Ch 45 Uterus, Ovaries, and Testes

Question 1

How do you confirm fetal viability in ultrasound?

Answer 1

Doppler

Question 2

How is the uterus differentiated from intestine?

Answer 2

Location and lack of distinct wall layering

Question 3

The uterine wall is always the same thickness - T or F?

Answer 3

False, it depends on the stage of the estrus cycle.

Question 4

The uterine lumen is not typically seen - T or F?

Answer 4

Depends; typically no, and if it is present then it will a hyperechoic central area representing mucus, except in proestrus and estrus when a small amount of anechoic fluid can be present.

Question 5

In which stage of the estrus cycle is the uterine wall the thinnest?

Answer 5

anestrus - there is also no fluid present normally in this stage.

Question 6

In which stage(s) can fluid be present in the uterus, normally?

Answer 6

estrus, proestrus
transiently following mating

Question 7

During which estrus stage(s) is the endometrium slightly thickened?

Answer 7

estrus, proestrus

Question 8

During which estrus stage(s) is the endometrium the thickest?

Answer 8

Diestrus

Question 9

Why is the endometrium the thickest during diestrus?

Answer 9

progesterone, it causes glandular hyperplasia

Question 10

What is the earliest that US can detect pregnancy in a queen?

Answer 10

15-17 days gestation - this is when the chorionic vesicle becomes visible

Question 11

What is the earliest that US can detect pregnancy in a bitch?

Answer 11

18-20 days gestation - this is when the chorionic vesicle becomes visible

Question 12

When can cardiac motion of a canine/feline fetus be detected on US?

Answer 12

after 23 days

Question 13

What is the normal gestation length in dogs/cats?

Answer 13

63-66 days

Question 14

Which method / calculation gives an 85-86% accuracy (of parturition with 2 days of estimation) in dogs?

Answer 14

BP (biparietal) diameter
ICC (inner chorionic cavity) diameter

Question 15

What is the accuracy rate in queens for BP and ICC measurements?

Answer 15

Reasonably good at ± 2 days, BP slightly better

ICC 65% (± 1 day), 85% (± 2 days)
BP 73.9% (± 1 day), 91.3% (± 2 days)

Question 16

Answer 16

• a) 15 to 17 days

Question 17

Answer 17

• b) 18 to 20 days

Question 18

Answer 18

d) 63 to 66 days

Question 19

Answer 19

c) Inner chorionic cavity diameter

Question 20

Answer 20

c) 23 to 25 days

Question 21

Answer 21

d) 43 days

Question 22

When does fetal mineralization occur in the cat, making radiographic diagnosis of pregnancy possible?

a) 32 days
b) 38 days
c) 48 days
d) 50 days

Answer 22

b) 38 days

Question 23

What sonographic feature indicates fetal age around day 35 in the dog?

a) Cardiac motion
b) Mineralisation of the skeleton
c) Limb buds and echogenic fetal skeleton
d) Visible uterus

Answer 23

c) Limb buds and echogenic fetal skeleton

Question 24

Why might an estimate of litter size in early pregnancy be inaccurate?

Answer 24

It may be an overestimation, since fetal resorption is relatively common.

Question 25

What is the spalding sign?

Answer 25

overlapping of fetal cranial bones, it is a sign of fetal demise/death

Question 26

Radiographic signs of fetal demise

Answer 26

- gas within or around the fetus - spalding sign (overlapping of cranial bones) - tightly curled fetus - collapse of the skeleton It can be helpful to compare to other littermates; if there is delayed development of one, it is an indication of demise.

Question 27

Sonographic signs of fetal demise

Answer 27

loss of heartbeat early embryonic resorption: echogenic particles within the yolk sac, progressive loss of fluid volume, hypoechogenicity of adjacent uterus

Question 28

Answer 28

Fetal demise in a cat. There is gas around the fetus and overlap of the skull bones (white arrow). Close-up of the skull and area of bone overlap (white arrows).

Question 29

Answer 29

Dystocia in a dog due to a single fetus that has grown to a size that cannot pass through the pelvic canal

Question 29

Answer 29

Dystocia in a dog due to a fetus presenting transversely

Question 30

Which cause of dystocia cannot be diagnosed radiographically?

Answer 30

uterine inertia

Question 31

What are the main causes of feto-maternal disproportion?

Answer 31

- If the dog is mated with a much larger breed - if a single fetus remains/exists - brachys, when head is large and pelvis flat

Question 32

what other anomaly is common in association with uterine anomalies?

Answer 32

renal agenesis

Question 33

why and when does cystic endometrial hyperplasia occur?

Answer 33

it's the result of an abnormal response of the endometrium to progesterone that is secreted during the luteal phase (diestrus)

Question 34

How long is each stage of the estrus cycle?

