Disease + pharmacology of the reproductive system Flashcards
What is the most common bacterial isolate of pyometria?
E. coli
What is the pathogenesis of pyometra?
*Endometrial hyperplasia = Increase in endometrial tissue growth leading to cystic changes (CEH)
*Cervical closure = Closure of cervix provides closed environment for bacterial growth
*Myometrial contractility =↓ in myometrial contractions interferes with normal defence mechanisms
*Hormone sensitivity = Positive feedback loop – increased receptor numbers and sensitivity
*White blood cell function = Progesterone down regulates uterine immune functions
What stage of oestrus cycle does pyometra affect?
Dioestrus
What are clinical signs of mild, moderate + severe pyometra?
*Mild = Pyrexia, Depression, Reduced appetite, Vaginal discharge (if open)
*Moderate = All of mild plus, Inappetence, Vomiting + PUPD, Abdo distension/pain
*Severe = All of mod plus, Collapse with Hypovolaemic Shock or Distributive Shock
How is a pyometra diagnosed?
*Clinical signs
Abdominal ultrasound - black dots = liquid
Why would you get leucocytosis (increase WBC) or leukopenia (low WBC) with pyometra?
*Leucocytosis = due to increased production - Neutrophilia + Left shift
*Leucopenia = due to increased consumption = poor prognosis
What is seen with biochemistry with pyometra?
*Pre renal azotaemia - If USG >1.035 = kidneys concentrating urine = patients dehydrated / in shock
*Renal azotaemia = E. coli = affects glomerular + tubular function
What is the treatment of pyometra?
*Surgical management - ovariohysterectomy (£1000-£2000)
*Medical management - common recurrence + expensive
*PTS
What should be done pre-op with pyometra?
*Haematology
*Biochemistry
*Urinalysis
*Assess shock + provide IVFT
*Likely anti-emetics + analgesia
*Broad spec IV antibiotics
*CONSENT
What should be considered with pyometra surgery?
*Uterus = friable = swabs
*Pack abdo opening with swabs - in case of spillage
*A LOT OF CLAMPS
*Flush prior to closure
What can be used as medical management? How do they work?
*Prostaglandin
*Dopamine agonists
*Progesterone receptor blockers
+ Also give antibiotics
*decrease effect of progesterone hormone
*Relax cervix to eliminate uterine infection
*Remove uterine contents
Why should you rule out owner being on hormone replacement therapy for ‘stump’ pyometra?
*Animals in contact will cycle if ingested some of the hormones
*Usually always ovarian remnant syndrome
What are clinical signs of ovarian remnant syndrome?
*Continued signs of oestrus after being spayed
*Signs of stump pyometra
When is the best time to perform surgery of ovarian remnant syndrome?
*When showing signs - makes ovarian tissue easier to find
What are the clinical signs of false pregnancy?
*6-8wks post season
*Lactation + mammary development
*Behavioural - nesting, aggression, guarding
*Inappetence
*Need to rule out pregnancy
