Dog pyometra: a complete guide

Dog pyometra is a condition that can be fatal if not treated on time. Intact (not spayed) female dogs are vulnerable to a potentially fatal ailment called pyometra. In this condition, there is pus builds up in the uterus of unspayed females, which causes infection and inflammation.

The origin of this word is from the Greek words Pyo, meaning pus, and metra, indicating uterus, which combines to form the word pyometra.

Dog pyometra

Hormonal shifts occur during a female dog’s regular reproductive cycle, causing the uterine lining to thicken in anticipation of pregnancy. In the absence of pregnancy, the dog’s uterine lining will continue to expand, providing a fertile breeding ground for bacteria. If by chance, a bacteria gain entry into the uterus through the cervix, it can lead to a massive infection that can be extremely fatal.

Pus made up of dead white blood cells, bacteria, and tissue debris, fills the uterus as the infection worsens. This buildup of pus can cause the uterus to become very inflamed and distended. Since the risk rises with age, pyometra most often affects senior dogs that have gone through numerous heat cycles.

This article will shed light on what is Pyometra in dogs, the different types of pyometra, the causes, diagnosis, treatment, and prevention of the same,

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Why does dog pyometra occur?

Pyometra in dogs is brought on by hormonal shifts that occur with each heat cycle. The uterine lining continues to thicken in preparation for pregnancy for several weeks after estrus (heat) because progesterone levels remain elevated. In the absence of pregnancy, following the numerous estrus cycles, the uterine lining will thicken to the point where cysts will form.

The formation of cysts in the uterus is known as cystic endometrial hyperplasia. Bacteria thrive in the secreted fluids from the thicker cystic lining. In addition, the uterine wall muscles are unable to contract and discharge any fluid buildup or bacteria when progesterone levels are high. Thus, this causes to the uterine wall to get infected.

Causes of dog pyometra

Medications that cause dog pyometra

Uterine alterations mimicking those of an estrous cycle can be the result of progesterone-based medications. When combined with estrogen or synthetic estrogen medications, progesterone’s effects on the uterus are amplified. Some reproductive system disorders are treated with drugs that include both estrogen and progesterone. Pyometra is a serious condition that must be watched for in any intact female taking hormones.

Dogs can get pyometra from bacteria.

The bacterium E. coli is a major cause of pyometra. In female dogs, E. coli infections tend to occur a few weeks following the end of the heat cycle. This is in part because white blood cells, which typically guard against infection, are blocked from accessing the uterus during estrus. This is a natural process that ensures healthy sperm make it through the female reproductive system unharmed by the body’s immune system.

The cervix opens into the uterus. Normally the passageway is tightly closed and does not allow bacteria to reach up to the uterus. However, during estrus, it relaxes to let sperm into the uterus. Bacteria present in the vagina can enter the uterus with ease if the cervix is open or dilated. When the uterine wall is thin and healthy, bacteria have a hard time surviving there since the environment does not promote bacterial survival.
However, when the uterine wall becomes thicker and cystic, the environment becomes ideal for bacterial growth. The abnormal thickness of the uterine wall or the hormone progesterone also prevents the uterine muscles from contracting normally to expel the bacteria out of the uterus.

Age of the dog

Although older dogs are more likely to develop pyometra, it can happen to any sexually-immature dog between the age ranges from young to middle aged. Most often canines are in heat for four weeks. During this time, the uterine wall thickens up in anticipation of pregnancy. The uterine wall alterations that cause this condition occurs after many years of estrus cycles with no pregnancy. Typically, pyometra will occur between two and eight weeks after the end of ovulation or the last menstrual period.

The different forms of dog pyometra

Open pyometra and closed pyometra are the two most common forms of this condition in canines. These variations are distinguished by the cervix’s health and the uterus’s capacity to drain out the pus.

Open Dog Pyometra:

Open pyometra, often called “open cervix pyometra,” is characterized by a persistently open cervix.
Pus and infected material can drain, in part or in full, via the vaginal opening and out of the uterus when the cervix is open.
A vaginal discharge that looks like pus or has a bloody hue is a common symptom of open pyometra.
Pus drainage from the cervix may reduce certain symptoms and postpone the development of more serious consequences.

