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The word Pyometra derived from the Latin “pyo” meaning pus and “metra” meaning uterus. The Pyometra is an abscessed, pus-filled infected uterus. The condition is very serious and immediate surgery is almost always needed. The surgery is very extensive. Pyometra causes toxins and bacteria to leak across the uterine walls into the bloodstream. This causes life threatening toxic effects. If no treatment is received, death is inevitable.
The classic patient is an older female dog. Although less common, Pyometra can also occur in female cats, rabbits, ferrets and guinea pigs. Pyometra can begin three to five weeks after the animal goes through a heat cycle. There are many clinical signs of Pyometra such as pus draining from the vagina/vulva, increased thirst and increased urination, enlargement of the abdomen as the uterus fills with pus, lethargy, poor appetite, weight loss, fever and dehydration.
There are two types of Pyometra. Open and closed Pyometra. Open Pyometra is the less severe of the two because the cervix is open and it allows the pus to drain out. Open Pyometra has often been misdiagnosed as an aberrant heat. Closed Pyometra leaves no avenue for the pus to drain since the cervix is closed. The pus builds up inside the uterus and it intensifies and spreads the infection. Pyometra can be compared to acute appendicitis in humans, because both are abscesses within an abdominal organ.
Diagnosis of Pyometra can be made several ways. Animals with Pyometra have a marked elevation of the white blood cell count and there is often an elevation of globulins (a type of protein that is produced by the immune system) in the blood. The gravity of the urine is also very low due to the toxic effects of the bacteria on the kidneys. If the cervix is closed, x-rays of the abdomen will identify the enlarged uterus. If the cervix is open then there will be minimal uterine enlargement so a x-ray will not be conclusive. Ultrasounds are also helpful to identify an enlarged uterus. Ultrasounds differentiate Pyometra from a normal pregnancy.
Treatment can be done with or without surgery. Animals with Pyometra are septic and often in shock so intravenous fluids and antibiotics are given immediately. The most common treatment is an emergency spay. This is done to remove the infected organ. Spaying completely removes the infection and prevents uterine rupture and peritonitis. This also prevents recurrence.
Although spaying is the most effective and the safest treatment, this also prevents breeding and for some owners this is not an option. If spaying is not an option Prostaglandin therapy and long term antibiotics are used to expel the pus from the uterus and to treat the infection. Prostaglandin therapy stimulates the uterus to contract. This treatment option requires three to five days to remove the infected material. This treatment should only be used with Open Pyometra because it will cause uterine rupture in cases of Close Pyometra. Less than thirty percent of female dogs are successfully treated this way. Dogs should be bred at the next estrus cycle and then spayed after parturition, because seventy percent will develop Pyometra again within the next two years.
Pet owners need to be aware of Pyometra and if it is suspected, pets need to be taken to a veterinarian clinic promptly. A full recovery is more likely if the Pyometra is caught in time.
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