Patologias reprodutivas diagnosticadas durante ovariosalpingoesterectomia (osh) em gatas e cadelas

Ovariohysterectomy in cats and dogs frequently uncovers unexpected pathologies. This study examines the prevalence of pyometra, neoplasia, and other conditions.

Reproductive Pathologies Diagnosed During Ovariohysterectomy in Cats and Dogs =============================================================================

Submit all excised uterine and ovarian tissues for histopathological examination following elective neutering. A simple visual inspection of the organs is insufficient, as a high percentage of tissues that appear normal to the naked eye will reveal microscopic anomalies. These frequently include conditions such as cystic endometrial hyperplasia or early-stage neoplasms which are impossible to identify without laboratory analysis, making routine submission a standard of care, not an exception.

In female canines, the most common incidental discovery is cystic endometrial hyperplasia, a direct precursor to pyometra, often found in asymptomatic animals undergoing the procedure. Ovarian cysts and benign tumors like leiomyomas are also frequently noted. In contrast, female felines more commonly present with uterine adenomyosis or fibromas upon tissue examination. These species-specific variations in genital system disorders underscore the necessity of a thorough assessment of all removed organs.

The systematic analysis of these tissues provides firm data that reinforces the health benefits of the spaying procedure far beyond population management. Identifying these silent abnormalities confirms the preventative value of the surgery, which averts future medical emergencies like uterine rupture or malignancy. This information refines clinical knowledge and strengthens the argument for early sterilization as a primary component of preventative medicine for companion animals.

Reproductive Pathologies Diagnosed During Ovariohysterectomy (OHE) in Queens and Bitches

Submit all excised genital tracts for histopathological examination, irrespective of their gross appearance. Macroscopic inspection alone is insufficient for identifying microscopic lesions, such as early neoplastic changes or cystic endometrial hyperplasia (CEH). This practice provides a definitive record of any pre-existing conditions.

Uterine abnormalities are frequently encountered. Pyometra, a bacterial infection most commonly caused by Escherichia coli, manifests as a uterus distended with purulent material. The closed-cervix form leads to systemic illness and toxemia, with a high potential for uterine rupture and septic peritonitis. The open-cervix form is characterized by vulvar discharge. CEH is a hormonally-driven condition, often preceding pyometra, that involves the formation of fluid-filled cysts in the endometrium. Hydrometra and mucometra are aseptic accumulations of serous or mucoid fluid, respectively, typically resulting from a congenital or acquired outflow obstruction.

Uterine neoplasia is less common. In female canines, leiomyomas are the most prevalent benign tumors of the uterine smooth muscle. In female felines, uterine adenocarcinoma is the primary malignant tumor, observed more often in animals over 10 years of age. Uterine torsion, a rare and acute condition, involves the twisting of a uterine horn, leading to vascular compromise and tissue necrosis.

Ovarian conditions are also identified upon surgical sterilization. Ovarian cysts are common findings. Follicular cysts, which are thin-walled and estrogen-producing, can cause persistent signs of estrus. Luteal cysts are thicker-walled, progesterone-producing structures that may contribute to CEH development or anestrus. Paraovarian cysts, remnants of the paramesonephric ducts, are typically found incidental to the ovary and lack clinical significance unless they are large enough to cause compression.

Ovarian tumors represent approximately 1% of all neoplasms in bitches. Granulosa cell tumors are the most common functional ovarian neoplasms; they can secrete estrogen or inhibin, leading to signs like bone marrow suppression, alopecia, or persistent estrus. Other ovarian neoplasms found at the time of gonadectomy include germ cell tumors, such as dysgerminomas and teratomas, and epithelial tumors like adenocarcinomas.

Macroscopic Identification of Uterine and Ovarian Abnormalities on the Surgical Table

Direct inspection and palpation of the removed uterus and gonads on the surgical tray provides immediate information on tissue alterations. Assess for symmetry, size, color, and texture before fixation. A healthy uterus in an anestrous animal is small, flaccid, and pale pink with a smooth serosal surface.

Uterine Anomalies: A uniformly enlarged, turgid, and discolored uterus–ranging from dark red to brownish-purple–is indicative of pyometra. Palpation reveals a doughy or firm consistency. In cases of hydrometra or mucometra, the uterine horns are symmetrically distended with thin, sometimes translucent walls, containing clear serous or viscous mucoid fluid. Cystic Endometrial Hyperplasia (CEH) presents as a thickened uterine wall with an irregular, cobblestone-like surface; small (1-2 mm) fluid-filled cysts may be visible through the serosa. Uterine neoplasia, such as an adenocarcinoma or leiomyoma, typically appears as a focal, firm, and often asymmetrical mass distorting the uterine horn or body. A leiomyoma is usually a well-demarcated, white-tan, solid nodule.

