Etiology, Diagnosis, and Prevention of Vulvitis and Vaginitis in Canine Obstetrics

Vulvitis is inflammation of the vulva and vestibule. It is mostly caused by infection from vulvar trauma during parturition, inadequate disinfection of hands or instruments during assisted delivery, and bacteria introduced by the tail. During mating, damage to the vulvar mucosa can also trigger this disease; vaginitis is inflammation of the vagina. Primary vaginitis is mostly seen in certain large breeds before sexual maturity, such as the German Shepherd and Boxer. Secondary vaginitis is mostly seen in adult dogs. Predisposing causes include prolonged estrus, unsanitary mating, infection during parturition, and secondary infection of the uterus, bladder, urethra, and vestibule. Vaginitis often occurs concurrently with vulvitis.

[Diagnosis]

(1) The symptoms of vulvitis and vaginitis are similar. Symptoms of vulvitis include purulent discharge from the vulva, restlessness, arched back, frequent urination, and groaning. The labia are swollen, and most affected dogs refuse examination of the vulva due to pain. The area around the vulva is often contaminated by discharge, inducing dermatitis. Primary vaginitis mostly presents as continuous copious purulent discharge from the vagina in dogs before sexual maturity, while secondary vaginitis, in addition to foul-smelling vaginal discharge, often involves the dog licking the vulva, along with symptoms of frequent urination and oliguria. On vaginal examination, the vaginal mucosa appears congested and swollen; other systemic symptoms of vulvitis and vaginitis are not obvious.

(2) Laboratory testing: microscopic examination of the discharge reveals large numbers of pus cells and epithelial cells, along with beta-hemolytic streptococci and Escherichia coli-like organisms. Vaginal cytology reveals large numbers of degenerated neutrophils. Blood counts and biochemical parameters are generally normal.

(3) To rule out urinary tract infection, cystocentesis can be performed prepubically to obtain urine for analysis and culture.

[Prevention and Treatment]

(1) For vulvitis, first clean the tail and vulvar area, open the vulvar cleft, and flush the vestibule with 0.1% potassium permanganate or 0.1% Rivanol solution. Wrap the base of the tail with a bandage and tie it to one side to avoid excessive irritation of the vulva. After cleaning, apply an anti-inflammatory ointment to the vulvar area.

(2) Vaginitis before sexual maturity requires no treatment and generally resolves spontaneously at the first estrus.

(3) For vaginitis in adult dogs, the bacterial infection should be treated definitively. For this purpose, the following solutions can be selected for vaginal irrigation: 0.1% potassium permanganate, 0.1% Rivanol, 0.2% nitrofurazone, 0.5% povidone-iodine, 0.05% chlorhexidine, etc. Vaginal irrigation should be stopped 1 week before mating. After irrigation, an antibiotic ointment can be applied, chlorhexidine suppositories inserted into the vagina, and metronidazole administered orally, etc. When necessary, systemic antibiotics may be used, but this should be based on the results of drug sensitivity testing performed on vaginal cultures. If no culture has been done, choose an antibiotic effective against Escherichia coli, such as trimethoprim, etc.

Note: Systemic antibiotics and vaginal irrigation should be continued until about 1 week after the vaginal discharge disappears.