Answer 34

Question 35

Answer 35

pyometra

Question 36

Answer 36

cystic endometrial hyperplasia

Question 36

uterus

Answer 36

cystic endometrial hyperplasia

Question 37

uterine horn

Answer 37

pyometra; dependent material (pus)

Question 38

Answer 38

uterine abscess from retained swab after c-section

Question 39

What is the most common and second most common uterine neoplasia in dogs?

Answer 39

Leiomyomas Leiomyosarcomas are much rarer

Question 40

What is the most common and second most common uterine neoplasia in cats?

Answer 40

Adenocarcinoma

Question 41

If there is unilateral uterine distension, what are the differentials?

Answer 41

neoplasia, polyps, but also pyometra (unilateral is possible)

Question 42

With what conditions is uterine torsion associated?

Answer 42

pyometra hematometra endometrial polyps

Question 43

What is the prognosis of uterine torsion?

Answer 43

poor; high fatality rate due to peritonitis and endotoxemia

Question 44

what kind of contrast medium is used for retrograde vaginography?

Answer 44

iodinated (150-200 mg I/mL

Question 44

5. What condition is NOT associated with uterine torsion? a. Pyometra b. Hydrometra c. Hematometra d. Endometrial polyps

Answer 44

b. Hydrometra

Question 45

Where should the tip of the catheter be, during a retrograde vaginogram?

Answer 45

within the VESTIBULE, not vagina (risk of rupture) - because if the tip is in the vagina, then the balloon will be in the orifice between vagina and vestibule (the cingulum), and then administration of contrast can result in rupture

Question 46

How much contrast for a vaginogram?

Answer 46

approx. 1 ml/kg

Question 47

Answer 47

Normal vaginogram; When the vagina and vestibular are maximally disternded, contrast will fill the urethra. Vg - vagina U - urethra Vb - vestibule F - Foley

Question 48

What is the cingulum?

Answer 48

Normal narrowing between the vestibule and vagina

Question 49

If a vaginogram is performed during estrus, what would you expect to happen with contrast?

Answer 49

It may pass into the uterus.

Question 50

What are the most common vaginal tumours in dogs?

Answer 50

Leiomyomas and fibromas Vaginal polyps are common in older dogs, occurring in the late part of the estrous cycle.

Question 51

What should be a suspicion if a malignant neoplasia is observed in the vagina?

Answer 51

That it is urethral in origin; Urethral neoplasia is usually malignant and may extend into the vagina/vestibule. Vaginal tumours are usually benign.

Question 52

Vaginal prolapse is seen mostly in ___________ during ________.

Answer 52

- young, intact, large-breed dogs - proestrus or estrus , or near/after parturition

Question 53

A mass lesion in the vagina/vestibula in a young dog might represent ________ and in an old dog, ___________.

Answer 53

edema, prolapse neoplasia

Question 54

ovary - normal or abnormal? what phase?

Answer 54

normal anestrus; hypoechoic and homogenous without visible follicles.

Question 55

Answer 55

cat with small mineralized suture granulomas at the site of ligation of the ovarian pedicles following an ovariohysterectomy.

Question 56

6. In which estrus cycle phase do follicles form? a. Proestrus b. Estrus c. Diestrus d. anestrus

Answer 56

a. Proestrus

Question 57

In which phase of the cycle are ovaries identified more easily?

Answer 57

Proestrus and estrus

Question 58

What is the normal size of ovarian follicles?

Answer 58

4-6mm, with a wall <1mm

Question 59

Ovarian follicles are initially too small to see, but they grow until the time of ovulation. When are they first seen?

Answer 59

1-3 days before ovulation

Question 60

How many ovarian follicles are usually seen?

Answer 60

3-5

Question 61

What happens to the follicles after ovulation i.e. what is the appearance?

Answer 61

They are replaced by slightly hypoechoic areas, which likely represent a combination of haemorrhage and follicular fluid

Question 62

Newly formed corpora lutea and follicles have distinct appearances = T or F?

Answer 62

False, their appearance is very similar, and B-mode US alone cannot determine whether ovulation has occurred.

Question 63

How would Doppler US help determine whether ovulation has occurred in a dog?

Answer 63

Daily monitoring of the proestrus ovary > detecting increases in blood flow, which would correlate with ovulation

Question 64

Answer 64

ovarian carcinoma, contains severeal hypoechoic fluid-filled regions

Question 65

ovary

Answer 65

granulosa cell tumour, it is more homogenous in appearance usually (than a carcinoma)

Question 66

Which type(s) of tumor account for 40-50% of canine ovarian tumours?

Answer 66

papillary adenomas and adenocarcinomas

Question 67

Papillary adenomas and adenocarcinomas account for ___% of canine ovarian tumours?

Answer 67

40-50