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Healing & Alternative Health
Dr. Carson's Holistic Animal Care:
SIGNS OF AGING IN THE DOG AND CAT, PART XXVIII:
Organs of the Abdomen:
The Uterus: Pyometra
by Kathleen M. Carson, D.V.M |
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This month I will continue to write about problems which can develop in the reproductive organs of our geriatric animals. The subject of this month’s column is a disease of the older female dog (and, more rarely, female cat). It’s called pyometra: “pyo” refers to pus or infection, and “metra” refers to the uterus.
This is not an extremely common condition since most female dogs and cats are spayed (have ovariohysterectomies or removal of the uterus and ovaries) when young, so they don’t have a uterus to get infected.
If a female has not been spayed when young, how/why does she develop a uterine infection when older? The answers lie in how her uterus is affected by her femalehormones, estrogen and progesterone. A female dog (aka bitch) “goes into heat” (has estrus) twice a year. When a bitch is in heat, her ovaries pour out the hormone estrogen. Estrogen makes her external genitalia (the vulva) swell, and it causes a blood--tinged vaginal discharge. She becomes very attractive to male dogs while in heat, and she will allow them to mate with her. (She won’t allow this when she’s not in heat). The total estrual cycle lasts about 3 weeks, from the time her vulva starts to swell until the bloody discharge stops and her vulva returns to its normal size. The middle week, when she’s most swollen, is when she ovulates (releases eggs from her ovaries into the uterus through the Fallopian tubes). If she mates during this middle week, she’ll get pregnant.
By the end of the 3rd week of estrus, a bitch’s ovaries will barely be producing any estrogen at all. Instead, they’re starting to produce the other female hormone, progesterone. Unlike the females of other species, the bitch’s ovaries produce progesterone for about 2 months after her estrus cycle whether or not she has mated and become pregnant. Progesterone causes the endometrium (lining of the uterus) to become thickened and engorged, producing an ideal environment for her babies to implant and grow. (This is why you can’t do a pregnancy test in a bitch; her hormone levels are the same whether she is pregnant or not.)
With repeated exposure to progesterone as the years progress, the endometrium in some bitches develops a condition known as cystic endometrial hyperplasia (CEH).
A uterus with CEH is much more prone to infection than one without. (The uterus itself is normally sterile, but the vagina has bacteria in it.) The vaginal bacteria can invade and “set up housekeeping” in a uterus affected with CEH.
If your older female dog has developed pyometra, what signs would you see? First of all, you would see the signs 1-2 months after her last heat cycle. Signs include: depression, lethargy, decreased appetite, increased thirst and urination, and vomiting. If her infected uterus has an open pyometra (the cervix, the sphincter or “door” between the vagina and the uterus, is open) you will also see a purulent or pus-filled vaginal discharge which smells bad. If, on the other hand, she has a closed pyometra, you won’t see the discharge, but her abdomen may be swollen. A bitch with closed pyometra is much sicker than one with an open pyometra because in the former case, all the toxic infected material is kept inside her body, where it eventually leaks into her bloodstream and causes life-threatening septicemia, or a body-wide infection.
What will your veterinarian find when he examines your dog with an open pyometra? He’ll see her depression and lethargy. She may be showing signs of dehydration. If she’s slender enough, he’ll feel an enlarged uterus when he palpates her abdomen. He’ll also find her purulent vaginal discharge.
If your dog has a closed pyometra, her depression, lethargy, and dehydration will be more pronounced. She may have a fever. Her abdomen will be distended, which may interfere with your veterinarian’s ability to palpate her enlarged uterus. He won’t find any vaginal discharge.
Radiographs (X-rays) of her abdomen will show her enlarged uterus; an abdominal ultrasound will show an enlarged uterus with thickened walls filled with material.
Her blood tests will show signs of a chronic infection (increased WBCs, decreased RBCs, increased blood protein, especially globulin), and possibly increased liver enzymes as well.
What will your veterinarian do to treat your dog’s pyometra? The best, permanent treatment is for him to remove your dog’s infected uterus as well as her ovaries. Most pyometras are resolved this way; exceptions would be with a purebred bitch used for breeding.
Of course, treatment for your dog’s dehydration and any septicemia is started first. This would include intravenous fluids as well as antibiotics. A sick older dog is an increased anesthetic risk; these steps will make her a better surgical candidate.
Your veterinarian has to be very careful when removing your dog’s infected uterus. The uterine tissue is more friable (likely to tear), and the last thing he wants is to have any of the toxic material inside your dog’s uterus spill into her abdomen; this would cause peritonitis, an infection of the lining of your dog’s abdominal cavity and organs. (There’s a good chance your dog wouldn’t survive this.)
Postoperative care will include more fluids and antibiotics and close observation. The worst risk has passed when the surgery is over, but your dog is still a very sick animal. She’ll need to be in the hospital at least a few days after her surgery.
What if you have a valuable breeding bitch and you’d like another litter from her? If she has a closed pyometra or is quite ill, you have no choice; she must have her uterus/ovaries surgically removed. On the other hand, if she has an open pyometra and isn’t very sick, you have the option of using medical versus surgical treatment.
What does medical treatment of a pyometra consist of? Your dog will need to be hospitalized so she can be closely observed. She’ll be given antibiotics, but these alone won’t resolve her pyometra. She will also be given injectable hormones called prostaglandins. These hormones cause her uterus to contract and expel its infected contents.
Medical treatment has its own unwanted side effects: the prostaglandins can also cause uncomfortable cramping, vomiting, diarrhea, constriction of her airways, and increased blood pressure. The uterine contractions could cause uterine rupture, which would bring about the peritonitis mentioned above.
Because pyometra causes uterine scarring, there is only ~50% chance she’ll become pregnant in the future. Also, since the medical treatment doesn’t resolve her CEH, she can also develop a future pyometra.
Obviously, prevention is better than a cure. Unless you have a purebred dog meant for breeding, have your dog spayed at 6 months.!
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Dr. Kathleen Carson, DVM
Veterinarian & Author
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Dr. Carson received her Doctor of Veterinary Medicine degree from the University of California at Davis in 1968. She's been a small animal practitioner (dogs and cats ) for all the years since, except for a short stint at the San Diego Zoo when she first graduated.
She belongs to the American Veterinary Medical Association and the American Holistic Veterinary Medical Association.
Since 1974 she's lived and practiced in the South Bay Area near Los Angeles. She started the area's first house call practice in 1976 and the first pet crisis/loss group in 1989. The human-animal bond is of special interest to her.
She started exploring complementary veterinary medicine in 1987. Her practice became 100% holistic in 1996. She utilizes acupuncture, herbs, supplements, Bach Flower Remedies, homeopathic remedies, nutrition and medications for her patients in her practice.
She's currently taking a leave of absence from her house call practice due to health reasons but continues to do phone consultations and to write.
E-mail:
Critterhlr@aol.com
website:
http://www.holistic
vetconsult.com
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