-
The Veterinary Clinics of North... May 2022Pyometra is a common disease in intact bitches and queens and occurs, although less frequently,in most other female pets. The illness is generally diagnosed within 4... (Review)
Review
Pyometra is a common disease in intact bitches and queens and occurs, although less frequently,in most other female pets. The illness is generally diagnosed within 4 months after estrus, in middle-aged to older bitches and queens. Hormonal and bacterial factors are important for the disease development, and progesterone plays a key role. The diagnosis is based on case history, clinical signs, and findings on physical examination, laboratory analyses and diagnostic imaging. Pyometra is potentially life-threatening and considered a medical emergency. Surgical ovariohysterectomy is the safest and most efficient treatment, but purely pharmacologic options are possible in less severe cases.
Topics: Animals; Dog Diseases; Dogs; Endometrial Hyperplasia; Female; Hysterectomy; Progesterone; Pyometra
PubMed: 35465903
DOI: 10.1016/j.cvsm.2022.01.004 -
The Veterinary Clinics of North... Jul 2018Pyometra is a common disease in dogs and cats. Hormones and opportunistic bacteria are fundamental in the development, with progesterone playing a key role. The disease... (Review)
Review
Pyometra is a common disease in dogs and cats. Hormones and opportunistic bacteria are fundamental in the development, with progesterone playing a key role. The disease should be suspected in intact bitches and queens presenting with illness, and particularly if within 4 months after estrus. Early diagnosis and treatment are vital to increase chances of survival as endotoxemia and sepsis often are induced. Typical clinical signs include vaginal discharge, depression, anorexia, polyuria and polydipsia, fever and gastrointestinal disturbances. Surgical ovariohysterectomy is the safest and most effective treatment. For breeding animals with less severe illness, purely medical treatments alternatives are possible.
Topics: Animals; Cat Diseases; Cats; Dog Diseases; Dogs; Female; Hysterectomy; Ovariectomy; Pyometra
PubMed: 29933767
DOI: 10.1016/j.cvsm.2018.03.001 -
Reproduction in Domestic Animals =... Jun 2014Pyometra is a reproductive disorder very common in bitches over 8 years of age in which physiological effects of progesterone on the uterus play a major role. The... (Review)
Review
Pyometra is a reproductive disorder very common in bitches over 8 years of age in which physiological effects of progesterone on the uterus play a major role. The traditional therapy for pyometra is ovariohysterectomy. The main advantage of ovariohysterectomy over medical management is that it is both curative and preventive for recurrence of pyometra. However, surgery is associated with the risk of anaesthesia and renders the bitch sterile. During the last 10 years, numerous medical treatments have been proposed to treat both open and closed cervix pyometra. The most effective medical treatment with minor side effects seems to be the repeated administration of aglepristone with or without the additional treatment with low doses of prostaglandins.
Topics: Animals; Dog Diseases; Dogs; Estrenes; Female; Prostaglandins; Pyometra; Receptors, Progesterone
PubMed: 24947858
DOI: 10.1111/rda.12302 -
The Veterinary Clinics of North... Sep 2023Pyometra is a common disease in intact bitches and queens and occurs, although less frequently, in most other female pets. In bitches and queens, the illness is... (Review)
Review
Pyometra is a common disease in intact bitches and queens and occurs, although less frequently, in most other female pets. In bitches and queens, the illness is generally diagnosed within 4 months after estrus, in middle-aged to older individuals. Complications such as peritonitis, endotoxemia, and systemic inflammatory response syndrome are not uncommon and associated with more severe illness. Ovary-sparing surgical options such as hysterectomy could be considered in individuals with high-risk for detrimental side effects of spaying or without infection of the uterus but has not yet been evaluated for safety in pyometra.
Topics: Dogs; Female; Animals; Pyometra; Dog Diseases; Uterus; Hysterectomy; Ovariectomy
PubMed: 37270345
DOI: 10.1016/j.cvsm.2023.04.009 -
Journal of Feline Medicine and Surgery Jan 2016Pyometra is a commonly occurring uterine disease in cats that often leads to loss of breeding potential and, in some cases, can be life threatening. An increased... (Review)
Review
PRACTICAL RELEVANCE
Pyometra is a commonly occurring uterine disease in cats that often leads to loss of breeding potential and, in some cases, can be life threatening. An increased incidence of cystic endometrial hyperplasia (CEH) and pyometra is seen with age. Most queens present with uterine lesions after 5-7 years of age (average 7.6 years, range 1-20 years). Clinical signs most commonly occur within 4 weeks of the onset of oestrus in queens that are either mated, spontaneously ovulate or are induced to ovulate (mechanical stimulation or hormone induction). The disease is most often observed in dioestrus.
