24/03/2021
Whiskey The Gernal shepherd female 9 yr old,
Suddenly stopped eating food and unable to walk with hind limbs.
Fever, anorexia, severe weakness, unable to stand, weakened hindlibs and mucous purulent va**nal discharge these are the primary symptoms observed.
On further investigation of blood
Her WBC count was 34000 with severe leucocytosis, luckly her kidney and liver parameters were normal.
So immediately we decided to operate her for PYOMETRA.
She is stable after surgery.
What is pyometra?
Pyometra is a secondary infection that occurs as a result of hormonal changes in the female's reproductive tract. Following estrus (heat), the hormone progesterone remains elevated for up to two months and causes the lining of the uterus to thicken in preparation for pregnancy. If pregnancy does not occur for several consecutive estrus cycles, the uterine lining continues to increase in thickness until cysts form within the uterine tissues (a condition called cystic endometrial hyperplasia). The thickened, cystic lining secretes fluids that create an ideal environment for bacterial growth.
In addition, the muscles of the uterus cannot contract properly either due to thickening of the uterine wall or the high levels of the hormone progesterone. This means that bacteria that enters the uterus and fluids that have accumulated cannot be expelled
During estrus, white blood cells, which would normally protect against infection by eliminating bacteria, are inhibited from entering the uterus. This normal occurrence allows s***m to safely enter the female's reproductive tract without being damaged or destroyed by these immune system cells.
The combination of these three factors can often lead to life threatening infection
How do bacteria enter the uterus?
The cervix is the gateway to the uterus. It remains tightly closed except during estrus, when it relaxes to allow s***m to enter the uterus.
"If the cervix is open or relaxed, bacteria can easily enter the uterus."
If the cervix is open or relaxed, bacteria that are normally found in the va**na can easily enter the uterus. If the uterus is ‘normal’, the uterine environment prevents bacterial survival; however, when the uterine wall has become thickened or cystic, due to cystic endometrial hyperplasia, perfect conditions exist for bacterial growth.
What are the clinical signs of pyometra?
The clinical signs depend on whether or not the cervix remains open. If it is open, pus will drain from the uterus through the va**na to the outside. Pus or an abnormal discharge is often seen on the skin or hair under the tail or on bedding and furniture where the dog has recently laid. Fever, lethargy, anorexia, and depression may or may not be present.
If the cervix is closed, pus that forms is not able to drain to the outside. It collects in the uterus ultimately causing the abdomen to distend. The bacteria release toxins that are absorbed into the bloodstream. Dogs with closed pyometra become severely ill very rapidly. They are anorectic, very listless and very depressed. Vomiting or diarrhea may also be present.
Toxins released by the bacteria affect the kidney's ability to retain fluid. Increased urine production occurs, and many dogs drink an excess of water to compensate. Increased water consumption may occur in both open- and closed-cervix pyometra.
How is pyometra treated?
"The preferred treatment is to surgically remove the infected uterus and ovaries..."
The preferred treatment is to surgically remove the infected uterus and ovaries by performing an ovariohysterectomy (spay). Dogs diagnosed in the early stage of the disease are very good surgical candidates. The surgery is somewhat more complicated than a routine spay at this stage. However, most dogs are diagnosed with pyometra when they are quite ill resulting in a more complicated surgical procedure.
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