Pyometra in a tiger (Panthera tigris)

Background: Captive tigers can live a long life, around 26 years. Among the diseases described some of non-infectious origin are quite common, such as chronic kidney disease, spondylosis, and biliary cysts or tumors. On the other hand, pyometra has been frequently reported in lions, who have a higher risk of developing the disease than tigers and leopards. Pyometra is a disease with few descriptions in tigers and it may be related to the physiological features of the species. The animal is listed as Endangered on the International Union for the Conservation of Nature Red List of Threatened. The present report aims to describe the diagnosis and treatment of pyometra in a captive tigress. Case: A 7-year-old entire female tiger (Panthera tigris) weighing 140 kg was presented with a 3-day history of anorexia and prostration. For clinical examinations, collection of laboratory and imaging tests, the patient initially underwent dissociative anesthesia to allow catheterization of the cephalic vein and intravenous general anesthesia for orotracheal intubation followed by anesthetic maintenance in isoflurane. On general physical examination, the animal had normal colored mucosa, vital parameters within normal limits, and a body condition score of 6 on a scale of 9. There was no presence of vulvar secretion. The blood count and the biochemical exams showed values within the normal range for the species. The chest X-ray in the right and left views did not demonstrate pulmonary abnormalities. Ultrasonographic examination of the abdomen showed distension of the uterine body and horns, which have intraluminal hyperechoic fluid content without flocculation. Based on the imaging exam, the diagnosis was suggestive of pyometra. Exploratory celiotomy was performed via ventral midline, confirming the condition, which was treated by ovariohysterectomy. The surgical technique was performed as described for therapeutic ovariohysterectomy in dogs and cats. Culture of uterine content identified Escherichia coli. The histological analysis identified diffuse endometritis associated with follicular cysts. The tiger had complete recovery without any complications. The patient was releasing 13 days after the surgical procedure and in the last contact four months after the surgery, it was in perfect health conditions. Discussion: Pyometra in large exotic felids has been occasionally reported, mainly in animals more than 10 years of age. Although the tigress in the report is estimated to be seven years old. The patient in question started with anorexia and prostration and as there was already a history of cystic endometrial hyperplasia, a possible pyometra was suspected, despite being uncommon in the species. There was not vaginal discharge. The definitive diagnosis was by means of ultrasound examination and ovariohysterectomy was performed. Abdominal surgery for these large felids is complex, due to the intra-abdominal volume the flank approach or by laparoscopic is suggested, however in this case a ventral midline incision was performed without intercurrences and complications in the post-operative period. The surgical technique like that used in small animals was effective for the treatment of pyometra in the tigress with the use of ovariohysterectomy. Culture of uterine content identified Escherichia coli, which has been the most commonly isolated pathogen in pyometra of large felids. It was concluded that, as in bitches with pyometra, early diagnosis and surgical treatment is ideal for the patient's recovery.

Histeropexia com aplicação de "toggles" para tratamento de piometra em mini horse / Pyometra treatment by histeropexy with toggles aplication in mini horse

