Small Animal Soft Tissue Surgery Q&A 09

A seven-year-old, female, mixed-breed dog is presented with a distended abdomen, polydipsia/polyuria and progressive anorexia and lethargy. At this time there is no vulvar secretion but the owners recall the dog having a thick yellowish discharge 10–12 days previously that quickly disappeared. Last estrus was ten weeks ago. A caudal abdominal sonogram is shown.

Question	Answer		Article
What is the suspected diagnosis?	Closed pyometra. The history of purulent vaginal discharge and the time since last estrus strongly support the diagnosis. Pyometra generally occurs between 9–12 weeks after estrus when the uterus is under progesterone influence from an active corpus luteum. The sonogram shows a dilated, fluid-filled uterus typical of pyometra.		Link to Article
What other procedures would you consider to confirm the diagnosis?	The sonogram in this case is sufficient for diagnosis. A hemogram, serum chemistry profile and urinalysis would help support the diagnosis (presence of a neutrophilia and mild anemia) and allow evaluation of hydration status, electrolyte balance and renal and hepatic function. Up to 50% of animals have concurrent nephropathy or hepatopathy, and most dogs have concurrent bacterial cystitis.		Link to Article
What is the treatment of choice?	Ovariohysterectomy. Use of antibiotics and prostaglandins (PGF2) is not advised in this case because of the extensive uterine dilation and closed cervix. This treatment can cause peritonitis from uterine rupture or reflux of purulent material up the uterine horns. Medical management is appropriate only for open pyometra when an owner declines ovariohysterectomy because they desire to breed the bitch.		Link to Article