding affected EDITOR: Michelle A. Kutzler, DVM, PhD, DACT
to good for severe vaginal stricture treated by bitches after the abnormality is treated.
vestibulovaginal resection and anastomosis.
Technician Tips
PEARLS & CONSIDERATIONS Although digital vaginal exam is helpful
in making a diagnosis of vestibulovaginal
Comments abnormality, direct visual inspection using
• Do not confuse normal narrowing at the vaginoscopy permits a much more accurate
vestibulovaginal junction with a pathologic diagnosis.
condition.

Vaginal Hyperplasia and Vaginal Prolapse Client Education
Sheet

BASIC INFORMATION ASSOCIATED DISORDERS PHYSICAL EXAM FINDINGS
Markedly prolapsed vaginal tissue is subject Bulge at the perineum or protrusion of a pink,
Definition to self-mutilation and may be dry, ulcerated, dome- or doughnut-shaped mass from vulva;
Edematous swelling of the vaginal mucosa necrotic, and devascularized; possible dysuria surface of protrusion may be dry, necrotic, or
cranial to the urethral orifice is an uncommon or pollakiuria ulcerated. Vaginal exam reveals:
disorder that occurs during estrogen stimulation Clinical Presentation • A urethral orifice located ventrally in all three
in the intact bitch. It may progress to vaginal types of vaginal hyperplasia
protrusion through the vulvar lips. DISEASE FORMS/SUBTYPES • Vaginal lumen is located dorsally in types I
Vaginal hyperplasia: and II but centrally located in type III.
Synonyms • Type I: slight to moderate eversion of the • In contrast, uterine prolapse is distinguished
Vaginal edema, hypertrophy, hyperplasia, vaginal floor cranial to the urethral orifice; by the presence of tubular masses in the
eversion, or protrusion confined to the vestibulum and appearing vagina or protruding from the vulva.
as a bulge at the perineum
Epidemiology • Type II: well-developed swelling of the Etiology and Pathophysiology
SPECIES, AGE, SEX vaginal floor, which may include the lateral • An exaggerated response of the vaginal
Intact bitch, 7 months to 16 years old vaginal walls, and protruding through the mucosa to estrogen (hyperemia, edema,
vulvar lips. The swelling appears dome keratinization), the swelling begins as an
GENETICS, BREED PREDISPOSITION shaped. eversion in the vaginal floor, cranial to the
• More common in large-breed dogs • Type III: well-developed protrusion of urethral orifice.
• Predisposed breeds: bulldog, mastiff, boxer, the entire circumference of the vaginal • Histopathologic exam of affected vaginal
Dalmatian, German shepherd, Saint Bernard, wall through the vulvar lips. The swelling tissue is consistent with submucosal edema
Labrador and Chesapeake Bay retrievers, appears doughnut-shaped and is a vaginal rather than hyperplasia or hypertrophy.
Weimaraner, Walker hound, springer spaniel, prolapse.
Airedale terrier, and American pit bull DIAGNOSIS
terrier HISTORY, CHIEF COMPLAINT
• One case report of type III vaginal prolapse • Previous occurrence of vaginal hyperplasia Diagnostic Overview
in a pregnant Maine coon cat • Onset of proestrus or estrus The diagnosis is suspected based on the presence
• Licking or irritation of the vulva of a vulvar swelling or protrusion in a young
RISK FACTORS • Mass protruding from vulva or bulge at the intact bitch. Typically, condition occurs during
• Young bitch under the influence of estrogen perineum one of the first three estrous cycles.
during proestrus or estrus; may occur or recur • Dysuria or pollakiuria
during diestrus, pregnancy, or parturition • Failure to allow intromission during Differential Diagnosis
• Can be observed as side effect of estrus breeding • Benign or malignant vaginal neoplasia
induction with estrogen • Tenesmus • Vaginal polyp or cyst

www.ExpertConsult.com