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BMC Veterinary Research Jun 2023Pyometra is a common infectious condition, especially in elderly bitches. In addition to an infected uterus, dogs may have concurrent urinary tract infection (UTI). The...
BACKGROUND
Pyometra is a common infectious condition, especially in elderly bitches. In addition to an infected uterus, dogs may have concurrent urinary tract infection (UTI). The preferred treatment is surgical removal of the ovaries and uterus, whereupon the general prognosis is excellent. In addition, antimicrobial therapy is frequently prescribed for postoperative treatment. However, no research exists on the benefit of postoperative antimicrobial treatment in uncomplicated canine pyometra. Antimicrobial resistance has become a major challenge in treatment of bacterial infections. Diminishing overuse of antimicrobial agents is essential for controlling the development of antimicrobial resistance in both animals and humans.
METHODS
This double-blinded, randomized, placebo-controlled two-arm clinical trial is designed to compare the incidence of postoperative infections associated with surgical treatment of uncomplicated pyometra followed by two different treatment protocols. For the study, 150 dogs presenting with an uncomplicated pyometra and that are to undergo surgical treatment will be recruited. Dogs with body weight < 3 or > 93 kg, complicated pyometra, primary disease increasing the risk of infection, or immunosuppressive medication will be excluded. All dogs will receive one dose of sulfadoxine-trimethoprim intravenously as an antimicrobial prophylaxis. Postoperatively, dogs will be randomized to receive either a five-day course of placebo or an active drug, sulfadiazine-trimethoprim orally. During the surgery microbiological samples will be taken from urine and uterine content. The follow-up includes a control visit in 12 days and an interview of the owner 30 days after surgery. If bacteriuria is detected at the time of surgery, a urinary sample will be cultured for bacterial growth at the control visit. The primary outcome is the incidence of a postoperative surgical site infection (SSI), and the secondary outcome is the occurrence of clinical UTI with bacteriuria. Intention-to-treat and per-protocol analyses will be performed to compare outcome incidences between the treatment groups.
DISCUSSION
Research-based evidence is necessary to create treatment guidelines for judicious use of antimicrobials. The goals of this study are to provide evidence for reducing the use of antimicrobials and targeting the treatment to patients proven to benefit from it. Publishing the trial protocol will increase transparency and promote open science practices.
Topics: Female; Humans; Dogs; Animals; Bacteriuria; Pyometra; Urinary Tract Infections; Bacterial Infections; Trimethoprim; Dog Diseases; Clinical Trials, Veterinary as Topic
PubMed: 37340459
DOI: 10.1186/s12917-023-03629-w -
Animals : An Open Access Journal From... May 2023The use of contrast-enhanced ultrasound (CEUS) has been widely reported for reproductive imaging in humans and animals. This review aims to analyze the utility of CEUS... (Review)
Review
The use of contrast-enhanced ultrasound (CEUS) has been widely reported for reproductive imaging in humans and animals. This review aims to analyze the utility of CEUS in characterizing canine reproductive physiology and pathologies. In September 2022, a search for articles about CEUS in canine testicles, prostate, uterus, placenta, and mammary glands was conducted on PubMed and Scopus from 1990 to 2022, showing 36 total results. CEUS differentiated testicular abnormalities and neoplastic lesions, but it could not characterize tumors. In prostatic diseases, CEUS in dogs was widely studied in animal models for prostatic cancer treatment. In veterinary medicine, this diagnostic tool could distinguish prostatic adenocarcinomas. In ovaries, CEUS differentiated the follicular phases. In CEH-pyometra syndrome, it showed a different enhancement between endometrium and cysts, and highlighted angiogenesis. CEUS was shown to be safe in pregnant dogs and was able to assess normal and abnormal fetal-maternal blood flow and placental dysfunction. In normal mammary glands, CEUS showed vascularization only in diestrus, with differences between mammary glands. CEUS was not specific for neoplastic versus non-neoplastic masses and for benign tumors, except for complex carcinomas and neoplastic vascularization. Works on CEUS showed its usefulness in a wide spectrum of pathologies of this non-invasive, reliable diagnostic procedure.
