Department of Small Animal Medicine and Surgery, School of Veterinary Medicine, St. George's University, True Blue, Grenada.
School of Veterinary Medicine, St. George's University, True Blue, Grenada.
Vet Med Sci. 2022 Sep;8(5):1872-1876. doi: 10.1002/vms3.860. Epub 2022 May 27.
This report documents a rare case of vulvar discharge associated with exogenous oestrogen exposure in a large-breed dog.
A 4-year-old spayed Weimaraner bitch was presented for evaluation of inappetence and intermittent sanguineous vulvar discharge. Physical examination, vaginal cytology, haematological, and ultrasonographic findings were indicative of a uterine stump pyometra. A celiotomy was performed, and the uterine stump appeared grossly cystic and thickened. Histopathological evaluation of the removed uterine stump and ovarian pedicles revealed cystic endometrial hyperplasia and no ovarian tissue. Fifteen days after surgery, the patient presented again with a sanguineous vulvar discharge. Vaginal cytology revealed predominantly superficial cells, indicating oestrogen influence. Further questioning of the owner revealed the long-term use of a topical oestrogen cream by a member of the household. Serial examinations were performed, and the cytology remained uniform, with predominantly superficial cells, indicating continued oestrogen influence. Progesterone and anti-Müllerian hormone tests were negative, which made the presence of ectopic ovarian tissue unlikely. These results coupled with the history of topical oestrogen cream use in the household suggested that the patient's clinical signs were most likely due to exogenous oestrogen exposure. After the owner implemented various recommendations made to prevent the exposure, the clinical signs resolved completely.
This case demonstrates that although rare, exogenous oestrogen exposure can be a cause of vulvar discharge in a large-breed spayed bitch. Therefore, regardless of the breed, exogenous oestrogen exposure must be included in the list of differential diagnoses for all clinical presentations associated with oestrogenic influence in dogs.
本报告记录了一例罕见的大型犬外阴分泌物与外源性雌激素暴露相关的病例。
一只 4 岁已绝育的魏玛犬母犬因食欲不振和间歇性血性外阴分泌物就诊。临床检查、阴道细胞学、血液学和超声检查结果提示子宫残端脓毒症。进行了剖腹手术,子宫残端外观呈明显囊性增厚。切除的子宫残端和卵巢蒂的组织病理学评估显示囊性子宫内膜增生,无卵巢组织。手术后 15 天,该犬再次出现血性外阴分泌物。阴道细胞学检查显示以表层细胞为主,表明雌激素的影响。进一步询问主人发现,一名家庭成员长期使用一种局部雌激素乳膏。进行了一系列检查,细胞学结果仍然一致,以表层细胞为主,表明持续存在雌激素影响。孕激素和抗苗勒管激素检测均为阴性,这使得异位卵巢组织的可能性不大。这些结果加上家中使用局部雌激素乳膏的病史,提示该犬的临床症状很可能是由于外源性雌激素暴露所致。在主人实施了各种建议以防止暴露后,临床症状完全缓解。
本病例表明,尽管罕见,但外源性雌激素暴露可导致大型犬已绝育母犬出现外阴分泌物。因此,无论品种如何,所有与雌激素影响相关的临床表现都必须将外源性雌激素暴露纳入鉴别诊断清单。