Preventive Screening of Ovarian and Uterine Abnormalities in Bitches: Role of Sonography in the Evaluation of 228 Cases
Introduction
The ultrasonographic appearance of ovarian and uterine abnormalities is well described in literature. Although the correlation between age and reproductive tract alterations has already been documented,1,2 the most suitable age for a preventive sonographic screening in bitches has not been suggested yet.
Objectives
To estimate the eligible age for an ultrasonographic screening of uterine and ovarian abnormalities in dogs.
Methods
Data concerning sonographic reports of intact females, evaluated by the authors in 2016 regardless of the reason of clinical exams, were retrospectively analyzed. Ovaries and uterus were considered abnormal when different from the normal sonographic appearance described in literature.3 The age of each bitch was expressed as the age ratio (actual/maximum age expected for the respective breed4,5). The cut-off age ratio was determined by ROC curves. Statistical analysis included Chi-Square, OR, Se, Sp. PLR, NLR, PPV and NPV.
Results
The cut-off age ratio for the 228 selected cases was 0.33 (AUC=0.895). Table 1 and 2 resume data and statistical results.
Table 1. Ultrasonographic abnormalities according to age ration cut-off in 288 bitches
Age
|
<Cut-off
|
≥Cut-off
|
Cases
|
n. 132
|
n. 96
|
Abnormalities
|
Absent n. (%)
|
Present n. (%)
|
Absent n. (%)
|
Present n. (%)
|
Ovaries
|
127 (96.2)a
|
5 (3.8)b
|
81 (84.4)c
|
15 (15.6)d
|
Uterus
|
121 (91.6)a
|
11 (8.3)b
|
35 (36.5 )e
|
61 (63.5)f
|
Overall
|
116 (87.9)a
|
16 (12.1)b
|
28 (29.2)e
|
68 (70.8)f
|
Different superscripts denote significant differences within rows and columns (p<0.05)
Table 2. Statistical analysis
OR
|
Se
|
Sp
|
PLR
|
NLR
|
PPV
|
NPV
|
p-value
|
17.6
|
81%
|
81%
|
4.2
|
0.2
|
71%
|
88%
|
<0.0001
|
Conclusions
This study suggests that the age-related uterine abnormalities are more frequent than the ovarian ones and that a preventive sonographic screening for ovarian and uterine abnormalities should be performed starting from the 33% of the maximum expected longevity of bitches.
References
1. Ortega-Pacheco et al. Theriogenology. 2007;67:382–390.
2. Nelson et al. Hum Reprod Update. 2013;19:67–83.
3. Penninck, d’Anjou. Atlas of Small Animal Ultrasonography. 2015:403–421.
4. Adams et al. JSAP. 2010;51:512–524.
5. O’Neill et al. Vet J. 2013;198:638–643.