Pyometra may be the scariest thing your female could ever get..
Pyometra, or pyometritis (in Greek, pyo means pus and metritis means uterine inflammation) is a disease that’s seen more often in unspayed dogs over the age of five – but it can occur at a younger age as well.
There can be many causes of pyometra, yet the main one is a combination of hormonal changes that happen within the heat cycle of your dog. Every heat cycle, there’s a natural reduction of white cells from the uterus to allow for safe sperm passage, causing a lapse in protection that can decrease the ability to fight infection. In most dogs, these heat cycles usually occur twice per year.
In nature, most dogs would breed and either produce puppies, abort or not conceive because of another underlying condition, lack of nutrition, stress in the environment, etc.
When dogs continue to go through estrus (heat) without being bred, their progesterone levels remain elevated for eight to ten weeks – this thickens the lining of the uterus in preparation for pregnancy. The entrance to the uterus is the cervix, which remains tightly closed, except during estrus when it can allow bacteria that are normally found in the vagina into the uterus.
In a normal, healthy uterus, the environment isn’t susceptible to bacteria, but when the lining continues to thicken with every estrus, some dogs will have a tendency to produce cysts that can start to expel large amounts of fluid. When progesterone levels are high, it decreases the ability of the muscles of the uterine wall to contract, which inhibits the ability to naturally discharge the fluid and bacteria inside.
The unhealthy uterine cavity will continue to fill with discharge. And the dog’s body temperature, along with the absence of circulating air inside the uterus, creates perfect conditions for bacterial growth. This bacterial growth can lead to an infection of the uterus, or pyometra.
One form of pyometra is much more dangerous than the other.
The Two Types Of Pyometra
There are two types of pyometra: Open and Closed.
Open pyometra occurs when the cervix is open. The open cervix gives the fluid a way to discharge.
Closed pyometra is when the cervix is closed. When the cervix is closed, there is no way for the infection and fluid to discharge – so the uterus continues to fill, leading to toxicity from the bacteria and if enough fluid builds up, the uterus can actually rupture.
This can cause septic infection and even death.
Closed pyometra typically ends in surgery because the infection has no place to drain. But in the case of open pyometra, there are several treatment options at your disposal – but the first and most important thing is to first have your veterinarian diagnose your dog.
If you decide to treat open pyometra at home (which is entirely possible with the support of your veterinarian and I’ll discuss this in Part 2), you must closely monitor her symptoms, including her temperature, and report this to your vet every two hours.
I’ll discuss the treatment options in a bit, but first, you need to know the signs of pyometra so you can watch your dog. The earlier you catch pyometra in dogs, the more success you’ll have avoiding emergency surgery.
A note to breeders: the use of progesterone or estrogen based drugs used for any reproduction condition can cause the same changes in the uterus and predispose your dog to pyometra. There are a few opinions on the exact physiology and causation, but all end with the same disease.
Pyometra Signs And Symptoms
Signs of pyometra can appear anywhere from two to eight weeks after your dog’s heat cycle, but we have seen them as late as 12 weeks.
The signs of open pyometra include:
Any excessive licking after their heat cycle.
Vaginal discharge (usually white, yellowish or green but it can also start off clear).
The dog can seem a little “off” in behavior (if they are usually cuddly, they may become distant, or the opposite: becoming needy rather than their usual independent nature).
They may be depressed, grumpy with other dogs or people, etc.
They may drink more often than usual, or become lethargic or picky with their food.
The signs of later stage or closed pyometra include:
✓ Excessive panting
✓ Increased thirst and water craving
✓ Distention of the abdomen
✓ Fever often 104 to 106oF
If your dog exhibits even one of the following symptoms after her heat, seek veterinary help immediately. The most important thing is to catch any of these symptoms early!
Once your dog has been thoroughly examined by your veterinarian, including her cervix and discharge, we recommend doing an ultrasound and blood work. The ultrasound will show the size of her uterus and rule out possible pregnancy.
If she does have pyometra, there will usually be a marked elevation of the white blood cell count; there is a type of protein produced by the immune system called globulins that could also be elevated.
Not spaying your dog brings huge benefits to her overall health but it also comes with the responsibility of being a diligent guardian to your dog. You can do this by watching closely for signs and symptoms two to eight weeks post heat, supporting her holistically to prevent this disease from happening and avoiding all contact with intact males to decrease the natural urge to become a mother.
With pyometra, the sooner your dog is diagnosed, the better her prognosis. If she shows any signs of the above signs, take her to your veterinarian immediately.
A Contributing Factor
This is something I’ve observed in my own practice.
A natural, hormonal and sexually suppressive situation could lead to pyometra. For example, I’ve noticed that many females who have been in close contact with intact males but aren’t allowed to breed exhibit a higher incidence of pyometra.
It’s possible that the increased desire and possibly stronger triggers of wanting to be a mother could contribute to the abnormal hormonal changes. This could also support my observation that dogs who go through many pseudo or false pregnancies may suffer a greater incidence of pyometra.
