Oestrus in a neutered bitch

RE: Oestrus in a neutered bitch

Sarah Keir — Fri, 20 Jan 2017 16:35:29 GMT

I reviewed the whole case before doing more invasive testing than bloods and only then realised that the dog was on Incurin! Stopped this and oestrus signs disappeared within a few days and the urinary incontinence that the dog had has not recurred yet. Perhaps one to NoBBLE me with?

RE: Oestrus in a neutered bitch

Laura Marshall — Fri, 20 Jan 2017 14:40:02 GMT

Hi there,

I was just wondering what the eventual outcome was with your patient Sarah? Was quite an interesting sounding case!

Laura

RE: Oestrus in a neutered bitch

Helen Perryman — Tue, 13 Dec 2016 18:17:52 GMT

[quote user="Sarah Keir"]

Anti-Mullerian Hormone <0.1ng/ml - looks like no ovarian tissue.

[/quote]We had a dog recently, imported from Romania a couple of years ago, had been spayed while in rescue centre there. She started showing signs of oestrus a year ago and had Anti-Mullerian hormone done at a different practice which was <0.1ng/ml. She continued to have recurrent vaginal bleeding and swollen vulva so we u/s scanned her recently - she had ovarian remnants bilaterally and a stump pyo. The lab said that the AMH is usually very reliable but it's clearly not 100%!

RE: Oestrus in a neutered bitch

Tim Charlesworth — Mon, 05 Dec 2016 15:15:53 GMT

[quote user="David Mills"]

[quote user="Tim Charlesworth"]As has been said, resection of remnants is usually straight forward, we usually find a large remnant when we go in[/quote]

Out of interest, do you think this is because the remnant grows with each season or it just stays the same from initial surgery?

[/quote]

Most of the time the "remnant" is (or at least appears to be) a complete ovary. I think that it's prob easier to miss the whole ovary (esp if fat dog etc) than to accidentally transect through it, so most f the time 10-15mm or so. Last granulosa cell tumour that we had was 8cm..

Looks like this is not this dog's problem though!

RE: Oestrus in a neutered bitch

janine redman — Sat, 03 Dec 2016 20:12:30 GMT

We had one this year. Had a funny coat pre spay, a working cocker, spayed by an experienced vet 5 years ago. Coat improved then deteriorated over the last 18 mths. Had loads of tests which were equivocal , ultrasound negative, ( experienced clinician but not a diplomat). Then developed vulval swelling and discharge.

ex lap found peice of ovarian tissue very close to aorta. Histopathologist thought a bit of ovarian tissue had remained and took a long while to develop a good blood supply. I think I read an article recently that if you leave fragments of rabbit ovarian tissue they can develop functional blood supply.

RE: Oestrus in a neutered bitch

Darren Long — Sat, 03 Dec 2016 11:33:55 GMT

I was taught by Gary at uni and during my repro course last month. sanguinous discharge during the oestrus cycle of the bitch is a result of uterine endometrial diapedesis which leaves the cervix causing the typical vulval discharge noted on examination.

RE: Oestrus in a neutered bitch

Sarah Keir — Fri, 02 Dec 2016 16:57:31 GMT

[quote user="Martin Atkinson"]

[quote user="Sarah Keir"]This dog has fairly major CKD as a consequence of PLN[/quote]Would that not be the reverse causation?

[/quote]

Glomerulonephritis causing PLN which has led to kidney damage and now CKD, azotaemia only in the past 6 months.

RE: Oestrus in a neutered bitch

Sarah Keir — Fri, 02 Dec 2016 16:56:27 GMT

Anti-Mullerian Hormone <0.1ng/ml - looks like no ovarian tissue.

RE: Oestrus in a neutered bitch

Martin Atkinson — Fri, 02 Dec 2016 15:00:55 GMT

[quote user="Sarah Keir"]This dog has fairly major CKD as a consequence of PLN[/quote]Would that not be the reverse causation?

RE: Oestrus in a neutered bitch

Dinu Catilina — Thu, 01 Dec 2016 20:13:38 GMT

Maybe either norethisterone tablets (like in greyhounds) either suprelorin implant.

RE: Oestrus in a neutered bitch

Sarah Keir — Thu, 01 Dec 2016 16:11:04 GMT

This dog has fairly major CKD as a consequence of PLN (urea now 26, creatitine now 240). The owners really do not want to put the dog through surgery (they declined renal biopsies when first diagnosed with PLN). Are there any medical options? When you say large remnant, what size 'large'?

Sarah

RE: Oestrus in a neutered bitch

David Mills — Thu, 01 Dec 2016 15:36:15 GMT

[quote user="Tim Charlesworth"]As has been said, resection of remnants is usually straight forward, we usually find a large remnant when we go in[/quote]

Out of interest, do you think this is because the remnant grows with each season or it just stays the same from initial surgery?

