Page 1009 - Small Animal Internal Medicine, 6th Edition

CHAPTER 55 Clinical Conditions of the Bitch and Queen 981

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A B

FIG 55.35
Perivulvar anatomy. (A) Perivulvar anatomy (hooded vulva) in an ovariohysterectomized
mixed breed bitch with chronic vulvar discomfort. (B) Marked perivulvar dermatitis in the
same bitch.

0

1
+ + +
+
SAGITTAL 2

3
+ 0.21 cm
A + 0.58 cm B

FIG 55.36
(A) Sagittal image of an ovariohysterectomized bitch with chronic vulvar discharge.
Cursors (x) note cervical height and (+) a focal hyperechoic structure. (B) Grass awn
removed vaginoscopically from caudal cervical os.

with Elizabethan collars, and initiation of antimicrobial (Previcox [Merial]) or grapiprant (Galliprant® Aratana) are
therapy only when indicated by proper interpretation of preferred. Narcotics (tramadol) or gabapentin may be neces-
culture and sensitivity testing should be undertaken. Anti- sary short term for adequate analgesia. If a specific cause is
microbial therapy should be limited to those cases where identified, resolution is more straightforward. Surgical cor-
pathogens have been identified as displacing normal flora. rection with careful postoperative control of self-mutilation
Analgesia and antiinflammatory therapies are indicated in is indicated if anatomic abnormalities (redundant dorsal and
most cases. A short antiinflammatory course of corticoster- lateral vulvar folds, significant vaginal stricture, granuloma-
oids can be useful in diminishing vaginal inflammation, but tous uterine stump, clitoral hyperplasia) have contributed to
the subsequent propensity for urinary tract infection must or caused the condition (Fig. 55.37). The identification and
be kept in mind, and problems with long-term use limit removal of foreign bodies should cure chronic vestibulo-
usefulness. NSAIDs such as carprofen (Rimadyl [Pfizer]), vaginitis. Appropriate management of chronic urinary tract
meloxicam (Metacam [Boehringer Ingelheim]), firocoxib infection (if identified) should resolve associated vaginitis.