Closed Dog Pyometra:

Closed pyometra, also known as “closed cervix pyometra,” occurs when the cervix closes and blocks the flow of pus out of the uterus. When the cervix is closed, pus builds up inside the uterus, which can worsen symptoms and increase the likelihood of severe complications.
The uterus undergoes distention and gets filled with infectious material. Since the material is unable to drain, It leads to severe pain and pressure on the uterus. If it is a case of closed pyometra, it’s a more serious condition that needs veterinarian attention right away.

Signs and Symptoms of Dog Pyometra

Indicators of a dog pyometra infection include:

• Having pale gums
• Lethargy
• Consistent weight loss
• Panting
• Drinking water excessively
• Frequent urination
• Vomiting
• Diarrhea
• Vulval licking and/or a bloody or pus-filled vaginal discharge
• Distention of the abdomen
• Fever
• Loss of Appetite

In older, intact female canines, pyometra should be suspected whenever one or more of the above-mentioned clinical symptoms are present.

Whether or not the cervix closes affects the clinical presentation. When the vagina is exposed, the uterus’ purulent discharge can escape from the vagina and be released. It is possible to see this discharge on the dog’s skin or fur under its tail or any surface it has recently lain on. Fever, fatigue, loss of appetite, and emotional instability are not always present if the dog is suffering from a case of open pyometra.

The discharge that develops cannot escape through the cervix if it is closed. As the discharge builds up in the uterus, the abdomen becomes distended. These bacteria then start to produce toxins, which are then taken up by the body’s circulatory system. Closed pyometra causes quick and severe illness in dogs. They refuse to eat (anorexia) and seem uninterested or unhappy. It’s also possible to have nausea, vomiting, or diarrhea.

The bacterial toxins destroy the kidneys’ ability to store fluids. The dog has to drink a lot of water to keep up with the increased pee output. This symptom is true for both forms of dog pyometra.

How can you prevent dog pyometra?

Pyometra in dogs is typically brought on by hormonal shifts and bacterial infection. Several causes can lead to pyometra in unspayed female dogs. Among these are:

Variability in the hormone levels

Due to hormonal oscillations that occur throughout a typical heat cycle in dogs, the uterine lining tends to thicken during this time. In the absence of pregnancy, the dog’s uterine lining will continue to expand, making it a fertile breeding ground for germs that can lead to illness.

Infection caused by bacteria entering the uterus:

During the menstrual cycle, bacteria can enter the uterus through the cervix. Escherichia coli (E. coli) and Streptococcus spp. are the most common bacteria that cause pyometra. However, other types of bacteria can have a role as well.

Risk factors

Certain factors can boost the chance of the occurrence of a bacterial infection like a shift in vaginal flora, weakened immunity, or a history of uterine infections.

History of Reproduction in dog pyometra

Dogs older than six or seven years often show signs of pyometra. This is because as the dog gets older, they are more likely to experience hormonal and anatomical changes in the uterus.

The no of heat cycles the dog has passed through already

The likelihood of pyometra increases with the number of heat cycles a dog has experienced without having a pregnancy. Having gone through several heat cycles without giving birth or being bred increases the danger for dog pyometra.

Breed-Specific Propensities

Some dog breeds may be more at risk for pyometra than others. Rottweilers, Golden Retrievers, German Shepherds, Siberian Huskies, and even certain toy dog breeds fall under this category.

Treatment with Progesterone

The risk of pyometra may be elevated by the use of progesterone-based hormonal therapy, such as those employed in estrus synchronization or the treatment of reproductive problems.

Diagnosis

If the dog is examined early in the disease process, she may only exhibit a little vaginal discharge as a symptom. However, most cases of pyometra in dogs are not diagnosed until a more advanced stage. If a female dog is sick, starts consuming more water than usual, and has not been spayed, she likely has pyometra. Symptoms like a vaginal discharge or an enlarged, aching abdomen should not be ignored by the dog guardians.

When the above-mentioned symptoms and signs are present, a diagnosis of pyometra is strongly considered. Unspayed female canines of any age will be suspected because of their prevalence in older dogs. Palpation, vaginal cytology, blood parameter evaluation, urinalysis, radiography, and ultrasound are just a few of the possible diagnostic procedures that can be used for the identification of the disease.

