Puppy bitches often suffer from a cluster of symptoms including cystitis, vaginal inflammation, vaginal discharge and sometimes urine scalding and dermatitis of the skin around the vulva.. Most of the time, this condition is treated with antibiotics only. Frequently, the vet goes through several different antibiotics with poor results. Many times an “inverted vulva” and vulvar conformation are blamed for the condition. Sometimes vulva surgery is advised.

In our experience, “puppy vaginitis” is usually caused by crystals in the urine. Many puppies have crystals in their urine. Usually these disappear as the dog grows up, and do not mean that the adult dog will have crystals. It is very important that young puppies have unrestricted access to water at all times. If the “puppy vaginitis” is in fact caused by crystals in the urine, treatment by antibiotics is neither sufficient by itself nor an appropriate first medication. If the crystals are not addressed, the problem won’t be cleared up. The chronic administration of antibiotics without getting to the root cause of the problem does over the course of the puppy’s first year, finally result in a highly resistant bacterial population in the vagina. Urinalysis may not always reveal the presence of the crystals. Because of the extremely irritated bladder and urethra (and vagina), the urine stream causes pain and is cut off quickly. Then the bitch tries again with a similar result, giving the typical sign of cystitis -- small frequent urinations. Inside the urinary bladder the crystals, being heavy, settle down to the bottom of the bladder. With the frequent painful urinations, the lower portion of the bladder often remains full of urine and crystal sediment that never fully empties out. The first morning urination is most likely to show us these crystals.

Cystitis always follows an ongoing harmful spiral. Insufficient water intake concentrates the urine, resulting in crystals precipitating out in the bladder. With urine stasis and incomplete emptying of the bladder, Bacteria multiply and change the pH (acid/base condition) of the urine, causing more crystals to precipitate out. The crystals irritate the bladder and urethra, causing the urine flow to be cut off quickly due to pain, and urine to remain in the lower portion of the bladder. Stagnant urine promotes more bacteria, changing the pH further, precipitating more crystals, and on and on. Cystitis is treated by a food additive or special diet food that corrects the pH of the urine, thereby working to dissolve the accumulated crystals. Then antibiotics stop the effects of bacteria on the pH, which decreases the amount of new crystal precipitation in the bladder. Forcing fluids is the simplest and most basic of all means of decreasing crystals, by diluting the urine. All of these measures are necessary to treat “puppy vaginitis” with urinary crystals as the basic cause.  NOTE: feeding vegetables has a detrimental effect on urine pH.

The so called inverted vulva is usually not a problem. Yes, zillions of bitches have a vulva that is surrounded by a fold of skin. Very seldom is this condition a problem unless basic hygiene is ignored by the owner. If your puppy is exhibiting signs of cystitis or vaginitis, and the area of skin around the vulva and vulvar fold is irritated, pay attention to the situation and clean inside this fold of skin. It is dead simple to do this – just pull on the hair of the vulva to bring it down and straighten out the fold. Then gently wash, rinse and dry the area, and apply a coating of bag balm or Desitin on the skin of the vulva and in and around the fold, to prevent further urine scalding. Way easier than surgery!!! Of the zillions of bitches with this conformation of the vulva, 99.9% have no problem. It is hygiene, not the conformation itself, that is responsible for the irritation and skin inflammation.

This stuff is not rocket science. The most important thing in treating “puppy vaginitis” is to determine, definitively, whether or not urinary crystals are responsible for the irritation and secondary infection in the bladder, the vagina and peri-vulvar structures. To definitively determine whether or not crystals are present, it may be necessary to pool several urine catches, obtain the first urine of the day, and do repeat urinalyses.

We routinely check the hair of the vulva and prepuce of 6 to 8 week old puppies for a ‘sticky’ feel. Sometimes we just remove this accumulation from the hair and dissolve it in a drop of water on a slide to see the presence of urinary crystals! Since we routinely observe for crystals, we are in a position to make sure the puppies’ fluid intake is maximized, avoiding the later development of the cystitis/vaginitis condition. Breeders must make sure puppy buyers understand the importance of 24 hour a day, 7 day a week unrestricted access to water by the puppy. Often new puppy owners think that withholding water when they aren’t home in the daytime, or overnight will make it easier to house break the puppy! It’s up to us as breeders to make a point of this in our educational packets for puppy buyers.

by Mary C. Wakeman, D.V.M.
BREEDERVET ©3/17/05 Ashford Animal Clinic Canine Fertility Center