Therapeutic and surgical management of open cervix pyometra in a bitch (original) (raw)
Management of Open-Cervix Pyometra in a Four-Year-Old German Shepherd-Cross Bitch
Nigerian Veterinary Journal, 2021
Department of Theriogenology and Production, Ahmadu Bello University, Zaria.Department of Veterinary Medicine, University of Ilorin,Ilorin.Department of Veterinary Surgery and Radiology, Ahmadu Bello University Zaria, Nigeria.Veterinary Teaching Hospital, Ahmadu Bello University Zaria, Nigeria.Department of Veterinary Microbiology, Ahmadu Bello University, Zaria, Nigeria. Department of Theriogenology, University of Abuja, Abuja, Nigeria. *Corresponding email: rhyme4bee@yahoo.com; Tel No: +2348035049184
Ovariohysterectomy and Partial Vaginectomy for Treatment of Cervicovaginitis in a Dog
Case Reports in Veterinary Medicine, 2019
A 1-year-old sexually intact female Labrador Retriever was evaluated for malodorous vaginal discharge, lethargy, and vomiting. A diagnosis of pyometra was suspected based on signalment, clinical signs, and abdominal ultrasonography. The dog underwent an exploratory celiotomy revealing a palpably enlarged cervix and edematous, fluid-filled vagina with an otherwise normal uterus. The ovaries, uterus, cervix, and cranial vagina were surgically resected. Histopathology revealed mild to moderate regionally extensive subacute neutrophilic cervicovaginitis due to an unknown underlying etiology. The dog did not exhibit any postoperative complications or recurrence of clinical signs in 6 months. This case represents an unusual disease condition, which presented in a manner typical for pyometra, yet required more extensive surgical resection.
Closed cervix is associated with more severe illness in dogs with pyometra
BMC Veterinary Research
Background: Pyometra, a life-threatening bacterial infection of the uterus, is classified as open or closed depending on the functional patency of the cervix i.e. presence or absence of vaginal discharge. In closed cervix pyometra, pus and bacterial products accumulate in the uterus, which is thought to induce a more severe illness. The aim of this study was to investigate whether disease severity or outcome differed in dogs with open or closed cervix pyometra. Results: Prospectively collected data from 111 female dogs diagnosed with pyometra at the University Animal Hospital, Swedish University of Agricultural Sciences, Uppsala, intermittently during 2005-2012 was analyzed. Seventy-two dogs (65%) had open cervix, whereas 39 dogs (35%) had closed cervix. Differences between the two groups were explored by Wilcoxon Two Sample Test for continuous variables and Chi-square or Fisher's exact test for categorical variables. P < 0.05 was considered significant. In dogs with open cervix the median age was 9.0 years and the median weight 26.0 kg. In dogs with closed cervix the median age was 9.6 years and the median weight 25.0 kg, with no significant differences between the groups (p = 0.69 and 0.24, respectively). Five dogs (4.5%) died, all with open cervix, and 16 dogs (14%) had complications. The general physical condition was moderately or severely depressed in 30% (21/71) of dogs with open cervix (severely depressed in 4 dogs, moderately depressed in 17 dogs) and in 56% (22/39) of dogs with closed cervix (severely depressed in 3 dogs, moderately depressed in 19 dogs). The general physical condition was mildly depressed in 41 dogs with open cervix and 16 dogs with closed cervix, whereas it was normal in nine dogs with open cervix and one dog with closed cervix. None of the included dogs had very severely depressed general physical condition or were non-responsive. Leukocytosis, neutrophilia, monocytosis and moderately to severely depressed general condition was more commonly found in dogs with closed cervix (p = 0.003, p = 0.008, p = 0.003 and p = 0.006, respectively). Sepsis was more commonly present in closed cervix pyometra (77%, 30/39 dogs) compared to open cervix pyometra (51%, 36/71 dogs) (p = 0.007). Presence of prolonged postoperative hospitalization did not differ significantly between the two groups. Conclusions: In dogs with closed cervix, sepsis was more common, the general physical condition more often moderately to severely depressed and leukocytosis, neutrophilia and monocytosis more frequently found. The results showed that closed cervix was associated with a more severe illness than open cervix at admission but not with poorer outcome as measured by postoperative hospitalization. These findings may be clinically valuable for optimizing monitoring and treatments in dogs with the disease.
