ABSTRACT
OBJECTIVE: To determine the rate of survival to hospital discharge and identify indicators associated with poor outcomes among female dogs (bitches) with pyometra treated with ovariohysterectomy (OHE) in a nonspecialized setting. ANIMALS: 405 bitches diagnosed with pyometra at the American Society for the Prevention of Cruelty to Animals Animal Hospital from January 1, 2017, to February 8, 2019. PROCEDURES: For this retrospective study, medical records were searched and data collected including patient history, clinical signs, serum biochemical analyses results, and outcome (survival to hospital discharge, length of hospital stay, and uterine rupture). Logistic regression models were used to assess multivariable associations and identify potential predictive variables. RESULTS: The rate of survival to hospital discharge for bitches with pyometra treated with OHE was 97% (394/405); 44% (174/394) stayed in the hospital ≥ 2 nights, and 3% (11/390) had a ruptured uterus. Bitches with a high BUN concentration or heart murmur had greater odds of death after OHE; however, the model had low predictive power. Those with uterine rupture, inappetence, high concentrations of BUN or serum creatinine, low PCV, or dehydration had greater odds of hospitalization ≥ 2 nights. There were no significant predictors of uterine rupture. CLINICAL RELEVANCE: The rate of survival to hospital discharge was high for bitches with pyometra treated with OHE in a nonspecialized setting; therefore, general practitioners could expect similar outcomes. With this important procedure widely available in general practices, more pets can receive treatment for this life-threatening disease.
Subject(s)
Dog Diseases , Pyometra , Uterine Rupture , Animals , Dog Diseases/drug therapy , Dogs , Female , Prognosis , Pyometra/surgery , Pyometra/veterinary , Retrospective Studies , Uterine Rupture/veterinaryABSTRACT
OBJECTIVE: To describe findings, determine the rate of survival to hospital discharge, and identify prognostic indicators of poor outcomes for female cats (queens) with pyometra treated with ovariohysterectomy (OHE) in a nonspecialized setting. ANIMALS: 134 queens with pyometra diagnosed between January 1, 2017, and December 31, 2019. PROCEDURES: The medical records were retrospectively searched and data including patient history, clinical signs, blood work results, and outcome (survival to hospital discharge, length of hospitalization, and uterine rupture) were collected from medical records. Logistic regression models were used to assess potential predictors of outcomes. RESULTS: Dehydration (69% [83/121]) and absolute neutrophilia (83% [52/63]) were commonly reported. The rate of survival to hospital discharge was 100% (126/126; 95% CI, 97% to 100%) for queens treated with OHE; 33% (41/126) were hospitalized ≥ 2 nights, and 4% (5/120) had uterine rupture. Queens with abnormal serum ionized calcium concentration or signs of depressed mentation had greater odds (OR of 4.64 and 2.26, respectively) of ≥ 2 nights' hospitalization. Queens with high rectal temperature, closed pyometra, or heart murmur had greater odds (OR of 35.66, 17.37, or 16.06, respectively) of uterine rupture. CLINICAL RELEVANCE: Our findings indicated that OHE for pyometra in queens was highly successful even when performed in a nonspecialty hospital with high-quality basic supportive care, and we believe most general practitioners who offer OHE could expect to see similar outcomes. With more general-practice veterinarians comfortable treating pyometra in their clinics, OHE for pyometra will be available to more pets, ultimately saving more lives.
Subject(s)
Pyometra , Uterine Rupture , Animals , Female , Hospitals , Pregnancy , Prognosis , Pyometra/surgery , Pyometra/veterinary , Retrospective Studies , Uterine Rupture/veterinaryABSTRACT
BACKGROUND: Ovarian ectopic pregnancy is rare, with an incidence of 1/7,000 to 1/40,000. Only a few of them progress to full term and survive. Most of them rupture in the first trimester and require emergency surgical intervention. CASE: An African American woman at 38 4/7 weeks' gestation presented to labor thd delivery with decreased smaal movement. Fetal presentation was vertex by ultrasound, which failed to detect ectopic pregnancy. The patient underwent cesarean section for nonreassuring fetal status. Dense pelvic adhesions and an unexpected, live, left ovarian ectopic pregnancy were encountered during laparotomy. CONCLUSION: This case stresses the importance of starting prenatal care early and having a routine first trimester transvaginal ultrasound, which could enhance