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Vulvitis and Vaginitis in Large Animals

By

Fabio Lima

, DVM, MS, PhD, DACT, University of California, Davis

Last full review/revision Apr 2021 | Content last modified May 2021

Contusion and hematoma of the vagina occur after parturition in all species but especially in mares and sows. Occasionally, vaginal hematomas in sows may rupture and cause serious hemorrhage that can be controlled by ligation of the labial branch of the internal pudendal artery. Necrotic vaginitis, vestibulitis, and vulvitis may follow dystocia in all species. Onset of clinical signs, including an arched back, elevated tail, anorexia, straining and dysuria, vulvar and perivulvar swelling, and sometimes a foul-smelling serous vaginal discharge, occurs within 1–4 days of parturition and may persist for 2–4 weeks. In most cases, only medical treatment is needed. Frequently, antimicrobial prophylaxis is indicated, because clostridial or other organisms may proliferate in the affected tissues, resulting in tetanus, blackleg, or other forms of clostridial myositis. Potential sequelae of necrotic vaginitis include perivaginal abscessation, transvaginal adhesions and permanent vaginal strictures.

Vestibular lymphocytic follicles, also referred to as granular venereal disease, granular vulvitis, or granular vulvovaginitis, are seen in cows and are characterized by hyperemia and hyperplasia of the lymphoid nodules of the vestibular mucosa. These lesions do not constitute a specific disease; rather, these indicate irritation of the vestibular mucosa. They can be reproduced experimentally by means of topical application of Ureaplasma ureolyticum or Mycoplasma spp in goats and cattle.

Infectious pustular vulvovaginitis of cows is caused by bovine herpesvirus 1 and is transmitted via natural breeding, nasogenital contact, or by insect vectors such as flies. Affected cows show signs of vaginal discomfort (e.g., raised tail, frequent urination) and have numerous, round, white, raised lesions of the vestibular mucosa. Within a short time, these lesions progress to pustules and erosions or ulcers. Mucopurulent vaginal discharge may be prominent, even in pregnant animals in which pregnancy is uninterrupted. Histologic lesions consist of necrosis of vestibular and vaginal epithelium, with intranuclear inclusion bodies typical of herpesvirus infection. When the virus is transmitted in the semen, infected bulls may have similar lesions of the penis and prepuce. Intrauterine inoculation of the virus produces necrotizing endometritis and cervicitis.

A disease characterized by vaginitis in cows and epididymitis in bulls occurs sporadically in eastern and southern Africa, where it is referred to as epivag. It is transmitted via natural breeding. In the early stages of infection, cows have severe vaginitis characterized by inflamed, reddish mucosa without ulcers, erosions, or vesicular lesions. A thick, creamy, white to yellow vaginal discharge develops. The infection may spread to the uterus and uterine tubes, and salpingitis and fimbrial adhesions frequently result in permanent infertility. Although epivag has been transmitted experimentally by transfer of exudate from affected animals, the cause is unknown.

Necrotic vulvitis manifesting as a severe granulomatous and necrotic lesion centered on the ventral commissure of the vulva of cows, sometimes occurs as a disease outbreak. It is associated with several pathogens, in particular, Porphyromonas levii.

Catarrhal bovine vaginitis has been reported in many countries. Although enteroviruses have been associated with this condition, the cause remains unknown. In areas of the world where bovine tuberculosis remains endemic, affected cows may have primary vaginal lesions resulting from service by infected bulls with genital lesions; however, uterine disease and cervicitis can also occur.

Vulvitis may also result from the interaction of a high-protein diet and infection with urease-producing organisms, such asCorynebacterium renale. Demodex mites have been seen on the vulvar skin of sheep; they usually are not associated with clinical signs but may produce granulomas.

Equine coital exanthema is caused by equine herpesvirus 3. It is an acute disease that occurs after breeding with an infected stallion, or via artificial insemination. Although mares rarely show systemic signs, red papules appear in the vaginal and vestibular mucosae 2–10 days after infection. Lesions may extend to the perivulvar skin. The lesions progress rapidly to pustules, then ulcerate, and finally heal, leaving depigmented scars. Stallions show similar lesions on the penis and prepuce. The disease causes discomfort and may prevent breeding but does not specifically impair fertility.

Dourine (covering sickness) is a chronic venereal disease of horses and other equids caused by the parasite Trypanosoma equiperdum. Early clinical signs include edematous swelling of the vulva with secondary vulvovaginitis.

Coital injuries in cattle and horses may occur when large adult bulls/stallions breed with heifers/fillies or relatively small cows/mares. Injuries of the vulva and vagina may also be caused by horned cattle. Vaginal injuries in a variety of species have also been inflicted maliciously.

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