CVC highlight: How to handle chronic vaginitis in veterinary patients
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 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.