Ovarian Alterations: Healthy ovaries are small, firm, and possess a slightly irregular surface corresponding to follicular structures. The presence of smooth, thin-walled, fluid-filled sacs suggests ovarian cysts. It is useful to differentiate true ovarian cysts, which arise from and distort the gonad's architecture, from paraovarian cysts, which are adjacent to but separate from the ovarian tissue and originate from embryological remnants. Ovarian tumors cause significant enlargement and an irregular, nodular contour. Granulosa cell tumors, for example, can be solid, multicystic, or hemorrhagic. Teratomas may contain grossly visible hair or bone fragments upon incision. In https://wazambagreece.com , luteinized cystic structures give the ovary a “bunch of grapes” appearance, often associated with prolonged progestin exposure.

Intraoperative Decision-Making and Specimen Handling for Histopathological Confirmation

Submit any surgically removed genital tract tissue exhibiting gross abnormalities for histopathological analysis. A decision to submit is based on specific visual and palpable deviations from normal anatomy observed at the time of the procedure.

Proper specimen preparation is non-negotiable for an accurate microscopic evaluation. Follow a strict protocol for tissue handling and fixation.

  1. Specimen Selection and Sectioning:
    • Select a representative section of the lesion, approximately 1.0 cm thick.
    • Include a margin of adjacent, normal-appearing tissue in the same sample for comparison.
    • For large masses, submit multiple sections from different areas, including the center and periphery.
    • For fluid-filled organs, collect a full-thickness section of the wall after contents have been drained. Do not submit only the fluid.
  2. Fixation Protocol:
    • Immediately place tissue sections into a leak-proof container with 10% neutral buffered formalin.
    • The volume of formalin must be a minimum of 10 times the volume of the tissue specimen (10:1 ratio).
    • Ensure the specimen is fully submerged. Large or dense tissues may need to be incised to allow fixative penetration.
    • Avoid using narrow-mouthed containers that require squeezing or distorting the tissue for insertion or removal.
  3. Container Labeling and Documentation:
    • Label the container, not the lid, with permanent ink.
    • Include the patient's name or ID, species, date, and specific tissue identity (e.g., “right ovary,” “uterine body mass”).
    • The accompanying submission form must contain a concise surgical report with a description of the gross findings, including the lesion's size, location, and consistency.

Clinical Significance and Postoperative Management Following Incidental Pathological Findings

Submit all abnormal-appearing uterine and ovarian tissues for histopathological examination. This action provides a definitive diagnosis, informs the prognosis, and dictates the necessity for any additional long-term monitoring or treatment. Without a tissue report, any assessment of future risk remains speculative.

For individuals with cystic endometrial hyperplasia (CEH) or pyometra, the complete removal of the uterus and ovaries is curative. Postoperative care should include a course of broad-spectrum antibiotics, ideally guided by culture and sensitivity of uterine contents if purulent material was present. Monitor the patient for 24-48 hours for signs of systemic inflammatory response, such as persistent fever, tachycardia, or lethargy, which could indicate pre-existing endotoxemia.

The discovery of ovarian cysts, such as follicular or luteal types, explains clinical signs like persistent estrus or abnormal cycle lengths. Surgical removal resolves the source of excess hormone production. The owner should be advised that hormone-related behaviors and physical changes will cease. If a granulosa cell tumor is suspected due to the cyst's appearance or size, careful intra-abdominal exploration for metastasis is warranted before closure.

When uterine or ovarian neoplasia is identified, prognosis depends entirely on the tumor type, grade, and stage. Benign tumors like leiomyomas require no further action beyond the surgical excision. Malignant neoplasms, such as leiomyosarcoma or adenocarcinoma, necessitate oncologic staging. This includes submission of the primary mass and any regional lymph nodes for analysis. Postoperative follow-up for malignant tumors involves thoracic radiographs and abdominal ultrasound at 3, 6, and 12 months to screen for metastatic disease. A referral to a veterinary oncologist for discussion of adjuvant chemotherapy is the standard of care for high-grade or metastatic cancers.

In cases of uterine torsion, postoperative management focuses on intensive monitoring for reperfusion injury and disseminated intravascular coagulation (DIC). This involves serial evaluation of coagulation profiles (PT, aPTT), platelet counts, and blood pressure. Fluid therapy and supportive care are paramount to manage shock and metabolic derangements.

Anatomical variations like uterus unicornis are incidental and carry no negative health implications following the complete removal of the existing horn and both ovaries. Inform the owner of the congenital finding, but no special postoperative management is required beyond routine recovery.