Bulgarian Journal of Veterinary Medicine, 2020
The aim of this report was to describe a clinical case of unilateral segmental aplasia of the uterine horn and vulvar hypoplasia associated with pyometra as a complication in a bitch. The patient was presented with abdominal pain, excessive vulvar licking, anorexia and lethargy. The vulva was found hypoplastic, flushed and without any discharge. Ultrasonography revealed an enlarged tip of the left uterine horn filled with fluid. Blood laboratory analysis showed a marked leukocytosis, so diagnosis of pyometra was made. Laparotomy and ovariohysterectomy were performed. During the operation unilateral segmental aplasia of the right uterine horn was observed. This is a very rare case of segmental aplasia of the uterus associated with hypoplasia of the vulva and with clinical signs of systemic disease in the bitch.
Pyometra with inguinal herniation of the left uterine horn and omentum in a Beagle dog
2007
Objective: To describe a unique case of pyometra with inguinal herniation of the left uterine horn and omentum. Case summary: A 7-year-old, 19 kg, intact female Beagle dog presented for surgical treatment of presumptive pyometra and biopsy of a caudal abdominal mass in the left inguinal mammary gland region. Ventral midline celiotomy was performed, and a distended, fluid-filled uterus with passage of the distal aspect of the left uterine horn through the left vaginal process into the inguinal canal was identified. The patient recovered uneventfully following ovariohysterectomy and left inguinal herniorrhaphy. New or unique information provided: This is the first documented report of inguinal herniation of a uterine horn associated with a pyometra.
Current perceptive on canine cystic endometrial hyperplasia-pyometra syndrome-A review
International Journal of Chemical Studies, 2020
Cystic endometrial hyperplasia-pyometra complex (CEH/P) is a life-threatening challenge in canine reproduction. Hormonal imbalances result in environmental and histological changes in the uterus leading to a predisposition to bacterial growth. Haematological analysis shows the total number of leucocytes is frequently elevated in cases of pyometra, although the degree is much less marked in cases of open cervix pyometra compared with closed cervix pyometra. Ovariohysterectomy is the treatment of choice for closed cervix or open cervix pyometra. If the condition is not life-threatening and the animal is enrolled in breeding programmed or particularly valuable or when the clinical situation precludes surgery, medical treatment may be considered.
Diagnosis and Medication of Pyometra in a Female Dog
2021
Pyometra, the purulent inflammation of uterus, is a common disease of genital apparatus of the dog. Diagnosis and treatment of this pathology is object of a lot of studies. Diagnosis is based on history and anamnesis, clinical and lab findings, Ultrasonography and histopathology, as a “gold standard” of it. Thirty-five female dogs (mean 7.6± 1.33 years old) of cross and pure bred, affected by pyometra (open and closed cervix) were diagnosed by ultrasonography and 12 uteri were used for histopathological studies. Pyometra was found out in 57.44% of nulliparous controlled female dogs. Ultrasonographic evaluated shown an enlargement and thickened of horns of uteri, lumen content was homogenous to anechoic/echogenic. Histopathological changes are related to Endometrium and its changes like as enlargement of cystic glands and presence of the pus in lumen of uterus. Ovariohysterectomy were realized in all female dogs. Three of them were euthanized some days after. The study aims to empha...
Journal of the American Veterinary Medical Association, 2022
OBJECTIVE To determine the rate of survival to hospital discharge and identify indicators associated with poor outcomes among female dogs (bitches) with pyometra treated with ovariohysterectomy (OHE) in a nonspecialized setting. ANIMALS 405 bitches diagnosed with pyometra at the American Society for the Prevention of Cruelty to Animals Animal Hospital from January 1, 2017, to February 8, 2019. PROCEDURES For this retrospective study, medical records were searched and data collected including patient history, clinical signs, serum biochemical analyses results, and outcome (survival to hospital discharge, length of hospital stay, and uterine rupture). Logistic regression models were used to assess multivariable associations and identify potential predictive variables. RESULTS The rate of survival to hospital discharge for bitches with pyometra treated with OHE was 97% (394/405); 44% (174/394) stayed in the hospital ≥ 2 nights, and 3% (11/390) had a ruptured uterus. Bitches with a high...
