My Poor Arlie Has A Distended Vulva - Treatment Options

[Rickiesmom]

I have read on this forum that prolonged testosterone administration in females can change the shape of the vulva, but that following retirement things usually gradually return to normal. Unfortunately this is not the case with Arlie and she is a potential surgery candidate. I would appreciate your experiences and thoughts. Here is the story:

 

We don't have the commonly associated UTI issues, thankfully, but she does lick the area persistently, and her anus for good measure, so both are usually pretty sore looking.

 

We have been treating the "natural" route - cleaning with a baby wipe, drying, applying cornstarch as you would baby powder, and then Unda 270 ointment, which is like vaseline with herbal additions. This works well as long as you do it religiously twice a day, but things regress badly if you miss even one day.

 

We went back to the clinic on Saturday and now are using Surulan instead of the Unda product. This is a prescription product containing antibiotics and a small amount of cortisone. The idea is to see if this works better over a two week period, and if yes, then to gradually decrease the frequency of application until we establish the maintenance regimen.

 

If it doesn't work, then surgery to restore the area to normal is recommended. My vet tells me there are generally no complications beyond the usual for any procedure involving anaesthesia, unless she rips the stitches out.

 

Would those of you who have been through this please comment on whether the topical approach was sustainable for you long term, and if not, what you chose to do; if surgery, what was the outcome?

 

Many, many thanks!

 

 

[2hounds]

I have no advice at all but wanted to offer a hug for you and Arlie!

 

[Guest KennelMom]

Is she leaking urine at all? Before Haley was diagnosed with spay incontinence she licked herself obsessively, most likely to clean herself from the urine that was leaking when she slept or relaxed. That pretty much stopped once she was on meds for spay incontinence. As a side note, my Haley also still has a fairly, um, prominent vulva compared to some of our other bitches who have gone back to a more "normal" appearance after retirement.

 

Hugs to Arlie I'll be interested to read replies if anyone has had experience with this...

[Rickiesmom]

There is no urine leaking; apparently because skin is sort of folded over the vulva at the base, it is a major collection area for bacteria, causing irritation - so she licks, causes more irritation so more licking. The vet also believes it probably burns when she pees, poor baby. Not sure why she is licking her anal area as well - maybe just proximity. She has been tested a couple of times for parasites and always come up negative so that doesn't seem to be it. She'll be going on Interceptor at the start of June as well (not that it gets everything).

 

Hope others who have dealt with this or similar issues will share their experiences.

 

Edited to add: Arlie did have a bad anal gland issue awhile back, but they are fine now. In fact when she was licking a lot recently I thought it was another occurrence of the anal gland issue and this is how the new (to me, maybe not to her) issue was found.

Edited May 15, 2007 by Rickiesmom

[Batmom]

Pretty sure one of mom2zeus' pups had this surgery -- you could PM her and ask, not sure she visits this forum regularly.

[Guest MomofSweetPotatoes]

I think SuzieQ's girl had it done. I can't remember now, but I think it was her pup.

[Burpdog]

Greytlady94 had a girl with this problem and she had surgery at A&M. Worked well!

[Guest jettcricket]

I think SuzieQ's girl had it done. I can't remember now, but I think it was her pup.

Yes she did...here's the thread:

 

http://forum.greytalk.com/index.php?showto...l=vulva+surgery

 

[patricia]

My daughters Chancie Pants has this but she is being managed well with topical treatment...the doc says as long as she continues to do well she will not have to have the surgery.

[feemandvm]

I haven't seen many recessed vulvas (I assume this is what you are referring to) in Greyhounds although I've treated many in other breeds. Here is how I handle them generally:

 

1. Check a urine sample for evidence of a UTI causing the licking.

2. Check the anal glands for distension that may cause the licking.

3. If the area has a bad infection, consider a culture as I've seen several dogs develop nasty pseudomonas infections in the folds that required specific antibiotics.

4. If the area is not ulcerated, considering cleaning daily with a medicated product like a Malaseb pledgette instead of a baby wipe.

5. You may want to consdier some short term anti-histamines or possibly even a very short course of steroids to control the itching if there is an infection to get the area to heal initially.

