Vaginitis is inflammation of the vagina.
Juvenile (prepuberal) vaginitis occurs in females < 1 year of age. Often it is an incidental finding on physical exam.
Adult vaginitis appears after the first estrus and usually occurs in spayed females. It generally involves a predisposing factor, including a congenital anomaly with urine or fecal contamination, chemical irritation, neoplasia, vaginal trauma, or foreign body. It is primarily seen in dogs, but is rarely seen in queens.
Etiology of Vaginitis in Small Animals
Vaginitis can be concurrent with vaginal neoplasia (ie, transmissible venereal tumor, leiomyoma) and bacterial contamination, including Pasteurella, Streptococcus, E coli, Pseudomonas, Mycoplasma, and Chlamydia, or viral infection, such as canine herpesvirus. Brucella canis infection is rare in patients with vaginitis but should be considered.
Additionally, vaginitis is seen subsequent to vaginal hematoma or abscess, exogenous androgen exposure, vaginovestibular strictures, or even zinc toxicity.
Clinical Signs of Vaginitis in Small Animals
Clinical signs of vaginitis include discharge from the vulva, pollakiuria, vaginal licking, spotting, scooting, and attracting males. Puppies may have a history of small amounts of clear to cloudy sticky vulvar discharge with occasional vulvar licking but rarely have any systemic signs. The signs of adult vaginitis are similar to puppy vaginitis but may be more pronounced.
Diagnosis of Vaginitis in Small Animals
Diagnostic testing for vaginitis should include urinalysis collected by cystocentesis to rule out an underlying condition in the urinary bladder, vaginal examination, microscopic examination of vulvar discharge as well as culture and sensitivity of vaginal and urine samples.
Concurrent cystitis should be ruled out.
On examination, the structural confirmation of the vulva should also be checked for any malformations or deformities that may have contributed to the vaginitis such as a recessed vulva.
Treatment of Vaginitis in Small Animals
No treatment of vaginitis is necessary in dogs with minimal clinical signs, but the area should be kept clean to prevent secondary bacterial infections.
If found on a pre-spay examination, the surgery should be postponed until the condition resolves. If it resolves prior to the first estrus surgery can proceed without waiting for the patient to go through a first estrus. Often this condition will resolve without intervention after the first estrus.
Vaginitis is treated with specific antimicrobials based on microbial culture and antimicrobial susceptibility testing only after ruling out or treating all underlying problems, such as vaginal strictures, urinary incontinence, or pyometra. If empirical antimicrobial treatment is required, amoxicillin-clavulanate has been demonstrated to be effective against 91% to 100% of bacteria commonly involved in vaginitis in female dogs.
If due to conformational issues, an episioplasty may be performed to remove excess skin folds around the vulva and will allow for freer voiding of urine. However, episioplasty should only be performed when the problem is serious and urine pooling is the suspected underlying condition.