CLINICAL CHALLENGES
Queens with pyometra often go undiagnosed as there may be few or only very mild clinical signs and laboratory changes. For example, the classic sign of mucopurulent bloody vulvar discharge often goes unnoticed. Abdominal ultrasound is the best tool for diagnosis of pyometra and for monitoring response to therapy.
PATIENT GROUP
Classically, middle-aged/older nulliparous intact queens present with pyometra. However, so-called 'stump pyometra' can occur if ovarian tissue is left behind during ovariectomy or ovariohysterectomy (ovarian remnant syndrome). Queens treated with exogenous steroid hormones such as high doses of megestrol acetate or medroxyprogesterone acetate for oestrus prevention can also develop CEH and pyometra.
EVIDENCE BASE
There has been little published to date on CEH, endometritis and pyometra in the queen and most of the currently available information has been extrapolated from studies carried out in the bitch. The queen and the bitch have very different reproductive physiology; thus, further research and investigation into the precise aetiopathogenesis of these disease processes of the uterus in the queen is warranted.
AUDIENCE
This review is aimed at clinicians working in small animal practice, especially those in countries where surgical sterilisation is not practised as commonly as in the United States, Canada or Australasia, and who will therefore see a greater proportion of intact queens.
Topics: Animals; Cat Diseases; Cats; Endometrial Hyperplasia; Female; Hysterectomy; Ovariectomy; Pyometra
PubMed: 26733546
DOI: 10.1177/1098612X15623114 -
Obstetrics and Gynecology May 2015Pyometra, an accumulation of pus in the uterine cavity, occurs rarely in children but should be considered in the differential diagnosis of an intra-abdominal or pelvic... (Review)
Review
BACKGROUND
Pyometra, an accumulation of pus in the uterine cavity, occurs rarely in children but should be considered in the differential diagnosis of an intra-abdominal or pelvic abscess.
CASE
A 10-month-old infant presented with an increasing abdominal mass. She had previous respiratory and diarrheal illnesses. She was underweight, febrile, and tachycardic with an 8×6-cm mobile tender mass in her lower abdomen. Investigations demonstrated leukocytosis and ultrasonogram confirmed a cystic mass. At laparotomy a pyometra was found. Needle aspiration and washout of the uterine cavity were performed but a second procedure was required to place a drain into the cavity.
CONCLUSION
Pyometra occurs rarely in childhood. A review of cases associates a hypoestrogenized endometrium exposed to transient bacteremia with obstruction to uterine drainage. Treatment should include continuous drainage of the uterus.
Topics: Abdomen; Abdominal Abscess; Anti-Bacterial Agents; Diagnosis, Differential; Drainage; Female; Humans; Infant; Pyometra; Ultrasonography
PubMed: 25932829
DOI: 10.1097/AOG.0000000000000664 -
Reproduction in Domestic Animals =... Apr 2017Pyometra is a common disease in countries where elective spaying is not routinely performed. Hormonal and bacterial factors are fundamental in the pathogenesis of the... (Review)
Review
Pyometra is a common disease in countries where elective spaying is not routinely performed. Hormonal and bacterial factors are fundamental in the pathogenesis of the disease, which manifests itself as a potentially life-threatening bacterial infection of the uterus. Surgical ovariohysterectomy is the safest and most effective treatment for pyometra, and it has recently been shown that laparoscopically assisted methods for surgical treatment are feasible to use in selected cases. New protocols for improved medical treatment alternatives have also been tested with promising results. To be able to predict outcome and presence of complications early would be valuable in clinical practice for optimizing therapy and increasing survival. Results of commonly investigated clinical and laboratory investigations have been shown to be useful as predictive markers, with leucopenia being associated with increased risk of peritonitis as well as prolonged post-operative hospitalization after surgical treatment. A cage-side rapid and cost-effective diagnostic test would be highly valuable in clinical practice, and detection of pyometra-specific upregulated genes in the uterus and the corresponding products is a potential start in identifying novel markers suitable for such as test. The focus of the present review is to highlight recent findings on pathogenesis, prediction of outcome, diagnosis and treatment. Additionally, central research questions and suggestions for future investigations about several aspects of canine pyometra will be addressed.
