Topics in Companion An Med 43 (2021) 100511

Review Article

Ovarian Cysts in the Bitch: An Update

Jisna K. Sasidharan, BVSca, Manas K. Patra, MVSC, PhDa,*, Laishram Kipjen Singh, MVScb,
Abhishek C. Saxena, PhDc, Ujjwal K. De., PhDc, Vidya Singh, PhDd, Karikalan Mathesh, PhDd,
Harendra Kumar, PhDa, Narayanan Krishnaswamy, PhDe

Keywords: A B S T R A C T
ovary
follicular cyst Functional ovarian cysts occur as solitary or multiple fluid-filled structures of variable size that are unilateral
luteal cyst
or bilateral in the bitches of age 6-8 years. Though the pathogenesis is obscure, insufficient LH surge, intrafol-
canine
licular changes in gonadotrophin receptors and growth factors are the possible reasons behind the occur-
cystic endometrial hyperplasia-pyometra
rence of hormonally active ovarian cysts that predisposes the bitch to the development of cystic endometrial
a
hyperplasia-pyometra complex and occasionally hyper estrogenism. In the presence of suggestive signs,
Immunoreproduction Laboratory, Animal
ultrasonography is the practical imaging modality for the clinical diagnosis that can be confirmed by assay of
Reproduction Division, ICAR-Indian Veterinary
ovarian steroids and histopathology. Medical management with gonadotrophin-releasing hormone ana-
Research Institute, Izatnagar, U.P., India
b
logues and human chorionic gonadotrophin is not preferred as they are not always successful. As uterine
Animal Reproduction Gynaecology and
pathologies are highly likely by the time of diagnosis, ovariohysterectomy is the treatment of choice for the
Obstetrics Division, ICAR-National Dairy
follicular and luteal cysts. Understanding the cellular and molecular changes in the hypothalamo-hypophy-
Research Institute, Karnal, India
c
seal ovarian axis will improve our understanding on the canine ovarian cysts.
Referral Veterinary Polyclinic, ICAR-Indian
© 2021 Elsevier Inc. All rights reserved.
Veterinary Research Institute, Izatnagar, U.P.,
India
d
Division of Pathology, ICAR-Indian Veterinary
Research Institute, Izatnagar, U.P., India
e
ICAR-Indian Veterinary Research Institute,
Hebbal, Bangaluru, India

Introduction in litter size.11 Predominant uterine histopathologies included cystic

The domestic dog is a monocyclic species that ovulates several
oocytes and carries multiple offspring. In the bitch, ovulations usually
take place at the beginning of estrus period after the LH peak and sev-
eral follicles ovulate within a time period of 1 2 days.1 The concentra-
tion of estradiol begins to decrease from peak to intermediate values
of 10-20 pg/mL, while the concentration of progesterone reaches 10-
25 ng/mL by day 10, at or shortly after the end of the estrus.1 If the
peak of LH is inadequate to induce ovulation of the dominant follicles,
or the receptor responsiveness is insufficient, it may lead to the pro-
duction of cysts in the ovary.2 Under clinical settings, follicular cysts
need to be distinguished from other cystic ovarian pathologies includ-
ing hyperplasia of rete ovarii and superficial cysts of germinal epithe-
lia3,4 and ovarian neoplasia.5 Although the life expectancy of different
dog breeds varies, there is an increased incidence of ovarian cysts over
6-8 years of age6 and ovariohysterectomy before the middle age of 6
years7 is useful for the prevention of reproductive pathologies.5,8
In a survey study with ovaries of 400 bitches, the incidence of ovar-
ian pathology was about 28.8%, of which more than 75% were non-
neoplastic cystic structures.9 The incidence of ovarian anomalies in the
bitches was reported to include luteal cysts (23.8%), rete ovarii hyper-
plasia (10.5%), follicular cysts (10.5%), oophoritis (7.9%), adenoma of
rete ovarii (4.0%), cysts of superficial (2%) structures, and parovarian
cysts (22%).4,6,10 The presence of steroid hormones producing cysts in
the ovary for a longer period not only predisposes to uterine patholo-
gies but also adversely affects the ovulation rate leading to a reduction
*Corresponding author. Manas K. Patra, MVSC, PhD, ICAR-Indian Veterinary Research
Institute, LPM Section, Immunoreproduction Laboratory, Animal Reproduction Divi-
sion, Izatnagar, U.P. 243 122, India.
E-mail address: drmanas01@gmail.com (M.K. Patra).
endometrial hyperplasia (CEH), periglandular fibrosis, lymphoplasmo-
cytary endometritis, and adenomyosis (19.7%, 14.5%, 4.0%, and 2.6%,
respectively).4 However, definitions of ovarian diseases and their mor-
phological and histological presentation are difficult to explain due to
numerous and time-dependent variations.12 The cyst diameter ranged
from 0.2 to 4.0 cm with a median value of 0.5 cm2. These cystic fol-
licles, despite their smaller size, cause considerable endocrine activity
to potentially interrupt the normal ovarian function with hyperestro-
genism as an extreme consequence.2
Although neutering minimizes the risk of reproductive diseases, it
cannot be practiced in the younger age of less than 2 years if the bitch
is intended for breeding.13 It is also important to mention that neuter-
ing prior to onset of puberty has some potentially deleterious conse-
quences such as, development of neoplasia (hemangiosarcoma,
lymphoma, mast cell tumors, and osteosarcoma) and risk of skeletal
abnormalities like intervertebral disc herniation in dachshunds
breed.14-16 Therefore, it should be weighed in the decision and also
promote the fact that breeding bitches should be bred early to enable
neutering before middle age.14 The pathogenesis, diagnosis, and treat-
ment of cystic ovarian diseases in the bitch are still unclear; hence, it is
important to establish an early diagnosis of the condition and adoption
of suitable treatment strategies to prevent the progress of the disease.
In this review, the morphological features of the canine ovary, inci-
dence, prevalence, types and clinical manifestations of the ovarian
cysts, diagnostic approaches and therapeutic options are discussed.
Ovarian Anatomy and Histology
The canine ovaries are located in the dorsal part of the abdominal
cavity lying caudal to respective kidneys and completely enclosed

