CVC highlight: How to handle chronic vaginitis in veterinary patients


CVC highlight: How to handle chronic vaginitis in veterinary patients

Here's one genitourinary condition that all veterinarians must be ready to manage in their female canine patients.
Dec 01, 2013

Autumn Davidson, DVM, MS, DACVIM
Despite the fact that most client-owned pets in the United States are neutered, you will come across disorders of the genitourinary tract in your practice. Chronic vaginitis, which is often seen in female dogs that have undergone an ovariectomy, is one that you should be ready to handle.

Clinical signs

Tomas Baker, MS
Affected dogs will have variable vulvar discharge, which is often mucoid to hemorrhagic or purulent, usually accompanied by licking, scooting, and pollakiuria. Perivulvar and vulvar dermatitis are also frequently present.

Five common causes

Chronic vaginitis develops for multiple reasons, and the primary cause is often masked and exacerbated by previous therapies such as long-term antimicrobial therapy, self mutilation, and topical irrigations.

Vaginal mucosal biopsy frequently shows nonspecific lymphocytic-plasmacytic inflammation, but sometimes suppurative (neutrophilic) or eosinophilic inflammation is predominant. Primary bacterial vaginitis is rare.

Vaginal cultures can show overgrowth of an atypical bacterial species (pure gram-negative cultures, resistant organisms, Pseudomonas species) or pure culture of Mycoplasma species if antibiotics have been used extensively. Occasionally, a yeast overgrowth is identified.

In your affected patients, consider these five causes:

1. Extensive perivulvar dermatitis associated with redundant dorsal and lateral vulvar folds

2. A granulomatous uterine stump (note: be sure to rule out stump pyometra)

3. Vaginal foreign bodies such as foxtails or bone fragments

4. Chronic urinary tract infection with urethritis, vestibulitis, or vulvitis

5. Cystic, urethral, vaginal, or vestibular neoplasia

We also often see vaginal strictures, but they are not usually causal. Most cases are idiopathic.