Electrocardiographic Findings in Bitches Affected by Closed Cervix Pyometra
Veterinary Sciences, 2020
Pyometra is considered the most common disease in intact bitches, being associated with potentially life-threatening disorders. Myocardial damage is a potentially life-threatening consequence of pyometra. The aim of this study was to describe the electrocardiographic patterns in bitches affected by closed cervix pyometra, to assess the clinical relevance of electrocardiographic changes with the occurrence of pyometra, and to relate their severity with laboratory and clinical findings. A total of 39 bitches with closed cervix pyometra and 10 healthy female dogs were included in this study. During the hospitalization, bitches underwent a complete physical examination. An electrocardiographic examination before the ovariohysterectomy was performed. Blood samples for biochemical and hematological analysis were also evaluated. Bitches suffering pyometra at least one arrhythmia 31/39 (79.4%), sinus tachycardia (22/39, 56.4%), ventricular premature complexes (9/39, 23%), increased amplitud...
A case of pyometra with leiomyoma, paraovarian cyst and sutured vagina in a bitch
The Thai Journal of Veterinary Medicine
The present case report describes a 6-year-old, mixed-breed bitch that was referred due to anorexia, polyuria, polydipsia, and lethargy for 2 weeks. The bitch had been spayed 4 years previously at a different clinic. Vaginal inspection by speculum and cytology was not possible because the vaginal canal had been closed surgically. Stump pyometra was suspected upon ultrasonographic and clinical examination. However, the whole uterus and ovaries were observed during surgery. Thus, the bitch had in fact not been spayed as noted anamnesis, but rather the vagina had been sutured to prevent copulation. Histopathological analysis of the uterus and ovaries revealed findings consistent with those for uterine leiomyoma, pyometra, and paraovarian cyst. Therefore, the bitch was diagnosed with pyometra with leiomyoma and a paraovarian cyst. Consequently, it is emphasized that vaginal suturing is an inappropriate and unacceptable method of contraception.
Vaginal Leiomyosarcoma Subsequent to Pyometra in a Labrador Retriever Bitch
İstanbul Üniversitesi Veteriner Fakültesi Dergisi, 2014
In this case, vaginal leiomyosarcoma subsequent to pyometra is described in a 10-year old Labrador Retriever bitch. Bloody, malodorous discharge related to pyometra was present from the vagina for 4 months. Ovariohysterectomy recommended but the owner refused the operation. Three weeks after the first examination a rapidly growing mass and a bulge were noticed in the vagina. The dog underwent ovariohysterectomy and a biopsy was taken from the mass at the vagina during this surgery and submitted to pathology laboratory. It was diagnosed as leiomyosarcoma in histopathological and immunohistochemical examinations. After the mass extirpated surgically the recurrence was occurred in one and a half months later. The bitch's general condition deteriorated rapidly and she died. Because of the late arrival of the patient to our clinic and in order to the request of the owner, treatment protocols could not be able to applied properly so the case was failed. The aim of this case is to transfer the surgical approaches to these kinds of reproductive pathologies to the literature. It is concluded that these kinds of pathologies should be treated immediately.
Theriogenology, 2016
The objective of the study was to describe the feasibility of a glove port technique for laparoscopic-assisted surgical treatment of canine pyometra. In this retrospective case series, a total of 10 female dogs (median age 7 years, range 5.5-10.5 years; median weight 37.0 kg, range 12.9-64.0 kg) with pyometra were included. A multiaccess port was created from a surgical glove attached to an Alexis wound retractor and placed in the ventral midline between the middle and caudal third of the distance between umbilicus and pubic rim. A vessel sealing device was used for transection of the ovarian pedicle. The port size was selected on the basis of maximum uterine diameter determined by ultrasound. Median incision length was 5.0 cm (range 3.1-7.7 cm) for a maximum uterine diameter of 4.0 cm (range 2.0-7.0 cm). Median surgical time was 57 minutes (range 48-65 minutes). No case had to be converted to open celiotomy. Complications included one case of minor, self-limiting splenic trauma by the endoscope. In eight dogs, the distended uterine horns endangered safe access to the ovarian pedicle, and the vessel sealing device was inserted through a second cannula placed periumbilically. Extension of the original incision was necessary to exteriorize organs in two dogs. All dogs recovered quickly and were discharged either on the day of surgery or 1 day thereafter. In conclusion, a surgical glove port technique in combination with an Alexis wound retractor is feasible for surgical laparoscopic treatment of canine pyometra up to a diameter of 7 cm.
