Pyometra is a hormonally mediated diestrual disorder characterized

reported primarily in older bitches (>5 yr old), 46 wk after estrus.

Etiology

Factors associated with occurrence of pyometra include administrat

estrogens to mismated bitches, and postinsemination or postcopula

decreasing myometrial activity. Cystic endometrial hyperplasia and

environment for bacterial growth. Progesterone may also inhibit the

urinary tract infections are the most likely sources of uterine contam

although Staphylococcus,Streptococcus, Pseudomonas, Proteus sp

Because queens require copulatory stimulation to ovulate and prod

Administration of medroxyprogesterone and other progestational co

Pyometra can develop in uterine tissue left after ovariohysterectomy

By itself, estrogen does not contribute to the development of cystic

progesterone on the uterus. Administration of exogenous estrogens

developing pyometra and should be discouraged.

Clinical Findings

Clinical signs are seen during diestrus (usually 48 wk after estrus)

lethargy, anorexia, polyuria, polydipsia, and vomiting. When the cer

cervix is closed, there is no discharge and the large uterus may cau

Physical examination reveals lethargy, dehydration, uterine enlarge

20% of affected animals have a fever. Shock may be present.

The leukogram of animals with pyometra is variable and may be no

Leukopenia may be found in animals with sepsis. A mild, normocytic

Hyperproteinemia due to hyperglobulinemia may be found. Results

induced impairment of renal tubular function or to insensitivity to an

complex deposition may result in proteinuria. These renal lesions ar

Diagnosis

Pyometra should be suspected in any ill, diestrual bitch or queen, e

from the history, physical examination, abdominal radiography, and

discharge. A CBC, biochemical profile, and urinalysis help exclude o

base status, and septicemia. The uterine exudate should be culture

causes of vulvar discharge, polyuria and polydipsia, and vomiting.

Py

Treatment and Prognosis

Ovariohysterectomy is the treatment of choice for pyometra. Medica

queen is desired. Fluids (IV) and broad-spectrum, bactericidal antib

corrected as quickly as possible, before ovariohysterectomy is perfo

uterine exudate is removed. Oral antibiotics (based on the results o

Medical therapy with prostaglandin F2 (PGF2) can be used for anim

in cats or dogs. PGF2causes luteolysis, contraction of the myometr

not be used in animals >8 yr old or in those not intended for breedin

its use in a severely ill animal. PGF2 also should be used with caut

uterine rupture. Pregnancy must be excluded, because prostagland

Naturally occurring PGF2 (0.25 mg/kg/day, SC, for 5 days) is comm

more potent than natural PGF2 and have been used to treat pyome
sensitivity tests, should be given for 2 wk.

The adverse effects of PGF2 include restlessness, anxiety, panting

vocalization and intense grooming behavior also may be seen. The

mg/kg. Severe ataxia, respiratory distress, and muscle tremors may

appropriate for treatment of shock are indicated. Uterine evacuation

Other antiprogestins (eg, aglepristone) are available in some Europ

compared with prostaglandins. Aglepristone is also used to treat bit

and 8 in 15 bitches with closed pyometra led to opening of the cervi

Animals should be reexamined 2 wk after completion of medical the

present, PGF2 therapy, using the same protocol, may be repeated;

for initial resolution of the pyometra is good if the cervix is open but

70% of queens with open-cervix pyometra may be fertile. Recurrenc

Therefore, the animal should be bred on the next and each subsequ

spayed. Prostaglandins should not be dispensed for client administr

pregnancy loss in people.