Clinical approach to conditions of the non-pregnant and neutered bitch

image of Clinical approach to conditions of the non-pregnant and neutered bitch
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This chapter looks at the clinical approach to conditions of the non-pregnant and neutered bitch; vulvar, vestibular and vaginal abnormalities; pathology of the uterus; pathology of the ovaries; endocrine abnormalities.

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18.1 Occluded vulva in a bitch. The perineum covers the vulvar lips completely, predisposing the bitch to developing vaginitis. (Courtesy of X. Lévy)
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18.2 Vaginoscopic view of mild vestibulitis in a bitch. The follicular reaction can be clearly seen. (© A. Fontbonne)
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18.3 Malignant tumour of the vulva in a bitch. (Courtesy of X. Lévy)
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18.4 Enlarged clitoris in a Cocker Spaniel bitch, which was in fact a male pseudohermaphrodite. (© A. Fontbonne)
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18.5 Haemangiosarcoma of the clitoris in a Lhasa Apso bitch. (© A. Fontbonne)
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18.6 Vaginoscopic caudal view of a vaginal septum in a bitch. Note that the vestibule (located caudal to the septum) is not involved as it is not derived embryologically from the Müller’s canals. (© A. Fontbonne)
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18.7 Stage 1 vaginal prolapse in a Great Dane bitch in oestrus. Note the deformation of the perineum, although no mucosa could be seen through the vulvar lips when the bitch was standing. Stage 2 vaginal prolapse in a bitch just before corrective surgery. Stage 3 vaginal prolapse in a Brabançon bitch in oestrus. Note the voluminous ulcerated oedematous ring at the vulvar opening. (a, © A. Fontbonne; b, Courtesy of X. Lévy; c, © A. Fontbonne)
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18.8 Purulent vulvar discharge in a 5-month-old Beagle bitch suffering from prepubertal vaginitis. Note the enlarged aspect of the vulva caused by frenetic licking. (Courtesy of G. Casseleux)
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18.9 Vaginoscopic appearance of the vagina of a bitch with secondary vaginitis. Note the inflammation of the vaginal mucosa and the circular stenosis in the centre, probably caused by a congenital abnormality. (Courtesy of X. Lévy)
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18.10 Technique for swabbing the vagina in order to perform bacterial culture and identification. A tubular speculum is inserted into the vestibular lumen in order to be able to pass the cotton part of the sterile swab into the anterior vagina. (© A. Fontbonne)
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18.11 Malignant haemangiosarcoma of the vagina. (Courtesy of X. Lévy)
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18.12 Slight protrusion of a vaginal leiomyoma in a bitch in oestrus. The differential diagnosis includes stage 1 vaginal prolapse. (Courtesy of Alfort Veterinary College)
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18.14 True vaginal prolapse in a bitch. Note the tubular appearance of the protruded mucosa. (Courtesy of JP. Mialot)
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18.15 Diagnostic approach to bitches with vulvar discharge.
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18.16 Caudal view of the uterine cervix showing the technique used to collect endometrial samples for cytological and bacteriological identification. A sterile human ureteral catheter is guided through the cervical ostium in order to inject and aspirate a small quantity of sterile saline solution. (Courtesy of E. Fontaine)
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18.17 Ultrasonographic appearance of the uterine horns of a bitch suffering from a moderately advanced pyometra. Note the thick endometrial walls and the hypoechoic content (pus). (Courtesy of Alfort Veterinary College)
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18.18 Cystic endometrial hyperplasia. Ultrasonographic appearance. Note the cystic endometrial glands and the hypoechoic content within the uterine lumen. Following surgical removal and opening of a part of the uterine horn. (Courtesy of Alfort Veterinary College)
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18.20 Mucometra. Note the anechoic appearance of the mucoid uterine contents. Mucus cannot be distinguished from the pus seen in cases of pyometra. (© A. Fontbonne)
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18.21 Benign uterine leiomyoma after ovariohysterectomy and incision of the horn. The affected bitch was just bleeding slightly from the vulva and was in good general health. (Courtesy of Alfort Veterinary College)
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18.22 Teratoma from a Boxer bitch after surgical removal and incision. Note the hair inside the ovary. (© A. Fontbonne)
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18.23 Alopecia of the perineum and caudal aspect of the hindlegs due to excessive oestrogenic stimulation. Such localization should initiate a search for an ovarian problem. (© A. Fontbonne)
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18.24 Ultrasonographic appearance of an ovarian teratoma. Note the solid and liquid parts, which is mucus present within the ovary. (© A. Fontbonne)
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18.26 Ultrasonographic appearance of a follicular cyst in a Golden Retriever bitch suffering from shortened interoestrous intervals. (© A. Fontbonne)
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18.27 A follicular cyst just before and just after surgical removal (cystectomy). (Courtesy of X. Lévy)
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18.28 Ultrasonogram of the area just caudal to the kidney (RK) in a bitch with ovarian remnant syndrome. Note the round hypoechoic structure (arrowed). (Courtesy of X. Lévy)
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18.29 Periovarian tissue removed surgically from the bitch in Figure 18.28 . Note the presence of a small remnant cyst. (Courtesy of X. Lévy)
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