Canine clinical cases (Proceedings)

Case #1

History

• 18 month old female intact Plott hound, "Donna"

• Bloody discharge that started approximately 4 1/2 weeks ago

• Discharge has increased and decreased during this time

• This is the first heat, and the owner would like to breed her

Clinical findings

• HR, RR, temperature normal

• Weight: 57 pounds

• Bloody vulvar discharge

Differentials

• Proestrus

• Estrus

• Endocrine Producing Ovarian Tumor

• Cystic Ovaries.

• Exogenous Estrogens

Possible diagnostics

• Vaginal Cytology

     o Is the reproductive tract normal?

• Progesterone Assay

     o Has progesterone started to elevate?

• LH concentration: No Value!

• Estradiol

     o No more value than a cytology!

• Ultrasound of the reproductive tract

     o Rarely of value, except to locate follicular like structures or tumors on the ovaries

• Karyotyping: Not indicated

• CBC, profile, urinalysis

     o May be performed if indicated

• Thyroid panel

• Radiographs

     o Unnecessary

• Laparoscopic examination or exploratory laparotomy may be considered

     o Rarely of value in a bitch with these signs!

Diagnostic test findings

• Vaginal Cytology

     o Normal proestrous/estrous cytology

Differential diagnoses

• Proestrus - Too long for normal proestrus

• Estrus - Not typical of normal estrus

• Endocrine Producing Ovarian Tumor - Rare

• Exogenous Estrogens - Watch the clover and birth control pills!

Diagnosis

• Cystic Ovaries

     o Diagnosis based on history (proestrus should not last over 18 days), and vaginal cytology

     o History must rule out exogenous estrogens!

Treatment

• Miberolone

     o 18 mcg/lb for 5 to 10 days

• Testosterone

     o 2 mg/kg up to 30 mg?

• Ovaban - Megestrol acetate

• hCG - 500 to 1000 units/animal

     o PREFERRED

• GnRH

Expected results

• Our treatment with hCG is 95% successful

• Signs decrease within 5 days and should be gone by 14 days

• Two treatments are 100% successful

Case #2

History

• 20 month old female intact Chinese Crested, "Tina"

• Tina was mated to a male Beagle by accident

• One previous litter, no problems

• Owner wishes to terminate pregnancy

Clinical findings

• HR, RR, and temperature is normal

• Weight: 6 pounds

• Slight serous discharge from the vulva

Differential diagnoses

• Proestrus

• Estrus

• Pregnant from Mismating

• Non Pregnant from Mismating

Possible diagnostic tests

• CBC, Profile, U/A: No Value

• Vaginal cytology

     o Look for presence of sperm and evidence of estrus

• LH Assay: No Value

• Ultrasound: Little to no value

• Radiograph: No Value

• Progesterone Assay

Diagnostic test findings

• Vaginal Cytology

     o Sperm Present on Cytology

     o Signs of estrus present

• Progesterone Assay

     o 11 ng/ml

Differential diagnoses

• Proestrus

     o Progesterone indicates estrus

• Estrus

     o In estrus and had ovulated when bred!

• Pregnant

     o Wait and See

• Non Pregnant

     o Wait and See

Diagnosis – mismated: Treatment

• Recommended ultrasound exam of Tina at 25 to 30 days from suspected time of ovulation based on progesterone concentrations

• If pregnant

     o ECP?

     o NO, NO, NO

• Prostaglandin F2Alpha

     o Excellent, inexpensive

• Ovariohysterectomy

     o Best for nonbreeders

• Ergots (??????????)

Expected results

• 100% effective

• Just continue treatment until fetuses disappear!

Case #3

History

• 4 ½ month old intact Yellow Labrador Retriever, "Lady"

• Vulvar discharge with duration of one month

• Dog licks the vulvar area

• Appears to go outside to urinate more often

• Discharge is mucoid

Clinical findings

• HR, RR, temperature are all normal

• Weight: 35 pounds

• Physical exam within normal limits except slight vulvar discharge

Differential diagnosis

• Metritis

• Pyometra

• Vaginitis

• Cervicitis

• Vaginal Tumors

Possible diagnostic tests

• Vaginal cytology

     o Determine if inflammatory or infectious process is present

• Vaginal culture

     o Only if cytology deems it is warranted

• CBC/profile

     o Limited value

• Brucella screening test?

• Ultrasound

     o Limited value

• Radiographs

     o Limited value

Diagnostic test findings

• Cytology

     o Numerous WBC

• Culture

     o Streptococcus sp. Sensitive to ampicillin

Differentials

• Metritis

     o Too young

• Pyometra

     o Has not had a heat

• Vaginitis

     o Possible and common

• Cervicitis

     o Rare in the bitch and rarer in the young non-bred bitch

• Vaginal tumors

     o Rare in a dog this young

Diagnosis

• Vaginitis-prepubertal

Treatment

• Local antibiotic therapy

• Premarin-weak estrogen

     o 20ug/kg

     o 0.625 mg tab/60 lbs twice a week

Expected Results

• Recovery is approximately 95%

• Stubborn cases may require retreatment or reculturing and using a different antibiotic

• May disappear after a normal estrus

Case #4

History

• 9 ½ year old coon hound, "Seeker"

• Blood in urine and ejaculate

• Used for breeding since he was 2 and up until he was 8

• Few other health problems

• Owners wish to use him again

Clinical findings

• HR, RR, temperature were all normal

• Weight: 48 pounds

• Prostate is enlarged and normal division between lobes is absent

• No pain on palpation

• Blood in ejaculate appears during the middle portion of collection

Differentials

• Prostatitis

     o Hypertrophy of the prostate

     o Acute Infectious Prostatitis

     o Chronic Infectious Prostatitis

     o Prostatic Cancer (?)

Possible diagnostic tests

• Examination of ejaculate

     o Possible testicular degeneration

• CBC/Profile

     o Little value since little systemic signs

• Brucella

     o Always a good idea since he is a breeder

• Testosterone concentration: Little value

• Culture of prostate: Limited value initially

• Urine culture: Probably no value

• Ultrasound of prostate: May be of value

Diagnostic findings

• Examination of the ejaculate

     o 12% primary abnormalities

     o 35% secondary abnormalities

     o Total number of cells within normal limits

Differentials

• Hypertrophy of the prostate

     o Fits the history of blood without systemic signs or pain

• Acute Infections Prostatitis

     o No increased temperature or pain

• Chronic Infectious Prostatitis

     o No recurrent epidsodes of pain, or other indications of a chronic infectious condition

Diagnosis

• Benign Prostatic Hypertrophy

Treatment

• Castration: Only true treatment

• Ovaban (magestrol acetate)

     o 0.25 mg/lb/day for at least 45 days

• Proscar

     o 1 mg/kg/day for at least 4 months

• Estrogens