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Journal of Investigative Medicine High... 2021Pyometra, a purulent infection of the uterus, is a rare cause of a very common complaint-abdominal pain. Risk factors include gynecologic malignancy and postmenopausal...
Pyometra, a purulent infection of the uterus, is a rare cause of a very common complaint-abdominal pain. Risk factors include gynecologic malignancy and postmenopausal status. The classically described presentation includes abdominal pain, fever, and vaginal discharge. In this article, we present an atypical presentation of nonperforated pyometra in an 80-year-old female who was admitted to the internal medicine inpatient service. She initially presented with nonspecific subacute right lower quadrant abdominal pain. Physical examination did not demonstrate vaginal discharge. Laboratory evaluation failed to identify an underlying etiology. Computed tomography scan of the abdomen and pelvis with oral and intravenous contrast demonstrated a 6.5 × 6.1 cm cystic containing structure within the uterine fundus, concerning for a gynecologic malignancy. Pelvis ultrasound confirmed the mass. Endometrial biopsy did not reveal underlying malignancy, but instead showed frank pus, leading to the diagnosis of pyometra. This report illustrates that pyometra should be considered in the differential diagnosis of lower abdominal pain in elderly women.
Topics: Abdominal Pain; Aged; Aged, 80 and over; Female; Fever; Humans; Pyometra
PubMed: 34105423
DOI: 10.1177/23247096211022481 -
Frontiers in Veterinary Science 2020The present study evaluated for the first time changes in the saliva proteome in bitches with pyometra through a high-throughput quantitative proteomic analysis. The...
The present study evaluated for the first time changes in the saliva proteome in bitches with pyometra through a high-throughput quantitative proteomic analysis. The aims were to explore whether saliva composition could reflect the physiopathological changes occurring in canine pyometra and to identify potential biomarkers of the disease. Saliva samples from six healthy (H) and six bitches with pyometra (P) were analyzed using tandem mass tags-based approach. Additionally, 15 samples were used for the validation of changes in haptoglobin (Hp) concentration in saliva of dogs with pyometra. Proteomic analysis quantified 707 proteins in saliva. Comparison of the two groups revealed 16 unique proteins significantly modulated in saliva, with S100A calcium-binding protein 12 (S100A12), vimentin, and Hp the most up-regulated in canine pyometra. According to PANTHER (Protein Analysis Through Evolutionary Relationships) classification tool, these proteins are mainly related to proinflammatory mediators, acute-phase proteins, and sepsis. In conclusion, it can be stated that there are changes in various proteins in saliva in canine pyometra reflecting different physiopathological changes occurring in this disease. These proteins could be a source of potential non-invasive biomarkers for this disease that should be confirmed in future studies.
PubMed: 32596263
DOI: 10.3389/fvets.2020.00277 -
Journal of the American Veterinary... Nov 2017OBJECTIVE To characterize clinical and laboratory findings in cats with naturally occurring sepsis, emphasizing hemostasis-related findings, and evaluate these variables...
OBJECTIVE To characterize clinical and laboratory findings in cats with naturally occurring sepsis, emphasizing hemostasis-related findings, and evaluate these variables for associations with patient outcomes. DESIGN Prospective, observational, clinical study. ANIMALS 31 cats with sepsis and 33 healthy control cats. PROCEDURES Data collected included history; clinical signs; results of hematologic, serum biochemical, and hemostatic tests; diagnosis; and outcome (survival vs death during hospitalization or ≤ 30 days after hospital discharge). Differences between cats with and without sepsis and associations between variables of interest and death were analyzed statistically. RESULTS The sepsis group included cats with pyothorax (n = 10), septic peritonitis (7), panleukopenia virus infection (5), bite wounds (5), abscesses and diffuse cellulitis (3), and pyometra (1). Common clinical abnormalities included dehydration (21 cats), lethargy (21), anorexia (18), pale mucous membranes (15), and dullness (15). Numerous clinicopathologic abnormalities were identified in cats with sepsis; novel findings included metarubricytosis, hypertriglyceridemia, and high circulating muscle enzyme activities. Median activated partial thromboplastin time and plasma D-dimer concentrations were significantly higher, and total protein C and antithrombin activities were significantly lower, in the sepsis group than in healthy control cats. Disseminated intravascular coagulopathy was uncommon (4/22 [18%] cats with sepsis). None of the clinicopathologic abnormalities were significantly associated with death on multivariate analysis. CONCLUSIONS AND CLINICAL RELEVANCE Cats with sepsis had multiple hematologic, biochemical, and hemostatic abnormalities on hospital admission, including several findings suggestive of hemostatic derangement. Additional research including larger numbers of cats is needed to further investigate these findings and explore associations with outcome.
