Journal of Canine Dev Research 2010; 6 : 79-82.

CLINICAL FINDINGS AND MEDICAL THERAPY OF PYOMETRA IN BITCHES Pramod Kumar1, G. N. Purohit1, Y. K. Barolia1 Sumit Prakash Yadav1 and Jitendra Bargujar2
1

Department of Animal Reproduction, Gynaecology and Obstetrics 2 Department of clinical Veterinary Medicine
College of Veterinary and Animal Science, Bikaner (Raj).334001

ABSTRACT A total of eleven cases of pyometra were diagnosed by clinical signs and ultrasonography. The proportion of bitches showing open and closed pyometra was 54.5% and 45.5% respectively. Bitches were treated by medical therapy using prostaglandins, antibiotics and supportive therapy. The therapy was initially successful in all treated bitches but within two months of therapy 5 bitches had reoccurrence and had to be referred for surgery. However in 54.5% (6/11) bitches a single therapy was successful. Key word Pyometra, sonography, canine Pyometra is a serious, potentially life-threatening hormone mediated disorder, commonly seen in the middle-aged diestrual bitches (Qureshi et al., 2002). Suspicion as to the possible presence of pyometra must be aroused in aged bitches (5-10 years) with history of gastritis, fever and abdominal distension not responding to routine therapy (Niskanen and Thrusfield, 1998). Pyometra is considered open when there is a vaginal drainage of pus. Conversely, it is considered closed when there is no drainage of pus. Ovariohysterectomy is generally recommended as the treatment of choice (Andersen and Farstad, 2006) however, when the breeding life of the bitch is considered important, medical therapies utilizing prostaglandins ( Gabor et. al., 1998; Smith, 2006 ), antibiotics , fluid replacement and antiprogestins should be considered (England et al, 2007 ). This paper describes the clinical findings and outcome of medical therapy of pyometra in 11 bitches. Materials and Methods Bitches (n=11) presented to the veterinary obstetrics and gynaecology outdoor between 2007 to 2010 were included. The medical records were reviewed and the outcome was evalualed. Only bitches with a serious nature of the disease and whose outcome of therapy was documented were included in the study. The diagnosis of pyometra was based on abdominal palpation, history and ultrasonography. The medical therapy used included administration of antibiotics (Amoxicillin plus Clavulamate potassium 12.5-25 mg/kg BD for 7-10 days), prostaglandin (carboprost trometamine 5- 10 g/kg IM daily for 3-5 days), fluid replacement and other medicines as required. Owners were warned about the possible side effect like vomition, salivation etc. and advised to give antiemetics like domperidone (0.5-1 mg/kg orally) when the side effects were severe. Bitches that did not respond to therapy within 10 days of treatment or when bitches had a recurrence of symptoms within 2 months of therapy were referred for ovariohysterectomy.

Journal of Canine Dev Research 2010; 6 : 79-82.

Results and Discussion- The breeds of bitches presented included Pomeranian (n=4),
German Shephered (n=3), Cocker Spaniel (n=1), Great Dane (n=1), Labrador (n=1), and Pugh (1) and their age was between 3 to 8 years. Previous findings have also recorded that the usual age for pyometra in the bitch varies from 5-10 years (Qureshi et al.2002; Niskanen and Thrusfield,1998). The most common clinical complaints are montioned in Table 1. The proportion of bitches with closed pyometra was 45.4% (5/11) where as, 54.6% (6/11) bitches had open pyometra. Only 36.3% (4/11) bitches evidenced abdominal distension and most of these bitches (3/4) had a closed pyometra. Both closed and open pyometra have been previously described in the bitch with nearly similar clinical findings. (Dow, 1957; Brodey, 1968; Hardy and Osborne, 1974; Qureshi et al,.2002; Smith,2006; Pretzer,2008).The most common sonographic finding was presence of anechoic fluid (Fig 1) and echogenic particles within the fluid .The amount of fluid varied from case to case. The presence of fluid was consistent with closed pyometra but one Pomeranian bitch showed the presence of fluid in the uterus although it had on open pyometra. The fluid seen sonographically was sometimes visible as small round sacs (Fig 2). A few bitches showed no consistent sonographic findings. These findings are consistent with previous findings of Qureshi et al., 2002 and England et al.,2007 who observed the presence of anecohoic fluid , fluid sacs and echogenic particles in pyometra affected bitches. Medical therapy was initially successful in all treated bitches as evidenced by the recovery from the clinical signs and disappearance of fluid seen ultrasonographically within 7-10 days of treatment. However, 45.5% (5/11) bitches had a recurrence of the clinical signs within 2 months of initial therapy. These bitches were referred for surgical treatment. A high proportion (54.5) of bitches did not evidence the recurrence of pyometra for upto 2 years and 2 (2/6) of these bitches delivered live pups. Table 1.clinical and sonographic findings in bitches with pyometra
S. No. 1 2 3 4 5 6 7 8 9 10 11 Breed G.S. G.S Pomeranian Pomeranian Cocker spaniel Great Dane Labrador Pomeranian G.S Pugh Pomeranian Age (Yr) 6 8 7 6 3 5 7 8 5 5 7 Clinical Component Gastritis Fever, diarrhea Gastritis, lethargy Gastritis, lethargy Gastritis, lethargy Fever, diarrhea Anorexia, gastritis Lethargy, gastritis Gastritis, fever Lethargy, fever Gastritis Vaginal pus discharge Present Absent Present Absent Present Absent Present Present Absent Absent Present Abdominal Distention + + + _ + + + Sonographic findings No specific Fluid sacs with echogenic material No specific Echogenic part with fluid No specific Fluid No specific Fluid _ Fluid + echogenic particles No specific

Note : + = Present and - = Absent

Journal of Canine Dev Research 2010; 6 : 79-82.

Fig 1.Showing presence of anechoic fluid and echogenic particles within the fluid.

Fig 2.Showing small round sacs of pus in the uterus.

Similar to the present study a large number of recent reports depict a good response to medical therapy on a short term basis (Andersen and Farstad, 2006; Smith, 2006; England et al.2007). The future breeding potential of bitches, treated by medical therapy continues to be poor. Andersen and Farstad (2006) recorded that only 37% of medically treated bitches retain their breeding potential and relapses are common in treated bitches. (England et al.2007). It was concluded that gastritis and fever are the most common clinical finding in pyometra affected bitches and although medical therapy of pyometra is possible, relapses are common and only few of such treated bitches retain their breeding potential.

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