http://dx.doi.org/10.1016/j.tcam.2021.100511
1938-9736/© 2021 Elsevier Inc. All rights reserved.
2 J.K. Sasidharan et al. / Topics in Companion An Med 43 (2021) 100511
Fig 1. Representative gross image showing ovarian bursa (arrows).
within the ovarian bursa.17,18 The ovarian bursa is formed by the
fusion of distal mesovarium and the mesosalpinx and contains a con-
siderable amount of adipose tissue that covers the easy view of ovary,
except in a small clear area of the mesosalpinx.19 The fat content of
ovarian bursa rises with age and the younger dogs display more
translucent ovarian bursa compared with older or overweighed
females (Fig 1).11 The ovarian surface epithelium is formed by a
monolayer arrangement of cuboidal to flat cells over the free surface
of the canine ovary. During the postnatal period, the mesodermal
derived ovarian surface epithelial cells express both epithelial and
mesenchymal features.20 The surface epithelium shows infolding
into the underlying stroma and forms numerous cortical tubules con-
sisting of cuboidal epithelium. The ovarian stroma is formed by the
collagen rich tunica albuginea and small round stromal cells around
the Graafian follicle. Besides, a group of round nuclear endocrine cells
with thin cytoplasm are arranged in a cord from the cortex to the
medulla. Rete ovarii is formed by lower cuboidal or columnar cells
along with stromal cells at the hilus of the ovary through which
nerves and vessels enter into the ovary.21
Ovarian Cysts
The survey report indicates that cystic ovarian disorders account for
around 80% of ovarian pathology in the canine.9 Since expanded cysts
lose their structure and the arrangement of cell linings alters under
pressure exerted by the cystic fluid, it becomes difficult to find out the
origin of the cyst in the ovary.22 Follicular and luteal cysts are the 2 types
of functional ovarian cysts. In addition, nonfollicular cysts often grow
from the surface or subsurface epithelium and mesonephric tubules of
the dog ovary.23 Hormonally active ovarian cysts are of clinical signifi-
cance in the bitch, as they can lead to hyperestrogenism.24 The steroidal
Fig 2. (A) Representative gross photographs showing follicular cysts in the ovary (blue arrow) of a 7-year-old non-descript bitch diagnosed with cystic endometrial hyperplasia-
pyometra complex (blue arrow). (B) Closure view of ovarian cysts (blue arrow) in a 12-year-old Spitz bitch.
Table 1
Incidence of Different Ovarian Cysts Reported in the Bitch
Types of cysts Incidence (%) Reference
9,21,23
Follicular cysts 6-23.9
9,41,21,27,23
Rete ovarian cysts* 11-90
9,41,21,27,23
Subepithelial surface cysts 4.0-52.3
27,23
Para-ovarian cysts 3.0-12.0
* Value includes cysts located in the rete ovarii and hilar region, hence it may also
contain paraovarian cyst.
hormones produced in ovarian cysts contribute to the multifactorial
evolution of pyometra.6,25,26
Incidence
Many bitches with ovarian cysts display no signs; thus, often
remain undiagnosed. With age, the occurrence and prevalence of cys-
tic ovaries increase in the bitch.1 There is also little knowledge on the
epidemiological implications of canine ovarian cysts. Histopathology
studies of canine ovarian cyst in various laboratories show that the
prevalence rate of epithelial cysts from rete structures and surface-
sub-surface epithelium is higher than that of other cyst struc-
tures.23,27 The incidence of different types of ovarian cysts is pre-
sented in Table 1.
Types of Cysts
Follicular Cyst
Follicular cysts are monolocular thin-walled and clear watery
fluid-filled structures, generally present over the ovarian surface as
solitary as well as multiple. The diameter of the single cyst ranges
from 1 to 5 cm, while the diameter of multiple cysts can be up to 10
cm.28 Although it is recorded in young bitches of one year and as old
as 19 years, the vulnerable age of the bitch who develops follicular
cysts is above 6-8 years.24 The research on follicular cyst pathogene-
sis indicates that the cysts are triggered by the failure of large antral
follicles to respond to ovulatory stimulation.29 The primary endocrine
lesion for anovulation is the central failure to produce temporal
GnRH pulses and LH surge which are essential for final follicular
growth and ovulation6 or from the peripheral level due to imbalances
in the follicular molecular homeostasis compromising its response to
the preovulatory LH surge. The former hypothesis would explain the
development of multiple follicular cysts, while the latter would
rather applicable to the occurrence of solitary follicular cysts.11
Retrospective examination of the ovaries after ovariohysterec-
tomy over a span of 12 months for the treatment of pyometra in the
veterinary polyclinic showed that 20.7% (17/82) bitches had follicular
cysts (Fig 2). The presence of ovarian cysts did not show any
 J.K. Sasidharan et al. / Topics in Companion An Med 43 (2021) 100511 3

