What is pyometra?

Pyometra, or uterine infection, is a complex, progesterone-dependent disease involving changes in the uterine environment and accumulation of bacteria and pus. It is the most common uterine diseases in intact bitches.. Pyometra can occur with either a closed or open cervix, meaning that an owner may or may not observe pus discharge from the vulva. Pyometra occurs most commonly in the dioestrus phase, or 1-2 months after a bitch has been in season. If left untreated, pyometra can result in systemic infection (sepsis). Pyometra can either be managed surgically or medically.

How do I know my bitch has pyometra?

You may notice pus coming from your dog’s vulva. Most of the other clinical signs are non-specific, such as inappetance, lethargy and excessive thirst. Diagnosis of pyometra is typically made via abdominal ultrasound, along with physical examination and signalment.

What are my options?

Most of our pyometra cases undergo medical management as they are either valuable breeding bitches, have other comorbidities, or for cost reasons. Unless peritonitis is present, it safer and far more cost effective to treat bitches medically than subject them to surgery. Studies have shown that combination therapy using anti-progestagens and prostaglandins had a success rate of 84% inresolving the pyometra and returning to normal fertility. We can also clear the infection by trans-cervical catheterisation and flushing of the uterus. Antibiotics may also be used to reduce the risk of bacterial translocation and systemic infection. Once the cervix is open and the pus is allowed to exit the uterus, the bitch may then be de-sexed in a safe, non-emergent manner a few weeks later. If this is a breeding bitch, mating and pregnancy at the next heat decreases the risk of recurrence.

Surgical management involves ovariohysterectomy or hysterectomy, as it is both curative and preventative of future infections. While it can be done, it is not our preferred method of treatment as most bitches are already in a compromised state when they are diagnosed with pyometra and may not cope well with major abdominal surgery.

Oldie but a goodie!

Medical Treatment of Pyometra and the use of Aglepristone