Pyometra

[Boss Bengal]

If ever there was a reason to spay your female cat, this would be the reason!
BE WARNED THERE ARE GRAPHIC IMAGES FURTHER DOWN THIS PAGE THAT MAY SHOCK SOME PEOPLE!!
Sometimes its the only way we understand what an illness or disease is!!

17 nov 2007

Cats and dogs that are not spayed are susceptible to a uterine infection called pyometra. It is commonly diagnosed in most veterinary practices. After a cat's or dog's oestrus (heat) cycle, the uterine lining becomes less able to fight off colonization by bacteria, and can rapidly lead to a severe infection. Pyometra literally means 'uterus of pus.' Gross. And dangerous: These pets often are brought to hospital for generalized lethargy, malaise, fever, lack of appetite, and excessive thirst.
In severe cases, these dogs and cats are often septic (bacteria in the blood) and in shock. These cases must be handled as a medical emergency. Treatment involves correcting the animal's dehydration (sometimes aggressively), antibiotics, and surgically removing the infected uterus and ovaries (i.e., spaying the pet). This disease can also be medically treated (more often in Europe) with antibiotics and a class of drugs called prostaglandins, but it is my opinion that pyometra should be treated surgically, and not medically.

I am posting photos of a case that I saw recently, of a cat that had the most severe pyometra I (and my colleagues) have ever seen. With the owner's permission, I am sharing this case: This was a darling older unspayed cat, about twelve years old, that presented to me with a decreased appetite and a massively distended belly. I took two radiographs (x-rays) of her belly, and this is what I found:

X-ray on her side

X-ray on her back

Without advanced knowledge of radiology, one can appreciate the distended abdomen. For those wtih some understanding, there is a large (massive actually) tubular soft-tissue opacity taking up much of the abdominal cavity that is consistent with pyometra. Keep this in mind when having a look at the following photos. These were taken while in surgery. What you see is the cat's uterus (and ovaries) that has almost completely been removed. It is huge.

This is the uterus after surgery. Take special note of the normal cat uterus to the right (barely visible!!), which was removed that same morning during a routine spay. Astounding.

The very sad news is that the cat died two days later. We were all saddened by this.
Please everyone, this is one very good reason to have your female pet spayed.
Posted by TorontoVet at 12:23 PM

[bundles of bengals]

thanks for posting that debs, very shocking!!
one of my breeding girls was sadly neutered earlier this year due to pyo. thankfully i was well aware of the condition & the first sign of a little discharge, i rushed her to the vet.
from an x-ray, we saw her uterus was full & we didn't want to risk trying to treat it. when they opened her up, they said her uterine horns were 2cm thick in places, which is very big...but nothing like the poor cat in those pictures!!
thankfully my willow made it through & is now a spoilt rotten pet & nanny to all the others, so sad that some aren't caught early enough & don't make it through this.

it certainly helps for people to be aware of these things.

[Boss Bengal]

Pyometra is the term used to describe a pus-filled uterus. Treatment for this infection typically involves the surgical removal of the female reproductive organs
. The operation removes both ovaries, the uterine horns, and the body of the uterus, thus removing the infection.

What Are the Indications For Performing Pyometra Surgery?

This operation is indicated whenever pyometra is diagnosed. Some people who wish to avoid sterilization may try antibiotics and prostaglandin medications in an attempt to treat the infection. Frequently, medical therapy is not successful and the patient's health worsens. Without prompt and appropriate treatment, there is a risk of uterine rupture and peritonitis, both life threatening. Surgical removal of the infected uterus is considered the treatment of choice.

What Preoperative Tests Are Needed?

Preoperative tests are typically necessary to diagnose pyometra.
Blood work, including a complete blood count and biochemical profile are commonly done. Radiographs (X-rays) of the abdomen to evaluate the uterus are also performed. In some cases, an abdominal ultrasound may be necessary. Urinalysis, chest X-rays and an EKG may also be performed. These recommendations vary on a case-by-case basis, and depend on the overall health of the pet. Pets with pyometra are usually not healthy and the degree of illness will determine the necessary preoperative tests.

What Type of Anesthesia Is Needed?

As in human patients, the procedure in dogs and cats requires general anesthesia to induce complete unconsciousness and relaxation. In the usual case, the pet receives a pre-anesthetic sedative-analgesic drug to help her relax, a brief intravenous anesthetic to allow placement of a breathing tube in the windpipe, and subsequently inhalation (gas) anesthesia in oxygen during the actual surgery.

How Is the Pyometra Operation Done?

Following anesthesia, the pet is placed on a surgical table, lying on her back. The hair is clipped over the middle of the abdomen and the skin is scrubbed with surgical soap to disinfect the area. A sterile drape is placed over the surgical site. A scalpel is used to incise the skin at the middle of the abdomen, and then the abdominal cavity is opened. The organs of the female reproductive tract are identified and the major blood vessels supplying the ovaries and the uterus are ligated (tied off). This must be done before these organs can be removed. Extreme care is used when removing the uterus to prevent rupture of the pus filled organ, which would result in contamination of the abdomen. Sutures (stitches) that dissolve over time are used to tie off the blood vessels and also to close the uterus above the cervix. The abdominal incision is then closed with one or two layers of self-dissolving sutures (stitches). The outer layer of skin is closed with sutures or surgical staples; these need to be removed in about 10 to 14 days.

How Long Does the Surgery Take?

The procedure takes about 45 minutes to an hour to perform in most cases, including the needed time for preparation and anesthesia. In some cases, especially in obese or large-breed dogs the procedure can take longer and may require two surgeons.

What Are the Risks and Complications?

The overall risk of this surgery is moderate to low. The major risks are those of general anesthesia, bleeding (hemorrhage), postoperative infection, peritonitis and wound breakdown (dehiscence) over the incision. Overall complication rate is low, but serious complications can result in death or the need for additional surgery.

What Is the Typical Postoperative Care?

Postoperative medication
should be given to relieve pain, which is judged in most cases to be mild to moderate and can be effectively eliminated with safe and effective pain medicines. Intravenous fluids and antibiotics are typically recommended to help improve the overall health of the pet following surgery. The home care requires reduced activity until the stitches are removed in 10 to 14 days. The incision line should be inspected daily by the pet owner for signs of redness, discharge, swelling, or pain.

How Long Is the Hospital Stay?

Depending on the severity of illness, some pets may be hospitalized for two to five days.