PEH and Cystic Endometrial Hyperplasia Flashcards
risk factor for CEH-Pyo
10X more likely if not bred
who does the CEH-pyo hit?
> 4 yrs old
Pathophysiology of CEH-pyo
repeated exposure of endometrium to estrogen and then long P4 metestrus –> the long P4 decreases immune/leukocyte function –> increase sus to bacteria –>
ALSO
prolif of endomet glands, excessive secretions, decreased myometrial activity –> cysts form –> even more prone to inflammation and infection
What effect does CEH have on embryos
prevents distribution and nourishment and placental attachment/development
SO what can be some predisposing factors to CEH-Pyo
estrogen tx, UTIs,
E coli, staph, strep colonizing
Breeds - rottie, st bernard, chow, G ret, min schn, CKCS, BMD
Clinical signs of CEH-pyo
none usually
may progress to muco/hemtouria/hydrometra - each are a sterile fluid
of course, pyometra then too
What is the cervical rule wiht CEH-pyo
closed = worse dz
clinical signs of pyometra
depression, leth, inapp, vomit, diar, abdominal enlargmenet PUPD, maybe nocturia Temp variable DH
How to dx pyometra
intact, over 4, not bred/preg
hx, clin path, vag cytology/culture, US, Rad
WHat are the clin path changes with pyometra?
leukocytosis (left shift), normocytic, normochromic anemia pre-ren azotemia hyper alb, gammaglobs, metabolic acidosis proteinuria (endotoxin related)
clin path change with CEH
maybe a regenerative anemia
Vaginal cytology/culture of CEH
lymphoplasmacytic inflammation, culture negative
Vaginal cytology/culture of CEH
neutrophilic inflammation, positive culture
What will pyometra look like on US, Rad?
US - clear, cloudy swirling
rads - homogen tubular fluid
What are the DDx for pyometra?
ABdominal distension - pregnancy
anorex/vomit/diar/PUPD - renal failure, DM, hepatic failure, HAC, UTI
Vag discharge - normal estrus, vaginitis, vaginal neoplasia, sub-involution of placetnal sites, retained placenta, metritis
