Pyometra

What is a pyometra?

This is a potentially life threatening condition which requires immediate veterinary treatment.

Pyometra is an infection of the lining of the uterus which often occurs shortly after oestrus (heat or season). Following a normal oestrus, progesterone levels remain increased for 8-10 weeks to prepare the uterus lining for a potential pregnancy.
If pregnancy does not happen, the progesterone levels do not return to normal and the lining continues to thicken, forming cysts. These cysts produce fluid which creates the ideal environment for bacteria to develop.

The cervix, which is the entrance to the uterus, usually remains closed unless oestrus is occuring. While the cervix is open, bacteria which normally live in the vagina will enter the uterus. Normally these bacteria won’t survive, but in a thickened uterus with the ideal environment created for bacteria they will thrive. Due to the thickening of the uterus it is also unable to contract fully and expel the bacteria.

Pyometra can occur in any unneutered dog or cat. It is more commonly seen in middle aged to older dogs, although young dogs are also susceptible. It occurs rarely in cats.

Older dogs which have had many oestrus cycles without a pregnancy, have the perfect uterine wall to promote this disease. It usually occurs 4-8 weeks after oestrus.

Clinical signs

These can vary considerably so you should always seek veterinary treatment.

  • Lack of appetite
  • Increased thirst
  • Lethargic
  • Temperature

If the cervix is open allowing drainage you will see a pussy, vulval discharge which is usually foul smelling. Your dog will often be continually cleaning her back end. This is called an open pyometra.

If the cervix is closed the pus continues to build up without draining causing the dog to become seriously ill, extremely quickly.

Diagnosis

A full clinical examination is performed by your veterinary surgeon. Pyometra is often suspected if the dog is not neutered, drinking more and has a vulval discharge, 4-8 weeks after oestrus. A blood sample may be collected and X-rays or an ultrasound scan may be performed to confirm the diagnosis.

Treatment

The most recommended option for treatment is surgery to remove the infected uterus and ovaries- an ovariohysterectomy or spay. Depending on the severity of the infection, your dog may need to be stabilised first using intravenous fluids and antibiotics, prior to surgery. Although the surgery being performed is a neutering operation, the surgery is much more complicated due to the enlarged and weakened uterus. It must be removed without rupturing to prevent the pus from leaking into the abdomen. Additionally there is always an increased anaesthetic risk when the patient is unwell. This is one of the reasons why veterinary surgeons always recommend spaying your dog at an early age when they are young, fit and healthy!

Medical treatment for pyometra is possible using injections containing prostaglandins which reduce the progesterone levels. This causes the cervix to open and expel the pussy contents of the uterus. Medical treatment for pyometra can be expensive especially in large dogs. It is not always effective and surgery may still be necessary.

Medical treatment can be considered for young bitches from whom the owner would like to consider breeding from at subsequent seasons. It can also be considered for older bitches where general anaesthesia and surgery is considered inadvisable.

Your veterinary surgeon will discuss the best course of treatment for your pet. If you do not seek any treatment for your pet suffering from a pyometra the outcome will potentially be fatal.

Neutering Your Female Dog – Spay

What is a bitch spay?

This operation involves removal of the entire uterus (womb) and ovaries via a midline incision into the dog’s abdomen. Your dog will be admitted as a ‘day patient’ and following a pre-operative check by your veterinary surgeon, she will be given a pre-medication and analgesic (pain killing) injection prior to her general anaesthetic. After surgery and following her recovery from the anaesthetic she will be ready to go home later the same day. You will be given full discharge instructions on how best to care for your dog after surgery and she will be checked by your veterinary nurse 3 days later to ensure the wound is healing. If there are any sutures present these will be removed 10 days later. We usually use intradermal (under the skin) sutures for our bitch spays, so there are no skin sutures requiring removal or to aggravate your dog while their wound is healing. Your dog will go home with some pain relief medication for a few days as well as a Buster collar to prevent any interfering with their wound. While the operation is more complicated than castration, it is still a routine procedure and their recovery is usually fairly quick.

What are the advantages?

  • Your dog will not have seasons and therefore cannot become pregnant.
  • Removal of their uterus and ovaries reduces the chances of infection in later life.
  • If your dog is spayed the incidence of mammary (breast) cancer is greatly reduced.
  • False (phantom) pregnancies are stopped.
  • Vaginal polyps (small nodules) are prevented.
  • Mismatings and unwanted puppies are avoided.

Are there any disadvantages?

