Page 2057 - Cote clinical veterinary advisor dogs and cats 4th

1030 Vaginitis

PEARLS & CONSIDERATIONS Prevention SUGGESTED READING
• Ovariohysterectomy McNamara PS, et al: Chronic vaginocervical prolapse
Comments
VetBooks.ir • Vaginal hyperplasia may progress to vaginal may prevent recurrence during the next AUTHOR: Kristine L. Gonzales, DVM, DACT
• Surgical excision of redundant vaginal tissue
with visceral incarceration in a dog. J Am Anim
Hosp Assoc 33:533-536, 1997.
estrous cycle.
prolapse (type III). Forcible separation during
breeding and excessive straining during par-
turition are other causes of vaginal prolapse. Technician Tips EDITOR: Michelle A. Kutzler, DVM, PhD, DACT
• If excision of vaginal tissue is performed in late Confirming ability to urinate and defecate is
estrus or early diestrus, bleeding is minimized. essential. Use of topical lubricant, an E-collar,
• If ovariohysterectomy is performed in and soft bedding minimize devitalization of
anestrus (serum progesterone concentrations exposed vaginal tissue.
< 2 ng/mL), development of pseudopreg-
nancy is minimized. Client Education
• Catheterize urethra during excision of vaginal Discuss heritability and intended plans for the
tissue to help prevent inadvertent urethral bitch. Ovariohysterectomy is the recommenda-
trauma. tion for nonbreeding bitches.

Vaginitis Client Education Bonus Material
Online
Sheet

BASIC INFORMATION • Clinical signs of concurrent disease (e.g., Differential Diagnosis
polyuria/polydipsia, urinary incontinence, • Urinary tract infection (UTI; p. 232)
Definition pruritus) • Metritis
Inflammation/irritation of the vagina • Vaginitis may be a contributing cause of • Cystic endometrial hyperplasia/pyometra
infertility. (p. 854)
Epidemiology • Uterine stump pyometra (p. 854)
SPECIES, AGE, SEX PHYSICAL EXAM FINDINGS • Vulvar, vaginal, or uterine tumor
• Spayed or intact bitches or queens • Vulvar mucoid, purulent, or rarely blood- • B. canis
• Prevalence: < 1% in bitches; rare in tinged discharge; occasionally no discharge • Canine herpesvirus (p. 466)
queens • Vulvar hyperemia • Transmissible venereal tumor (p. 993)
• Juvenile onset: bitches 8 weeks to 1 year of • Vaginal cytologic exam: white blood cells
age (WBCs) with or without bacteria Initial Database
• Adult onset: bitches > 1 year of age • Digital vaginal exam may reveal vaginal • CBC, serum biochemistry profile: generally
stenoses or septa. unremarkable
RISK FACTORS • Atrophic or juvenile vulva with excessive • Urinalysis: unless there are contraindications
Anatomic abnormalities (vaginal strictures or skin folds with concurrent perivulvar (e.g., coagulopathy, abdominal effusion,
septa), perivulvar dermatitis with atrophic juve- dermatitis suspected urinary neoplasia, pyometra),
nile vulva and excessive skin folds, perivulvar • Overweight dogs with urinary incontinence obtain cystocentesis sample
dermatitis in overweight dogs with urinary with excessive perivulvar skin folds and ○ Urine culture and susceptibility testing
incontinence, systemic illness (e.g., diabetes persistent moisture and urine scalding for UTI (common)
mellitus, hyperadrenocorticism) • Vaginoscopy (p. 1184) to assess discharge
Etiology and Pathophysiology in the vagina; vesicular lesions (e.g., canine
CONTAGION AND ZOONOSIS • Many dogs have idiopathic vaginitis. herpesvirus) or lymphoid follicles (non-
Brucella canis, canine herpesvirus, transmissible • Congenital anatomic abnormalities specific indicators of inflammation), urine
venereal tumor ○ Stenoses just cranial to the urethral papillae pooling, masses, foreign bodies (e.g., fetal
○ Vaginal septa bands of tissues in the vaginal bone fragments, grass awns)
Clinical Presentation vault due to remnants of the medial walls • Vaginal cytology (p. 1183)
DISEASE FORMS/SUBTYPES of the müllerian (paramesonephric) ducts ○ In adult dogs, noncornified epithelial
• Juvenile onset versus adult onset or abnormal merging with the caudal cells with WBCs (± bacteria) support a
• Acute versus chronic (i.e., present for > 1 urogenital sinus diagnosis of vaginitis.
month) • Concurrent systemic diseases (e.g., diabetes ○ A bloody discharge indicates a pos-
mellitus, hyperadrenocorticism) sible coagulopathy, blood-borne parasites
HISTORY, CHIEF COMPLAINT • B. canis, canine herpesvirus, transmissible (Babesia sp), foreign object, or tumor.
Juvenile onset: venereal tumor ■ Rule out estrual sanguineous discharge in
• Most commonly scant whitish yellow vulvar • Vaginal foreign body (e.g., grass awn, fetal bitch if an ovarian remnant is possible.
discharge; occasionally large volume bony fragment)
• Excessive vulvar licking Advanced or Confirmatory Testing
• Females usually are not systemically ill. DIAGNOSIS • Guarded bacterial culture from the cranial
Adult onset: vagina: moderate to heavy growth of one
• Most commonly mucoid to purulent vaginal Diagnostic Overview or two bacterial types (more might suggest
discharge The diagnosis is generally suspected because of normal flora)
• More prevalent in spayed compared with vulvar discharge (p. 1045). In the dog, vaginal • Serologic titer for B. canis (p. 1319)
intact females palpation and vaginoscopy with sampling for • Survey radiography assesses the pelvic canal
• Pollakiuria, discomfort (e.g., excessive vulvar cytologic exam are the cornerstones of establish- for mineralized foreign bodies (e.g., fetal
licking, pain when urinating) ing the diagnosis of vaginitis. bone remnants)
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