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Pyometra

What is it?

An infection of the uterus with pus in intact (not spayed) female dogs and cats. The hormonal influences of an intact female dog and cat allows the uterus to go through changes that allows for bacteria to infect the reproductive tract. This is a medical emergency that requires rapid intervention to prevent sepsis (whole body bacterial infection) and death. The most effective method to treating a pyometra is to perform a spay (ovariohysterectomy) which is a surgery that removes the infected ovaries and uterus from the body. Preoperative stabilization and resuscitation are usually necessary before surgery can be performed. This usually involves aggressive intravenous fluid and blood pressure stabilization, intravenous antibiotics as well as blood glucose (sugar) and electrolyte imbalance control. When stable, the patient undergoes surgery.

Clinical Signs

Any intact female dog or cat with the following signs can possibly be sick with a pyometra:

  • lethargy
  • anorexia (not eating)
  • excessive drinking and urinating
  • bloody, cream or yellow/green, malodorous vaginal discharge
  • pale gums

NOTE: Some patients only have purulent vaginal discharge and no other clinical signs whereas some patients have no discharge at all due to a closed cervix (a “closed pyometra”) that traps the bacterial infection within the uterus with no drainage tract.

Complications

  • Infection
  • Sepsis
  • Organ failure
  • Pain
  • Dehiscence of the surgical site/wound closure
  • Cardiovascular compromise (arrhythmias, low blood pressure)
  • Death

Aftercare and Prognosis

  • Patients recovering from a pyometra surgery should be expected to spend 1-2 days in the hospital after surgery, longer if there are complications before, during or after the surgery (see above).
  • After discharge from the hospital the aftercare is minimal as the care is generally the same as it would be for a routine spay.
  • Restricted activity for 14 days. Short leash walks only to go to the bathroom. No running, jumping or rough play during this time.
  • Pain medications and antibiotics will be prescribed for the patient following surgery.
  • An Elizabethan (E) collar (“cone”) is provided and must be worn at all times to prevent self-trauma of the surgical site. A loose fitting breathable T-shirt or post-surgical onesies may also be considered.
  • Daily monitoring of the surgical site. Complications include oozing, a foul smell, swelling or pain at the surgical site. A bandage may be applied to the surgical site to be kept on for the first day (and removed thereafter) after surgery to minimize leaking from the incision.
  • The prognosis for survival with surgery can be as high as 80–100%. The results of performing a pyometra spay is generally a rapid recovery with minimal risk of recurrence, however, if sepsis and organ failure develops, the prognosis can be much poorer. Prompt identification of relevant clinical signs (see above) and rapid intervention by a veterinary team can mitigate the risks of these potentially life-threatening consequences.