1887

Uterus

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Abstract

A complete ultrasonographic examination of the abdomen should always include the uterus in the entire bitch or queen. In the neutered animal, the vaginal or uterine stump should be examined where possible. However, specific indications for ultrasonographic examination of the uterus include: pregnancy diagnosis; assessment of fetal viability; investigation of infertility; vaginal discharge; haematuria; evaluation of palpable masses in the caudal abdomen/pelvis; and systemic signs suggestive of pyometritis. This chapter examines the value of ultrasonography compared with radiography and computed tomography. Imaging technique and normal ultrasonographic appearance are addressed followed by uterine diseases. This chapter contains three video clips.

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Figures

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16.1 Sagittal image of the caudal abdomen of an entire Springer Spaniel bitch. The uterus (arrowed) lies dorsal to the bladder. A central hyperechoic line is visible.
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16.2 4-week pregnancy in a Jack Russell Terrier. The fetus is clearly visible, surrounded by fetal fluids and fetal membranes, within the uterus.
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16.3 A Great Dane pup near term. The heart (H) is visible to the right of the image, surrounded by the lungs (arrowed). The hypoechoic liver (L) is visible to the left of the image.
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16.4 4-week pregnancy in a Domestic Shorthaired cat.
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16.5 One uterine horn of a Great Dane bitch, which had undergone a Caesarean operation 5 days previously. The uterus is involuting well, with residual luminal fluid at a minimum, but remains enlarged with an overall diameter of approximately 2 cm.
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16.6 Transverse section through the distended uterus of a 9-year-old German Shepherd Dog presented for persistent vaginal bleeding since oestrus. The uterus contains fluid with few echoes. The final diagnosis was pyometra.
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16.7 Rough Collie bitch with pyometra. The uterine horns are distended with fluid, which contains echoes that could be seen to swirl in real-time images.
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16.8 Sagittal image of the caudal abdomen of a 13-year-old entire Cocker Spaniel bitch, presented with a persistent vaginal discharge since oestrus 2 months previously. There is irregular thickening of the uterus (arrowed), which lies dorsal to the bladder. The uterus is also mildly heterogeneous in echogenicity.
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16.9 Ultrasonogram of the right uterine horn (arrowed) of a 10-year-old Cocker Spaniel bitch with CEH. Note the multiple small hypoechoic foci within the thickened horn.
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16.10 A 3-year-old Springer Spaniel crossbred dog presented with pyrexia of unknown origin. The bitch had undergone ovariohysterectomy 5 days previously. A mass of mixed echogenicity (arrowed) is visible cranial to the bladder. The mass was considered most likely to be a result of the recent surgery, and thus an incidental finding.
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16.11 A 10-month-old neutered Border Collie bitch presented with pyrexia and lethargy. A rounded hypoechoic mass (arrowed) in the caudal abdomen, ventral to the colon (C), was identified. The mass was confirmed as a uterine stump granuloma.
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16.12 This ill defined, rounded, hypoechoic, mildly heterogeneous mass in the caudal abdomen of an 11-year-old entire Cocker Spaniel bitch was confirmed as a vaginal mass, which extended just cranial to the pubic brim.

Supplements

Normal uterus in a dog.

This clip shows a scan of the caudal abdomen in an entire bitch. When the clip starts, the fluid-filled bladder lies superficially and to the left of the screen. To the right of the screen, an echogenic line with acoustic shadowing deep to this represents the faeces-filled colon. As the clip continues, a narrow hypoechoic tube is seen lying deep (dorsal) to the bladder. This is the uterus.

4-week pregnancy in a Jack Russell Terrier.

One fetus lies within its gestational sac just beneath the transducer; the head is to the left and the torso to the right. The flickering heartbeat is visible within the torso. A second fetus lies deep to the first.

4-week pregnancy in a cat.

A single fetus is seen surrounded by fetal fluids and membranes within the uterus. This short clip shows movement of the fetus and the flickering beating of the fetal heart.

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