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Vaginal Cytology 1183

• The collection bag should be emptied based chlorhexidine solution. Flush the vulva/ temporarily clamping the line during animal
prepuce with 0.05% chlorhexidine solution.
on a predetermined schedule (e.g., q 1-8h) • Empty closed collection system (if needed). transport can prevent retrograde flow of urine
back into the animal.
or when it is almost full.
VetBooks.ir • Wash hands before and after handling the • The urine collection line and bag should be • When moving a patient with an indwelling
urinary catheter, ensure that the collection
urinary catheter or collection system.
replaced when there is gross contamination
• Put on exam gloves. Evaluate the urinary
retrograde flow of urine back to the animal.
catheter and collection system, and ensure that cannot be easily cleaned. bag is always below the patient to prevent
that the catheter is still in place and there Postprocedure
are no leaks in the system. Ensure that all disconnected bags or lines SUGGESTED READING
• Use surgical scrub to clean skin around the are properly connected after collection bag is Aldrich J: Urethral catheterization. In Creedon JM,
vulva/prepuce, as well as exposed area of emptied. et al, editors: Advanced monitoring and procedures
the catheter and collection system. Follow for small animal emergency and critical care, ed
by rinsing with gauze and water. Pearls 1, West Sussex, UK, 2012, John Wiley & Sons.
• Wipe the skin around the vulva/prepuce, • Clamps attached to fluid lines are usually AUTHOR: Adesola Odunayo, DVM, MS, DACVECC
as well as exposed area of the catheter and removed to prevent them from being acciden- EDITORS: Leah A. Cohn, DVM, PhD, DACVIM; Mark S.
collection system with gauze and 0.05% tally closed, preventing urine flow. However, Thompson, DVM, DABVP Procedures and Procedures and Techniques Techniques

Vaginal Cytology Bonus Material
Online

Difficulty level: ♦ • A fast Romanowsky-type stain kit (e.g., Procedure
Diff-Quik) • Wet the cotton-tipped swab with a couple
Synonym • A booklet of bibulous paper of drops of saline solution.
Colpocytology • A brightfield microscope • Introduce the swab just ventral to the dorsal
vulvar commissure into the vaginal vault.
Overview and Goal Anticipated Time • Advance the swab 0.5-3 cm (depending on
Examination of cells exfoliated from the Total procedure: < 10 minutes dog breed and size) horizontally into the
vaginal epithelium can assist in determining • Sample collection: 10-60 seconds vestibular area, and then immediately tip it
reproductive status and local inflammatory • Making of slide smear and staining: ≤ 4 at ≥ 45° angle (almost toward to the anus)
conditions (vaginitis). In clinical practice, it minutes and advance it craniodorsally until in the
is important to determine whether the bitch • Reading of slide and interpretation: ≤ 2 vagina proper.
has a keratinizing (proestrus) or keratinized minutes • The swab is then repositioned horizontally,
vaginal epithelium (estrus). and adequate exfoliation of vaginal epithe-
Preparation: Important lium cells can be accomplished by moving
Indications Checkpoints the swab tip back and forth and by twirling
• Staging the bitch’s reproductive status for • Have a kit with main supplies for collecting the swab shaft a couple of times.
breeding management the vaginal specimen: a box of glass slides, • The swab is then quickly withdrawn from
• Assisting in determining whether a previ- a 3-mL syringe that has been prefilled with the bitch’s vagina and rolled onto the glass
ously spayed bitch is experiencing estrual saline solution, a permanent marker or smear in two or three streaks; do not roll
symptoms resulting from ovarian remnant pencil to write the patient’s ID in the glass the swab tip back and forth on the same
syndrome (p. 732) or exposure to exogenous slide area.
hormone. Vaginal keratinization (cornifica- • Ensure a stain kit and a microscope are • Air-dry and proceed to staining (according
tion) is a bioassay for estrogen. available for use. to the manufacturer’s instructions).
• Evaluating the nature of any vulvar discharge • Blot the wet, stained slide onto a sheet of
Possible Complications and bibulous paper, and proceed to brightfield
Contraindications Common Errors to Avoid microscopy.
None; care and strict aseptic technique must • Avoid inadvertently introducing the swab • Initial screening of the slide is done at 100×
be used when sampling the pregnant bitch. into the bitch’s urethra. When that happens, magnification for an overall assessment of
a diagnosis of nonkeratinized (cornified) types of cells (i.e., determination of the
Equipment, Anesthesia vaginal smear is made. To avoid it, ensure percentage of cornified vs. noncornified
• Cotton- or rayon-tipped swab, prefer- the swab is introduced into the bitch’s vaginal epithelial cells).
ably with a (semiflexible) plastic shaft vagina just ventral to the dorsal vulvar • Intermediate stages of epithelial cells or
(polystyrene) that is 6 inches long. Sudden commissure. microorganisms (fungal, bacterial) can be
movements by uncooperative bitches may • For vaginal smears without enough cells for further examined at 400× or 1000× (under
cause the wooden-shaft, cotton-tipped swabs interpretation, repeat the procedure to ensure immersion oil) if needed.
to break during the specimen collection enough cells are collected. • Noncornified cells (parabasal and small,
procedure. • Vaginal smears with too many spindle-shaped intermediate-stage cells) are small, round cells
• A 3-mL syringe with saline solution to wet cells likely indicate that vestibular or clitoral with a large, stippled nucleus. Noncornified
the cotton tip fossa cells, not vaginal epithelial cells, were cells have large nucleus-to-cytoplasm ratios.
• A glass slide (preferably a premium pre- collected. For proper reading and interpreta- Cornified cells (large, intermediate-stage and
cleaned glass slide with frosted end for patient tion, cells must be collected from the middle superficial cells) have a more angular shape,
identification) to cranial vaginal regions. and the nucleus is pyknotic or not apparent

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