significant association with CEH in Fisher’s exact test (P = .78), about
35.3% bitches having ovarian cysts had the concurrent CEH-pyome-
tra, whereas 58.8% had pyometra without any cystic changes in the
endometrium. Histomorphometric categorization of pyometra sup-
ports the presence of pyometra without CEH where the gland lumina
present only in less than 10% of the endometrium with no cysts and
the endometrium/myometrium ratio significantly decreases due to
severe endometrial atrophy, although a high degree of fibroblast pro-
liferation is also seen in the endometrium and myometrium layers.30
Only 5.9% bitches however, developed cystic ovaries without any
uterine pathology (data unpublished). Nulliparity predisposes 94.15%
of cases to the incidence of ovarian cysts. The histopathological modi-
fication of the Graafian follicle and the cystic follicle is presented in
Fig 3.
The experimental administration of nonsteroidal aromatase
inhibitor letrozolein the rat resulted in ovulatory failure and develop-
ment of polycystic ovarian syndrome.31 Consequently, inhibiting the
function of aromatase enzyme that catalyzes the rate limiting step in
the production of estrogens from androgens is one of the rational
intraovarian disruptions in steroidogenesis that might have been cor-
related with its pathophysiology.32 The induction of estrus in dogs
using deslorelin is reported to be associated with the development of
multiple follicular cysts in the ovaries.33 A positive immunoreaction
to inhibin alpha and a negative immune response to cytokeratin AE1/
AE3 and desmin was shown in the granulosa cell lining of follicular
cysts.22 Among the steroid hormone receptors, androgen receptors
(AR) and estrogen receptors (ERa and ERb) are expressed in develop-
ing follicles, but a moderate AR and ERb reactions have been observed
in the follicular cysts. In addition, upregulation of antiapoptotic pro-
teins Bcl-2 and survivin in the granulosa and theca cells, along with
downregulation of active caspase-3 in secondary follicles and follicu-
lar cysts, suggest chronic persistence of ovarian cyst in dogs.34
Persistent follicular cysts are hypothesized to result in hyper-
estrogenism in the bitch with prolonged estrus extending up to three
months.24,35 Hyperestrogenism-related signs include pancytopenia,
anemia, granulocytopenia, thrombocytopenia and consequent epi-
staxis, hematuria, petechia, or hemorrhagic vulvar discharge.28 In
chronic cases, the bitch develops typical symmetrical bilateral alope-
cia and bone marrow suppression, lichenification, and hyperkerato-
sis.36 Alopecia most frequently observed on the caudal aspects of
both thighs.37 Though hyperestrogenism is uncommon in the bitches
with follicular cysts, development of CEH-pyometra complex is

