Ulcerative Posthitis and Vulvitis: Introduction

Ulcerative Posthitis and Vulvitis: Introduction
(Sheath rot, Pizzle rot, Enzootic balanoposthitis)

Ulcerative posthitis is principally a disease of sheep but occasionally is seen in goats and cattle (usually in castrated males). Females are less commonly and usually less severely affected.

Etiology and Epidemiology:

This moderately contagious disease is caused by Corynebacterium renale , a gram-positive, diphtheroid bacterium capable of hydrolyzing urea. When protein intake is high, urinary urea concentration increases. Hydrolysis of urea by C renale results in local production of large quantities of ammonia, which is believed to irritate the penis, lamina interna of the prepuce, and skin surrounding the preputial orifice. The condition is more common in male castrates, probably because of the hypoplastic nature of the penis, exacerbated in some cases by failure of penile-preputial separation that leads to pooling of urine in the prepuce. If preputial hair is cut too short or becomes caked with mud or organic matter, drainage of urine away from the preputial orifice (normally facilitated by this hair) is impaired, and ulcerative lesions may develop.

The incidence of ulcerative posthitis is highest in Merino and Angora wethers, which is attributed to the long hair or wool surrounding the prepuce in these animals, allowing urine to soak the area, which in turn is conducive to bacterial growth and activity. The condition can be transmitted experimentally by infective material from a preputial or vulvar ulcer. Ulcerative posthitis or vulvitis has a seasonal occurrence that varies with local animal husbandry methods. Peak incidence corresponds to the time when animals graze lush green pasture (eg, spring and early summer in New Zealand or autumn and winter in southern Brazil) or are fed or have access to high-protein feedstuffs.

Clinical Findings:

In mild cases, signs are limited to swelling of the prepuce. In severe cases, swelling and inflammation interfere with urination and result in straining, which needs to be differentiated from urolithiasis ( Urolithiasis: Overview). Histologic characteristics are acanthosis, parakeratosis, and hyperkeratosis, followed by leukocyte invasion and ulceration. Ulcers and scabs may be found around the preputial orifice, on the lamina interna of the prepuce, and on the shaft of the penis. Urine and exudate may accumulate in the prepuce. The condition may cause severe discomfort. If the preputial orifice or urethra is occluded, affected animals may die. Ulcerative vulvitis begins with signs of vulvar inflammation, including swelling and redness, and progresses to development of a yellow exudate with ulceration and scab formation around the vulva, vestibule, and caudal vagina. The glans clitoridis may be swollen, red, and ulcerated.

Lesions of ulcerative posthitis or vulvitis should be distinguished from those of granular posthitis or vulvitis (associated with Mycoplasma spp or Ureaplasma spp , Vulvitis and Vaginitis in Large Animals: Introduction), herpesviral balanoposthitis or vulvovaginitis ( Bovine Herpesvirus 1), ulcerative dermatosis ( Ulcerative Dermatosis of Sheep: Introduction [sheep only]), or contagious ecthyma (orf, Contagious Ecthyma: Introduction [goats only]). Removal of the scabs of ulcerative posthitis or vulvitis characteristically results in little or no hemorrhage.

Treatment and Control:

If possible, affected animals should be isolated from the rest of the herd and not fed a high-protein diet. Lesions should be examined to ensure that they do not interfere with urethral patency. Clipping and cleaning hair around the prepuce may be beneficial. C renale is usually sensitive to penicillins and cephalosporins, which may be beneficial if practical. Ulcerative posthitis is controlled principally by limiting dietary protein to a level consistent with requirements. Implantation of wethers with 70-100 mg of testosterone every 3 mo is effective in preventing ulcerative posthitis. Castration by the “short scrotum” technique to produce induced cryptorchidism results in sterile animals that have higher concentrations of circulating testosterone and a much lower incidence of posthitis than animals castrated by conventional procedures.