Body Temperature Fluctuation After Ovariohysterectomy in Dogs in Luteal Phase, Inactive Phase and Pyometra: A Clinical Study of 77 Cases.

Progesterone (P4) has a thermogenic effect in the bitch and a decrease in P4 has been associated with a mild transient decrease in body temperature. The aim of this study was to investigate the presence, the extent and the pattern of possible hypothermia after ovariohysterectomy (OHE) in healthy dogs in luteal phase and in bitches with pyometra that underwent therapeutic OHE. Sixty-two healthy dogs and 15 dogs with pyometra that underwent standardized OHE were included. Rectal temperature was measured 1 hour preoperatively (pre-op) and 6, 9, 12, 18, 24, 30, 36, 42, and 48 hours postoperatively (post-op). Serum P4 was measured 30 minutes pre-op and 6 and 24 hours post-op. Healthy dogs were classified in 3 groups based on their initial P4 concentration and in 3 separate groups based on their oestrus cycle stage. The temperature differentiation between the groups of the study was assessed using the repeated measures mixed-design ANOVA analysis. Temperature measured 18-42 hours post-op was significantly decreased compared to pre-op when initial P4 >8 ng/mL but not significantly decreased when P4 <8 ng/mL. Post-op temperature fluctuation in pregnant dogs showed no significant difference compared to dogs in diestrus. Dogs with pyometra had significantly lower temperature 6-48 hours post-op compared to all other groups. Conclusively, mild hypothermia (37.5-37.9°C) may be anticipated 18-42 hours after OHE performed in early diestrus or pregnancy in healthy dogs. More significant hypothermia (37.1-37.5°C) may be anticipated in normally recovering pyometra cases.

Fertility outcome after medically treated pyometra in dogs.

Cystic endometrial hyperplasia-pyometra complex (CEH/P) is a challenge in canine reproduction. Present study aimed to assess fertility after medical treatment. One-hundred-seventy-four bitches affected by CEH/P received aglepristone on days 1, 2, 8, then every 7 days until blood progesterone < 1.2 ng/mL; cloprostenol was administered on days 3 to 5. Records were grouped according to bodyweight (BW): small (< 10 kg, n = 33), medium (10 ≥ BW < 25 kg, n = 44), large (25 ≥ BW < 40 kg, n = 52), and giant bitches (BW ≥ 40 kg, n = 45). Age; success rate; aglepristone treatments number; relapse, pregnancy rates; diagnosis-relapse, -first, -last litter intervals; litters number after treatment, and LS were analyzed by ANOVA. Overall age was 5.14 ± 1.75 years, without difference among groups. Treatment was 100% successful, without difference in treatments number (4.75 ± 1.18), relapse (15/174, 8.62%) and pregnancy (129/140 litters, 92.14%) rates, intervals diagnosis-relapse (409.63 ± 254.9 days) or -last litter (418.62 ± 129.03 days). The interval diagnosis-first litter was significantly shorter (163.52 ± 51.47 days) and longer (225.17 ± 90.97 days) in small and giant bitches, respectively. Overall, 1.47 ± 0.65 litters were born after treatment. Expected LS was achieved in each group, as shown by ΔLS (actual-expected LS by breed, overall -0.40 ± 1.62) without differences among groups. Concluding, CEH/P affects younger dogs than previously described. Relapses were rarer than previously reported. Medical treatment with aglepristone+cloprostenol is effective and safe, preserving subsequent fertility, as demonstrated by negligible changes in LS.

Life course analysis of the impact of mammary cancer and pyometra on age-anchored life expectancy in female Rottweilers: Implications for envisioning ovary conservation as a strategy to promote healthy longevity in pet dogs.

Mammary cancer and pyometra are important health hazards associated with ovary conservation in pet dogs. Early ovariohysterectomy may reduce the incidence of these two diseases, but an estimate of the extent to which the development of mammary cancer or pyometra adversely influences overall longevity is missing. As a first step toward addressing this knowledge gap, the results of a historical cohort study of Rottweilers that lived in North America are reported. Questionnaires completed by owners and veterinarians were used to obtain lifetime health and medical information on 242 female Rottweilers, including years of lifetime ovary exposure, age at death, and cause of death. To determine the extent to which longevity was shortened in females that developed these ovary-associated diseases, age-anchored life expectancy-defined as the median number of remaining years until death for females alive at specified ages during the life course-and years of life lost, a measure of premature mortality, were estimated. Mammary carcinoma was diagnosed in 19 (7.9%) females; median age at diagnosis was 8.5 years; case fatality was 37%. Pyometra was diagnosed in 16 (6.6%) females; median age at diagnosis was 5.4 years; case fatality was 7%. Median lifetime ovary exposure for the study population was 4.3 years. Although risk for developing both diseases increased with longer ovary exposure, longer ovary exposure (≥4.3 years) was also associated with an overall longevity advantage-a 33% decrease in mortality, living 17 months longer than females with shorter ovary exposure (P=0.002). Analysis of age-anchored life expectancy showed that at no time points during the life course was the current or future diagnosis of mammary carcinoma or pyometra associated with shortened survival compared to females who never developed these conditions. This lack of longevity disadvantage is an expected result for diseases with late-onset, moderate (<50%) case fatality (mammary carcinoma) or low (<10%) case fatality (pyometra). These findings fail to support the notion that a strategy, such as elective ovariohysterectomy, implemented to reduce the incidence of mammary carcinoma and pyometra will beneficially impact overall longevity. It follows that future efforts to find and implement effective longevity-promoting interventions should look beyond reducing the incidence of a particular disease to considering trade-offs.

