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1184.e2 Vaginal Palpation in the Bitch

Vaginal Palpation in the Bitch
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Synonym Vagina
Digital vaginal exam

Overview and Goal Vaginovestibular junction
Minimally invasive digital exam of the vagina
to evaluate vaginal anatomy. Possible disorders
include circumferential vaginovestibular Urethral opening Vestibule
strictures, vaginal septa and other congenital
anatomic anomalies, vaginal tumors, and
trauma during breeding.

Indications
• Vaginal discharge Clitoral fossa
• Reluctance to allow natural mating VAGINAL PALPATION IN THE BITCH Anatomic relationship of vestibule and vagina in the bitch. Dorsal
• Urinary incontinence (urine pooling) is toward top of image, cranial to left.
• Dystocia
• Recurrent lower urinary tract infection
Contraindications vagina. If the examiner proceeds slowly, • A vaginal exam using a speculum or otoscope
• Contraindications to this procedure are few. he or she should be able to pass the finger may be performed for visualization of the
• If infection of the reproductive tract is a beyond the cingulum in most bitches vaginal walls and vault.
consideration, samples from the cranial (depending on the size of the bitch and ○ Assessment of vaginal structures or septa
vagina for culture should be taken first; the size of the finger). (just cranial to the urethral opening)
vaginal swab and cytologic exam is performed ○ Inflamed walls in vaginitis cases
next, before digital exam. Procedure ○ Urine on the floor of the vagina in urine-
• Animal should be restrained in standing pooling disorders
Equipment, Anesthesia position. ○ Evidence of trauma in difficult breeding
• Minimal restraint usually required • Vulvar lips should be gently wiped with a ○ Evaluation of vaginal folds and mucosa
• Antiseptic cleanser mild antibacterial cleanser. for timing of estrus
• Sterile exam glove • Examiner should wear sterile gloves. • Vaginoscopy with an endoscope to observe
• Sterile water-soluble lubricant • After coating the gloved index finger with the entire vagina and potentially the cervix
the sterile lubricant, the finger is passed into
Anticipated Time the vulva and turned directly upward (90° Pearls
With a cooperative bitch, the procedure should angle to the floor in the standing animal). • Vaginal procedures in general (cytologic
take < 5 minutes from gentle cleansing of the The upward direction is important to avoid evaluation, digital exam, vaginoscopy) are
vulvar lips to finishing the exam. the urethral opening. remarkably well tolerated when bitches are
• When the finger cannot go any farther in estrus.
Preparation: Important dorsally, it is turned directly cranially (parallel • When not in estrus, most bitches will resent
Checkpoints to the floor) and advanced over the ischium the performance of a vaginal procedure and
Have an assistant to provide restraint. and into the vaginal vault: may require sedation for its completion
○ As the finger passes over the ischium (see inside back cover of book for sedation
Possible Complications and into the vagina, there may be a slight protocols).
Common Errors to Avoid tightening at the vestibulovaginal junction
• Urethral opening lies on the ventral surface (cingulum). Depending on the size of the SUGGESTED READING
of the vestibule and should be avoided: bitch and the size of the hand, most fingers Johnston SD, et al: Disorders of the canine vagina,
○ This is not difficult if the finger is passed should pass through this junction. vestibule and vulva. In Johnston SD, et al, editors:
up to the vaginovestibular junction (cin- ○ If the finger is well lubricated and does not Canine and feline theriogenology, Philadelphia,
gulum), perpendicularly to the ground in pass this point, a vaginal stricture should 2001, Saunders, pp 225-242.
the standing bitch. be considered. Reproduced from the third edition in
• The cingulum is one barrier to the entrance unabridged form.
of the uterus and should not be mistaken Alternatives and Their
for the cervix or a stricture: Relative Merits AUTHOR: Carlos R. F. Pinto, MedVet, PhD, DACT
○ The canine vagina is very long (up to 12 • Due to the length of the canine vagina, EDITORS: Leah A. Cohn, DVM, PhD, DACVIM; Mark S.
inches [29 cm] in giant-breed dogs), and a speculum exam may not provide more Thompson, DVM, DABVP
the cervix is unlikely to be palpated on information than a digital exam; for
digital exam of the vagina. complete visualization of the vagina, vagi-
○ The cingulum acts a barrier to pathogens noscopy with an endoscope is recommended
and will be narrower than the vestibule or (p. 1184).

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