Veterinary Medicine - October 2008 - (Page 565)

testing for canine brucellosis, which may be exhibited as persistent mucopurulent vulvar discharge,18 and ruling out systemic disease by performing a complete blood count and serum chemistry pro le. Canine herpesvirus infection in prepubertal bitches or spayed adult female dogs is associated with vesicular or rm lesions on mucosal surfaces, including the vagina, and no other clinical signs.16,17 Unfortunately, tests for canine herpesvirus infection are imprecise and not clinically useful, so this infection may only be suspected after other causes have been ruled out.19 Be aware that in most bitches (73% in one study) vaginitis resolves regardless of the therapy used.2 I have had success in asking owners to keep track on a calendar when clinical signs are evident. This objective record better permits the owner and the veterinarian to determine the frequency and severity of clinical signs and to monitor progress with therapy. TREATING VAGINITIS How you treat an affected dog depends on the form of vaginitis present. Below is a summary of suggested therapies based on the diagnostic ndings. Juvenile vaginitis In most bitches with juvenile vaginitis, physical and cytologic examinations reveal mucoid to mucopurulent vaginal discharge and mild erythema in the vaginal vault, and vaginal bacterial cultures reveal no signi cant growth. Most cases will resolve spontaneously with time, and conservative therapy is the norm. If the only clinical signs are those that you nd incidentally, treatment is not necessary. Excessive discharge or vulvar licking and marked growth of aerobic bacteria from a vaginal sample warrant appropriate antibiotic therapy. Dogs may bene t from twice-daily cleaning of the perivulvar area with baby wipes or a nonalcohol-based otic cleanser.9 Douching, or ushing of the vaginal vault, has not been reported to be an effective therapy in dogs with juvenile vaginitis. A common question is, “Should dogs with juvenile vaginitis be allowed to go through one estrous cycle before ovariohysterectomy?” No studies have evaluated whether this would be bene cial. In a retrospective study describing seven dogs with juvenile vaginitis that were left intact, three improved after one estrous cycle, one improved after two estrous cycles, and three showed no change after multiple estrous cycles but had subsequent resolution by 3 years of age.2 These results suggest that it may not be the hormonal changes and associated vaginal epithelial changes of estrus that resolve the vaginitis but that a dog’s increasing immunocompetence with maturity may be of bene t. The known increased incidence of mammary neoplasia in bitches left intact is a strong incentive not to leave bitches intact as a treatment for vaginitis unless severe clinical signs are present. Bacterial infections. In some dogs, it is dif cult to know whether vaginitis caused a UTI or if a UTI caused vaginitis. Concurrent bacterial cultures of vaginal vault samples obtained by using a guarded vaginal swab and a urine sample collected by cystocentesis may permit you to localize disease at the time of presentation. Treatment for a UTI is based on urine bacterial culture and antimicrobial sensitivity testing. Signi cant growth from vaginal bacterial culture samples also prompts appropriate antibiotic therapy. Empirical therapy is not recommended. Mycoplasma species organisms and Escherichia coli may emerge in the vagina during inappropriate antibiotic therapy, strongly arguing against indiscriminate use of antibiotics.20 Anatomical abnormalities. Vaginal anomalies are a common underlying cause of vaginitis, possibly because the anomaly permits urine to pool and irritate the vaginal mucosa. Urine pooling is best evidenced by positional urinary incontinence (urine leakage when the dog changes position such as when arising or jumping up), or Adult-onset vaginitis The most common primary problems reported in dogs with vaginitis are UTIs, reported in 26% to 60% of cases; vaginal anatomical anomalies, reported in 20% to 36% of cases; and systemic disease, reported in 15% of cases.1,2 VETERINARY MEDICINE October 2008 565 http://www.nonin.com http://www.nonin.com

Table of Contents Feed for the Digital Edition of Veterinary Medicine - October 2008

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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