PubMed: 37238045
DOI: 10.3390/ani13101615 -
Antibiotics (Basel, Switzerland) May 2023Neuro- and nephrotoxicity of polymyxins are known but clinical studies in horses are lacking. The aim of this study was to describe neurogenic and nephrogenic side...
Neuro- and nephrotoxicity of polymyxins are known but clinical studies in horses are lacking. The aim of this study was to describe neurogenic and nephrogenic side effects of hospitalized horses receiving Polymyxin B (PolyB) as part of their treatment plan. Twenty horses diagnosed with surgical colic ( = 11), peritonitis ( = 5), typhlocolitis ( = 2), pneumonia, and pyometra (each = 1) were included. Antimicrobial treatment was randomized to GENTA (gentamicin 10 mg/kg bwt q24 h IV, penicillin 30.000 IU/kg q6 h IV) or NO GENTA (marbofloxacin 2 mg/kg bwt q24 h IV, penicillin 30.000 IU/kg q6 h IV). The duration of PolyB treatment ranged from 1 to 4 days. Clinical and neurological examinations were performed, and serum PolyB concentrations were measured daily during and three days following PolyB treatment. Urinary analysis, plasma creatinine, urea and SDMA were assessed every other day. Video recordings of neurological examinations were graded by three blinded observers. All horses showed ataxia during PolyB treatment in both groups (median maximum ataxia score of 3/5, range 1-3/5). Weakness was detected in 15/20 (75%) horses. In 8/14 horses, the urinary γ-glutamyltransferase (GGT)/creatinine ratio was elevated. Plasma creatinine was mildly elevated in 1/16 horses, and SDMA in 2/10 horses. Mixed-model analysis showed a significant effect of time since last PolyB dose ( = 0.0001, proportional odds: 0.94) on the ataxia score. Ataxia and weakness should be considered as reversible adverse effects in hospitalized horses receiving PolyB. Signs of tubular damage occurred in a considerable number of horses; therefore, the nephrotoxic effect of polymyxins should be considered and urinary function monitored.
PubMed: 37237756
DOI: 10.3390/antibiotics12050854 -
The Pan African Medical Journal 2023Herlyn-Werner-Wunderlich syndrome is a rare congenital anomaly of the Mullerian and Wolffian ductal system, manifesting as a triad of dipelphys uterus, obstructed...
Herlyn-Werner-Wunderlich syndrome is a rare congenital anomaly of the Mullerian and Wolffian ductal system, manifesting as a triad of dipelphys uterus, obstructed hemivagina, and ipsilateral renal agenesis. Patients usually remain asymptomatic till menarche and experience progressive dysmenorrhea, suprapubic lump, and/or features of infection (pyometra, pelvic collection, etc.) afterward. We hereby present a case of a young lady with Herlyn-Werner-Wunderlich syndrome with a large endometriotic cyst, likely arising from the right hemiuterus. She presented with dysmenorrhea and progressive abdominal distention for seven years. She was treated by laparoscopic ovarian cyst excision and right hemihysterectomy that relieved her symptoms.
Topics: Humans; Female; Dysmenorrhea; Endometriosis; Uterus; Menarche; Kidney Diseases
PubMed: 37159630
DOI: 10.11604/pamj.2023.44.79.32667 -
Medicina (Kaunas, Lithuania) Mar 2023Pyometra is a uterine infection that causes pus to accumulate in the uterine cavity. Pyometra primarily affects postmenopausal women. Multiple aetiologies, including...
Pyometra is a uterine infection that causes pus to accumulate in the uterine cavity. Pyometra primarily affects postmenopausal women. Multiple aetiologies, including cervical stenosis, have been identified. Medical therapy using intravenous antibiotics and surgical evacuation are the conventional treatment options for pyometra. Here, we present a unique case of a novel therapy for pyometra in a geriatric patient; percutaneous alleviation of the causative cervical stenosis was performed using balloon dilatation, along with endometrial drainage of the infected fluid through her vagina, a natural route. This technique has overcome the need for other invasive therapies. The patient's clinical condition improved significantly after this minimally invasive treatment. Percutaneous balloon dilatation of the cervix for stenosis or occlusion in patients with pyometra facilitates drainage of the infected endometrial fluid. This alternative management technique ensured a satisfactory postoperative course and tolerance in the short-term follow-up. Furthermore, the technique ensured good aesthetic results, with its minimally invasive approach in selected patients, compared to other means of evacuation.
