What are the common ‘female’ problems that owners consult the vet about? (15)
Neutering Stopping a season Suspected pregnancy Misalliance Calling False Pregnancy Lactation Dystocia Mating time Fertility problems Vulval discharge Vulval mass Vulval swelling Abdominal distension Systemic illness
What are the common ‘male’ problems that owners consult the vet about?
Neutering Behavioural modification Testicles missing Testicles of different sizes Difficulty defecating Systemic illness Preputial discharge Penis sticking out Penile mass Penile/testicular injury
What is misalliance?
What is the first question you should answer when faced with a potential reproductive problem?
Is this just a manifestation of normal reproductive physiology?
What do we use to diagnose reproductive problems?
Combination of a variety of diagnostic tests
What things should be taken from a history with a reproductive problem?
Define owners problem/reason for visit Age, breed and sex Neutered/entire Females - last season (when, normal, mating?), breeding history Current/planned use of animal Previous illnesses/surgery Additional general information
What should you perhaps do if a breeder is coming in with a reproductive problem>
Touch up on reading to ensure you know what you are talking about
Why would use of the animal affect your decision in reproductive problems?
Depends on decision to neuter if owner wishes to breed from the animal
What should be examined clinically in the female?
General PE Vulva Mammary glands Vaginal examination (possibly) Rectal examination (possibly) Response to behavioural stimuli
What should be examined clinically in the male?
General PE Scrotum and testes Prepuce and penis Mammary glands (possibly) Rectal examination
What do we want to assess in a general physical examination with a potential reproductive problem?
Signs of anaemia/shock
What do we want to focus on in abdominal examinations with a potential reproductive problem?
Abdominal mass Uterine enlargement Fluid thrill Visceral displacement Pain
What is fluid thrill?
Free fluid within the abdomen
Blot the abdomen and can feel it come through wall on the opposite side
What do we check mammary glands for?
Enlargement Lactation Masses Pain Discharge
What should we check the scrotum for?
Check skin Presence of two testicles Size Shape Consistency Mobility Pain
What should we check the vulva/prepuce for?
Discharge - colour, consistency, smell, inflammation
Mucous membranes and junction
Extrude penis - shaft and external urethral orifice
How well tolerated are digital rectal examinations? Vaginal examinations?
Rectal well tolerated
Vaginal usually resented in dogs and not possible in most cats
When are vaginal examinations possible in cats and easier in dogs?
During parturition as muscle relaxed
What should you use when undertaking a rectal examination?
What are you checking in a rectal examination?
Anal sacs Urethra Prostate Vagina Enlarged dorsal lymph nodes Pelvic diameter
What are the signs of oestrus?
What is an extremely important thing in coming up with differential diagnoses?
Neutered status - eliminates hormone driven reproductive disease
What do haematology and biochemistry allow detection of?
Changes that are suggestive of: infection/sepsis, azotaemia, hypo/hypercalcaemia, hypoglycaemia, anaemia
What are urinary tract infections closely related to?
Reproductive tract infections
What are hormonal assays particularly helpful for?
Detecting incompletely excised gonadal tissue
Aid pregnancy diagnosis
Predict optimal mating time
What are the four commercially available hormonal assays in the UK?
What are the two main diagnostic images used in reproductive problems?
What is becoming an increasingly important diagnostic imaging tool in reproductive diagnosis?
Cross sectional imaging - CT
What is ultrasound most useful for?
Imaging parenchymatous organs Distinguishing fluid from soft tissues Image guided centesis and biopsies Assessing viability of pregnancy Detecting free abdominal fluid Determining origin of organ enlargement Abdominal pathology/change
What is ultrasound not good at?
Imaging intrapelvic structures
Detecting bony change
Detecting foetus number
What is radiography most useful for?
Imaging bony changes - foetal mineralisation, foetal number, pelvic anatomy, injury to os penis
Contrast techniques - extent and location of luminal abnormalities
Thoracic radiography - pulmonary metastases
What is a good method of examining the lumen of the vagina?
What are the two scopes used to examine the vagina?
Short scopes - vestibule, caudal vagina, place urethra catheters
Longer scopes - rigid or flexible, entire vagina
What can be a useful aid to breeding management?
Vaginal mucosa - changes in appearance tell stage of oestrus cycle
What does endoscopy allow detection of?
What is an important tool for assessing the stage of the reproductive cycle in the bitch?
How are aspirates normally obtained?
Under ultrasound guidance
What are the four ways that biopsies may be taken?
Why is vaginal/preputial bacteriology not that useful?
Usually normal flora
Doesn’t advance diagnosis that much
What is important for evaluation of male infertility?
Collection of ejaculate
Rarely collected on investigation of clinical disease
When should exploratory laparotomy/laparoscopy be used?
Only when confirming differential diagnosis
Need a specific surgical plan following investigation