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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog
Satisfied Customers: 28932
Experience:  University of California at Davis graduate veterinarian with 45 years of experience.
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11 week old German Shepherd is bleeding from vulva. Shes

Customer Question

11 week old German Shepherd bitch is bleeding from vulva. Shes had blood tests etc and theres no signs of problems. Urine sample came back fine. Shes on antibiotics, seemed to clear up for a day but shes started bleeding heavily (with blood clots) again tonight. Theres no major change in herself. Only signs of distress when she trys to clear herself up.
Submitted: 3 years ago.
Category: Dog
Expert:  Dr. Michael Salkin replied 3 years ago.
Aloha! You're speaking to Dr. Michael Salkin
I'm sorry to hear of this with Ellie. When testing has ruled out a systemic cause for such bleeding we need to consider congenital (present at birth) anomalies that have predisposed to a severe bacterial vaginitis - a vaginitis not typical of the common puppy vaginitis in which a blood-tinged discharge can be seen but the finding of such heavy bleeding is unexpected. We're looking for a double vagina, hypoplasia of the vaginal vault, vaginal stenosis or stricture. Ellie needs to be heavily sedated or anesthetized and vaginoscopy peformed with a flexible or rigid endoscope. An otoscope might suffice in such a small pup but may miss the most cranial aspect of her vaginal vault. Scoping should identify the source of her bleeding. Ellie might need referral to a specialist vetirinary internist who is more likely than Ellie's vet to have the appropriate equipment for scoping and biopsy if necessary.

Ellie's temporary response to antibiotics is consistent with the presence of infection but her recrudescence (relapse without cure in between events) of bleeding suggests an underlying cause of that infection such as those disorders I mentioned above. Canine herpesvirus will infect the genital tract but I would expect a quite systemically ill pup if that virus were present.

Please respond with further questions or concerns if you wish.
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Customer: replied 3 years ago.

Thankyou for your response. From what you have mentioned above, can these conditions be fix permanently? or will there be underlying problems in the future. I don't know if this helps, but she produces clots, when they are wiped away she bleeds then it subsides and remains clear for a few hours, then happens again, (oddly, happens more during the evening that during the day).


 


I shall arrange an appointment with my vets tomorrow.


 


in your professional opinion, does her symptoms sound serious? I think im may be more worried that Ellie herself haha


 


Thankyou for your responses.


 


 

Expert:  Dr. Michael Salkin replied 3 years ago.

You're quite welcome. To answer your questions directly...

1) Some anomalies are surgically reparable. For example, persistent vaginal membranes can be excised; a stenotic vagina, however, is unlikely to be able to be enlarged. Scoping is essential to clarify if an anomaly is present.

2) Her episodic bleeding indicates a coagulopathy such as hemophilia but it sounds as if that has been ruled out. I would consider persistent infection, then, to be the next most likely cause of her bleeding. Can you confirm that she's been tested for hemophilia with a complete coagulation diagnostic panel?

3) I'm afraid that I would be putting the cart before the horse by prognosticating at this time. Bleeding as you've described is not a common symptom of the most common vaginal problem seen in such a young pup - puppy vaginitis. I'm looking for a coagulopathy or congenital anomaly such as a vascular defect or one of the structural anomalies mentioned above which has predisposed to a very severe puppy vaginitis.

I very much want to follow up with you about Ellie's unusual presentation. I'm going to check back with you in a few days for an update. Feel free to return to our conversation - even after rating - prior to my contacting you if you wish.

Customer: replied 3 years ago.

Looking at Ellies notes the tests that have been included are:


 


PCV- Packed cell volume = 34%


TS- Total Solids. Plasma Solid = 52 g/l


Blood Glucose Level = 9.2 mmol/l


Blood Urea Nitrogen, Urinalysis. <12 mmol/l


 


MDB unremarkable and coags normal. looked at blood smear too and RBC morphology normal and platelets clumping at feathered edge so no signs of Thromocytopeania.


 


I dont know if any of this information aids you. The next step was to go to imaging of the abdomen to check uterus/ ovaries. This was if the symptoms had persisted, but they had seemed to have cleared up until now. (which is too late in the night to go Vets in the UK).


 


Thankyou for your advice, its helped greatly. (i shall sleep more at ease). I appreciate you checking back in a few days.


 


Thanks,


Rachel


 

Expert:  Dr. Michael Salkin replied 3 years ago.

Thank you. Nothing exciting on the test results but please confirm that "coags normal" also means that hemophilia was tested for and not just a PT and PTT run. A mild to moderate form of hemophilia A has been propagated widely in German shepherds.

I can't imagine anything to do with her uterus and ovaries at such a young age.

I'll speak to you soon. Thank you for your kind accept. I appreciate it.

Expert:  Dr. Michael Salkin replied 3 years ago.
May I have an update on Ellie, please?
Customer: replied 3 years ago.

Hi, we took her back to our vets the following morning. He is convinced that it's an aggressive case of juvenile Vaginitis and prescribed her some more antibiotics and some anti inflammatorys. He said it's odd as she's behaving in her normal manor. She's still bleeding on and off, however he said by tues/ Wednesday if it hasn't cleared up he will start looking down the route of sedating her and looking internally. The vet said he wants to make sure the antibiotics aren't working before he went down the more serious routes as she's only a pup.


 


So far, we are still non the wiser. Thank you for asking, we should know more later on in the week hopefully.

Expert:  Dr. Michael Salkin replied 3 years ago.
Thank you for the update, Rachel. Please keep me posted.