SUBINVOLUTION OF PLACENTAL SITES IN A LEISHMANIOTIC BITCH

SUBINVOLUTION OF PLACENTAL SITES IN A LEISHMANIOTIC BITCH Quartuccio M, Marino G, Ajello A, Pugliese M, Zanghì A Department of Veterinary Sciences, Messina. Aim: To report a case of subinvolution of placental sites (SIPS) in a bitch, discussing the probable relationship with the concomitant leishmaniosis. M&M: A 12 month Jack Russel bitch was admitted for a persistent vulvar bloody discharge 9 weeks post partum. The bitch underwent complete physical examination, haematology and serum biochemistry screen, vaginal cytology and ultrasound. Results: Physical examination of the bitch revealed pale mucosae, normal lymph nodes, weakness, a mild ulcerative facial dermatitis and abundant bloody discharge from the vulva. Haematological parameters showed a mild anaemia with a marked thrombocytopenia. Vaginal cytology revealed parabasal cells, many red blood cells, few neutrophils, and some scattered trophoblastic cells. Abdominal palpation revealed multiple ovoid structures. Ultrasound examination of the caudal abdomen confirmed the presence of at least 4 solid uterine swellings (up to 1.2 cm) with a variably echoic appearance. The subinvoluted areas were interspersed with involuted segments (0.5 cm) with an evident echoic central line. A diagnosis of SIPS was done. An antibiotic coverage was given (metronidazole and spiramycin) and the bitch was re-evaluated after 3 days. The clinical picture did not change, platelet number were slightly increased. Tests for haemoparasites were started. A low dose progestin therapy was administered in addition: megestrol acetate 0.1 mg/kg os SID for a week and half dose for another week [1]. After 4 days, the vaginal discharge disappeared; after 15 days the subinvoluted placental sites were reduced to 0.8 cm. A 1:20480 IFAT titre for leishmaniosis was found and an appropriate therapeutical approach was applied. Conclusion: Post partum uterine involution requires about 14 weeks in the bitch, but bloody discharge should not exceed 6 weeks post partum. SIPS is an enigmatic and uncommon gestational trophoblastic disease; it affects young bitches after the first whelping and it is characterized by persistent bloody discharge and collagenous/necrotic masses at placental site level [2]. Rarely, SIPS is an emergency, necessitating blood transfusion and surgery. Ecbolic or progestin therapies have been proposed, but spontaneous recovery may occur [3]. Pathogenesis is unknown, but it is likely that residual trophoblastic cells invading the uterine wall are firstly responsible of the lesion. Clotting disorders have been proposed as complicating factors of SIPS. To our knowledge, this is the first reported case of SIPS in a leishmaniotic dog. Although a coincidence cannot be ruled out, authors’ hypothesis is that the parasitic disease may have played a role in the worsening of SIPS interfering with the clotting mechanism. References: 1. Voorhorst MJ, van Brederode JC, Albers-Wolthers CHJ, de Gier J, Schaefers-Okkens AC: Successful Treatment for Subinvolution of Placental Sites in the Bitch with Low Oral Doses of Progestagen. Reprod Domest Anim 48: 840-3, 2013. 2. Al-Bassam MA, Thomson RG, O'Donnell L: Involution abnormalities in the postpartum uterus of the bitch. Vet Pathol 18: 208-18, 1981. 3. Sontas HB, Stelletta C, Milani C, Mollo A, Romagnoli S: Full recovery of subinvolution of placental sites in an American Staffordshire terrier bitch. J Small Anim Pract 52: 42-5, 2011.