One of my clients called me the other day and told me that his dog was on time for delivery and looked like the fetus has came out half way and stucked in the middle. I quickly rushed to his house to have a look. I was a little skeptical as he didn't mention anything about his dog being mated before. Anyway, I've promised him to have a look and there I went.
To my surprise, the dog wasn't delivering as what my client have told me. It was a case of vaginal prolapse, or more convincingly vaginal hyperplasia causing the vagina to prolapse. There wasn't any puppies in the uterus as I couldn't palpate any. It was a labrador and most of the time, a labrador might gave birth to at 7 - 8 puppies in a batch.
The occurence of vaginal hyperplasia is usualy under the influence of the hormone estrogen. Estrogen can cause the vaginal wall to become edematous and swell, thus, making it large enough to protrude outside the vulvar lips. Some people may prefer the words "vaginal edema" rather than vaginal hyperplasia because it does not involved a true organ prolapse or hyperplasia of the vagina.
Treatment depends on the stage of estrus, extend of the fold prolapse, whether it's a breeding bitch or whether the dog is pregnant. In this case, the dog was not pregnant nor was it on heat. It was a puzzle for us as to why this condition has occured in a non pregnant, non-estrus bitch. Further check on the blood revealed "band neutrophil", a condition of the white blood cell, neutrophil indicating toxic changes in the body. And, in the bitch, it is highly suggestive of "pyometra", an infective and inflammative condition of the uterus. And, true enough, ultrasound diagnosis revealed the dog was having pyometra and the possibility of cystic ovaries.
The best treatment for pyometra is to remove the entire uterus and the ovaries together so that the dog can be saved immediately. A pyometra has always being regarded as a "time bomb" as it can rupture anytime if the swelling was large enough. So, there we went, into the surgical room. The dog has 2 problems to be solved - a pyometra and vaginal hypreplasia.
Upon opening up the abdominal cavity, the first organ I saw was the enlarged uterus. We have to remove the entire uterus as it was too risky to leave it because it was so big! Look at my hand and compare it to the size of the uterus.
After we have removed the pyometral uterus, we proceeded with the removal of the prolapse vagina.
After the prolapse vagina has been removed, the remaining stump was sutured and put back in place. The dog was saved from pyometra which can cause death if not treated. This case was very special because the vaginal hyperplasia was probably due to the hormonal effect caused by the cystic ovaries. Most literature stated that vaginal hyperplasia occurs during estrus or at the end of pregnancy. And, I treasured very much the experience of seeing a vaginal hyperplasia out of the "norm".