6. Oral abx as needed if a true infection is present.

7. Consider a fatty acid supplement. I like to use these in almost any skin problem.

 

 

I can generally clear up the inflammation/infection with oral mediations and once it is no longer ulcerated I begin using the Malaseb pledgettes once or twice daily. If I can't keep the area looking good with the pledgettes then I will recommend surgery. The recovery period is the tough part of that b/c it is uncomfortable and some dogs will scoot out the sutures. Pain management is a MUST following the surgery!!!!!!!!

 

 

[Rickiesmom]

Yes she did...here's the thread:

 

http://forum.greytalk.com/index.php?showto...l=vulva+surgery

Thank you for posting this link - just read through the thread. Perhaps Maggie Mae's mom will give us a "one year later" update.

 

Based on her experience and the comments of others, I really hope we can keep this under control without surgery.

 

Arlie has not been having UTIs which is a real plus, and I'll look into the Malaseb pledgettes and other treatment options suggested by Dr. Feeman. We have a recheck on May 22 so I can discuss with my vet then. I'll also see if I can get a couple of pictures to show exactly what the issue is.

 

[Guest Winterwish]

I haven't seen many recessed vulvas (I assume this is what you are referring to) in Greyhounds although I've treated many in other breeds. Here is how I handle them generally:

 

1. Check a urine sample for evidence of a UTI causing the licking.

2. Check the anal glands for distension that may cause the licking.

3. If the area has a bad infection, consider a culture as I've seen several dogs develop nasty pseudomonas infections in the folds that required specific antibiotics.

4. If the area is not ulcerated, considering cleaning daily with a medicated product like a Malaseb pledgette instead of a baby wipe.

5. You may want to consdier some short term anti-histamines or possibly even a very short course of steroids to control the itching if there is an infection to get the area to heal initially.

6. Oral abx as needed if a true infection is present.

7. Consider a fatty acid supplement. I like to use these in almost any skin problem.

 

 

I can generally clear up the inflammation/infection with oral mediations and once it is no longer ulcerated I begin using the Malaseb pledgettes once or twice daily. If I can't keep the area looking good with the pledgettes then I will recommend surgery. The recovery period is the tough part of that b/c it is uncomfortable and some dogs will scoot out the sutures. Pain management is a MUST following the surgery!!!!!!!!

 

I don't know anything about it,but this sounds like a really good treatment plan.

 

(Just want to mention that,altho' studies conflict,cornstarch is thought by some to contribute to yeast infections. Not to say it does cause them,but wanted to mention that.)

 

Keeping your girl in my thoughts and hoping it can eventually be gotten under control without surgery.

[Fiona3]

We've had two females in the last 8 years that have had this surgery - both have been very successful. Prior to surgery both had constant UTI infections, sore vulva area, discharge and were generally uncomfortable in spite of all the treatment and daily cleaning with medicated wipes. In their case the cause was the flap that had grown over the vulva area causing infections that were treated with antibiotics (which only cleared things up briefly).

 

After surgery, there were no further infections and no irritation of any kind. I hate to put my pups thru surgery but I can honestly say they were both much happier and healthier after the procedure.

 

Good luck to Arlie and whatever treatment you choose!

[Greytlady94]

Greytlady94 had a girl with this problem and she had surgery at A&M. Worked well!

 

My Renie did have the surgery to reconstruct at A & M University small animal clinic. This was several years ago and Renie has had absolutely no problems since the surgery, once it was healed of course. Renie did wear an Elizabethan collar for three weeks, which of course she hated, but after a couple of days she did become somewhat more comfortable with the collar. Renie was on an antibiotic and pain meds following her surgery.

 

In my experience treating the area did absolutely nothing to end the problem. Renie was seen by several specialists and was treated with multiple meds with the area being cleaned and treated several times a day. It would look a bit better for a bit but never got completely "well". I would highly recommend the surgery, as long as it is done by a veterinarian who has experience in successful reconstruction. I wish I had Renie's surgery done right after I adopted her and realized there was a problem instead of spending two years with testing, multiple veterinarians and multiple treatments.