View source for Small Animal Abdominal and Metabolic Disorders Q&A 11

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'''A three-year-old, female Collie-cross had a routine ovariohysterectomy at 18 months of age. Since that time she has had clinical signs of oestrus approximately every seven months and has been attractive to male dogs. Presently she has a red-tinged vulval discharge. A vaginal smear has been obtained and stained with a modified Wright-Giemsa stain.'''

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<FlashCard questions="4">
|q1=What are the features of the vaginal smear, and what is the likely diagnosis?
|a1=
Both large and small intermediate epithelial cells and some erythrocytes are present within the smear. 

These changes are associated with an elevation in plasma oestrogen concentration, and the likely diagnosis is that of ovarian remnant syndrome.

The presence of erythrocytes indicates that some uterine tissue remains and makes the diagnosis simpler.
|l1=Vaginal Smear for Oestrus Detection in the Bitch
|q2=What techniques could be used to confirm this diagnosis?
|a2=
Collection of a vaginal smear when the bitch has clinical signs of oestrus provides a simple and rapid method of diagnosis. 

It is also possible to measure peripheral plasma progesterone concentrations two weeks after the signs of oestrus have disappeared.

Raised progesterone concentrations are diagnostic for luteal tissue present within the ovarian remnant. 

Investigative techniques include diagnostic laparoscopy or laparotomy.
|l2=Ovarian Remnant Syndrome#Diagnosis
|q3=What are the differential diagnoses for this condition?
|a3=
The differential diagnoses for recurrent vulval discharge in an ovariohysterectomized bitch include:
*vaginitis (which may be related to changes in local immunity associated with removal of the ovaries), 
*certain bacterial or viral infections (although these are very rare as primary causes), 
*chemical irritation (e.g. urine), 
*mechanical irritation (foreign bodies), 
*vaginal or urethral neoplasia, 
*stump pyometra 
*and diseases of the urinary tract. 

Differential diagnoses for attractiveness to males includes vaginitis and anal gland disease.
|l3=Ovarian Remnant Syndrome#Differential Diagnosis
|q4=How should the condition be treated?
|a4=
Surgical removal of the ovarian remnant will be curative. 

Frequently the remnant is associated with the right ovarian pedicle, and surgery is best performed during or shortly after oestrus when the ovarian tissue reaches its maximum size.
|l4=Ovarian Remnant Syndrome#Treatment
</FlashCard>

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