RE: Oestrus in a neutered bitch

Tim Charlesworth — Thu, 01 Dec 2016 15:21:55 GMT

Hi, yes we see ovarian remnants occuring as one of 2 distinct presentations. The first is the "my dog still has seasons" and the second is "mass effect" or sudden change in hormonal status (normally corresponding to granulosa cell tumour development and this is often years after spay). As has been said, resection of remnants is usually straight forward, we usually find a large remnant when we go in but its important to check and resect both pedicles and check the cervical stump while you're there. You can do all of this laparoscopically if the owners don't want/are reluctant for open surgery.

Best of luck with the case,

Tim

RE: Oestrus in a neutered bitch

Hannah Wynne Richards — Wed, 30 Nov 2016 11:24:37 GMT

Martin We agree

Wynne

RE: Oestrus in a neutered bitch

Sarah Keir — Wed, 30 Nov 2016 11:06:11 GMT

Imaging performed - abdominal and perineal approach ultrasound - no masses only vaginal wall at about 0.5cm diameter. Also vaginal ensoscopy with rigid endoscope - no masses only soft oedmatous walls of vagina.

Sarah

RE: Oestrus in a neutered bitch

Martin Atkinson — Wed, 30 Nov 2016 10:55:01 GMT

[quote user="Hannah Wynne Richards"]

Hang on. Spay, 7 years no probs, then apparent oestrus! I'd say recent pathology as opposed to ovarian remnant

Wynne

[/quote]My thoughts also. I would be concerned about a vaginal tumour here. Not sure why that would cause a swollen vulva but it could be oedema from internal pressure. I'd like some imaging on this one before going on an ovary hunt.

RE: Oestrus in a neutered bitch

Eilidh Corr — Tue, 29 Nov 2016 22:15:40 GMT

My understanding was that stump pyos occur because of the effects of an ovarian remnant, not because of the presence of uterine remnants.

RE: Oestrus in a neutered bitch

Sarah Keir — Tue, 29 Nov 2016 11:29:09 GMT

I was taught on my BSAVA medicine course (Gary England) that bleeding in oestrus in bitches comes from the vaginal wall becoming leaky (which is also why it is oedematous) - perhaps I was taught wrong? I routinely remove the entire uterus in ovariohysterectomies as my ligatures are transfixing ones through the cervix.

Sarah

RE: Oestrus in a neutered bitch

rhmrcvs — Mon, 28 Nov 2016 22:06:01 GMT

From memory great ideas from Andria Cauvin, she taught us medicine at the RVC, top notch.

RE: Oestrus in a neutered bitch

grumpyoldman — Mon, 28 Nov 2016 21:25:32 GMT

[quote user="Hannah Wynne Richards"]

Hang on. Spay, 7 years no probs, then apparent oestrus! I'd say recent pathology as opposed to ovarian remnant

[/quote]

some of them would cycle with 18 month intervals + the clients would put up with it, not notice, as swelling and discharge often less and shorter duration, or more commonly, get fobbed off until it got sick with a stump pyo.

RE: Oestrus in a neutered bitch

Dinu Catilina — Mon, 28 Nov 2016 21:21:16 GMT

[quote user="Sarah Keir"]

Good ideas Andira

Bleeding in oestrus is vaginal not uterine and this dog does not have a uterus (I removed it 7 years ago).

I am moderately good at finding adrenals so lack of finding them on my scan is most likely to suggest a normal size! I have definitely found adrenal masses in the past.

Sarah

[/quote]

Not trying to just be controversial but bleeding is uterine, you can actually can see the trace of blood coming out through the cervix when you visualise it by endoscopy. And do you routinely remove all the uterus including the cervix at ovariohisterectomy?

Interesting case, please let us know the outcome!

RE: Oestrus in a neutered bitch

Glenn Hodgson — Mon, 28 Nov 2016 18:32:43 GMT

Ive used suprelolin fir bitches a few times, non spayed. They have a reflex season alot of the time 1st implant, then if works a treat as long as kept uo to date.

Nit quite the same as your dog but may help...

RE: Oestrus in a neutered bitch

Hannah Wynne Richards — Mon, 28 Nov 2016 17:28:16 GMT

Hang on. Spay, 7 years no probs, then apparent oestrus! I'd say recent pathology as opposed to ovarian remnant

Wynne

RE: Oestrus in a neutered bitch

grumpyoldman — Mon, 28 Nov 2016 17:04:03 GMT

I have seen these ,not recently, used to get 3-4 a year from a local outlet before it was taken over. .The former owner of that used to suppress them with delvosterone. Even 10-20 mm stump pyos can get quite toxic though. When they came in for a second opinion over their "hormones being too strong and breaking through etc" I ex lapped then and removed the remnants, its pretty easy and most obvious when they are in season . The stump pyo's can be a bit more challenging to get at but its the same deal. I always put it down to making new grads spay with thio on the needle with worn instruments and poor muscle relaxation .

RE: Oestrus in a neutered bitch

Sarah Keir — Mon, 28 Nov 2016 16:51:08 GMT

Good ideas Andira

Bleeding in oestrus is vaginal not uterine and this dog does not have a uterus (I removed it 7 years ago).

I am moderately good at finding adrenals so lack of finding them on my scan is most likely to suggest a normal size! I have definitely found adrenal masses in the past.

Sarah