Fig 3. Representative photomicrographs of canine ovary. (A) Graafian follicle with eosinophilic antral fluid surrounded by granulosa cell layer, (B-E) A section of follicular cyst lined
by irregular thin layer of granulosa cells along the basement membrane with wider antral diameter (B- bar 500 mm, C- 100 mm, D- bar 1000 mm, E- 500 mm), diagnosed in a 7-year-
old nulliparous German shepherd bitch resented with a history of purulent vaginal discharge for about 4 weeks.
4 J.K. Sasidharan et al. / Topics in Companion An Med 43 (2021) 100511
Fig 4. Representative photomicrographs of canine ovary. (A) Normal corpus luteum having luteal cell layers arranged in sheets, (B-D) luteal cyst showing partial luteinization in the
follicular wall and fibrin bands are spreading through the lumen of follicle. (Bar 10 mm). This was incidental finding during an elective ovariohysterectomy in a 3-year-old German
Shepherd bitch.
common28,29 leading to polyuria and polydipsia, mucus or purulent
vaginal discharge, vomiting, abdominal distension, abdominal dis-
tress or pain.24
Luteal Cyst
Luteal cysts are solitary cysts, lined by luteal tissue and frequently
range from 1.5 to 3.0 cm in diameter.9 Compared to follicular cysts,
these cysts are comparatively thicker and consist of opaque walls
with accumulation of pale eosinophilic fluid. The formation of luteal
cysts eventually necessitates luteinization of granulosa cells; thus,
requires an additional step in cell differentiation compared to follicu-
lar cysts.6 Histology revealed lining of cyst by several layers of granu-
losa-lutein cells and a thin layer of fibrin (Fig 4) on the luminal
surface.6 The luteal cysts are capable of producing progesterone in
low concentrations for a prolonged period of time.24
Cystic Corpus Luteum
A persistent fluid-filled cavity is often indicative of incomplete
luteinization and is known as cystic corpus luteum. Histologically,
these cysts contain several layers of luteal cells that are separated by
a thin, single fibroblast layer from the central cavity.38
Cystic Rete Ovarii
Rete tubules are present as a small mass of irregular, anastomos-
ing tubules in the hilus region of most of the canine ovary. Presence
of cystic rete ovarii is shown in Fig 5. This type of cystic structure
does not produce sex steroid hormones39 and the rete ovarii tissue is
physiologically unaffected by sex-hormone-regulated differentiation
and maturation processes.40 The epithelial lining of the small-sized
cysts is similar to that of rete tubules and the large-sized cysts are
lined by epithelium where, the cells show the loss of polarity. Most
larger rete cysts are round in shape than the smaller ones.9 Age is not
a predisposing factor for the production of rete ovarii cysts, unlike
follicular cysts.41 In contrast to follicular cysts, the cystic rete ovarii
show a positive immunoreaction to desmin and AE1/AE3.21,22 In the
normal canine ovary, expression of damage-associated molecular
pattern molecule, S100-positive immunoreaction at rete ovarii is
demonstrated. However, cystic rete ovarii were not always S100-pos-
itive, and an S100-positive immunoreaction is observed in various
kinds of cysts. To the end, its differentiation proved confounding
unless ovarian rete is observed in the vicinity.22
Cyst of Subsurface Epithelium (SES)
Cyst of subsurface epithelium arises from the ovarian surface and
also be termed as germinal cysts.3 Cysts are rarely larger than 5 mm,
and lined with nonsecretory cuboidal or low columnar epithe-
lium.9,22 They are often microscopic in size, multiple in numbers and
commonly bilateral. The SES cysts grow at the surface, typically
enlarging the size of the ovary. In the caudal pole of the kidney, the
swollen ovaries can be palpated as relatively solid ovoid masses. In
transabdominal palpation, the dogs occasionally show signs of
abdominal distress.27 The cysts of SES are immunoreactive to placen-
tal alkaline phosphatase and placental alkaline phosphatase can serve
as a histological marker of SES cyst.22
Diagnosis
Differential diagnosis of the type of ovarian cysts is made by ultra-
sonography,42 estimation of ovarian steroid hormone concentra-
tions,6 and histopathology. Information on breeding history along
with physical examination is appropriate for the preliminary diagno-
sis of hyperestrogenism in follicular cysts.11 In certain cases, the
swollen vulva with dark sero-hemorrhagic or mucus discharges is
also observed.43 Transabdominal ultrasonography provides first line
of evidence for the ovarian cysts (Fig 6) and their significance needs
to be correlated with clinical signs and estimation of estrogens. Small
nonproductive cystic structures often escape diagnosis till they
achieve enough size to be visualized during an abdominal
 J.K. Sasidharan et al. / Topics in Companion An Med 43 (2021) 100511 5

