What is a recessed vulva?
A recessed vulva, also known as a juvenile or hypoplastic vulva, is an anatomical condition in which a female dog’s vulva is partially hidden by surrounding skin folds. The exact cause is not fully understood, but genetics are thought to play a role in the development of this condition. It is more common in medium to large-breed dogs, especially those that are overweight.
A recessed vulva can predispose a dog to vaginitis and urinary tract infections. The skin folds around the vulva can trap moisture when the dog urinates. This moisture, combined with the dog’s body heat, make it easy for bacteria to grow in this area. These bacteria can affect the skin folds around the vulva (perivulvar dermatitis), migrate into the vagina (leading to vaginitis), or migrate up the urinary tract (leading to a urinary tract or bladder infection).
What are the clinical signs of a recessed vulva?
Some dogs show no clinical signs and the recessed vulva is found incidentally, when their veterinarian performs a physical examination. In many affected dogs, clinical signs of a recessed vulva are related to inflammation and infection in the skin folds around the vulva.
- Affected dogs might be seen scooting (dragging their vulva across the floor to relieve itching) or licking at their vulva excessively.
- You may notice a foul odor coming from the area of your dog’s vulva; this odor is associated with infection.
- Affected dogs may become incontinent, leaking small or large amounts of urine when they sleep.
In other cases, a recessed vulva leads to urinary tract infections. These infections may occur in addition to skin fold inflammation, or they may be the only clinical signs. Signs of a urinary tract infection may include:
- Urinary accidents in a house-trained dog
- Straining to urinate
- Visible blood in the urine
- A foul odor to the urine
How is a recessed vulva diagnosed?
Your veterinarian can diagnose a recessed vulva when they perform a physical examination. In an affected dog, the vulva cannot be seen because it is covered by overlaying skin folds. Closer examination may reveal accumulated moisture and debris in the skin folds surrounding the vulva.
Your veterinarian will likely perform additional diagnostic tests to determine what effects the recessed vulva is having on your dog’s health. These tests may include:
- Blood work: A complete blood cell count and serum biochemistry profile
- Urinalysis: To assess the composition of the urine
- Urine culture: To identify bacteria present in the urine
- Imaging: Using radiographs (X-rays) or ultrasound to assess for bladder stones and other bladder abnormalities
- Skin swabs: Your veterinarian may take swabs from the skin folds around the vulva to see what types of cells are contributing to the irritation (e.g., inflammatory, bacterial, or yeast cells)
How is a recessed vulva treated?
Many dogs with a recessed vulva develop bacterial infections that require treatment. The antibiotics used for treatment vary based upon the type and severity of infection. In the case of a mild skin infection, topical antibiotics may be effective. In the case of vaginitis, bladder infections, or more severe skin infections, oral antibiotics are often required.
Once the infection has been treated, the underlying conformational defect should be addressed, especially when a dog experiences recurrent infections or infections that do not resolve with antibiotic therapy. If the underlying conformational defect is not addressed, the infections will recur. There are two key treatment options for a recessed vulva:
- Medical management. In mildly affected dogs, topical treatments with medicated shampoos or wipes may be sufficient to keep signs at bay and prevent secondary infections. In overweight dogs, weight loss can be beneficial by decreasing the size of the skin folds around the vulva.
- Surgical treatment. In severely affected dogs, or dogs that do not respond to medical treatment, a vulvoplasty or episioplasty may be considered. This procedure restores the vulva’s normal conformation.
What is the prognosis for a recessed vulva?
The prognosis for a recessed vulva depends on its severity and which treatment option is attempted. In general, dogs that undergo a vulvoplasty experience a significant improvement in clinical signs. In dogs given medical treatment only, the prognosis depends on the severity of the condition and the response to treatment.
