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Client Library Article
PYOMETRA
| About Pyometra |
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Pyometra is a bacterial infection of the
uterus which can be life threatening if it is not treated promptly.
Pyo= pus and metra=uterus, hence the name pyometra, describing a pus filled
uterus. Pyometra develops 2-10 weeks after the end of the estrus cycle which occurs
only 2x/year in dogs but as often as every 2-3 weeks in cats. A pyometra is termed open if the cervix is relaxed
and allows pus and discharge to drain out the vulva, and closed if the cervix is tight and
the infection is sequestered in the uterus. Approximately 85% of pyometras are
open, 15% are closed. Patients with closed pyometras are usually more
debilitated than
those with open pyometras. In either case, the optimal treatment for a
pyometra is to spay the animal as soon as possible. Pyometras do no
generally respond to antibiotic therapy alone since the uterus acts like a
huge abscess pocket. Owners must be aware that
surgery to remove a large infected uterus is much more difficult due to
engorged blood vessels and the possibility of a uterine tear even with
gentle handling. The body wall incision will be considerably longer as
well. Occasionally, the surgeon finds that the uterus has already
ruptured and must take additional steps to treat peritonitis. All
patients with pyometra should receive intensive pre & post-operative
care for several days after surgery for optimal outcome. Even with proper
care, some dogs do die during & after surgery. For this reason (as well as
population control), most veterinarians recommend to spay all female dogs
who are not going to be used for breeding. With no uterus, there is no
chance for infection.
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| Symptoms |
- Anorexia
- Lethargy
- Drinking more water & urinating more
- Vomiting / diarrhea- common with closed pyometras
- Smelly Vaginal discharge
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| Diagnosis |
| Based on clinical signs and diagnostics. The veterinarian
can often palpate a large thick uterus, and if an open pyometra, a
smear of the vaginal discharge can be examined under the microscope to look for
infection. A CBC will show an elevated white blood cell count. Radiographs of
the abdomen will show a large distended tubular structure representing a pus
filled uterus. Ultrasound can also be used to image a uterus full of pus. |
| Treatment- surgery |
| The optimal and most successful treatment is surgery to
remove the uterus and ovaries- otherwise known as a "spay". Most animals
with pyometra need to stabilized before surgery with IV fluids and antibiotics.
As previously mentioned, the surgery is complicated by engorged blood vessels
and a large heavy uterus that tears easily with even gentle handling. There is
a higher risk for bleeding and contamination of the abdomen with pus when
removing the uterus. Most surgeons will lavage or rinse out the abdomen
after the uterus is removed before suturing up the body wall.
Post-operative care includes IV fluids, antibiotics, and possibly a
blood or plasma transfusion. Blood pressure and heart rhythms should
be monitored for at least 24 – 48 hours after surgery and problems addressed
promptly. |
| Prognosis-
depends on the type and duration of the pyometra |
| Open pyometras carry a better prognosis than closed due to 2
factors- since open pyometras drain, there is less of a toxin buildup in the
body, and due to the discharge, owners bring their dogs to the veterinarian
sooner. Additionally, as with most diseases, aggressive veterinary care greatly
favors the outcome. |
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