sonography normal payometra male dog bitch

1. Submitted to:
Dr.P.V.Parikh
Professor and Head
Department of Veterinary Surgery
and Radiology, AAU.
VSR-606

2.  List common indications for reproductive
sonography
 Describe technique for female and male reproductive
sonography
 Recognize and describe normal female and male
reproductive organs
 Recognize and describe pregnancy
 Recognize and describe hyperplasia, infection and neoplasia
of the female and male reproductive tract

3.  Indications for examination of the male reproductive tract
 andrologic evaluation of breeding dogs,
 identification of retained testicles,
 difficulties or abnormalities in urination or defecation,
 abdominal, scrotal, and penile pain or discomfort,
 caudal abdominal mass lesions; perineal hernia,
 clinical signs compatible with hormonal imbalances
(hyperestrogenism),
 scrotal or penile trauma,abnormalities noted on rectal
 examination and palpable scrotal abnormalities.

4. Prostate
 Normal Prostate
 Normally a small, oval, symmetrical,
 bilobed structure
 Echogenicity is variable
 Intact male prostate is iso- to hyperechoic compared to
surrounding fat
 Neutered male prostate is hypoechoic to surrounding fat
 Prostatic urethra may or may not be visible

11. Abnormal Prostate:-
 Primary disorders affecting the prostate gland are benign
hyperplasia with variable degrees of cyst formation, infection,
abscessation, and neoplasia
 Sonographic appearance of prostatic disease is variable and
extremely non-specific
 mineralization commonly associated with neoplasia
 Invasion into urethra/bladder more likely neoplastic
 Nearly any change in neutered male should be considered
cancer until proven otherwise

12.  Benign Hyperplasia:-
 Enlarged prostate gland
 symmetric or asymmetric
 smooth or nodular
 Generally hyperechoic
 May see cysts
 Changes should be less severe than other prostatic diseases

13.  Normal Testicles:-
 Very homogenous, granular pattern
 Thin capsule
 Mediastinum testis – central, linear
 Echogenic structure
 Use to identify cryptorchid testicle
 Epididymis has a less echoic, slightly
 “lacy” appearance

16.  Testicular Neoplasia
 Variable appearance, not specific for tumor type
 Parenchymal disruption
 Hypo- or hyperechoic nodules
 Large lesions complex, cystic
 Focal and multifocal lesions occur

17.  Cryptorchid Testicle
 Located anywhere from caudal to kidney to the
 scrotum
 Generally atrophied and difficult to find - look for
mediastinum testis

18. Female Reproductive Tract
Indications:
 pregnancy diagnosis and fetal viability
 pyometra
 ovarian or uterine tumor
 Infertility
 Technique – female
 Dorsal recumbency
 As usual, use highest frequency
 transducer possible - >7.5 MHz
 5.0 MHz adequate for most disease states.

19.  Remember anatomy
Ovaries located caudal and ventral to
kidneys,lateral to great vessels
 Uterine body located dorsal to bladder, ventral
to colon
 Uterine horns located “somewhere” in between
Vagina and cervix located in pelvic canal

20. Normal Uterus:-
 3 layers visible - mucosa, muscularis, serosa
 solid, homogenous structure
 layers often not seen but may see 5 layers in
crosssection
 Differentiate from the layers of GI visible in
crosssection
 Nongravid uterine body can be imaged
 Uterine stump sometimes visible in spayed
 bitches

22.  Pregnancy
 May detect as early as10-11 days
 negative scan should be repeated
 Ideally scan > 28 days
 Cardiac activity present
 Day of gestation Finding
Pregnancy
 Ultrasound excellent for assessing presence and viability
 Heart rate, fetal movements
 Fetal stress results in decreased heart rateand decreased fetal
movements
 Do not guarantee a fetal number based on ultrasound
 Radiography at late term gestation much better at assessing
total number

23. Day of gestation Finding
10-20 Anechoic gestational sac
23-25 Oblong embryo
28 Cardiac activity
35 Limb buds
33-39 Fetal skeleton
35-39 Urinary bladder
39-47 Kidneys and eyes

27. Pyometra
Variable appearance
 Usually symmetrically enlarged, but may be focal
or segmental
 Luminal contents usually homogenous and
 Echogenic, but may be anechoic
 Uterine wall variable
 Smooth and thin, thick and irregular, cystic

30.  Stump Pyometra:-
 Usually a granulomatoid, mass-like lesion rather
than an “abscess”
 Must differentiate from uterine stump tumor

32.  Uterine Neoplasia
 Rare
 Variable appearance
 Usually intraluminal
 Often benign
 May cause fluid buildup in uterus

34. Normal Ovary
 Small and oval to bean shaped
 Moderate variation from dog to dog
 and even from side to side
 1.5 x 0.7 x 0.5 cm (25lb dog)
Don’t worry if larger unless
 Very larger
 Abnormal texture
 There are clinical signs
 Cortex and medulla - follicles in cortex

35. Normal Ovary
 Anestrus/proestrus: homogeneous, may be hard to find
 Proestrus: follicular cysts become visible
 Ovulation: cyst may decrease in size and number
 Diestrus: may see corpora lutea or hemorrhagica (can
look like follicles!)

38. Cystic Ovarian Disease
 True cystic lesion
 generally >2.5cm
 may be solitary or multiple
 Often other changes in repro tract that may be more
clinically significant

39. Ovarian Neoplasia
 Uncommon
 May involve BILATERAL horns
 May be primary, metastatic, benign,malignant – biopsy
necessary
 Often complex features but may be hyperechoic or
hypoechoic
 Often diagnosis of exclusion
 Mass lesion in region of ovary