Topics: Animals; Blood Coagulation Disorders; Cat Diseases; Cats; Female; Male; Sepsis
PubMed: 29035656
DOI: 10.2460/javma.251.9.1025 -
PloS One 2015Cystic endometrial hyperplasia (CEH), mucometra, and pyometra are common uterine diseases in intact dogs, with pyometra being a life threatening disease. This study...
Cystic endometrial hyperplasia (CEH), mucometra, and pyometra are common uterine diseases in intact dogs, with pyometra being a life threatening disease. This study aimed to determine the gene expression profile of these lesions and potential biomarkers for closed-cervix pyometra, the most severe condition. Total RNA was extracted from 69 fresh endometrium samples collected from 21 healthy female dogs during diestrus, 16 CEH, 15 mucometra and 17 pyometra (eight open and nine closed-cervixes). Global gene expression was detected using the Affymetrix Canine Gene 1.0 ST Array. Unsupervised analysis revealed two clusters, one mainly composed of diestrus and CEH samples and the other by 12/15 mucometra and all pyometra samples. When comparing pyometra with other groups, 189 differentially expressed genes were detected. SLPI, PTGS2/COX2, MMP1, S100A8, S100A9 and IL8 were among the top up-regulated genes detected in pyometra, further confirmed by external expression data. Notably, a particular molecular profile in pyometra from animals previously treated with exogenous progesterone compounds was observed in comparison with pyometra from untreated dogs as well as with other groups irrespective of exogenous hormone treatment status. In addition to S100A8 and S100A9 genes, overexpression of the inflammatory cytokines IL1B, TNF and IL6 as well as LTF were detected in the pyometra from treated animals. Interestingly, closed pyometra was more frequently detected in treated dogs (64% versus 33%), with IL1B, TNF, LBP and CXCL10 among the most relevant overexpressed genes. This molecular signature associated with potential biomarkers and therapeutic targets, such as CXCL10 and COX2, should guide future clinical studies. Based on the gene expression profile we suggested that pyometra from progesterone treated dogs is a distinct molecular entity.
Topics: Animals; Biomarkers; Dog Diseases; Dogs; Female; Gene Expression Profiling; Molecular Targeted Therapy; Pyometra
PubMed: 26222498
DOI: 10.1371/journal.pone.0133894 -
Veterinary World Jul 2022Canine pyometra, either the closed (closed pyometra [CP]) or open (open pyometra [OP]) cervix type, is a frequent uterine disease in intact old age bitches. Therefore,...
BACKGROUND AND AIM
Canine pyometra, either the closed (closed pyometra [CP]) or open (open pyometra [OP]) cervix type, is a frequent uterine disease in intact old age bitches. Therefore, early diagnosis and appropriate medical and surgical treatments are crucial to avoid the life-threatening condition in these bitches. This study aimed to investigate clinical alterations, blood parameters, causative bacteria, antimicrobial susceptibility, and uterine histopathology obtained during aseptic surgical treatment on bitches with pyometra.
MATERIALS AND METHODS
Sixty bitches of various breeds and ages with presumptive pyometra diagnoses were included in the study. The diagnoses were based on history, clinical examination, blood parameters, radiography, and ultrasonography. All pyometra bitches were ovariohysterectomized as an emergency surgical treatment. In addition, uterine content and tissues were submitted for bacterial isolation, antimicrobial susceptibility, and uterine histopathological analysis.
RESULTS
Except for abdominal CP distention, no specific clinical signs were linked to the pyometra type. The mean values of total white blood cell count (WBC) and plasma protein were predominantly raised in pyometra bitches regarding hematological parameters. Leukocytosis was found in both types; however, the WBC in CP was markedly higher than in OP. The mean value of blood urea nitrogen increased in the CP group. and were the most frequent causative bacteria isolated in CP and OP, respectively. All isolated bacteria were 100% susceptible to imipenem, meropenem, and carbapenem. Marbofloxacin was the second most effective drug against isolated bacteria from both groups. Uncomplicated cystic endometrial hyperplasia (CEH) was not presented in the CP group. CEH and chronic endometritis (type IV), the most severe uterine histopathological changes, were discovered in the CP and OP.
CONCLUSION
The CP and OP groups presented leukocytosis, increased plasma protein, and CEH and chronic endometritis. Depression, abdominal distention, and enlarged uterine size were the major characteristics of the CP group. Furthermore, abdominal distension is presented in other abnormalities in clinical practices, providing a differential diagnosis. Drugs in the carbapenem group were the most effective against isolated bacteria; however, they are not routinely used due to bacterial resistance concerns. Thus, marbofloxacin was recommended as an alternative medical treatment because it is convenient to manage by both oral and injection routes.
