Case Report - Pyometra

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History:

Eight-year-old, intact, female Bassett.  Finished her heat six weeks ago. She is now hardly eating. She’s drinking copious amounts of water (and urinating often). A lump (one centimeter in diameter) was detected in one of her mammary glands a year ago. It’s never been tested.

Examination:

She has lost a lot of weight. She is also depressed, which means not as active as she should be and not paying attention to things that go on around her.  Her temperature is slightly elevated (it is 39.6 and normal is less than 39.2). Her heart rate is also increased. When I felt her mammary lump, it has grown to about three centimeters, is multi-lobulated, and it is non-painful. I can feel a tubular structure in her abdomen lying on the body wall in front of her bladder. It is about three centimeters in diameter.

Assessment: 

Putting together the structure I am feeling in the belly, the time after being in heat, fever and excessive drinking, I am thinking that there is a strong possibility of a pyometra. There is no discharge from the vulva and she hasn’t been licking there so it would be a closed pyometra with pus building up in the uterus. The mammary tumor is not considered a problem at this time – we’ll reassess that later after the current problem is solved.

Plan:

I did a blood test and it revealed a high white blood cell count (40,000 rather than a normal under 15,000). This suggests there is an infection going on. Next, I arranged an ultrasound examination. We found an enlarged uterus filled with fluid. This was the tubular structure I could feel. We had the diagnosis – a pyometra.

Outcome:

I did surgery to remove the uterus, along with the ovaries (an ovariohysterectomy). We did it right away because we didn’t want her getting critical if the uterus ruptured. I also took the mammary tumor off at the same time. The prognosis is good. She recovered and the test on the mammary tumor showed that it was benign. Both the conditions could have been prevented by spaying.

Some students wonder why she was drinking so much. Toxins produced by the bacteria growing in the uterus cause the urine to be diluted (or more specifically, the urine isn’t concentrated). This means she produces more (dilute) urine and secondarily has to drink more water to compensate.

If you'd like to comment on this or have any questions, please post a note in lesson 1 for everyone to see. I will answer any questions.