Pyometra is a pus-filled uterus and ovaries due to cystic endometrial hyperplasia, inflammation, and bacterial infection.
Pyometra
Pyometra is a pus-filled uterus and ovaries due to cystic endometrial hyperplasia, inflammation, and bacterial infection. Hormonal imbalances or an abnormal response to hormones facilitates bacterial adherence. Peritonitis may occur.
This is the most common uterine disorder of intact bitches with an incidence of 19 to 25% by the time dogs are 10 years of age. Average age is 8.5 years. Nulliparous bitches are most often afflicted.
Signs
Signs include vaginal discharge (50 to 85% incidence), vomiting/anorexia (75%), lethargy (20 to 70%), abdominal pain (22.7 to 75%), polyuria-polydipsia (20 to 70%), and pyrexia (20 to 42%). The incidence of an open cervix (vaginal discharge) ranges from 40 to 73.3%.
Diagnostics
Positive bacterial uterine cultures occur in 25 to 84.3% of cases. A single species of bacteria is seen in 91.5% of cases. Escherichia coliis the most common (50 to 90% incidence).
Endotoxininteracts with renal distal convoluted tubules and collecting ducts, inhibiting anti-diuretic hormone. A decrease in the glomerular filtration rate (azotemia) is due to decreased urinary concentration ability, immune complex deposition, and renal tubule changes.
Hypoalbuminemia (81% incidence) and azotemia (6 to 30%) are seen. Anemia (59.7% incidence) and leukocytosis (37 to 54.3%), are seen. A urinary tract infection is diagnosed in 5.6 to 70% of cases. Abdominalimaging depicts an enlarged uterus.
This condition is so common and the signs so characteristic of this disease that an online televet service may be crucial in understanding the urgency of surgical intervention of pyometra is suspected.
Surgery
Ovariohysterectomy is curative. Death occurs in 0 to 27% of dogs. Surgical sterilization via ovariohysterectomy or ovariectomy is preventative of pyometra.
Shadi Ireifej DVM DACVS