Topics: Humans; Female; Aged; Pyometra; Constriction, Pathologic; Uterus; Vagina; Drainage
PubMed: 37109647
DOI: 10.3390/medicina59040689 -
BioMed Research International 2023Canine pyometra, which is accompanied by bacterial contamination of the dog uterus, is defined as a complex disease associated with the activation of several systems,...
Canine pyometra, which is accompanied by bacterial contamination of the dog uterus, is defined as a complex disease associated with the activation of several systems, including the immune system. This study uses text mining and microarray data analysis methods to discover some existing targeted gene drugs and expand potential new drug indications. Text mining ("canine pyometra") and microarray data analysis (GSE99877) were used to obtain a common set of genes. These genes and protein-protein interaction (PPI) networks were analyzed using Gene Ontology and the Kyoto Encyclopedia of Genes and Genomes. Then, the important genes clustered in the PPI network were selected for gene-drug interaction analysis to provide evidence for potential drug discovery. Through text mining and data analysis, we obtained 17,544 text mining genes (TMGs) and 399 differentially expressed genes (DEGs), respectively. There were 256 repeat genes between TMGs and DEGs, including 70 upregulated genes and 186 downregulated genes. Thirty-seven genes clustered in three significant gene modules. Eight of the 37 genes can target 23 existing drugs. In conclusion, the discovery of 8 immune response-related genes (, , , , , , , and ) targeting 23 existing drugs may expand the drug indications for pyometra-related diseases in dogs.
Topics: Humans; Female; Animals; Dogs; Gene Expression Profiling; Pyometra; Microarray Analysis; Gene Regulatory Networks; Protein Interaction Maps; Data Mining; Computational Biology; Gene Ontology
PubMed: 37101686
DOI: 10.1155/2023/7839568 -
Veterinary Medicine and Science May 2023Recent studies and consensus statements in veterinary and human medicine recommend more judicious use of antimicrobials. While guidelines have been provided for some...
BACKGROUND
Recent studies and consensus statements in veterinary and human medicine recommend more judicious use of antimicrobials. While guidelines have been provided for some veterinary diseases, others have poorly elucidated guidelines. Postoperative treatment of canine pyometra is a condition with minimal guidelines regarding antimicrobial use.
OBJECTIVE
To identify and investigate patterns of antimicrobial use following surgically treated canine pyometra.
METHODS
A 23-question survey, sent to 863 small and mixed animal practitioners, investigated demographics, patterns of antibiotic use, rate of culture submission and participant's recollection of outcomes of surgically treated pyometra cases. Responses were analysed for relationships between demographics, patterns of antibiotic use and culture results to better understand reasoning for antibiotic protocols.
RESULTS
One hundred and fifty-two responses were received. Overall, 76% of veterinarians stated they always use preoperative and perioperative antibiotics, and 74% stated they always use postoperative antibiotics. A total of 16 different antibiotics were reported. Twelve per cent of respondents regularly submitted a culture. Culture submission was impacted by cost, prior experience, poor owner compliance, result turnaround time and anticipated results.
CONCLUSIONS
Most respondents always used antibiotics and rarely or never submitted a culture. To optimise patient care, future clinical studies are needed to determine specific guidelines for the use of culture and antibiotics in the treatment of canine pyometra following ovariohysterectomy.
Topics: Female; Animals; Humans; Dogs; Veterinarians; Arizona; Pyometra; Anti-Infective Agents; Anti-Bacterial Agents; Surveys and Questionnaires; Dog Diseases
PubMed: 37051761
DOI: 10.1002/vms3.1130 -
Molecular prevalence and phylogenetic confirmation of bovine trichomoniasis in aborted cows in Iraq.Veterinary World Mar 2023Bovine trichomoniasis, caused by , is a venereal disease that is distributed in many countries, including Iraq. Compared with other abortive infectious diseases,...