Pyometra in Bitches: A Review of Literature
Journal of Veterinary Science and Technology, 2018
Pyometra is a frequently diagnosed bacterial infection of the uterus in intact, sexually mature bitches, leading to the accumulation of purulent material in the uterine lumen. Approximately one third of the anoestrous bitches can be diagnosed with pyometra. Closed-cervix pyometra is particularly dangerous, because septicaemia and toxaemia may develop rapidly and if left untreated can result in death of the patient. Due to the insidious nature of the disease and its sometimes equivocal clinical signs, patients are often presented in poor condition for anaesthesia and surgery. Keywords: Pyometra, uterus, bitches Cite this Article Prasad VD, Kumar PR, Sreenu M. Pyometra in Bitches: A Review of Literature. Research & Reviews: Journal of Veterinary Science and Technology. 2017; 6(2): 12–20p.
Mummified papyraceous fetuses in the abdominal cavity of an elderly female dog with pyometra
Arquivo Brasileiro de Medicina Veterinária e Zootecnia, 2012
This paper reports on a rare case of fetal papyraceous mummification after asymptomatic uterine rupture in an elderly female dog with pyometra. The patient had a history of mating six months before the examination but no apparent signs of gestation or parturition. Exploratory laparotomy was used to identify a rupture of the left uterine horn and the presence of cystic endometrial hyperplasia and pyometra. Two mummified papyraceous fetuses were observed in the abdominal cavity and had adhered to the spleen, pancreas, intestine and omentum. Ovariehysterectomy and corrective surgery were performed. The patient had remained healthy after uterine rupture until a new estrous cycle and the development of pyometra. Bitches that are 10 years old or more are predisposed to implantation failure, pregnancy or parturition problems and they should not be breed to avoid complications.
Gynaecological Complications Following Improper Ovariohysterectomy in a Dog
The aim of this case report was to describe the gynaecological complications that were related to improper ovariohysterectomy in a dog. Another aim of this report was to highlight the necessity of careful and proper surgical technique to the clinicians. Ovariohysterectomy is an irreversible technique which is used routinely in female animals. In present case a 5 years old Golden Retriever dog that was presented to our clinic with the complaint of enlargement of the abdomen and bloody vaginal discharge was described. The bitch had been spayed previously in a private clinic in 2006. After this surgery the bitch continued to exhibit signs of estrus and mated several times. Radiography and ultrasonography revealed two large fluid accumulation likely due to the fact that of remnant uterine horns. It was decided to operate on the bitch. During the surgery it was detected that only the bifurcation of the uterus was excised at the first surgery which had been performed in the private clinic...
Treatment of a Recurrent Pyometra by Surgical Uterine Drainage in a Main Coon Cat
Veterinary Sciences
Pyometra is a uterine disease typical of the luteal phase of the estrus cycle. For selected patients, such as breeding subjects, ovariohysterectomy is not a valid resolutive option. Medical treatments involving cloprostenol and aglepristone have been developed for the cats, but they can be ineffective in rare cases. Transcervical drainage and flushing have been described for the dogs, as well as for large wild cats. However, to the author’s knowledge, there are no report of uterine drainage in cats. The present case describes an alternative treatment of pyometra in a 3-year-old Main Coon previously treated with aglepristone. The patient underwent a laparotomy: the uterus was exposed, and a sterile urinary catheter was inserted into each horn, through the wall of the uterus, to allow the drainage of pathological collection and a subsequent lavage with lukewarm sterile saline. Medical treatment with aglepristone and marbofloxacin was associated. After treatment, no recurrence was repo...
