Veterinary Medicine - October 2008 - (Page 564)

Vaginitis in dogs PEER-REVIEWED from the rectum (Table 1).3-6 Because some dogs have markedly erythe vagina is not sterile, interpret thematous vaginal mucosa with culture results with caution and no other evidence of vaginitis. have the laboratory quantify bacteIn a survey of eight dogs, four of rial growth. A signi cant culture which were control dogs and four result is moderate to heavy (3+ to of which had clinical vaginitis, two 4+) growth of one or two bacterial of the normal dogs had mild to species. Collect culture samples moderate erythema of the vaginal with a long, guarded instrument, if mucosa. Three of the eight dogs possible.7 Aerobic bacterial culture developed erythema secondary is suf cient because Mycoplasma 2. Cytologic examination of a vaginal specimen from a dog to diagnostic testing.15 with vaginitis reveals noncorniﬁed vaginal epithelial cells and and Ureaplasma species have not Because cytologic or culture been cultured more commonly polymorphonuclear cells (modiﬁed Wright’s stain; 100X). sample collection may induce from dogs with vaginitis than from erythema, you may be tempted dogs with no history of reproductive tract revealing vaginal anomalies visible with to do vaginoscopy rst. However, vagidisease, and fungal vaginitis in dogs is a vaginoscope in 96% of cases.12,13 noscopy requires lubrication to introduce rare in North America.8,9 Vaginal anomalies described in dogs the instrument, so the vagina may be include adulterated by the lubricant or by cells Urinalysis and • Strictures, or stenoses, which are cir- or debris pushed into the vaginal vault bacterial culture cumferential narrowings of the vaginal with the vaginoscope, creating artifactual UTIs and vaginitis are often concurrent.2 vault. Theses narrowings are most change in other diagnostic tests. I prefer UTIs are frequently caused by bacteria commonly found just cranial to the to collect all other samples rst and perascending from the distal urethra and urethral papilla. form vaginoscopy last, recognizing that surrounding area.10 It is easy to see how • Vaginal septa, which are pillars or artifactual changes may have occurred. vaginal ora overgrowth could cause UTIs walls of tissue within the vagina. Vaginoscopy also helps you assess and, conversely, how infected urine passing discharge present in the vaginal vault; through the vagina could cause vaginitis.11 Both these anomalies result either from vesicular lesions (e.g. seen with canine Diagnosing a UTI requires collecting abnormal dissolution of the appropriate herpesvirus infection) or lymphoid folurine directly from the urinary tract since portions of the paired paramesonephric licles (e.g. seen as a nonspeci c indicator free-catch samples will be contaminated (müllerian) ducts or abnormal joining of in ammation)16,17; urine pooling, which with vaginal contents. Collecting urine by of the paramesonephric ducts with the may be best identi ed by performing cystocentesis for urinalysis and aerobic caudal urogenital sinus. vaginoscopy in recumbent and standing bacterial culture is recommended. The incidence of vaginal anomalies in patients9; masses; and foreign objects. dogs has not been reported. Anecdotal evidence suggests that many dogs with Other important Digital vaginal examination It is important to perform a digital vagi- vaginal anomalies do not have genito- diagnostic tests nal examination in all dogs with clinical urinary disease. One study attempted to Finally, a complete work-up for vaginitis signs of vaginitis. Vaginal anatomical create an objective measure of the degree in dogs, especially those with adult-onset anomalies (described below) are a com- of stricture based on measurements of the disease, includes performing serologic mon underlying problem in dogs with vagina and vestibule from vaginograms.14 TABLE 1 adult-onset vaginitis. Vaginal strictures or This study did not speci cally address septa can be detected by digital vaginal dogs with vaginitis but did, in general, Aerobic Bacteria examination in 88% of cases.12,13 show that dogs with severe vaginal strictures and associated disease of the Isolated from Dogs Vaginoscopy genitourinary tract had a poor response with Vaginitis* Vaginoscopy can help you diagnose to any treatment modality.14 Escherichia coli vaginal anatomical anomalies and assess The vaginal mucosa should be the same Streptococcus species the degree of erythema of the vaginal mu- rosy-pink color as healthy oral mucous Staphylococcus species cosa. While vaginoscopes are marketed membranes. While vaginitis cannot be Pasteurella multocida for dogs, their length and the diameter of diagnosed without evidence of vaginal Proteus mirabilis their viewing ori ces are similar to that in ammation, be aware that some diag*In decreasing order of frequency. of large otoscope cones. Thus, a large oto- nostic tests (e.g. vaginal swab, vaginoscopy) scope cone is adequate for vaginoscopy, readily cause vaginal erythema and that 564 October 2008 VETERINARY MEDICINE

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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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