Module 1: Pyometra Flashcards
Life-threatening uterine infection that affects older dogs. It is extremely common.
Pyometra
Pyometra will affect 1/4 of intact female dogs by the age of _______
10
What are the breeds predisposed to pyometra?
- Bernese Mountain Dog
- Great Dane
- Leonberger
- Rottweiler
- Irish Wolfhound
They are must higher to develop Pyometra if they have NEVER been ___________
Pregnant
This disease happens during _________, a period of HIGH Progesterone following their estrous cycle
Diestrus
1/3 of these cases can happen during ___________, meaning that they have not had a recent heat cycle within the past four weeks
Anestrus
What predisposes them to Pyometra?
CEH (Cystic Endometrial Hyperplasia)
- A cystic degenerative change of the endometrium (lining of the uterus)
- Intact females develop over time
- Prolonged/repeat exposure to estrogen and progestogens
CEH (Cystic Endometrial Hyperplasia)
(T/F) Not all dogs with pyometra have CEH
True
What is the most common type of bacteria that creates pyometra?
E. coli
Has the ability to produce endotoxin, that then gets into the blood stream to cause many problems
E. coli
What are the Clinical Presentations for Pyometra?
- Recent Estrus ( 4-6 weeks)
- +/- Vulvar Discharge
- PU/PD (50%)
- Lethargy
- Anorexia
- Vomiting/Diarrhea
- Fever is NOT common
(T/F) You will always see discharge no matter if the cervix is closed or opened
False, if it is closed you may not see any sort of discharge
When do you consider pyometra?
in ANY intact bitch that is sick
What is the most common hallmark in a laboratory result for Pyometra?
Elevated White Count with Left Shift (elevation in segmented neutrophils)
- Does not differentiate early pregnancy
- Enlarged uterus
Radiographs
- Rule out pregnancy
- Thick uterine wall
- Hypo-hyperechoic uterine contents
Ultrasound
What is our treatment for Pyometra?
- Spay (Ovariohysterectomy)
- CEH is a progressive disease with no cure
When do we only pursue medical management?
- VALUABLE breeding animal
- YOUNG
- Good body condition
- Normal renal function
- NO evidence of endotoxemia
- +/- Open Cervix
What is the goal of Medical Management?
Reduce the effects of Progesterone
- Is a progesterone antagonist, that blocks progesterone from binding to the receptor
- it does not lower progesterone but stops the effects of progesterone in the reproductive tract. This will allow the uterus to contract, it will open the cervix, and will help clear the discharge
Aglepristone (Alizin)
- is unavailable commercially in the US
Is natural prostaglandin that causes lysis of the CL. By getting rid of the CL, it gets rid of the source of Progesterone
Prostaglandin F2 alpha
- makes them sick
What is multimodal therapy? (helps evacuate the uterus faster)
- Dopamine Agonist (Cabergoline/Bromocriptine)
- Misoprostol (PGE2)
Antibiotics for __________ weeks
3 - 4
