Pyometra in Bitch

 

  Introduction

Pyometra is a hormonally mediated diestrual disorder in bitches which can induce high mortality if not treated on time and is usually prevalent in those countries where routine spaying of young bitches is not in practice (Jena et al., 2013).  Pyometra is reported primarily in older bitches (>5 yr old), 4–6 wk after estrus (MSD, 11^th ed.). There are two types of pyometra: open and closed type. Open type is characterized by dilated cervix with discharge of fowl smelling pus like contents and closed type is characterized by closed cervix, dilated abdomen, depression, vomiting and increased thirst.

  Etiopathogenesis

E. coli is the predominant pathogen isolated from pyometra uteri, but other species may also occur (Hagman, 2018). Other bacteria commonly isolated from uteri in cases of canine pyometra include Klebsiella spp., Streptococcus spp., Enterobacter spp., Staphylococcus spp., Pseudomonas spp., Proteus spp. and Citrobacter spp. (Chotimanukul and Sirivaidyapong, 2010). The pathogenesis of pyometra in the bitch involves estrogen stimulation of the uterus, followed by prolonged intervals of progesterone dominance (Smith, 2006).

Hematology and Biochemical Tests

The hematolgical report shows leucocytosis with neutrophils on left shift and in biochemistry report, total protein is normally seen elevated (Jena et al., 2013).

Diagnosis

It can be done on the basis of history, clinical signs, blood report, biochemistry report and x-ray/ ultrasonography (USG) report.

  Differential diagnoses

Mucometra

Hydrometra

Hemometra

Vulvar discharge

These disease may have similar clinical presentation, so for diagnosis proper observation of USG report is necessary (Jitpean et al., 2017).

 Treatment

OVH is treatment of choice. Fluids (IV) and broad-spectrum, bactericidal antibiotics should be administered. Fluid, electrolyte, and acid-base imbalances should be corrected as quickly as possible, before ovariohysterectomy is performed. The bacterial infection is responsible for the illness and will not resolve until the uterine exudate is removed. Oral antibiotics (based on the results of the culture and sensitivity) should be continued for 7–10 days after surgery (Aiello, 2016). Patients presenting with pyometra should be stabilized, and the decision whether to pursue medical management or surgical management of the uterine disease should discussed with the dog's owner. Medical management of pyometra is best performed in patients of appropriate breeding age that are reproductively valuable and free of life-threatening illnesses, including septicemia, endotoxemia, and organ dysfunction (Dennis and Ham,2012)

References

·         Boel A. Fransson, & Ragle, C. A. (2018). Pyometra in Small Animals. Veterinary Clinics of North America - Small Animal Practice, 48(4), 639–661. https://doi.org/10.1016/j.cvsm.2018.03.001

·         Chotimanukul. S, Sirivaidyapong. S (2010). The relationship of canine vaginal and uterine bacterial species in closedcervix and opened-cervix pyometra. Proceedings of 13th Association of Institutions for Tropical Veterinary Medicine, Bangkok, Thailand. 184–186.

·         Dennis.J, Hamm,L. (2012).Surgical and medical treatment of pyometra. Retreived at http://veterinarymedicine.dvm360.com/ at 20 September 2018.

·         Jena, B., Sadasiva Rao, K., Reddy, K. C. S., & Raghavender, K. B. P. (2013). Physiological and haematological parameters of bitches affected with pyometra. Veterinary World, 6(7), 409–412. https://doi.org/10.5455/vetworld.2013.409-412

·         Jitpean, S., Ambrosen, A., Emanuelson, U., & Hagman, R. (2017). Closed cervix is associated with more severe illness in dogs with pyometra. BMC Veterinary Research, 13(1), 7–13. https://doi.org/10.1186/s12917-016-0924-0

·         Smith, F. O. (2006). Canine pyometra. Theriogenology, 66(3 SPEC. ISS.), 610–612. https://doi.org/10.1016/j.theriogenology.2006.04.023

·         Aiello, S. E. (2016). The Merck veterinary manual. Kenilworth (NJ: Merck. Retrieved from https://www.msdvetmanual.com/reproductive-system/reproductive-diseases-of-the-female-small-animal/pyometra-in-small-animals at 20 September 2018.