Background: Brazil is an important horse breeder that creates about three million jobs and movements about R$16,15 billions per year. Although, it is important to the horse breeding industry success that the animals reproductive performance be kept. The mare pregnancy loss causes abundant forfeitures to horse breeders, furthermore, the chronic pyometra is one of that causes. The chronic pyometra is an uncommon mare condition, clinical treatments are often ineffective, under those circumstances the hysterectomy, ovariohysterectomy and uteropexy are recommended. This report proposes to describe the chronic pyometra surgical treatments with the uteropexy technique in mini horses that do not respond to the clinical treatment. Case: A 14-year-old mini breed horse mare weighing 117 kg was sent to Veterinarian Hospital (HV) of the Paraná Federal University (UFPR), presenting dystocia background and intrauterine purulent secretion. The clinical treatment had been conducted, but not well succeeded. An hysteroscopy was conducted with a cervix rupture monitoring, uterine mucosa edematiated and crispy, presenting liquid and a high amount of purulent secretion in the uterus horn and body. The biopsy identified uteropexy. The post-surgical complications were minimums and 30 days after the procedure the laparoscopy was repeated with uterine healing monitoring, without adherences and the uterus were at horizontal position. The hysteroscopy was conducted where a small amount of purulent secretion was perceived. Ten days after the second laparoscopy the patient was discharged. Two years after the procedure, the animal responsible informed that there was not a relapse. Discussion: the mare pyometra occurrence is uncommon and emerges by nature protection false mechanisms. Any change or flaw in one of these protection mechanics barriers, may result in a reproductive change due to uterine infection, resulting in reduction of mare reproductive capacity. Probably this reports patients developed pyometra due to the cervix lesion it's presented made easier the uterus external microorganisms entrance, that predisposes an chronic uterine infection. As many authors report, the chronic pyometra clinical treatment is not always successful, also observed in the case reported, indicating then surgical treatment. There are many pyometra surgical treatments indications as: Wedge resection technique in case of cervix adherence, uteropexy technique, ovary-hysterectomy technique or hysterectomy. The ovary-hysterectomy and the hysterectomy was not conducted for being considered highly invasive. This case choice procedure was the uteropexy, which corresponds to fixing the broad ligament of the uterus to the abdominal wall, repositioning it horizontally, to obtain a better drainage and motility, since this is your anatomic position. In the report, the surgical technique was conducted satisfactorily, certifying the uterine elevation by laparoscopy in the postoperative and also by the responsible report, that the animal does not relapse in two years. The postoperative complications were not alarming, considering that it ceased 24h after the procedure. The conclusions present in this treatment show that the hysteropexy conducted by videosurgery with toggles application developed the necessary uterine elevation to the liquid drainage, that allows the mare to execute the uterine cleaning by the physiological form.(AU)

Piometra em cadela com complicação renal / Pyometra in bitch with renal complications

A piometra é uma infecção supurativa do útero, aguda ou crônica, com grande acúmulo de pus na cavidade uterina. O seu desenvolvimento é precedido pela hiperplasia cística endometrial, que é uma resposta exagerada e anormal do endométrio à estimulação da progesterona crônica e repetidamente, levando ao acúmulo de fluído no lúmen uterino e glândulas endometriais. Normalmente afeta animais de meia idade ou idosos, mas animais jovens também podem apresentar essa patologia, em decorrência a tratamentos hormonais. Essa patologia resulta de uma infecção bacteriana no endométrio, principalmente por Escherichia coli, após hiperplasia cística em decorrência de uma prolongada estimulação hormonal. A insuficiência renal aguda (IRA) é a principal complicação da piometra canina e ocorre secundária a glomerulonefrite por deposição de imunocomplexos, sendo diretamente ligada a longos períodos de internamento e ao óbito em cadelas com piometra. O presente relato tem por objetivo descrever um caso de piometra em uma cadela com complicações renais, atendido na Clínica Veterinária Bullmastiff.

Pyometra is a suppurative infection of the uterus, acute or chronic, with large accumulation of pus in the uterine cavity. Its development is preceded by endometrial cystic hyperplasia, which is an exaggerated and abnormal response of the endometrium to stimulation of chronic progesterone and repeatedly, leading to fluid accumulation in the uterine lumen and endometrial glands. It usually affects middle aged or elderly animals, but young animals may also present this pathology a result of hormonal treatments. This pathology results from a bacterial infection in the endometrium, mainly by Escherichia coli, after cystic hyperplasia due to a prolonged hormonal stimulation. Acute renal failure (ARF) is the main complication of canine pyometra and occurs secondary to glomerulonephritis by deposition of immunocomplexes, being directly linked to long periods of hospitalization and death in bitches with pyometra. The present report aims to describe a case of pyometra in a dog with renal complications, attended at the Veterinary Clinic Bullmastiff.