In closed pyometra, when uterine enlargement and distension are common, palpation (feeling for an enlarged uterus) is more helpful. In cases of open pyometra, vaginal cytology can help determine what exactly is in the vaginal discharge. A cytological examination involves collecting a small sample of the discharge and viewing its components under a microscope. The veterinarian will check for irregularities such as an elevated white blood cell count and the presence of germs.

Even though pyometra starts in the uterus, the infection can travel to other parts of the body and cause septicemia (blood poisoning). Therefore, tests such as a blood count and urinalysis are carried out to ascertain the level of infection. Pyometra is characterized by deviations in specific blood parameters.

Closed pyometra is best diagnosed using radiography since the swollen, fluid-filled uterus may be seen on x-rays. An ultrasound can detect the fluid-filled uterus typical of closed pyometra and the thickened uterine wall seen in open pyometra.

Canine Pyometra and Its Treatment

Surgical option

Surgery to remove the uterus and ovaries (ovariohysterectomy) is the gold standard for treating pyometra. In less severe cases of open pyometra, medical therapy may be explored if the guardian intends to breed the dog in the future. Owners should be made aware of the risks involved and the decreased success rate compared to surgical options if they select non-invasive treatment.

When the pyometra is closed, surgery is the only option, especially if the infection has spread to other parts of the body. It’s also common in senior canines that will not be made to participate in the reproduction process. As soon as the dog’s health stabilizes, an ovariohysterectomy is performed. Patients who are frail or elderly pose a greater danger during anesthesia. Dogs normally make a speedy recovery. Thus, the dog is sent home with the guardian soon. The guardian is supplied with medicines for inflammation and pain and antibiotics to prevent any infection from occurring.

In less severe cases of open pyometra, or if the dog is young and/or genetically valuable, the veterinarian may opt for medical intervention. Prostaglandin injections, antibiotics, and fluid therapy are all part of the medical management process. Antibiotics are often prescribed for at least 2 weeks and prostaglandin injections for 3-7 days. The treatment may be extended depending on the recovery pace of the dog. Excessive panting, diarrhea, and vomiting are all possible side effects of therapy. After therapy finishes, dogs will need to be checked again to identify that all signs of infection have gone.

Someday, I hope to breed my dog. Is It possible to avoid surgery if possible?

Most cases of pyometra in dogs require surgical intervention. Even though pyometra can be treated medically, the success rate is low and there is significant danger and possibility for long-term problems. Prostaglandins are a class of hormones that decrease progesterone levels in the blood by relaxing and opening the cervix and stimulating contractions in the uterus, resulting in the discharge of pus and bacteria. Although they have the potential to be used to treat this illness, they are not without significant drawbacks and are not always effective.

Side effects of using prostaglandins

The use of prostaglandins comes with unpleasant side effects such as agitation, rapid breathing, nausea, vomiting, diarrhea, excessive salivation, and stomach pain. After being administered, the negative effects show up within fifteen minutes and can linger for a few hours. Each subsequent treatment makes them less severe than the last.
After giving your dog an injection, you can try to decrease the pain by keeping her busy for 30 minutes.
Since the clinical improvement does not occur for roughly 48 hours, this therapy option is unsuitable for critically ill dogs that require urgent life-saving care.

Prostaglandins are responsible for the contraction of the uterus, which can lead to its rupture and the subsequent spread of infection throughout the abdominal cavity, a condition called peritonitis. In cases of dog pyometra with a closed cervix, this is the most likely scenario.
Success, recurrence, and future reproductive success vary among patients treated with prostaglandins for pyometra. Your dog’s specific condition will dictate the treatment plan your vet recommends.

Prophylactic options for dog pyometra

Spaying (ovariohysterectomy) and general reproductive health care are two methods for protecting dogs from pyometra.

Spaying:

Pyometra can be avoided by spaying your dog. Removing the uterus and ovaries, this operation renders pyometra impossible. Spaying a dog can be done at any time once it has reached sexual maturity, but often occurs between the ages of six and twelve months before the dog has its first heat cycle.
Spaying should be done at the appropriate time for each dog, according to her health and development.

