Dog with 11 months of vaginal bleeding caused by vaginal blood vessel

Abstract

CASE DESCRIPTION: A 6-year-old 36.5-kg (80.3-lb) spayed female Labrador Retriever was evaluated because of an 11-month history of vaginal bleeding. Previous radiographic, endoscopic, and surgical interventions had failed to detect an underlying cause for the bleeding. The dog was examined on an emergency basis because of severe anemia after the bleeding increased in severity. CLINICAL FINDINGS: Bleeding was severe, and results of vaginoscopy and radiography (after administration of a contrast agent) did not confirm the cause of the hemorrhage. An exploratory episiotomy revealed multiple bleeding vascular abnormalities within the vaginal mucosa cranial to the external urethral orifice, which were suggestive of vascular ectasia. TREATMENT AND OUTCOME: A total vaginectomy was performed via a ventral midline incision and a pubic symphysiotomy. Macroscopic and microscopic examination of excised vaginal tissues confirmed changes compatible with vascular ectasia. The dog made an uneventful recovery with no further vulval bleeding until 19 months after surgery, at which time vulval bleeding recurred. Further investigation and treatment were declined by the owner. CLINICAL RELEVANCE: Vascular ectasia may be a cause of chronic vaginal hemorrhage and life-threatening anemia in dogs. In the dog of this report, the diagnosis was made on the basis of direct observation during exploratory episiotomy and histopathologic findings. To manage the condition, total vaginectomy was performed; however, despite radical surgery, bleeding recurred.