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Vaginal Hyperplasia and Vaginal Prolapse 1029

VetBooks.ir Diseases and Disorders

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A C D
VAGINAL HYPERPLASIA AND VAGINAL PROLAPSE A, Type I vaginal hyperplasia: slight to moderate eversion
of the vaginal floor cranial to the urethral orifice, appearing as a bulge at the perineum. B, Type II vaginal hyperplasia:
well-developed swelling of vaginal floor, which may include lateral vaginal walls, protruding through vulvar lips. Swelling
appears dome shaped. C, Type III vaginal hyperplasia: well-developed protrusion of entire circumference of vaginal
wall through vulvar lips. Swelling appears doughnut shaped. D, Type III vaginal prolapse reduced to smaller size after
6 weeks. A stay suture was placed in vulvar lips to prevent recurrence protrusion of relaxed tissue for 2 additional
weeks. At suture removal, there was no recurrence.
• True vaginal prolapse with concurrent • Ensure that vaginal tissue is kept • Artificial insemination can be performed in
entrapment of visceral organs (rare) clean. breeding bitches.
• Uterine prolapse • Apply topical sterile, water-soluble lubrication • Regression of hyperplastic vaginal tissue
• Urethral neoplasia or antibiotic ointment. should be expected within 1 week fol-
• Apply an Elizabethan collar or protective lowing ovulation. Induction of ovulation
Initial Database pants. may hasten regression of vaginal tissue by
• Stage of hormonal cycle based on vaginal • Provide a clean environment to minimize decreasing estrogen stimulation. Gonad-
cytologic exam tissue trauma. otropin-releasing hormone 2.2 mcg/kg
• Vaginal exam to locate the urethral orifice, • Schedule an ovariohysterectomy, which IM repeated in 48 hours can be used
vaginal lumen, origin of the protruding mass, prevents recurrence and may hasten resolu- for ovulation induction in nonbreeding
and the size of its base tion; regression of tissue can occur within cycles.
• Ensure that the animal is able to urinate. 21 days.
• Recognize that spontaneous regression at end Drug Interactions
Advanced or Confirmatory Testing of estrus is common. Avoidance of progestational drugs that con-
• Biopsy of vaginal mass confirms diagnosis tribute to pyometra.
in atypical bitches. Chronic Treatment
• In severe cases, survey radiographs can be • Ovariohysterectomy prevents recurrence in Possible Complications
used to evaluate visceral organ involvement; nonbreeding bitches. • Necrosis, infection, and devascularization of
contrast radiography can confirm the location • Surgical excision of prolapsed vaginal tissue vaginal tissue
of the urethral orifice and vaginal lumen. in bitches intended for breeding or in those • Evisceration of abdominal organs
with severely inflamed or devitalized vaginal • Urination and defecation difficulties
TREATMENT tissue
○ May prevent recurrence during subsequent Recommended Monitoring
Treatment Overview estrous cycles or at parturition • Monitor viability of prolapsed vaginal
Treatment goals are to prevent drying, necrosis, ○ Various surgical techniques are described tissue.
and devitalization of exposed vaginal tissue; involving circumferential incision at the • Evaluate ability to urinate.
prevent future recurrence; and prevent urethral base of the prolapse.
obstruction. ○ Episiotomy may be needed. PROGNOSIS & OUTCOME
• Manual reduction of prolapsed tissue and
Acute General Treatment placement of stay sutures in the vagina do • Good prognosis with ovariohysterectomy
• Insert a urethral catheter to relieve obstruc- not prevent recurrence and may cause the • Recurrence rate is 66% in untreated
tion when present. bitch discomfort. bitches.

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