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Diagnosis: Uterine Hemorrhage due to Endometrial Venous Aneurysms

Lab Animal volume 32, pages 24–25 (2003)Cite this article

Harkness and Wagner1 found that bloody urine is rare in rabbits. Clinicians have attributed hematuria to multiple causes, including endometrial venous aneurysms2,3; endometrial hemagiomatosis4; uterine adenocarcinoma2,5,6; urolithiasis and concomitant cystitis1,2,5,6; bladder polyps, uterine polyps, renal infarcts, and pyelonephritis2,5,6; and leptospirosis1. Usually, physical examination, urinalysis and urine culture, abdominal radiographs and/or cystogram will verify the presence of hematuria and suggest or confirm an appropriate diagnosis2. If obvious kidney and bladder problems are not apparent, uterine disease should be suspected. The most common cause of hematuria in a female rabbit is blood from the reproductive tract associated with uterine adenocarcinoma, and not cystitis as in other domestic animals. Diagnosis of uterine diseases in the rabbit nearly always requires an exploratory laparotomy or laparoscopy and examination of the uterus or uterine biopsies by an experienced pathologist2. When infectious and neoplastic causes have been ruled out for cystic disease, uterine diseases must be suspected. The most common cause of bleeding in an intact female is uterine adenocarcinoma. If other causes have been ruled out, ruptured endometrial venous aneurysms are a strong possibility.

Confirmation of endometrial venous aneurysms requires exploratory laparotomy and pathological examination of the uterus by an experienced pathologist2. This author has found that the description of uterine polyps reported by Garibaldi et al.5,6 is more typical of endometrial venous aneurysms. The endometrial hemangiomatosis reported by Baum4 could also be a case of endometrial venous aneurysms, although this author found that the published photomicrographs and description suggest that endometrial hemangiomatosis and endometrial venous aneurysms are different conditions.

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Figure 2: Photomicrograph of the uterus shown in Fig. 1.
Figure 3: Photomicrograph of the left uterine horn shown in Fig. 1, illustrating papillary hyperplasia of the endometrium.

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  1. Allison is currently affiliated with Experimental Pathology Laboratories, Inc., 615 Davis Dr., Suite 500, Durham, NC 27713. nallison@epl-inc.com.,

    Neil Allison DVM, DACVP

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  1. Neil Allison DVM, DACVP
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Allison, N. Diagnosis: Uterine Hemorrhage due to Endometrial Venous Aneurysms. Lab Anim 32, 24–25 (2003). https://doi.org/10.1038/laban0203-24

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