20070406About Toa Payoh Vets Singapore Toa Payoh Veterinary Surgery, animal doctor, horse, dog, cat, rabbit, hamster, clinic info

Hyperestrogenism in the old female dog. What is the solution? Spaying. But this is now a high-anaesthetic risk case as the dog is over 8 years old. So, the owner is in a dilemma. To wait or not?
	No endocrine alopecia. Excellent skin and coat due to a high supply of the female hormone, estrogen
		Blood-tinged vaginal discharge can be seen if you check carefully
The complaint is increasing bouts of dark-coloured diarrhoea from once a month to more frequent once a week
HYPERESTROGENISM "My dog has diarrhoea once a month for the past 4 months," the man in his 30s said. "Now, she has diarrhoea more than once in 2 weeks." There was no change in her diet. This dog looked so much younger than her 13 years. Her heart sounds were normal and she had no loss of appetite. What was the cause of her increasing frequency of diarrhoea? Was this a simple case of gastro-enteritis? Hyperestrogenism A general examination from head to toe and up to below is best for any case. "The vulva is abnormally large, around 10X the normal size," I turned the dog upside down so that the man could see what I meant. "There is a slight pinkish mucoid vaginal discharge. She may be having pyometra (infection of the womb and/or urinary tract infection. Due to her continual licking of the vaginal discharge over several days, her stomach and intestines could be infected. She then suffers from diarrhoea from once a month to more frequently when the discharge persists." "Your dog is likely to have ovarian cysts or tumours. Excessive estrogen, a female hormone is produced making the vulva grow so big. And also the womb tissues could be degenerated and become cystic, leading to womb infection called pyometra." The man in his late 30s seemed convinced. "What to do now?" The solution is simple. A spay. But this dog is old. Although she is healthy on the surface, she may die on the operating table during anaesthesia and surgery. This is the type of situation I dread. If she had been spayed when she was young, this problem would not exist. But now she needed to be spayed or her health would deteriorate with time. "There is a possibility of her dying on the operating table," I forewarned the owner. "Talk to your wife. The chances are 50:50 for your dog, based on her general good health externally. If she survives, she may live to 20 years old. If not, she will be gone on the day of the operation." Blood tests and X-rays would be useful but they would cost more. They would not alter the downhill progress of the adverse effects of the Hyperestrogenism. I sent the home with antibiotics. Spay your female dog when she is young or seek veterinary advice when she has abnormal enlargement of her private parts. This case appeared to be a simple case of gastro-enteritis but if you review the history and check the signs and symptoms carefully, it is more likely that the primary cause is Hyperestrogenism. So, giving antibiotics would resolve the problem for some time. Buying time for the old companion. More Singapore small breed pet dogs are living past 10 years of age. The owners must be proactive and they really have to spend time checking them for any abnormal tumours and discharges. Spaying is one way but not every owner wants their female dogs spayed. A health check annually or more would have been best, if you want your old friend to live longer. TIPS FOR VET STUDENTS Hyperestrogenism in female dogs High serum estrogens (estradiol, estriol and estrone). Exogeneous Hyperestrogenism: All ages associated with estrogen administration. Endogenous Hyperestrogenism: 1. Ovarian follicular cysts -Young female dogs 2. Ovarian tumours mainly. Adrenal tumours? - Old female dogs. Signs include non-pruritic bilateral endocrine alopecia, vulval enlargement, haematuria with thrombocytopenia, nymphomania, being attractive to male dogs and pyometra. 3. Blood test for high serum estrogen levels. This may not be welcome by the owner due to economic reasons. In the above case, the "diarrhoea" is likely to be the dog licking and ingesting the infected vaginal discharge from the womb. Spaying would be the solution but the dog may die on the operating table as she is aged. So, the owner has no solution actually. If only this dog was spayed when she was young. But who can predict the future?