Haemato-Biochemical Studies Before and After Ovario-Hysterectomy in Bitches Affected with Pyometra
The Indian Journal of Veterinary Sciences and Biotechnology, 2020
This study was conducted on 18 bitches; 10 affected with pyometra and 8 normal healthy bitches to evaluate and compare the haematobiochemical profiles before and after surgical intervention. The blood samples were collected from confirmed cases of canine pyometra and healthy bitches just before and on day 8 th and 15 th after surgery. The mean values of haemoglobin, packed cell volume, total erythrocyte count, total platelet count were significantly (p < 0.01) lower, and erythrocyte sedimentation rate and total leucocyte count were significantly (p < 0.01) higher in bitches affected with pyometra as compared to healthy ones on day 0. These differences gradually narrowed down on day 8 th and 15 th post-operative with improvement in profile of operated pyometric bitches. The mean neutrophil count was significantly increased, whereas the values of lymphocytes, monocytes and eosinophils were decreased in bitches with pyometra than in healthy ones, which gradually normalized in post-operative period. Significantly (p < 0.05) higher values of plasma urea nitrogen (46.13 ± 6.79 vs. 24.32 ± 5.16 mg/dl), creatinine (1.92 ± 0.42 vs 1.14 ± 011 mg/dl) plasma total protein and globulin (4.87 ± 0.27 vs 2.85 ± 0.19 g/dl) with lower A:G ratio (0.51 ± 0.03 vs 0.99 ± 0.10) were recorded in bitches with pyometra as compared to healthy ones, which declined non-significantly by 8 th and 15 th day post-operative in affected bitches. There was significant decline in the plasma levels of total cholesterol and enzymes aspartate amino transferase and alanine aminotransferase in bitches with pyometra at 8 th and 15 th day post-operative as compared to pre-operative values, however the differences between healthy and affected bitches were statistically non-significant, perhaps due to wide variation in the profiles of individual animals. It is concluded that haemato-biochemical profile in conjunction with clinical signs can be used to predict the severity of canine pyometra.
Acta Cirúrgica Brasileira
Purpose: To evaluate the use of barbed sutures over the surgical time, the leukogram, the tissue thickness in which the sutures were employed (ultrasonography), the costs, and the possible complications in bitches with pyometra submitted to ovariohysterectomy (OH). Methods: Convectional 2.0 polyglyconate suture was used in the control group (CG n = 10) and 2.0 barbed polyglyconate suture in the barbed group (BG n = 10) to perform celiorrhaphy (simple continuous pattern) and subcutaneous closure (continuous intradermal pattern). Data were assessed using paired (leukogram between 24 and 48 h within the same group) and unpaired (leukogram, surgical time, tissue thickness, and costs) Student's t-test. The Fisher exact test was used to assess the occurrence of seroma between groups (p < 0.05). Results are shown as mean ± standard error of mean. Results: The time spent to perform the celiorrhaphy (195.30 ± 17.37 s vs. 204 ± 16.00 s), subcutaneous closure (174.0 ± 15.86 s vs. 198.0 ± 15.62 s), and the total surgical time (24.30 ± 1.44 min vs. 23.00 ± 1.30 min) did not differ between BG and CG, respectively (p > 0.05). Leukogram at 48 h post-surgery did not differ between groups (p = 0.20). No differences were observed in the subcutaneous and the abdominal wall thickness (cm) assessed by ultrasonography at 48 h in BG (0.31 ± 0.04, 0.80 ± 0.05) and CG (0.34 ± 0.03, 0.72 ± 0.06), respectively. Similarly, 15 days post-surgery the same structures did not differ between BG (0.26 ± 0.02, 0.74 ± 0.08) and CG (0.26 ± 0.03, 0.64 ± 0.05) (p > 0.05). In one bitch from each group, a mild seroma was observed on one side of the surgical wound 48 h after surgery (p = 1.00). The procedures in which barbed sutures were used had an average additional cost of R$ 200.00 ± 11.66 (p < 0.0001). Conclusions: Barbed suture has proven to be efficient and safe for abdominal and subcutaneous closure. However, considering its current high cost in addition that the surgical time of bitches with pyometra undergone OH was not reduced, no advantages were observed with the use of barbed sutures for this type of surgery.
Clinical Changes and Uterine Hemodynamic in Pyometra Medically Treated Bitches
Animals, 2020
Cystic endometrial hyperplasia–pyometra complex is a canine endometrial disorder, considered the most common and important among uterine diseases. The treatment of choice is ovariohysterectomy, but medical treatments have become an alternative. However, no studies have been performed in order to evaluate uterine hemodynamic changes during medical treatment for pyometra bitches. Therefore, the aim of this study was to compare the effectiveness of two medical protocols by means of clinical (heart rate, respiratory rate and body temperature), medullar response (complete blood count (CBC)) and uterine hemodynamic evaluation in pyometra bitches. For such purpose, 10 bitches with pyometra were assigned to two groups: Aglepristone Group (n = 5) and Associative Group (aglepristone + prostaglandin; n = 5). The Associative Group had altered respiratory rate and decreased body temperature. The Aglepristone Group had decreased plasma protein, however, leukocyte count reduced over time for both ...