18. Disorders of vagina and vulva -vaginal prolaps, vulval discharge, vaginitis, tumours

What is vaginal prolapse?

Oedema, hyperplasia and protrusion of the vagina, hormone induced by oestrogen stimulation

What can vaginal prolapse lead to?

Vaginitis and cystitis

When does vaginal prolapse typically resolve?

As soon as oestrogen levels decline

Which bitches are predisposed to vaginal prolapse?

Young bitches in their second or third oestrus, brachycephalic breeds

What are the clinical signs of vaginal prolapse?

Mass protruding from vulva, slight vaginal discharge, reluctance or failure to breed

What are the three stages of vaginal prolapse?

Stage 1 (slight protrusion inside vulva lips), Stage 2 (moderate pear-shaped mass between vulvar lips), Stage 3 (huge oedematous mass protruding out)

What is a key difference between vaginal and uterine prolapse regarding timing?

Vaginal prolapse occurs during oestrus, while uterine prolapse occurs around parturition

How is vaginal prolapse diagnosed?

History (oestrus?), vaginal exam

What is the treatment for vaginal prolapse if it's not causing problems?

No treatment

How is protruding vaginal prolapse managed?

Keep clean and moist, antibiotic ointment and sugar (to reduce oedema)

What is the permanent correction for recurrent vaginal prolapse?

Ovariohysterectomy (OHE)

What is juvenile vulva (hidden vulva)?

A conformational issue where the vulva is partially or completely engulfed by skin folds

What can juvenile vulva lead to?

Perivulvar dermatitis, vaginitis, and cystitis

Which animals are predisposed to juvenile vulva?

Overweight, spayed females, medium to large breeds

What are the clinical signs of juvenile vulva, often related to secondary infections?

Licking, odour, incontinence, urinary tract infection (UTI) symptoms

How is juvenile vulva diagnosed?

Physical exam and urinalysis

What is the treatment for juvenile vulva?

Treat bacterial infections, weight loss, vulvoplasty if severe

What is juvenile vaginitis?

Vaginitis occurring before the first oestrus in puppies from 8 weeks of age

What is the typical clinical sign of juvenile vaginitis?

Mucoid/mucopurulent discharge

What is the usual outcome for juvenile vaginitis?

It typically resolves after the first oestrus

Is treatment generally recommended for juvenile vaginitis?

No

What are the two categories of vaginitis in intact adult females?

Primary and secondary

What are the potential primary causes of vaginitis in intact adult females?

Bacterial or viral (canine herpesvirus)

What are some potential secondary causes of vaginitis in intact adult females?

Hermaphroditism, anatomical problems, urinary problems, foreign bodies, pyometra, neoplasia, diabetes

What are the clinical signs of vaginitis in intact adult females?

Discharge, cystitis, perivulvar pruritus, licking, male attention outside oestrus

How is vaginitis in intact adult females diagnosed?

Excluding other causes of discharge, vaginal cytology, endoscopy, bacteriological swab, Brucella canis test

What is the treatment for vaginitis in intact adult females?

Treat underlying cause if secondary, antibiotics (careful of normal flora)

What is a characteristic of vaginitis in neutered adult females?

Can become chronic and difficult to cure, especially if neutered before first oestrus

What treatments may help vaginitis in neutered adult females?

Oestrogen, corticosteroids in severe cases

How common are tumours of the vagina and vulva compared to other reproductive tumours?

Second most common after mammary gland tumours

At what age are vaginal and vulvar tumours more common in bitches?

Older than 10 years

What percentage of vaginal and vulvar tumours are benign?

90%

What are some examples of benign vaginal and vulvar tumours?

Leiomyoma, fibroma, polyps, histiocytoma, melanoma

What are some examples of malignant vaginal and vulvar tumours?

Leiomyosarcoma, adenocarcinoma, squamous cell carcinoma (SCC), haemangiosarcoma

What is transmissible venereal tumour (TVT)?

A malignant, sexually transmitted tumour with cauliflower-like masses

What are the clinical signs of vaginal and vulvar tumours?

Bleeding or discharge, vulvar mass, dysuria, haematuria, tenesmus, licking, dystocia

How are vaginal and vulvar tumours diagnosed?

Vaginoscopy examination, fine needle aspiration (FNA) cytology, USG, X-ray

What is a key difference in the aetiology of vaginal prolapse versus uterine prolapse?

Vaginal prolapse is primarily hormonal (oestrogen), while uterine prolapse is mechanical (straining, pulling).