BACKGROUND AND AIM
Bovine trichomoniasis, caused by , is a venereal disease that is distributed in many countries, including Iraq. Compared with other abortive infectious diseases, prevalence of is expected to be relatively low in the field by veterinarians. This study aimed to estimate the prevalence of in aborted cows by conventional polymerase chain reaction (PCR) and phylogenetic analysis of local isolates was documented in the National Center for Biotechnology Information as the first sequenced isolates from Iraq.
MATERIALS AND METHODS
Vaginal fluids were collected from 62 aborted cows and examined by PCR. Data were reported for the following parameters: Vital signs (body temperature and respiratory and pulse rates), age (<4, 4-8, and >8 years), reproductive health status (premature calving, embryonic death, pyometra, and healthy newborn), breed (pure or crossbred), type of breeding (natural or artificial), bull-to-cow ratio (1:<10, 1:10-20, and 1:>20), contact of cow with bull(s) from other farmers (yes or no), and contact with stray animals (dogs and cats).
RESULTS
A total of 20.97% of aborted cows were positive for . Phylogenetic analysis for 10 positive local isolates demonstrated high identity with the Thai (MN560972.2) and Chinese (MH115435.1) isolates, with an identity range of 98.8%-99.5% and 98.6%-99.3%, respectively. Clinical data showed that the vital signs differed insignificantly between cows positive and negative for . Prevalence and risk of infection increased significantly in <4-year-old, early calving, embryonic death, crossbred, and naturally inseminated cows that had direct contact with bulls from other farmers, and contact with stray animals. Fetal pneumonia and death of premature calves were significant among positive aborted fetuses.
CONCLUSION
is highly prevalent in aborted cows in Iraq and phylogenetic analysis demonstrated an identity between the local and global isolates, that is, Thai and Chinese, of cats.
PubMed: 37041823
DOI: 10.14202/vetworld.2023.580-587 -
Animal Reproduction Science Apr 2023This prospective case series investigated potential uterine causes of infertility in queens. Purebred queens with infertility (failure to conceive, embryonic death, or...
This prospective case series investigated potential uterine causes of infertility in queens. Purebred queens with infertility (failure to conceive, embryonic death, or failure to maintain pregnancy and produce viable kittens), but no other reproductive disorders were examined approximately 1-8 weeks before mating (Visit 1), 21 days after mating (Visit 2), and 45 days after mating (Visit 3) if pregnant at Visit 2. Investigations included vaginal cytology and bacteriology, urine bacteriology, and ultrasonography. At Visit 2 or 3, uterine biopsy or ovariohysterectomy was performed for histology. Of nine eligible queens, seven were non-pregnant by ultrasound at Visit 2 and two had lost pregnancies by Visit 3. Ovulation was confirmed by serum progesterone concentration in all queens. Ultrasonic appearance of the ovaries and uterus was compatible with a healthy status except for one queen with signs of cystic endometrial hyperplasia (CEH) and pyometra, a follicular cyst in another, and fetal resorptions in two queens. Six cats had histologic lesions of endometrial hyperplasia, including CEH (n=1). Only one cat had no histologic uterine lesions. Bacteria were cultured from vaginal samples in seven queens at Visit 1, (two were non-evaluable), and in five of seven queens sampled at Visit 2. Uterine cultures were negative except for the cat with pyometra. All urine cultures were negative. In summary, the most frequent pathology observed in these infertile queens was histologic endometrial hyperplasia, which can potentially inhibit embryo implantation and healthy placental development. This suggests that uterine disease might contribute substantially to infertility in purebred queens.
Topics: Female; Animals; Cats; Pregnancy; Endometrial Hyperplasia; Pyometra; Placenta; Uterus; Infertility; Cat Diseases
PubMed: 37003062
DOI: 10.1016/j.anireprosci.2023.107225 -
Asian Journal of Surgery Jul 2023
Topics: Female; Humans; Pyometra; Endometrium; Uterus
PubMed: 36907738
DOI: 10.1016/j.asjsur.2023.01.107