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Vulvar Discharge 1045

PEARLS & CONSIDERATIONS for carrier and clear dogs may overlap at the Technician Tips
low end of the normal range (50%-70% Sample quality is important for obtaining valid
Comments
VetBooks.ir • Specific diagnosis of VWD requires mea- • A direct mutation detection strategy is offered depletion of VWF, blood samples should be Diseases and Disorders
VWF:Ag).
VWF:Ag assay results. To avoid activation and
surement of plasma VWF concentration
drawn directly into tubes or syringes contain-
for several breed variants of VWD by several
(VWF:Ag).
from cheek swabs or blood samples. Using
○ The findings of normal coagulation panel commercial companies using DNA isolated ing anticoagulant and centrifuged to separate
plasma as soon as possible after collection.
and platelet count do not rule out VWD. this method, dogs are classified as VWD
• Signs of mucosal hemorrhage (rather than affected if they are homozygous for a Client Education
petechiae) are typical manifestations of mutation or VWD carrier if they are hetero- Owners and breeders should be aware of VWD
VWD. zygous. DNA analyses provide unambiguous and be advised to screen their pets to prevent
information on the presence, absence, and propagation of the trait. Consider screening for
Prevention copy number of a specific mutation type. VWD at puppy or wellness exams for breeds
• Screen animals preoperatively to determine • Selective breeding practices can reduce the with high prevalence or severe forms of VWD
baseline VWF:Ag for breeds or lines with prevalence or eliminate VWD from an (e.g., Doberman pinscher, Shetland sheepdog).
a high prevalence of VWD. The risk of affected pedigree. Breeding two clear parents
abnormal bleeding is greatest for dogs with is ideal and is expected to produce entire SUGGESTED READING
VWF:Ag < 25%. litters of clear pups. Breeding one carrier Brooks MB, et al: Von Willebrand disease. In Weiss
• Clinically affected dogs should not be used parent to a clear mate may be acceptable, and DJ, et al, editors: Schalm’s Veterinary hematology,
for breeding. Carriers of the VWD trait can the clear pups produced from these matings Ames, IA, 2010, Wiley-Blackwell, pp 612-618.
be identified based on low level of VWF:Ag can be used for subsequent generations. AUTHOR: Marjory B. Brooks, DVM, DACVIM
(<50%). The VWF protein assay is relatively Carrier-to-carrier matings may produce EDITOR: Jonathan E. Fogle, DVM, PhD, DACVIM
fast and inexpensive and does not require affected pups and therefore should be
knowledge of mutation type; however, values avoided.

Vulvar Discharge Bonus Material
Online

BASIC INFORMATION • May be occur with subinvolution of placental ○ Color (colorless, brown, green, red,
sites (SIPS) in the bitch purulent)
Definition • Others: perivulvar pyoderma, urinary tract ○ Smell (malodorous or not)
Discharge from the vulva usually originates infection (UTI), urinary incontinence, ○ Volume (mild, moderate)
from the reproductive tract (vagina or uterus) urethritis, pseudohermaphroditism, her- • Discharge associated with bacterial infections
but may be seen with urinary tract disease. It maphroditism is typically purulent/mucosanguineous and
may be abnormal or physiologically appropriate. malodorous with moderate volume.
Clinical Presentation
Epidemiology DISEASE FORMS/SUBTYPES • Discharge due to inflammation is typically
mucoid, white or clear, mild to moderate
SPECIES, AGE, SEX Canine brucellosis is caused by B. canis. volume, and not malodorous.
More common in the bitch than queen (spayed However, dogs are susceptible to Brucella abortus • Rectal palpation may reveal foreign body or
or intact) and Brucella suis and may act as a reservoir. mass in the posterior vaginal vault and/or
pelvic urethra.
RISK FACTORS HISTORY, CHIEF COMPLAINT • Digital vaginal exam may reveal discharge;
• Sexually intact bitch • Visible vulvar discharge small mucosal nodules (reactive lymphoid
• Breeding bitch or queen (pregnancy loss, • Increased genital grooming tissue) may be palpable with any inflamma-
parturition) • Staining of carpet/bedding tion and are not pathognomonic for any one
• Vaginal stricture or septum, vaginal foreign • Scooting (rubbing perineum on floor) cause.
body, vaginal neoplasia • Pollakiuria • Most vaginal strictures are palpable at
• Ovarian remnant syndrome • Attracting males the level of the urethral papilla because
• Urethral neoplasia, ectopic ureters, redundant • Hair staining in perineal area this is where the müllerian ducts and
lateral/dorsal vulvar fold • Lethargy, inappetence in cases of sepsis (e.g., urogenital sinus fuse during embryonic
• Mibolerone treatment pyometra) development.
• Exposure to transdermal hormone replace- • Polyuria and polydipsia (pyometra) • Fever, signs of septic shock, distended uterine
ment therapy horns, and/or abdominal discomfort may be
PHYSICAL EXAM FINDINGS noted with pyometra.
CONTAGION AND ZOONOSIS • Abnormalities are generally restricted to • Petechiae or bleeding may be present with
• Brucella canis genital tract; exception is pyometra with thrombocytopenia or coagulopathy secondary
• Campylobacter jejuni secondary sepsis to sepsis/disseminated intravascular coagula-
• Transmissible venereal tumor • Inflamed, moist, red perivulvar skin ± moist tion related to pyometra.
or ulcerative pyoderma
ASSOCIATED DISORDERS • Red ± ulcerated vulvar mucosa; clitoral Etiology and Pathophysiology
• Frequently associated with pyometra enlargement • Intact adult: purulent discharge is normal
• Often associated with abortion/premature • Classification of discharge type assists in estrous, abnormal in diestrous; may be
labor, metritis, or endometritis diagnostic approach secondary to pyometra (p. 854) or early

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