In conclusion, a complete workup of the bitch that has not shown a puberal estrus by 24 months of age should include a general screen with hemogram, chemistries profile and urinalysis, karyotype, serum thyroid hormone profile, serum progesterone concentration, and serum luteinizing hormone concentration, if available. If the results of these tests are normal, an exclusion diagnosis of immune-mediated oophoritis, which can be confirmed by ovarian biopsy, should be considered. Bitches with primary anestrus secondary to thyroid insufficiency or chronic debilitating disease may show normal reproductive cycling and performance after successful treatment of these disorders; in other patients, prognosis for future reproduction is poor.
