Vulvar Fold Dermatitis

Associated Terms:

Juvenile Vulva, Recessed Vulva, Episioplasty, Vulvoplasty

The term "ACVS Diplomate" refers to a veterinarian who has been board certified in veterinary surgery. Only veterinarians who have successfully completed the certification requirements of the ACVS are Diplomates of the American College of Veterinary Surgeons and have earned the right to be called specialists in veterinary surgery.

Your ACVS board-certified veterinary surgeon completed a three-year residency program, met specific training and caseload requirements, performed research and had research published. This process was supervised by ACVS Diplomates, ensuring consistency in training and adherence to high standards. After completing the residency program, the individual passed a rigorous examination. Only then did your veterinary surgeon earn the title of ACVS Diplomate.

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Overview:

Figure 1

Irritation to the skin around the vulva, or vulvar fold dermatitis, is caused when there excessive skin or folds of skin around the peri-vulvar area. This can be due to obesity, breed conformation, or due to early neutering (juvenile vulva). These excessive skin folds can lead to the accumulation of urine and vaginal secretions. A moist, dark environment is created where bacteria and yeast can thrive, resulting in vulvar fold dermatitis (Figure 1). This can also lead to recurrent urinary tract infections, vaginal infections, and urinary incontinence. Episioplasty, also known as vulvoplasty, is a reconstructive surgical procedure performed to remove excess skin folds around the vulva to provide better ventilation of the area.

Signs and Symptoms:

Licking at the vulva
Scooting
Foul odor and/or vaginal discharge
Frequent or bloody urination
Red, irritated skin around the vulva
Inappropriate urination or incontinence
Frequent or persistent urinary tract infections

Diagnostics:

Your veterinarian will want to perform a thorough work up on your pet to ensure that there are no other underlying issues. This condition can usually be diagnosed on a physical exam. However, secondary diseases should also be identified and treated. Therefore, your veterinarian will likely perform blood screening to check kidney function and for signs of infection. Tests can include a complete blood count (CBC), serum chemistry, and urine check. A culture of the urine may also be required. They may also recommend skin testing of any active infection of the skin around the vulva. This could include a skin scrape, cytology, and/or culture. A ultrasound of the bladder can also help rule out other causes of urinary dysfunction such as a mass or ectopic ureters.

Treatment:

Figure 2

Medical management of vulvar fold dermatitis with oral antibiotics, topical antibiotics, cleansing, drying agents, or lotions may be successful, but is often unrewarding. For the majority of cases surgery is warranted. Any active infection should be cleared prior to surgery, so your surgeon will likely start these therapies to prepare your pet for the most successful procedure.

Surgical treatment (episioplasty), is a reconstructive procedure aimed at removing the extra skin folds around the vulva. The amount of perivulvar skin to be removed is determined by pinching the redundant skin between the thumb and forefingers. A crescent-shape incision is made around the vulva and the excessive skin and subcutaneous tissue is removed (Figure 2). The wound is closed which pulls the vulva out from the extra skin.

Aftercare and Outcome:

It is very important to allow the surgical site time to heal for the best possible outcome. Pets should be kept confined and prevented from licking or rubbing the surgical site until it is completely healed. An Elizabethan collar or wound covering will be required to protect the area. Oral pain medications and antibiotics are warranted. Cold compresses of the area immediately after surgery can help with decreasing inflammation.

Complications from this procedure include opening of the wound (dehiscence), infection, or not removing enough skin. It’s also important to note that this condition can be complicated by other factors, so the surgery may not completely resolve clinical signs.

The prognosis after episioplasty is excellent after healing. Pets should be monitored for recurrence of signs and kept lean to prevent further excess skin from developing.

Content Theme:

Animal Owners

Also known as:

Vulvar Fold Dermatitis

Juvenile Vulva

Recessed Vulva

Episioplasty

Vulvoplasty

This Animal Health Topic was written by and reviewed by Diplomates of the American College of Veterinary Surgeons. Any opinions stated in this article are not necessarily the official position of the American College of Veterinary Surgeons.

The American College of Veterinary Surgeons recommends contacting an ACVS board-certified veterinary surgeon or your general veterinarian for more information about this topic.

To find an ACVS Diplomate, visit www.acvs.org/find-a-surgeon.

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