PubMed: 36185522
DOI: 10.14202/vetworld.2022.1804-1813 -
Animals : An Open Access Journal From... Mar 2021Canine pseudo-placentational endometrial hyperplasia differs from the classical form of cystic endometrial hyperplasia for the well-organized tissue architecture...
Canine pseudo-placentational endometrial hyperplasia differs from the classical form of cystic endometrial hyperplasia for the well-organized tissue architecture resembling the canine placenta. After the discovery, it has been inconstantly reported. The present work reports the clinicopathological details of six spontaneous cases retrieved retrospectively from a large database. The lesion was found in young non-pregnant female dogs (median 2.0 years) at the end of dioestrus. It could be imaged by ultrasound and was always grossly detectable as single or multiple uterine enlargements of 2-3 cm in diameter with a villous whitish tissue growing on the mucosa and occluding the lumen. Histology confirmed the tissue architecture of the canine placenta with a basal glandular layer, a connective band, a spongy layer and a tortuous and compact labyrinth, often poorly recognizable. The pseudo-placentational hyperplasia is a non-inflammatory proliferative lesion although numerous mast cells inhabit the connective band, and a superimposed inflammatory infiltrate was seen in a case. Canine pseudo-placentational endometrial hyperplasia has very peculiar features, and it is a model for canine placentation and may help to better understand the cystic endometrial hyperplasia/pyometra complex.
PubMed: 33800885
DOI: 10.3390/ani11030718 -
Brazilian Journal of Veterinary Medicine 2022This randomized clinical trial aimed to evaluate different fluid therapy protocols associated with inhalational or total intravenous anesthesia in the cardiorespiratory...
This randomized clinical trial aimed to evaluate different fluid therapy protocols associated with inhalational or total intravenous anesthesia in the cardiorespiratory stability of bitches with sepsis subjected to a surgical procedure to control the infectious focus. Thirty-two bitches diagnosed with pyometra and sepsis and treated at the University Veterinary Hospital between 2018 and 2019 were recruited. After admission, diagnosis, clinical, and laboratory evaluation, patients were randomly distributed into the following groups: propofol 5 (P[5]: preoperative restrictive fluid therapy-5mL/kg/h and intravenous general anesthesia); propofol 10 (P[10]: preoperative liberal fluid therapy-10mL/kg/h and intravenous general anesthesia); and isoflurane 5 (I[5]: preoperative restrictive fluid therapy-5mL/kg/h and inhalational general anesthesia). Lactate on admission (LAC1) and release (LAC2), heart rate (HR), respiratory rate (RR), systolic blood pressure (SBP), rectal temperature (RT), oxygen saturation (SpO), and carbon dioxide extraction rate (EtCO) were analyzed at PRE, T10, T20, T30, T40, T50, TEXT, and TDIS. Clearance of 20% of lactate occurred in 18 dogs, with the P[10] group displaying the best performance. There was no statistical difference in vasopressor requirements among the groups. Liberal fluid therapy showed greater cardiovascular stability than restrictive therapy in the perioperative period. Regarding general anesthesia, isoflurane showed greater cardiorespiratory stability than propofol during anesthetic maintenance. In conclusion, although the three proposed protocols are safe and there is no difference in their superiority, some observed changes may be relevant and considered when it is possible to individualize the therapy for the patient.
PubMed: 36128403
DOI: 10.29374/2527-2179.bjvm001222 -
Journal of Veterinary Pharmacology and... Nov 2022The purpose of this study was to evaluate the pharmacokinetics of intravenous (IV) ondansetron in a population of hospitalized dogs exhibiting clinical signs of nausea....
