Hypoplastic (Recessed) Vulva in Dogs

Summary

Hypoplastic vulva (aka “recessed” or “juvenile” vulva) is common condition of canine conformation in which the vulva is at least partially engulfed by the skin folds that surround it. Spayed female dogs are predisposed. There is also some evidence to suggest that the earlier dogs are spayed, the more likely they are to suffer this condition.

The fact of a recessed vulva, in and of itself, would not be a serious issue. However, local skin infections are extremely common among these patients. Vaginitis, urinary tract infections, and even urinary incontinence are also commonly reported in these cases.

Here’s how it happens:

The extra skin folds in these patients act like a dam, thereby collecting urine. Moisture, heat, the absence of light and the accumulation of skin debris in such close quarters all serve to fashion an ideal environment within the skin folds for bacteria to thrive. Infection of the vagina and urinary tract occur when these bacteria travel upwards and into these regions.

Further, the rubbing of these excessive skin folds during the course of daily life causes small amounts of localized trauma. This yields additional itchiness, which leads to self-trauma (licking and scooting) and, therefore, more trauma and infection.

Young to middle-aged, medium to giant breed dogs are predisposed. The increased fleshiness inherent to fatter dogs means that overweight and obese dogs are further predisposed.

Symptoms and Identification

Obvious evidence of a hypoplastic vulva would include a vulva that is not immediately visible upon direct observation of the dog’s backside. When examined more closely, accumulated debris within the adjacent skin folds

Symptoms include excessive licking of the vulvar area, scooting, malodor, hematuria and sometimes even urinary incontinence (which may be related to and not the result of the recessed vulva).

Affected Breeds

While all breeds of dogs are theoretically susceptible, medium to giant breeds dogs have been shown to be more at risk. Those among these who are predisposed to obesity would seem to be especially predisposed. So, too, are dog breeds with a predilection for allergic skin disease and other inflammatory skin diseases, as these dogs are especially at risk of suffering severe skin infections.

Treatment

Treating the skin infection along with any resulting urinary tract or vaginal infections is of immediate concern, of course. Oral antibiotics and topical treatments (frequent use of shampoos and wipes) the standard approach. Unfortunately, however, this treatment plan is unlikely to produce permanent results in the face of the continual challenge posed by these dogs’ abnormally shaped vulva.

Episioplasty (aka “vulvoplasty”) is a surgical procedure designed to correct the defect. This relatively simple procedure, in which skin from between the anus and vulva is resected, is considered the treatment of choice for dogs with these excessive perivulvar skin folds. The previously recessed vulva is thereby exposed.

If the dog is considered only mildly affected, however, an assiduous maintenance regimen consisting of routine wiping with medicated wipes and cleansing with medicated shampoos may be considered an acceptable approach to treatment as long as infections are effectively kept at bay.

Veterinary Cost

The cost of this condition depends, primarily, on the severity of the condition. If chronic infections ensue and frequent courses of antibiotics are required, ongoing expenses to the tune of hundreds of dollars a month may be required.

Alternatively, a one-time epesioplasty undertaken by a board-certified surgeon often proves 100% effective in curing the condition. Unfortunately, too many pet owners are stung by its price tag ($1,500 to $3,000) and delay in electing this procedure. Many end up spending significantly more than this sum in lifetime treatments, all the while incurring what some veterinarians term “reduced quality of life” costs.

Prevention

Judicious breeding programs that select for bitches with more advantageous vulva conformation are the obvious means of prevention. However, it’s equally clear that if female dogs maintain a normal weight they’ll be less likely to suffer the more severe manifestations of this conformational disease.

References

Hammel AP, Bjorling DE. “Results of Vulvoplasty for Treatment of Recessed Vulva in Dogs.” JAAHA 2002, Vol. 38, N.1, p. 79-83.

Lightner BA et al. “Episioplasty for the treatment of perivulvar dermatitis or recurrent urinary tract infections in dogs with excessive perivulvar skin folds: 31 cases (1983-2000).” JAVMA 2001, Vol. 219, N. 11, p. 1577-1581.

Seguin MA, Vaden SL, Altier C, et al. Persistent urinary tract infections and reinfections in 100 dogs (1989–1999). J Vet InternMed. 2003;17:622–631