Topics: Animals; Anti-Infective Agents; Bacterial Infections; Dog Diseases; Dogs; Female; Hysterectomy; Laparoscopy; Ovariectomy; Progesterone; Prognosis; Pyometra; Treatment Outcome
PubMed: 27807901
DOI: 10.1111/rda.12843 -
Theriogenology Aug 2006Pyometra, literally meaning pus in the uterus, is a common disease entity of intact bitches. Similar conditions occur, including hydrometra and mucometra [De Bosschere... (Review)
Review
Pyometra, literally meaning pus in the uterus, is a common disease entity of intact bitches. Similar conditions occur, including hydrometra and mucometra [De Bosschere H, Ducatelle R, Vermeirsch H, Van Den Broeck W, Coryn M. Cystic endometrial hyperplasia-pyometra complex in the bitch: should the two entities be disconnected? Theriogenology 2001;55:1509-19]. The exact etiology is unknown; however the repeated and prolonged response to estrogen followed by long intervals of progesterone dominance in the intact bitch leads to hormonally mediated changes in the endometrium. The endometrium changes when impacted by bacterial infiltration; changes in endometrial steroid receptors can result in the clinical syndrome described as pyometra. This paper will describe the signalment, risk factors, prevalence, proposed etiologic events, and both medical and surgical therapies. In addition, the prognosis for successful outcome and effects on future reproduction will also be described.
Topics: Animals; Diagnosis, Differential; Dog Diseases; Dogs; Endometrial Hyperplasia; Endometritis; Female; Prognosis; Uterine Diseases
PubMed: 16828152
DOI: 10.1016/j.theriogenology.2006.04.023 -
The Veterinary Clinics of North... May 1986Pyometra is a relatively uncommon diestral uterine disorder seen primarily in older bitches and queens. The incidence of pyometra appears to be increasing, especially in...
Pyometra is a relatively uncommon diestral uterine disorder seen primarily in older bitches and queens. The incidence of pyometra appears to be increasing, especially in younger animals, as a result of increasing use of estrogen and progesterone for mismating and for certain medical disorders. The clinical signs of pyometra and abnormalities on physical examination are dependent on the patency of the cervix and how quickly the client recognizes the problem. Ovariohysterectomy is still the treatment of choice; however, prostaglandin F2 alpha as a medical alternative in the management of pyometra is gaining more and more acceptance. The goal of prostaglandin F2 alpha therapy is to salvage the reproductive tract in the young breeding bitch or queen in the hopes of obtaining future litters. The results have been very promising, especially for bitches or queens with open-cervix pyometra. Prostaglandin F2 alpha appears to offer the owner a reasonable alternative in the management of pyometra.
Topics: Animals; Cells, Cultured; Dog Diseases; Dogs; Female; Physical Examination; Uterine Diseases; Vagina; Vaginal Smears
PubMed: 3487159
DOI: 10.1016/s0195-5616(86)50061-9 -
Topics in Companion Animal Medicine 2022Current management practices of pyometra in the private practice setting are not well documented. The goal of this study was to understand pyometra management in the...
Current management practices of pyometra in the private practice setting are not well documented. The goal of this study was to understand pyometra management in the private practice setting, and the current relationship private practices have with high quality, high volume, spay-neuter (HQHVSN) clinics regarding referral for pyometra surgery. An anonymous electronic survey was piloted and distributed using SurveyMonkey via email, social media, and the Independent Veterinary Practitioners Association targeting veterinarians who see companion animals. A total of 153 responses were received from June to July 2021, with respondents distributed throughout the United States. Practices performed a median of 10 spay and neuters per week, with the median spay cost being $350 (IQR 250-500) for dogs and $250 (IQR 180-350) for cats. The median cost of a pyometra surgery was $1000 (IQR 700-1500) for dogs and $750 (IQR 450-1000) for cats. All practices treated pyometra at least sometimes, despite the disruption (major 19%, moderate 47%, mild 29%, none 5%) to their day. All pyometra presentations were accepted for treatment at least sometimes: BAR/QAR (98%), depressed or non-ambulatory (88%), and obtunded or lateral (62%) with mean estimated survival of 96%, 74%, and 31%, respectively. The majority (56%) of clients were reported to sometimes have trouble paying for all recommended services, while it was less often reported that clients often (31%) or rarely (13%) had trouble. Private practices willing to refer only did so always 20% of the time and sometimes 36% of the time. Private practices will do what they can to treat most pyometras that present at their practice within a timely manner before referring elsewhere. There is currently inconsistent utilization of HQHVSN clinics as a potential referral resource due to location or appointment availability.
Topics: Animals; Dog Diseases; Dogs; Female; Humans; Private Practice; Pyometra; Surveys and Questionnaires; Veterinarians
PubMed: 35918019
DOI: 10.1016/j.tcam.2022.100695