Case Outcome on Betty: The pit bull with a vaginal mass

 This is the case outcome on Betty, a 2 year old in tact pit bull that presented with an acute onset of a vaginal mass. 

The appearance and palpation of the mass was characteristic of a vaginal prolapse. Betty was likely in estrus at the time of presentation. She was not having difficulty urinating. Some areas of mucosal necrosis were evident on the prolapsed tissue. (Fig. 1) 

Fig. 1: Vaginal prolapse in the 2 year old pit bull

We advised the owner to have Betty spayed as soon as possible. In the meantime, we recommended that they keep the tissue clean and lubricated, and place an Elizabethan collar on her to prevent self trauma of the area. 

Within a few days of having her spayed, Betty's prolapse was significantly improved. (Fig. 2)

Fig. 2: Appearance of the vaginal prolapse on Betty a few days after
ovariohysterectomy

The superficial necrosis had sloughed and completely healed, and Betty was doing well otherwise. Approximately 2 weeks later, the vaginal prolapse had completely resolved. (Fig. 3)

Fig. 3: Complete resolution of vaginal prolapse on Betty after
ovariohysterectomy

This case exemplifies the rapid resolution of vaginal prolapse after ovariohysterectomy without the need for resection of the vaginal tissue. A key element of this case is that there were only very focal areas of mucosal necrosis, not severe full thickness vaginal necrosis that would require removal. Resection of vaginal tissue with either hyperplasia or prolapse is rare in my experience. 

Etiology

Vaginal prolapse usually occurs during estrus due to estrogen stimulation of the tissues. Other causes are exogenous estrogens or prolapse during parturition. 

Diagnosis

Vaginal prolapse is suspected when a doughnut shaped mass has protruded from the vagina in an in tact female dog. It can appear similar to vaginal hyperplasia (edema); both usually occur during estrus. Vaginal neoplasia is a differential diagnosis.

Treatment

Keep the prolapsed tissue clean and well lubricated. On initial presentation, hyperosmotic solutions of dextrose or granulated sugar can be used to reduce swelling and possibly permit reduction of the tissue back into the vagina. If necessary, temporary sutures across the labia can be placed to cover the tissue and keep it moist until the swelling reduces. Recommend ovariohysterectomy to allow prompt reduction of tissue swelling and resolution of the prolapse. In breeding animals, warn owners that recurrence of the prolapse is possible in subsequent estrus cycles.