Pyometra Kills
This article is dedicated to Nova and Star. Nova, who we thought was expecting puppies but came down with pyometra - a very dangerous and life threatening infection intact bitches can get. And Star, who was ruling the pack with an iron paw one minute, and two hours later was fighting for her life. It's not known how it's transmitted, only that it's very dangerous. The uterus fills with pus and becomes huge and toxic. She recovered from that, only to tragically and suddenly die 3 weeks later. I have added information to the site about Pyometra as it's something anyone with an intact girl should know more about. Even though we were aware of the symptoms, we didn't see it coming because the symptoms are not easily noticed if you are expecting pregnancy. They are easy to miss until it's advanced and dangerous. This is our first experience with this scary infection. Unfortunately, even with excellent care we didn't expect her to die a month later from complications. She had made a complete recovery after being spayed, or so we thought. But with any surgery comes the risk of blood clots, and suddenly without warning, we lost her. Thanks to all our puppy owner friends, the friends we've made from this website, and everyone who has helped us through this awful trying period.
SYMTOMS EASILY MISSED:
temperature, thirst, weakness, sometimes discharge, high white cell counts
About Pyometra...
You've bred your girl...everything looks good. She seems tired, is drinking a fair amount of water and her belly is getting larger - she seems pregnant. Suddenly she seems more lethargic and walks carefully, so you attribute it to just being pregnant - maybe with a larger litter than you anticipated...but then she gets picky and finally refuses to eat. You take her to the vet for an ultrasound and lo and behold - she's not pregnant at all - she has Closed Cervix Pyometra! A life threatening and dangerous infection of the uterus. You have two options - spay (dangerous and 5-10 times more expensive due to the risk) or Prostaglandin therapy (extremely risky and dangerous, painful and miserable for the bitch and expensive too). Unfortunately, sometimes your decision is made for you before you can decide what to do.
Or...you return home to find her weak and almost to collapse. She was fine a couple of hours earlier so you wait a bit to see if it's something passing. It's not, so you rush her to the emergency vet with no symptoms other than you know something is wrong and she's not acting "normal". She's weak and lethargic, but unless they do an ultrasound, it's difficult to tell she is even sick except that you know something is wrong.
Pyometra is an infection of the uterus which usually occurs 2 to 6 weeks after a heat (estrus) cycle. Because during estrus, the cervix is open to allow conception, some of the body's natural defenses are relaxed allowing infection to enter the uterus from the the vagina. The cervix then often closes down again allowing the the uterus to fill with infectious material or "pus". Pets may exhibit a variety of symptoms, the most common being lethargy, loss of appetite and increased water intake and urination. If the cervix is open, there may be a heavy purulent (pus) vaginal discharge.
There are two kinds of Pyometra:
1) Open Pyometra: This is easier to detect because there is a purulent discharge, lethargy, fever, anorexia, and sometimes vomiting.
2) Closed Cervix Pyometra: This more sinister and deadly because there is no discharge but the other signs and symptoms are present. The infection remains within the body and diagnosis is difficult because nothing shows externally. Blood work, radiology, ultrasound and physical examination are used to rule out other causes before a definite diagnosis of Closed Cervix Pyometra can be made. With ultrasound, sometimes fluid can actually be seen in the horns of the uterus and white cell counts may be high, leading to the diagnosis.
Both kinds of Pyometra are life-threatening so an ovariohysterectomy is recommended by most veterinarians because even if treated medically with prostaglandins, it will almost always recur. The uterus may be hundreds of times normal size, sometimes exceeding that of a pregnancy. The wall of the uterus can also become very thin and susceptible to rupture. Left untreated, Pyometra is a fatal condition. Surgery and concurrent treatment is extremely costly. For a valuable brood bitch or one at the height of a show career there is the option of hormone treatment to expel the pus from the uterus and treat with strong antibiotics. Unfortunately the treatment is very hard and dangerous. In the course of treatment prostaglandins are given causing the uterus to, in a sense, go into labor to push out the infected pus. There is risk the uterus could rupture, or that the infection could be pushed out through the fallopian tubes into the body cavity causing perionditis. Treatment with prostaglandins has proved to be successful in a majority of cases of open cervix Pyometra, but unsuccessful in a majority of closed cervix cases. If the uterus ruptures, there are no options except spay, antibiotics and supportive care.
If treated with prostaglandins, she should be bred at the next heat in order to forestall another episode of Pyometra. I've heard the possibility is almost a 50/50 chance of it recurring at the next heat. Treatment with prostaglandins in closed cervix Pyometra is very risky and much less likely to be effective. Spaying is really the safest means of saving her life. (and we've now had 2 girls die, even though they were spayed so take this VERY VERY seriously!)
There is no evidence to support the notion that bitches who experience oestrous cycle anomalies or pseudopregnancies are more at risk of developing Pyometra. It is not caused by an artificial insemination breeding or natural breeding since an unbred bitch can get it as well. It is more likely as the bitch gets older. During estrus the interior wall of the vagina is devoid of white blood cells protect against infection because they would kill the sperm. Introduction of bacteria by almost any means can take hold and cause infection.
Unless too much time has passed and the dog has become too sick to withstand the surgery, most dogs will make a complete recovery following Pyometra surgery. In our case we had complications to the pyometra. Be sure your vet gives STRONG antibiotics, even if she is spayed. In Nova's case, we strongly suspect the infection went to her heart. She died almost instantly in our arms with no time to even rush her to the vet. With Star we knew what to look for, but again, 3 different vets missed important signs. The pyometra went into her spine and she developed spinal meningitis - which can look like a lot of other problems to the untrained eye. One vet diagnosed glaucoma, another saw meningitis, but didn't do a spinal tap to prescribe the RIGHT antibiotic, by the time we found a neurologist that knew what to do we had lost precious time. Star died of seizures from the meningitis which was a leftover from the pyometra.
Excellent
Pyometra links:
[all links open in a new window]
Dr. R. V. Hutchinson (a well-known expert in dog reproduction - includes SYMPTOMS!)
The Pet Center (very graphic, showing the actual spay surgery - if you are squeamish, you might want to avoid this one)
The International Stafford On-Line Magazine (stories & case histories)
Petcare at Vin.com (alternative therapy to spay)