If you’ve never seen a false pregnancy, signs can vary in so many ways. Common symptoms are:
• Nesting (constantly taking blankets and pushing them into a ball or nest).
• Taking all their stuffed toys into their bed.
• Whining more than normal, restlessness or seeming frustrated,
• Engorged mammary glands and even producing milk.
• Increased or ravenous appetite or no appetite at all.
• Wanting more attention or wanting to be alone.
In most cases, symptoms will appear between the second and third month after a heat, but I’ve seen them as early as one month post heat and as long as four months post heat.
Conventional Treatment Options For Pyometra:
If you suspect your dog has pyometra, your best bet is to consult with a homeopathic veterinarian. This is your best chance at avoiding surgery. In Part 2, I’ll help you choose the right remedies so you can work alongside your vet.
But chances are, your vet will suggest a different approach from homeopathy, so I want to discuss some of the options he’ll give you. Then you’ll know the pros and cons of these conventional treatments before making a decision.
This is a synthetic steroid.
Historically, aglepristone has been shown to disengage progesterone’s support of pregnancy by blocking its receptors. By taking over the progesterone receptors, the drug also removes the effect progesterone plays in containing pyometra, allowing the dog’s natural uterus purging mechanism to occur.
This treatment is said to be quick and very gentle, and may help avoid surgery and that’s a good thing. However, your dog may experience inflammation and pain at the injection site.
These are a group of hormones that destroy the corpus luteum (a hormone secreting body in the female reproductive system). They have uterotonic effects, reduce the blood levels of progesterone and are known to relax and open the cervix, and contract the uterus to expel bacteria, fluid and pus.
Again, avoidance of surgery is the benefit of prostaglandin treatment, however there are several drawbacks, including: Side effects such as restlessness, panting, vomiting, defecation, salivation, and a painful abdomen.
If the treatment isn’t successful, the dog is even sicker and a poorer candidate for surgery and recovery.
Many veterinarians believe that because prostaglandins cause the uterus to contract, there’s a risk of the uterus rupturing, which can result in infection and acute kidney failure.
Aglepristone And Low Dosage Prostaglandins
These two treatments are sometimes combined. According to reproductive veterinarians, the two combined treatments offer the best solution, as long as the prostaglandin therapy is given in very low doses.
Estrogens are potentially effective, but come with worrying side effects such as further damage to the endometrium and potential bone marrow suppression. Many vets consider these risks far outweigh the benefits.
A New Option For Pyometra
Advanced new techniques are showing promise with both open and closed pyometra.
A transcervical endoscopic catheter that’s normally used for intrauterine insemination can be used to infuse warm saline containing prostaglandin F-2a into the uterus. An ultrasound is performed two days later and if fluid is still detected, the treatment is repeated.
Despite this new treatment option, ovariohysterectomy (or spay), still seems to be the treatment of choice for most veterinary hospitals.
I’m sure this is because the new technique is still in the testing stage; also the combined aglepristone and low dosage prostaglandin treatment has not been widely used, and is therefore not trusted in the case of a life-threatening illness.
Vets also recommend surgery because it not only eliminates the immediate emergency, but also prevents reoccurrence in the future. But performing a spay when the uterus is filled with bacteria is more challenging than a routine spay. And if you can avoid spay, you’ll avoid the loss of hormones that can contribute to other health issues. Sterilization is also undesirable when a breeder considers a dog very important to her line.
But if you and your vet opt for an emergency spay, then there are some questions you need to ask.
First, make sure your vet is completely confident in the procedure. This is major surgery that’s more risky than routine spay so it’s OK to ask your vet how often he’s done this surgery and if he feels comfortable with it. If he’s not careful, the uterus can rupture and fill the abdominal cavity with infection, putting your dog in real peril.
You also need to ask your vet if he will do a lavage during surgery. A lavage includes filling the abdomen with a sterile solution to decrease the risk of infection. Once the uterus is removed, the solution is sucked out along with any residual infection. Even if the uterus doesn’t burst, it can still leak fluid into the abdominal cavity, so a lavage is an important step to reduce the risk of surgery post-op.
If this is an emergency and outside of regular hours, you also need to ask your vet if there is anybody there to help him if the surgery goes wrong. If your vet isn’t fully staffed, then it might be a good idea to take your dog to a fully staffed emergency clinic for the spay – they’ll be better prepared should anything go wrong.
Most of the time your dog will do just fine, but it’s a good idea to be prepared for the worst. Complications may arise.
Author Julie Anne Lee
After many years working as a veterinary technician, Julie developed an equally passionate commitment to homeopathy. Today she puts her experience as an animal care provider and compassionate advocate to develop simple and easy-to-follow products in her pet care health line called the Adored Beast.
There is a TON of great information on their website: www.dogsnaturallymagazine.com