A 12- year-old, spayed female Doberman pinscher cross presented with a history of intermittent vaginal bleeding. A piece of ovary had been left within the dog at the time of her ovariohysterectomy (spay) years before, but could not be identified on exploration of the abdomen. The dog had exhibited bouts of vaginal bleeding that was apparently responsive to androgen therapy, for years. The drug that the owner had been using for therapy was no longer available, and the dog was presented for a work-up when vaginal bleeding recurred.
On physical examination, there were no abnormal findings beyond those of old age in a large breed dog. The abdomen was palpably normal. The mucous membranes were pink and capillary refill time was 1 second. The heart rate and rhythm were normal.
The vaginal cytology specimen below was collected.
Based on the above vaginal cytology, what are your rule-outs for the cause of vaginal bleeding in this dog?
This dog is not in heat. If the intermittent vaginal bleeding was due to her being in heat, the vaginal epithelial cells should be numerous and should be cornified. Cornified cells large and misshapen. On this slide, the cell number was low, and all the cells that were seen were small, round and healthy looking. A cause outside of the remnant of ovary must be investigated. Other causes for vaginal bleeding include abnormalities of the urinary tract, such as infection or neoplasia (cancer), vaginitis or vaginal neoplasia, infection of the stump of uterus left after the spay, or a clotting disorder.
Doberman pinschers as a breed are predisposed to a bleeding disorder called VonWillebrand's disease. There was no evidence of infection on the vaginal swab, and the dog was not showing clinical signs suggestive of urinary tract disease. The owner elected to do bloodwork to assess for VonWillebrand's disease; if that result is normal, we will sedate the dog and thoroughly examine her vagina with a lighted scope.
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