Piometra em cadela com complicação renal / Pyometra in bitch with renal complications

A piometra é uma infecção supurativa do útero, aguda ou crônica, com grande acúmulo de pus na cavidade uterina. O seu desenvolvimento é precedido pela hiperplasia cística endometrial, que é uma resposta exagerada e anormal do endométrio à estimulação da progesterona crônica e repetidamente, levando ao acúmulo de fluído no lúmen uterino e glândulas endometriais. Normalmente afeta animais de meia idade ou idosos, mas animais jovens também podem apresentar essa patologia, em decorrência a tratamentos hormonais. Essa patologia resulta de uma infecção bacteriana no endométrio, principalmente por Escherichia coli, após hiperplasia cística em decorrência de uma prolongada estimulação hormonal. A insuficiência renal aguda (IRA) é a principal complicação da piometra canina e ocorre secundária a glomerulonefrite por deposição de imunocomplexos, sendo diretamente ligada a longos períodos de internamento e ao óbito em cadelas com piometra. O presente relato tem por objetivo descrever um caso de piometra em uma cadela com complicações renais, atendido na Clínica Veterinária Bullmastiff.(AU)

Pyometra is a suppurative infection of the uterus, acute or chronic, with large accumulation of pus in the uterine cavity. Its development is preceded by endometrial cystic hyperplasia, which is an exaggerated and abnormal response of the endometrium to stimulation of chronic progesterone and repeatedly, leading to fluid accumulation in the uterine lumen and endometrial glands. It usually affects middle aged or elderly animals, but young animals may also present this pathology a result of hormonal treatments. This pathology results from a bacterial infection in the endometrium, mainly by Escherichia coli, after cystic hyperplasia due to a prolonged hormonal stimulation. Acute renal failure (ARF) is the main complication of canine pyometra and occurs secondary to glomerulonephritis by deposition of immunocomplexes, being directly linked to long periods of hospitalization and death in bitches with pyometra. The present report aims to describe a case of pyometra in a dog with renal complications, attended at the Veterinary Clinic Bullmastiff.(AU)

Função renal em cadelas com piometra antes e após ovariosalpingohisterectomia / Renal function in bitches with pyometra before and after ovariohysterectomy

Com o objetivo de avaliar a função renal de cadelas com piometra, foi analisada a bioquímica sérica antes e após ovariosalpingohisterectomia de 20 cadelas atendidas no Hospital Veterinário da Universidade Federal do Piauí. Animais com mais de sete anos de idade e sem raça definida foram os mais acometidos. O sinal clínico observado com maior freqüência foi secreção vaginal, característica de piometra de cérvix aberta. Hematologicamente foi detectada anemia normocítica normocrômica nos dois momentos. Foi evidenciada também leucocitose, alteração comum na infecção. Os índices de uréia e creatinina séricas permaneceram aumentados em alguns animais, mesmo após a cirurgia, possivelmente em decorrência de disfunções renais atuando concomitantemente com a piometra. O conhecimento da alteração dos indicadores da função renal tanto antes como após a remoção do útero é importante porque seleciona as cadelas mais graves, detecta precocemente lesão renal, melhorando assim o prognóstico da doença e a sobrevida do animal.

In order to evaluate the renal function of bitches with pyometra, it was analyzed the serum biochemistry before and after ovariohisterectomy of 20 dogs treated at the Veterinary Hospital of the Federal University of Piauí. Animals with more than seven years old and mixed breed were the most affected. The clinical signs most frequently noted was vaginal discharge, characteristic of open cervix pyometra. It was detected normocytic anemia in two moments. It also demonstrated leukocytosis, change common in the disease. Seric levels of urea and creatinine remained increased in some animals, even after surgery, possibly due to renal dysfunction acting concurrently with pyometra. Knowledge of change in indicators of renal function both before and after removal of the uterus is important because allows to select illness bitches, detecting early kidney damage, improving the prognosis and survival of the animal.