Clinical Cases on Reproduction

Reproductive tract pathology is diverse, with many different possible diagnoses. However, the symptoms that your patients are presented with are limited, eg. infertility or vaginal discharge. Therefore, a thorough history and complete physical examination are required in order to achieve an accurate differential diagnosis and to limit the number of necessary further examinations.

History
To be able to interpret the findings during the following physical examination in intact queens and bitches, it is important to take into account information regarding the oestrous cycle. In cases of vaginal discharge, for example, knowledge on the oestrous cycle stage can help to interpret the discharge as either physiological or pathological.

Physical examination
Besides the external examination, in bitches, an internal examination often is a necessary part of a complete physical examination. In cats, however, due to the small dimensions, an internal examination is difficult to perform and therefore only indicated in selected cases. If necessary, cats are sedated in order to be able to perform the examination properly.

As observation of the entire vagina is important, a rigid tubular speculum with a minimal length of 20 cm and a diameter of 12 mm, in conjunction with a light source, can be used to perform vaginoscopy. Human paediatric proctoscopes (eg. cat. no. 8834.08, R. Wolf, Germany), that can be connected to a light source, are a practical alternative for use in bitches of most sizes. Another option is the use of a cysto-urethroscope, which are longer and have a smaller diameter (eg. cat. no. 027KL/027NL/325B, K. Storz, Germany).

Depending on the resulting differential diagnosis, further examination can range from diagnostic imaging to provocation tests of the pituitary-gonadal axis and establishing the karyotype.

In several clinical cases, the diagnostic steps taken will be discussed and examples will be given of the expected findings.