Vaginal Malformations and Acquired Lesions in Cats

An altered or abnormal anatomic vaginal architecture, or vaginal malformation, can be due to congenital anomalies such as an imperforate hymen (where the hymen is solid, not allowing fluids through the vaginal canal from the uterus, or normal penetration [such as for breeding]; generally a congenital anomaly); dorsoventral septum (or septae, where the vagina has a vertical dividing membranous wall/partition); hymenal tightening; cysts (a sac with liquid inside); or to acquired conditions such as vaginal overgrowth, foreign bodies, strictures (tightenings), adhesions (abnormal fibrous tissue sticking to the structures), and cancer.

Symptoms and Types

• Vulvar discharge
• Excessive licking of the vulva
• Frequent or inappropriate urination
• Straining to urinate or defecate
• Wetting in the house, in the bed, etc.
• Attractive to males
• Refuses mating
• Mass at lips of the vulva
• Skin disorder around the vulva
• Abnormally small vulva

Causes

• Congenital
• Inflammatory
• Hormonal
• Traumatic
• Cancerous

Diagnosis

Your veterinarian will perform a thorough physical exam on your cat, taking into account the background history of symptoms and possible incidents that might have led to this condition. A complete blood profile will be conducted, including a chemical blood profile, a complete blood count, a urinalysis and an electrolyte panel to rule out other diseases. The urinalysis may show evidence of a secondary urinary tract infection. After the initial examination, your veterinarian will perform a gynecological examination as well.

The order in which the procedures are performed is important. They are listed here in the recommended order:

• Vaginal culture to identify secondary infections
• Vaginal cytology (cell examination) to identify stage of the estrous cycle; reveal inflammatory or cancerous cells
• Digital examination (with a finger) of the vaginal canal
• Vaginoscopy: an examination of the internal structure of the vagina using a small camera
• Vaginography: X-rays performed after special dyes have been placed in the vaginal canal, so that the shape and structure of the vagina can be better viewed as the dye fills the vaginal space
• Ultrasonography will be done when the results of the previous procedures suggest an anatomic abnormality

Positive-contrast Vaginography

• Defines the structural boundaries of the vagina
• Defines the structural boundaries of the cervix
• Identifies strictures (narrowings), septae (partitions), persistent hymens, masses, rectum to vagina or urethra to vagina fistulas (abnormal connecting passageways between two normally separate canals), vaginal rupture, and diverticula (outpouching of hollow or fluid filled sac like structure)
• Urinary incontinence may require excretory urography (X-rays of urination with dyes) to rule out ectopic (abnormally positioned) ureters (the tubes running from the kidneys down to the bladder), or a bladder  with its neck positioned in the pelvis

Abdominal ultrasonography

• Cranial vaginal masses may occasionally be imaged
• Fluid buildup in the vagina (hydrocolpos) or uterus (hydrometra) may be seen in cases of imperforate hymen, due to solid structure of hymen blocking the flow of fluids from the uterus