THE MERCK VETERINARY MANUAL
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Overview of Vulvitis and Vaginitis in Large Animals

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Contusion and hematoma of the vagina are noted infrequently after parturition in all species but particularly in mares and sows. Occasionally, vaginal hematomas in sows may rupture and cause serious (or fatal) hemorrhage that can be controlled by ligation of the labial branch of the internal pudendal artery. Necrotic vaginitis, vestibulitis, and vulvitis may follow dystocia in all species. Onset of signs, consisting of arched back, elevated tail, anorexia, dysuria, straining, vulvar and perivulvar swelling, and possibly a fetid, serous discharge, begins within 1–4 days of parturition and may persist for 2–4 wk. In most cases, only gentle and conservative treatment is needed. Prophylactic antibiotic treatment is wise, because clostridial or other organisms may proliferate in the damaged tissue and cause tetanus (see Tetanus), blackleg (see Blackleg), or other forms of clostridial myositis. Possible consequences of necrotic vaginitis include permanent stricture of the vagina, transvaginal adhesions, or perivaginal abscessation.

Vestibular lymphocytic follicles, also called granular venereal disease, granular vulvitis, or granular vulvovaginitis, are seen in cows and are characterized by vestibular hyperemia and hyperplasia of the lymphoid nodules of the vestibular mucosa. These lesions do not constitute a specific disease but reflect irritation of the vestibular mucosa. They can be reproduced experimentally by topical application of Ureaplasma ureolyticum or Mycoplasma spp in goats and cattle.

Infectious pustular vulvovaginitis of cows is caused by bovine herpesvirus 1 (see Bovine Herpesvirus 1) and is transmitted by natural service, nasogenital contact, or mechanically by insects such as flies. It is characterized by vaginal lesions. Affected cows show signs of vaginal discomfort (raised tail, frequent urination) and have numerous, round, white, raised lesions of the vestibular mucosa. Within a short time, these lesions progress to pustules and erosions or ulcers. Mucopurulent discharge may be prominent, even in pregnant animals in which pregnancy is uninterrupted. The histologic lesion consists of necrosis of vestibular and vaginal epithelium, with intranuclear inclusion bodies typical of herpesvirus infection. The virus may be secreted in the semen of infected bulls (which have similar lesions of the penis and prepuce). Intrauterine inoculation of the virus produces necrotizing endometritis and cervicitis.

A severe disease characterized by vaginitis in cows and epididymitis in bulls occurs sporadically in eastern and southern Africa, where it is referred to as epivag. The disease is spread by natural mating. In the early stages of infection, cows have intense vaginitis characterized by reddened mucosae without ulcers, erosions, or vesicular lesions. A thick, creamy, white to yellow discharge develops. The infection spreads to the uterus and uterine tubes, and salpingitis and fimbrial adhesions frequently result in permanent infertility. Although epivag has been transmitted experimentally by transferring exudate, the cause is unknown.

Necrotic vulvitis has been observed as a severe granulomatous and necrotic lesion centered on the ventral commissure of the vulva of cows, sometimes occurring in outbreak form. It is associated with several pathogens, possibly acting synergistically and, in particular, Porphyromonas levii.

Catarrhal bovine vaginitis has been reported from many countries. Although enteroviruses have been associated with this condition, the cause remains unknown. In areas of the world where bovine tuberculosis (see Tuberculosis and other Mycobacterial Infections) is still endemic, vaginal lesions may be either a primary lesion after service by a bull with genital infection or evidence of uterine disease or of cervicitis.

One cause of vulvitis in sheep is ulcerative dermatosis (see Ulcerative Dermatosis of Sheep), characterized by crusted ulcers of the vulvar skin, penis, prepuce, and facial skin. Posthitis and vulvitis are also caused by the interaction of a high-protein diet and infection with urease-producing organisms, usually Corynebacterium renale. Demodex mites have been seen in the vulvar skin of sheep; they usually are not associated with lesions but may produce granulomas.

Equine coital exanthema (see Equine Coital Exanthema) is caused by equine herpesvirus 3. It is an acute disease without systemic signs. Red papules appear in the vaginal and vestibular mucosae 2–10 days after infection, which occurs as a result of mating with an infected stallion. Lesions extend to the perivulvar skin. The lesions progress rapidly to pustules, then ulcerate, and finally heal, leaving depigmented scars. Stallions show similar lesions on the penis and prepuce. The disease causes discomfort and may prevent mating but does not specifically inhibit fertility.

Dourine (see Dourine) is a venereal disease of horses. Early signs are characterized by edematous swelling of the vulva and secondary vulvovaginitis of the swollen, irritable tissue.

Coital injuries of cows and mares may be attributable to the relatively large size of the penis in these species compared with the vagina. Injuries of the vulva and vagina may be caused by horned cattle. Vaginal injuries in a variety of species have also been inflicted maliciously.

Last full review/revision December 2014 by Robert O. Gilbert, BVSc, MMedVet, DACT, MRCVS

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