Generally, coping with disorders in small animal reproduction, is a rewarding subspecialty in veterinary medicine. Clients
owning pets with urogenital problems are usually very motivated to achieve resolution. Although demanding of the clinician's
time and expertise, the breeder client tends to be very loyal and compliant. A good reproductive practice generates its own
referrals, and usually is quite busy. Obstetrics and pediatrics are undeniably rewarding parts of the specialty for veterinarians
and their staff. Reproductive practice incorporates the interesting fields of physiology, endocrinology, embryology, genetics,
metabolism, nutrition, pediatric and maternal critical care, anesthesia, pharmacology and anatomy. The field is uniquely both
medical and surgical.
Frustrations do exist in the small animal reproductive practice, not just limited to the demanding breeder client. Technology
in the small animal field has not kept pace with that in the equine or bovine fields, and even less so with the human obstetrics,
gynecology and urology. The primary reason is a lack of funding supporting the development of technical expertise in a field
where anticipated financial returns are poor. The Westminster Best in Show stud dog will never match the financial expectations
of the Triple Crown winner or the syndicated bull. The value of pet dogs and cats is more personal, but even the most motivated
dog or cat owner cannot generally afford to back the development of a technique for intra cytoplasmic insemination, cryopreservation
of ova, or embryo transplant in their pet. Technology developed for equine and bovine patients is usually not applicable nor
effective in the canine or feline. Canine and feline neonatology and pediatrics are exacerbated by small patient size. The
natural fecundity of dogs and cats and the consequent pet overpopulation problem (and the recent successful dog cloning) raise
further ethical concerns in the field. Clinicians should guide their clients through the myriad of genetic screenings advised
for the particular breed, as well as discuss responsible puppy placement and early neutering. Some dogs and cats simply should
not be bred (aggressive or defective individuals), a recommendation all veterinarians should feel comfortable making.
Unsolved and controversial clinical problems are not uncommon to the reproductive practitioner. Progress in understanding
the etiology, pathophysiology and proper therapeutics of such problems has also been hampered by anecdotal information abounding
amongst the breeder clientele and often amongst veterinarians as well. The internet frequently becomes an annoyance, used
by clients to challenge a clinician's decisions. University residencies and post doctorate programs limited to and promoting
advances in small animal theriogenology are uncommon. Collaboration amongst small animal reproductive specialists is developing
but remains limited. Discussion of some of the frustrating clinical problems familiar to the small animal reproductive practice
MYTH: Puppy Vaginitis is always a Disease that Needs Treatment
An apparently healthy female puppy is presented with mucoid vulvar discharge, usually white to yellow, and sometimes copious.
The discharge can be accompanied by mild perivulvar dermatitis. The puppy is not typically attentive to the discharge, and
there is not any associated change in urinary behavior (dysuria or pollakiuria). Clients often have a difficult time deciding
if a puppy has normal urinary behavior or not. The age of onset ranges from 6 weeks to puberty, the duration days to months,
and the disorder often intermittent.
Cytologic examination of the discharge finds suppurative inflammation. Vaginal cultures (aerobic) generally fail to grow anything
but normal flora in small mixed numbers. Similar organisms could be cultured from an asymptomatic littermate. A urinalysis,
acquired by cystocentesis, is characteristically normal (a decreased urine specific gravity is typical for young dogs lacking
adult concentrating abilities), and urine culture, if performed, negative. The clinician needs to perform enough diagnostics
to rule out more significant causes of vulvar discharge and feel comfortable with the diagnosis of benign puppy vaginitis.
The specific etiology of puppy vaginitis is unknown. An imbalance of juvenile vaginal glandular epithelium is postulated.
The condition is reported in the literature to resolve both with puberty and with ovariohysterectomy, two very different events
endocrinologically, therefore neither likely to truly cause resolution. Puppy vaginitis diminishes with maturity. The term
"puppy vaginitis" is a misnomer, as it is asymptomatic and not indicative of inflammation. Important rule-outs (some of which
are associated with inflammation) include urinary tract infection, urinary incontinence with associated mucosal scalding,
the onset of the initial estrous cycle, vaginal foreign bodies (i.e. foxtails) and urogenital anatomic anomalies (ectopia,
disorders of sexual differentiation, significant strictures).