Fig 5. Representative photomicrograph of cystic rete ovarii. (A) Ovarian cortex and medulla (B) wide cystic cavity in the rete ovarian region indicated by asterisk, (C-D) the luminal
part of the cysts is encircled by fibrinous band and accumulation of cystic fluids and ill differentiated cellular debris (bar 10 mM). It was an incidental finding during an elective ovar-
iohysterectomy in a 1-year-old nondescript bitch.

ultrasound.11 Follicular cysts are typically visible as thin-walled
anechoic structures with acoustic enhancement in the ultrasonogra-
phy.26 The SES and rete cysts without sufficient size remain unrecog-
nized during ultrasound scanning of the ovaries.26 Compared to
ultrasound imaging, abdominal radiography is not very beneficial.44
Despite the fact that computed tomography scan and magnetic reso-
nance imaging provide optimum resolution for detecting even
smaller cysts45,46 ultrasound remains the choice of imaging as it is
readily available, informative, easy to perform, and does not require
anesthesia or radiation.
Observation of persistent heat indicates the estradiol dominance
in females.23 The measurement of estradiol in the peripheral circula-
tion aids in the diagnosis of follicular cyst in a bitch with typical clini-
cal signs and demonstration of cyst in the ovary by ultrasound. The
endocrine potential of each cyst in the ovaries can be ascertained by
analyzing the oestradiol-17ß and progesterone concentration in the
cystic fluid. The cyst-fluid levels of estradiol-17ß ranged from 2.0 to
568000.0 pg/mL (median 545.0 pg/mL) and the concentration of pro-
gesterone ranged from 0.1 to 20,138.0 ng/mL (median 31.0 ng/mL).2
Moreover, the level of hormones varies in different types of cysts
present on the same ovary.2 In the presence of suggestive clinical
signs, histopathology helps in arriving at a confirmatory diagnosis.
Hemogram is a useful ancillary diagnostic aid along with a detailed
clinical evaluation to eliminate reproductive pathologies associated
with ovarian cysts such as CEH-pyometra, which predisposes the bitch
to life-threatening systemic inflammatory response syndrome.47,48
Pancytopenia is common in the bitches with estrogen producing ovar-
ian cysts that can aid in the diagnosis.28,49 Concentration of serum
C-reactive protein is suggested to be a useful predictor of ovarian
cyst.50 In addition, differential diagnosis of ovarian cysts, particularly
from the granulosa-theca cell tumor, which is often powered by hor-
mones and produces estrogens, should be considered; hence, histopa-
thology is always indicated for confirmation. The response to medical
treatment allows for differentiation of follicular cysts with granulosa

