Veterinary Medicine - October 2008 - (Page 563)

T Figure 1 extdropcap_ Diagnosing and Treating Canine Vaginitis The dog is postpubertal or is an adult and is spayed. The dog is prepubertal (not known to have had its ﬁrst estrus). Clinical signs are mild to moderate. Clinical signs are severe. Conservative therapy is best. Collect a sample from the cranial vagina for aerobic bacterial culture. Treat with antibiotics only if the culture results reveal moderate to heavy (3+ to 4+) growth of one or two bacterial species. Twice-daily cleansing of the perivulvar area with baby wipes or a nonalcohol-based otic cleanser may be beneﬁcial. Signs may or may not resolve if the bitch is allowed to go through one or more estrous cycles. Signs resolve eventually in many cases no matter what treatment is used. Collect a sample from the cranial vagina for aerobic bacterial culture. Treat with antibiotics only if the culture results reveal moderate to heavy (3+ to 4+) growth of one or two bacterial species. Consider adjunctive therapy (as for dogs with idiopathic adult-onset vaginitis), remembering that estrogens should not be used in dogs that have open physes and that glucocorticoid pharmacokinetics may be altered in very young dogs compared with adults. Perform the following diagnostic tests: • Cytologic examination of vaginal epithelial cells: If corniﬁed cells are present, the dog may be intact or have an ovarian remnant. Noncorniﬁed epithelial cells support a diagnosis of vaginitis. • Cytologic examination of vaginal discharge: Hemorrhagic discharge is suggestive of a coagulopathy, neoplasia, a foreign object, or blood-borne parasites such as Babesia or Ehrlichia species. Mucoid or mucopurulent vulvar discharge is supportive of a diagnosis of vaginitis. • Vaginal bacterial culture • Urinalysis and urine culture: Collect the urine sample by cystocentesis • Digital vaginal examination: Assess for vaginal anatomical anomalies. • Vaginoscopy: Assess the degree of inﬂammation present, remembering that normal vaginal mucosa should have the same color as healthy oral mucous membranes. Assess for discharge, urine pooling (recumbent and standing), masses, and foreign objects. • Serologic testing for canine brucellosis • CBC and serum chemistry proﬁle An underlying cause cannot be identiﬁed. An underlying cause can be identiﬁed. Treatment options include the following: (In many cases, signs resolve regardless of the treatment used.2) • Antibiotics: Treat with antibiotics only if culture results reveal moderate to heavy (3+ to 4+) growth of one or two bacterial species. • Diethylstilbestrol: 0.1 to 0.2 mg/kg (maximum dose = 1 mg) orally once daily for ﬁve days; taper to twice weekly. • Phenylpropanolamine: 1 to 1.5 mg/kg orally two or three times daily • Glucocorticoids (not recommended in dogs with urinary incontinence): prednisone 0.5 to 1 mg/kg orally once or twice daily; taper the dose if effective or if the side effects (polyuria and polydipsia) are severe. • Diphenhydramine: 2 to 4 mg/kg orally three times daily in dogs with signs of atopy; taper the dose if treatment is effective or if the side effects (sedation) are severe. OR: • Hydroxyzine: 1 to 2 mg/kg orally two to three times daily in dogs with signs of atopy; taper the dose if treatment is effective or if the side effects (sedation) are severe. Treat the underlying cause. If the clinical signs do not resolve, treat as for idiopathic vaginitis. VETERINARY MEDICINE October 2008 563

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Veterinary Medicine - October 2008 Contents Leading Off Clinical Exposures Idea Exchange Stalking Stones Vaginitis in Dogs CE Form Advertiser Index Marketplace/Classifieds Mind Over Miller

Veterinary Medicine - October 2008

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