15/11/2024
Written by my Vet friend Paul Boland.
Medical treatment of canine pyometra.
Pyometra is a bacterial infection in the uterus, where the uterus becomes full of puss. 80% of infections are caused by E.coli and it usually occurs after a season because progesterone reduces the local immune response in the endometrium. Progesterone-induced endometrial hyperplasia leads to cystic endometrial hyperplasia that, in turn, can lead to pyometra. Clinical signs include drinking and urinating more, lethargy, anorexia, vomiting, dehydration and eventually collapse and death if the disease is not treated. If the cervix is open, there will be a serosanguinous purulent discharge.
Diagnosis is made by clinical history, clinical signs, blood results and ultrasound. The treatment of choice is surgery, but some breeders may want a bitch treated medically. The disease can be treated medically but may recur. In conjunction with intravenous fluid therapy, pain relief and antibiotics, oral Cabergoline ‘Galastop’ 5mcg/kg/day is used because it reduces progesterone. Alternatively, Aglepristone ‘Alizin’ 10mg/kg subcutaneously at two injections, 24 hours apart and then 7 days later, can be used to reduce progesterone. After the cervix opens, the prostaglandin Cloprostenol ‘Estrumate’ 5mcg/kg every other day by injection is added to induce uterine emptying (the result of its spasmogenic activity) and to remove the stimulatory effects of progesterone (the result of its luteolytic action). Ultrasound will confirm that the treatment has worked. Antibiotics are continued for 4 weeks after the treatment has worked. I have successfully used this treatment on one of my bi***es, and she subsequently had two normal litters.