Fig 6. Representative ultrasonography images showing (A) cystic ovary in association with pyometra in a 6-year-old Dalmatian bitch presented with the history of sero-sanguine-
ous discharge for 10 days, vomiting and polydipsia. (B) Multiple ovarian cysts in the right ovary of a 7-year-old Spitz presented with a history of blood tinged purulent vaginal dis-
charge and diagnosed as cystic endometrial hyperplasia-pyometra complex.
6 J.K. Sasidharan et al. / Topics in Companion An Med 43 (2021) 100511
cell tumors, although failure is sometimes reported in hormonal treat-
ments.29 Other ovarian neoplasms such as papillary cyst adenoma and
cystic adenocarcinoma occur commonly in the bitch and stimulate the
production of ovarian steroids that predisposes in the development of
CEH-pyometra.28
Treatment
Considering the low occurrence and under diagnosis, it is not sur-
prising to see that limited literatures are available on the medical
treatment of ovarian cysts with respect to recovery, relapse and post-
treatment complications. Therapeutic options are mainly available
for follicular and luteal cysts, since other ovarian cysts do not cause
clinical disease in dogs.51 In a case series, conservative medical treat-
ment with either hCG and/or GnRH analogue resulted in a success
rate of 40% in the first, 33.3% in the second and 66.7% on the third
attempt.52 The bitches were treated with hCG at doses between 450
and 3000 IU per animal or GnRH analogue buserelin at doses
between 0.8 and 6mg per animal. Buserelin therapy has been per-
formed 2-6 times at 12-hour intervals or 3 times at 8-hour intervals
in different bitches. But the types of cysts have not been described
and a long-term observation of the efficacy of the therapy and poten-
tial recurrence has not been carried out.52 Although GnRH analogues
or hCG are used for the treatment of ovarian cysts in bitches,
response to treatment varies and several case studies showed a fail-
ure of hormonal therapy53 and induction of pyometra therefore,
demanding for a surgical alternative. Further, the potential hypersen-
sitive reactions limit the use of hCG for the treatment functional ovar-
ian cysts.
Ovariohysterectomy is a curative treatment procedure in most
cystic ovarian disorders to prevent the potential recurrence.51 It is
the treatment of choice for most uterine diseases, including: congeni-
tal anomalies, pyometra, localized or diffuse CEH, uterine prolapse,
uterine neoplasia, and uterine rupture.53 The surgical drainage and
flushing of the cystic structures were attempted in unusual case stud-
ies.54 The aspiration of cystic fluid through laparotomy or ultrasound-
guided aspiration are the other treatment options for ovarian cysts52
with 56% whelping in the bitches with follicular cysts.54 No medical
treatment is indicated in nonproductive ovarian cysts as they are
innocuous. In another report cystectomy performed through a
median laparotomy caused cessation of the clinical signs but an ovar-
iohysterectomy had to be performed due to the occurrence of CEH at
2 months after the procedure.55 Ovariectomy is another effective
method for permanent sterilization of female dogs with no known
demerits. It is also indicated for the treatment of ovarian neo-
plasms.56 In the Netherlands and other European countries, ovariec-
tomy is preferred over ovariohysterectomy as the standard approach
for neutering. A major advantage of overiectomy is that it can be per-
formed faster through a smaller celiotomy and with less traction on
the female genital tract.56 Whereas ovariohysterectomy is preferred
way of sterilization in the United States based on the presumption
that future uterine pathology is prevented by removing the
uterus.57,58 Technically, ovariohysterectomy is associated with more
surgical complications like intra-abdominal and vaginal bleeding,
ureteral ligation, uterine stump complications, ovarian remnants,
and sinus tracts.56
Conclusion
The occurrence of hormonally active ovarian cysts originating
from the follicles is high in the bitches of middle to advanced age.24
As persistent follicular cysts increase the risk of CEH-pyometra and
have the potential to induce hyper estrogenism, treatment is neces-
sary. Treatments with GnRH analogues or hCG are not always suc-
cessful in every case of hormonally active ovarian cyst; hence,
ovariectomy is the only proven therapy. It is an important fact that
bitches should be bred early to enable neutering before middle age.
As endometrial disease is a common consequence of functional ovar-
ian cysts, bitches become subfertile, even if the affecting ovary is
removed. Ovariohysterectomy is the treatment of choice for func-
tional ovarian cysts in the absence of breeding value of the bitch.
Acknowledgments
The authors copiously thank the anonymous reviewers for their
critical inputs and valuable suggestions in revising the manuscript.
The support of The Director, ICAR-IVRI, Izatnagar in facilitating the
review process is acknowledged. The work was supported by a grant
(BT/ADV/Canine health/ GADVASU /2017-18) from Department of
Biotechnology, Ministry of Science and Technology, India to Manas K
Patra for a project, “Identification of diagnostic and prognostic bio-
markers in cystic endometrial hyperplasia and pyometra led systemic
inflammatory response syndrome in dog”.
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