Checkups with the Vet:

Keep an eye on your dog’s reproductive health by taking her in for checkups at the vet’s clinic regularly. When you take your dog in for a routine wellness visit once a year, the vet may evaluate his or her overall health and advise you on any potential reproductive issues.

Controlling the external hormone levels:

It is important to use caution when administering hormonal therapy like progesterone-based medications. Pyometra can be prevented by avoiding hormonal medications that could disrupt the reproductive cycle.

Maintaining a Clean Environment:

Keep your dog clean and healthy by bathing and wiping down her privates regularly. In case you see any discharge or an unusual vaginal odor, wipe it up right once and talk to your vet.

Proper breeding methods

Selecting healthy, genetically-sound breeding couples is an essential part of any responsible breeding program. Only those dogs should be bred that have passed all necessary health tests and have no history of reproductive problems.

Healthy eating and regular exercise:

Feed your dog a healthy, well-rounded meal that will boost his immunity and general well-being. Keeping up with a regular exercise routine is important for both weight management and general health.

Always keep in mind that avoiding a problem is preferable to fixing one. The risk of pyometra in dogs can be greatly reduced with timely spaying, frequent veterinarian care, and good reproductive health. To find out what preventative measures are ideal for your dog, you should talk to your vet.

Pyometra in Dogs: Potential Complications and Long-Term Consequences

If the dog pyometra is not treated or is allowed to worsen, it can cause several problems and long-term damage. As a dog guardian, it is important to note that among the potential side effects and consequences are the following:

Uterus rupture

The infected uterus can become fragile and more likely to rupture in the later stages of pyometra. Complications from a uterine rupture include severe abdominal discomfort, infection throughout the body, and even death.

Sepsis

Pyometra is a uterine infection, and if it spreads outside the uterus, it can cause sepsis. Without timely treatment, sepsis, a systemic inflammatory reaction to infection, can affect many organs and prove fatal.

Peritonitis

Damage to the uterus can lead to peritonitis if the infection escapes into the abdominal cavity. Peritonitis, caused by infection and inflammation of the abdomen lining, can cause intense discomfort, high body temperature, and other symptoms of generalized sickness.

Damage to the Kidneys:

Pyometra is an infection that can spread to the kidneys and cause permanent damage or failure. Alterations in urine output, electrolyte imbalances, and other potentially fatal consequences can develop from kidney malfunction.

Septic shock

Septic shock can also occur in severe episodes of pyometra, particularly when systemic infection is present. Low blood pressure, organ failure, and a systemic inflammatory response are hallmarks of septic shock, a potentially fatal illness.

Impairment of the reproductive system

Pyometra can cause reproductive system impairment, which can have negative effects on fertility. In extreme situations, ovariohysterectomy (the removal of the ovaries along with the uterus) may be required, leading to permanent infertility.

Chance of recurrence

Some dogs who have been treated for pyometra may get the ailment again despite the best efforts of their veterinarians. As opposed to surgical procedures, this occurs more frequently with medical care.

Effects of Dog Pyometra on Long-Term Health

A dog’s overall health and organ function may be negatively impacted by pyometra. The dog’s immune system, organ function, and general health may be permanently compromised depending on the severity of the illness and its associated problems.

It cannot be overstated how important it is to seek veterinarian care right away for pyometra. Early discovery, rapid treatment, and proper management can reduce the risk of complications and long-term effects. Pyometra and its complications can be avoided with regular veterinary checkups and spaying.

Final thoughts on dog pyometra

Overall, pyometra in dogs is a significant medical emergency that can potentially be fatal for intact (unspayed) female canines. Pus builds up inside the uterus, causing infection, inflammation, and a variety of symptoms. Awareness and ethical dog care require an understanding of pyometra, its causes, and risk factors.

Successful management of pyometra requires quick diagnosis and veterinarian attention. In case, the cervix stays open in the case of dog pyometra, the dog may start to show mild symptoms like vaginal discharge. However when the cervix is closed, pyometra can cause serious problems.

The likelihood of developing pyometra can be greatly reduced with preventative measures. Sterilization is the greatest form of prevention, which completely removes any danger. Uterine rupture, sepsis, peritonitis, renal injury, and septic shock are all potential outcomes of untreated pyometra. The dog’s health, fertility, and finally, the quality of life may all suffer as a result of these issues.

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Dr. Shruti

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