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What is pyometra?

Pyometra literally means “pus in the womb” and is seen a lot less commonly these days due to increased awareness about neutering. It is a serious life-threatening condition which we still, however, see quite frequently.

How can I tell if my bitch has pyometra?

Pyometra, or “pyo “ for short, can present from the obvious: thick pus seeping from the bitch’s vulva to much vaguer symptoms of being a bit quiet and perhaps off her food. The reason for this wide range of clinical signs depends on how long the pyo has been established and whether the pus is able to drain out of the womb or not.

A classic example would be an unspayed bitch who has been in season 1-3 months ago, who is drinking a lot ( polydipsia), seems a bit tired or depressed, is off her food and in some cases even vomiting. She may or may not have a vulval discharge – usually noticed by her spending an abnormal time licking her private parts.

Investigations to confirm a pyo often include an ultrasound scan and blood tests.

What causes a pyometra?

Unfortunately, the answer isn’t a simple one, as a pyometra can be caused by one or a combination of underlying factors such as hormonal changes in the lining of the womb as the dog gets older. Infection can reach the womb via the bloodstream from elsewhere in the body or can “ascend ”ie creep up the reproductive tract from outside the body especially if the bitch has recently given birth.

How can pyometra be treated?

Treatment options vary but most will involve surgical removal of the infected womb and its contents when it is safe to do so. Many patients with severe pyometra show signs of being toxic or even in shock and require intravenous fluids and antibiotics first to prepare them for surgery.  Sometimes, in suitable cases, a short course of drugs will be given to expel pus from the uterus before waiting for them to become a safer candidate for surgery. Essentially though spaying is the treatment of choice.

Why can’t antibiotics be used to treat this infection?

Due to the location and amount of pus, any antibiotics rarely penetrate the infection effectively. Also, in those few cases which do respond initially, the underlying medical conditions such as hormonal changes in the lining of the womb mean that the condition is likely to recur post-treatment. The most effective treatment remains to spay.

What is the difference between pyometra spay and a normal spay?

The main differences between a routine spay and a pyometra spay are due to the size of the uterus. When the uterus is very enlarged with a pyo, a much bigger surgical incision is required, the tissues are quite fragile and the blood vessels enlarge. All this leads to a much longer time on the operating table. Also as these dogs are often toxic, intravenous fluids are necessary at the time of surgery and they may need to be hospitalised for a couple of days afterwards, compared to a routine bitch spay who we would expect to discharge on the day of the procedure.  As this is a life-threatening surgery may have to be performed out of hours: at night or weekends.

This means that the cost of pyometra spay is typically 6-8 times the cost of a routine spay. Pyometra is certainly one of the biggest reasons vets advise you to get your bitch spayed if you’re not planning to breed from her. Though dogs with pyometra usually make a successful recovery with a good prognosis, this is one incidence where prevention is certainly preferable to cure. Our vets are always happy to discuss neutering.

Jackie Beattie