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Canine clinical cases (Proceedings)
Clinical reproductive case studies.
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