The purpose of this study was to evaluate the pharmacokinetics of intravenous (IV) ondansetron in a population of hospitalized dogs exhibiting clinical signs of nausea. The causes of nausea included pancreatitis, gastroenteritis, endocarditis, chemotherapy-induced nausea, diabetes mellitus and ketoacidosis, acute kidney injury with aspiration pneumonia, pyometra, uroabdomen, neoplasia, and hepatopathy. Twenty-four dogs were randomly assigned to one of the following IV ondansetron protocols: 1 mg/kg q12h, 0.5 mg/kg q12h, 1 mg/kg q8h, 0.5 mg/kg q8h. Serum was collected at 0, 0.25, 0.5, 1, 2, 4, 8, 16, and 24 h after the first dose, and nausea scores were recorded at multiple time points. Ondansetron and arginine vasopressin (AVP) concentrations were measured via high-performance liquid chromatography coupled to tandem mass spectrometry and ELISA, respectively. Noncompartmental pharmacokinetic modeling and dose interval modeling were performed. Ondansetron displayed linear pharmacokinetics. In the 0.5 mg/kg group, mean C = 214 ng/ml, AUC = 463 ng/ml*h, and calculated half-life was 1.9 h. In the 1 mg/kg group, mean C = 541 ng/ml, AUC = 1057 ng/ml*h and calculated half-life was 1.6 h. Serum ondansetron concentrations were not significantly different between dogs that required rescue anti-nausea medication (non-responders) and dogs that did not require rescue therapy (responders). In total, 83.3% of patients in the 0.5 mg/kg q8h, 0.5 mg/kg q12h, and 1 mg/kg q8h groups had improvement in nausea scores. In total, 66.7% of patients in the 1 mg/kg q12h group had improvement in nausea scores. In total, 33% of patients had resolution of nausea in the 0.5 mg/kg q8h, 1 mg/kg q8h, and 1 mg/kg q12h groups, and 16% of patients had resolution of nausea in the 0.5 mg/kg q12h group. AVP concentrations were highly variable and did not correlate with nausea scores. Nausea scores significantly decreased regardless of dosage protocol. AVP was not a reliable biomarker of nausea in this group of dogs.
Topics: Dogs; Animals; Ondansetron; Antiemetics; Nausea; Half-Life; Area Under Curve; Double-Blind Method
PubMed: 35899472
DOI: 10.1111/jvp.13087 -
Animals : An Open Access Journal From... Apr 2024This study evaluated the efficacy and safety of two anesthetic agents, alfaxalone and propofol, on maternal physiological parameters (heart and respiratory rates, blood...
This study evaluated the efficacy and safety of two anesthetic agents, alfaxalone and propofol, on maternal physiological parameters (heart and respiratory rates, blood pressure, and temperature) on either ovariohysterectomies or cesarean sections in bitches. A total of 34 healthy and pyometra-affected females (classified as ASA II), were induced with IV propofol (4 mg/kg), while 35 females, both healthy and pyometra affected, were induced with IV alfaxalone (1 mg/kg). For cesarean sections, females (ASA II) were induced with propofol ( = 14) or alfaxalone ( = 14). Additionally, the neonatal viability and modified Apgar score were recorded at 5, 60, and 120 min post-delivery. There were no significant differences in the physiological parameters when comparing the use of propofol and alfaxalone in bitches undergoing ovariohysterectomies, regardless of their health status, nor when comparing cesarean sections. It was observed that bitches induced with propofol occasionally required an additional dose for maintenance of the anesthesia. Neonatal mortality rates were similar for both groups; however, alfaxalone was associated with higher neonatal viability as indicated by the Apgar scores. The findings suggest that both anesthetic protocols are effective and safe for use in canine reproductive surgeries, with no major differences in basic physiological parameters' alteration or neonatal outcomes between the two agents.
PubMed: 38731346
DOI: 10.3390/ani14091343 -
Australian Veterinary Journal May 2022Bovine trichomoniasis, caused by the protozoal parasite Tritrichomonas foetus, is a highly contagious venereal disease characterised by early pregnancy loss, abortion...
Bovine trichomoniasis, caused by the protozoal parasite Tritrichomonas foetus, is a highly contagious venereal disease characterised by early pregnancy loss, abortion and pyometra. Persistently infected bulls and cows are the primary reservoirs of infection in infected herds. This research investigated the prevalence of T. foetus infection in bulls from properties located across northern Australia and New South Wales. Preputial samples were collected from 606 bulls at slaughter and tested for T. foetus using the VetMAX-Gold Trich Detection Kit (Thermo Fisher Scientific). The apparent prevalence of T. foetus infection varied between regions, with northern regions in the Northern Territory, Queensland and Western Australia showing a prevalence of 15.4%, 13.8% and 11.4%, respectively. There was some evidence of an association between infection and postcode (P = 0.06) and increasing bull age (P = 0.054). This study confirms that T. foetus infection is likely to be present in many beef breeding herds and contributing to lower than expected reproductive performance, particularly across northern Australia.
Topics: Abattoirs; Abortion, Veterinary; Animals; Cattle; Cattle Diseases; Female; Male; Northern Territory; Pregnancy; Prevalence; Protozoan Infections, Animal; Tritrichomonas foetus
PubMed: 35080007
DOI: 10.1111/avj.13149