Any surgical procedure involving general anaesthesia carries a small risk.  As with castration, your dog will be assessed prior to surgery to ensure she is fit and well and full instructions will be given when she goes home to minimise potential problems.

A small proportion of larger breeds can develop urinary incontinence, which may require treatment later in life.

Minor coat changes may be noticeable in certain breeds such as Irish Setters.

It is a common fallacy that a neutered dog will become fat and lazy. They may have a decreased activity level following neutering, which in turn causes weight gain IF your dog continues to be fed the same amount of food as before they were neutered. Neutered pets can require up to a 30% reduction in their feeding requirements. This is due to no longer utilising energy in to reproduction.This extra energy may then be stored as excess body fat instead.  

After your dog is neutered, we recommend moving her onto a neutered dog food. Royal Canin have developed a competitively priced, veterinary exclusive pet food, Royal Canin range. This is high in protein and low in fat to help combat against any weight gain. Your veterinary nurse will be able to advise you on the best feeding regime for your dog.

When to spay?

Bitches can be spayed from six months of age so prior to their first season.  If they have had seasons then ideally three months after the end of their last season i.e. in-between seasons.  The younger she is the greater the benefit from surgery.

Are there any alternatives?

Cinque Ports Vets are pleased to be able to offer our clients the option of keyhole (laparoscopic) surgery for routine bitch spays and other procedures where appropriate.

Keyhole spay involves the introduction of a camera and specialised instruments into the abdomen through two or three small incisions. Many of the traditional surgical procedures such as spaying can be now performed laparoscopically. Traditional surgery involves the removal of the ovaries and uterus (ovariohysterectomy) but laparoscopically generally only the ovaries are removed (ovariectomy).

The tissues are visualised under high magnification and blood vessels are cut and sealed using specialist equipment.

It is well established in human surgery that laparoscopic procedures provides quicker healing time and less post-operative complications than other methods. This is proven also in modern veterinary medicine.

The benefits of laparoscopy for our pets are similar and aim for a faster and more comfortable return to normal activity. One typical example is the young, very active bitch that is not likely to accept easily periods of complete rest from exercise post neutering.

After Keyhole surgery dogs will still need to be kept on the lead but the risk of damaging the surgical wounds (because of the small size) is greatly decreased. Please be aware that we do need to shave a little more fur than with a traditional procedure and Keyhole surgery is a little more expensive due to the cost of the equipment required and the expertise.

Useful links:
www.royalcanin.co.uk

Rabbit Spay Advice

Once you have made an appointment for your pet to be neutered, it is important that your pet eats as normal up to their operation, therefore food and water should NOT be removed the night before the procedure.

Once admitted they will be examined by your vet and given a health check.

Rabbits are given a combination of drugs to induce general anaesthesia.  Once your pet has had a health check and the vet is happy to proceed, the combination drug is given into the muscle.  This injection will take 5-10 minutes to take effect.  They will then be under general anaesthesia.  She will then be transferred through to the Prep room and prepared for theatre.

An endotracheal tube may be placed into her trachea to maintain a clear airway for us to give her oxygen and if necessary a gaseous anaesthetic to maintain anaesthesia.

Spay

Once asleep under anaesthetic she will be prepared for theatre. Her veterinary nurse monitors her anaesthetic while shaving an area of hair from the abdomen.  Once the hair been removed the area is then cleaned using an antiseptic soap. This procedure is carried out to reduce any bacteria on the skin and provide a sterile operation site. All the hair will grow back in time. She is then transferred to theatre.

The nurse will carefully monitor the anaesthetic during the surgery.  The vet will perform an ovariohysterectomy where the uterus and ovaries are removed.  This is a permanent and irreversible procedure.

Once the surgery is complete another injection is then given into the muscle. This injection reverses the initial injection and can take a further 10 minutes for your pet to be fully awake. During this time she will be constantly monitored by the Hospital nurse and is kept warm.

Once she is sitting up and alert, the Hospital nurse will contact you to update you on their progress and arrange a collection time. On discharge a veterinary nurse will explain all the necessary post- operative care.

We will only discharge a patient when we feel they are fully awake and are able to walk. Some pets take longer to fully recover than others and are treated on a case by case situation, so don’t panic if a late time is requested for collection.

Benefits of having your rabbit spayed:

  • No unwanted kittens
  • Reduced incidence of mammary tumours
  • No ovarian tumours
  • No uterine tumours (especially common in rabbits)