Unusual giant cyst as a consequence of the ovarian remnant syndrome in a bitch.

An 9 years old German shepherd bitch was presented to the Veterinary Hospital of the University of Bari "Aldo Moro" with a 1 year history of enlarged abdomen. The bitch was neutered 3 years before and no signs of heat were seen since then. The owner claimed a progressive increase in abdominal volume that had started about 1 year earlier and progressed faster in the last 2 months when there also was a deterioration of the general conditions with dysorexia. It worsened in anorexia for about 2 days. On physical examination the bitch was thin, depressed and reluctance to move with a distended and swollen abdomen. At superficial palpation the abdominal wall resistance was detected, the rigidity was due to an intra-abdominal fluid collection. A complete blood and urine tests showed nothing relevant. The ultrasonographic examination showed the presence of a spider-web-like structure with septa and an anechoic content that occupied most of the abdominal cavity displacing the viscera. We proceeded with an exploratory laparotomy. The opened abdomen revealed the presence of a cystic formation that occupied most of the abdominal cavity (about 25 cm in diameter) developed on a remnant of the right ovary and containing about 13 lt of serum-hematic fluid and many adhesions between abdominal organs and tissues. The presence of other cysts on a further left ovarian residue was also highlighted: one with a diameter of about 10 cm and others smaller than about 5 cm. Fragments of right ovarian cysts and uterus were stored in 2% buffered formalin to be subjected to histological examination. The subject recovered from anesthesia was discharged with the following therapy: amoxicillin clavulanate (12.58 mg/kg bid for 10 days) and robenacoxib (1 mg/kg sid for 5 days). The histological examination of the cysts revealed that the wall had the internal theca replaced by fibrous tissue, several layers of degenerated granulosa cells. This finding suggest a follicular stromal cyst. Uterine tissue showed signs of cystic endometrial hyperplasia. At 10 days post-surgery check-up the bitch appeared to be in good health with no signs of depression and pain. She was completely recovering and gaining weight. The owner claimed that the bitch had started feeding again the day post surgery and had been improving day by day. Usually the subjects with ovarian remnant syndrome (ORS) manifest the typical signs of estrus, such as vulvar serohematic discharge, receptivity to the male, nymphomania, and kyphosis due to abdominal pain. Additional clinical signs are: endometrial cystic hyperplasia, pyometra and infrequently diabetes mellitus (1). The peculiarity of this clinical case is represented by the giant dimension of the follicular cyst and the presence of non-specific clinical signs due to the compres