Cystic endometrial hyperplasia-pyometra syndrome in bitches: identification of hemodynamic, inflammatory, and cell proliferation changes.

Cystic endometrial hyperplasia (CEH)-pyometra syndrome is one of the most common diseases of noncastrated female dogs. However, determination of etiological mechanisms and differential diagnosis of CEH-pyometra syndrome are undefined. The aim of this study is to compare immunohistochemically the expression of cyclooxygenase-2 (COX-2) inflammatory mediator, Ki-67 antigen proliferation marker, vascular endothelial growth factor (VEGF-A) angiogenesis mediator and its FLT-1 and KDR receptors, and correlate with Doppler velocimetry of uterine artery and endometrial vascularization in bitches with CEH-pyometra syndrome. Bitches were allocated into CEH-mucometra Group (n = 13), Pyometra Group (n = 11), and Control Group (n = 8). Pyometra Group presented cytoplasmatic staining intensity for COX-2, VEGF-A, and FLT-1 and KDR receptors in luminal epithelium cells significantly higher compared to CEH-mucometra and Control groups. For the glandular epithelium, Pyometra Group had higher immunostaining score for VEGF-A and its receptors (FLT-1 and KDR). Hemodynamic indexes showed negative correlation with VEGF-A and its receptors as well as with COX-2. On the other hand, uterine vascularization score showed positive correlation in relation to immunostaining of COX-2, VEGF-A, and receptors in the endometrium luminal epithelium. In conclusion, uterus of bitches with CEH-pyometra syndrome show inflammatory process characterized by COX-2 expression, resulting in greater expression of proliferative Ki-67 marker as tissue response against the infectious agent. Furthermore, the increased VEGF-A expression and its receptors in CEH-pyometra reflect the increased blood flow and lower vascular resistance. Therefore, canine pyometra is characterized by an inflammatory, proliferative, and vascular disorder.

A Case Report and Literature Review of Spontaneous Perforation of Pyometra.

BACKGROUND: Pyometra is defined as an accumulation of purulent material in the uterine cavity. Spontaneous perforation is a very rare complication of pyometra. The clinical findings of perforated pyometra are similar to perforation of the gastrointestinal tract and other causes of acute abdomen. CASE REPORT: We report a rare and difficult case of peritonitis in an elderly female that was caused by a spontaneous perforation of pyometra. A 90-year-old postmenopausal woman was referred to our hospital with complaints of vomiting, fever, and abdominal pain. Computed tomography revealed a large amount of ascites, cystic mass in the uterus, and intraperitoneal and intrauterine air. Transvaginal ultrasound demonstrated a thin area around the fundus. An emergency laparotomy was performed for the suspected gastrointestinal perforation or perforation of pyometra. At laparotomy, copious purulent fluid was present in the peritoneal cavity; however, no perforation of the gastrointestinal tract was observed. We identified a perforation site over the uterine fundus and purulent material exuding from the cavity. Subsequently, hysterectomy and bilateral salpingo-oophorectomy were performed. The patient was discharged on postoperative day 13 with no complications. Histopathologic studies revealed endometritis and myometritis with no evidence of malignancy. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: With diffuse peritonitis, ruptured pyometra should be considered, even in elderly female patients. This case illustrates the importance of clinical knowledge of acute gynecologic diseases. Here we also review the perforation of pyometra with no evidence of malignancy.

Positive correlation between patency and mRNA levels for cyclooxygenase-2 and prostaglandin E synthase in the uterine cervix of bitches with pyometra.

Factors involved in patency of uterine cervices in the bitch with pyometra remain to be clarified. This study examined relationship between patency and mRNA levels for inducible nitric oxide synthase (iNOS), cyclooxygenase (COX)-1, COX-2 and prostaglandin E synthase (PGES) in the uterine cervix of bitches with pyometra. Cervical patency was measured by inserting the stainless steel rods with different diameter into cervical canals. Levels of mRNA expression were determined by semi-quantitative reverse transcription-polymerase chain reaction. The cervical patency was positively correlated with mRNA levels for COX-2 and PGES, but not those for iNOS and COX-1. The results suggest that gene expression of COX-2 and PGES may be involved in the regulation of patency in the uterine cervix of bitches with pyometra.

Pyometra in childhood.

BACKGROUND: Pyometra, an accumulation of pus in the uterine cavity, occurs rarely in children but should be considered in the differential diagnosis of an intra-abdominal or pelvic abscess. CASE: A 10-month-old infant presented with an increasing abdominal mass. She had previous respiratory and diarrheal illnesses. She was underweight, febrile, and tachycardic with an 8×6-cm mobile tender mass in her lower abdomen. Investigations demonstrated leukocytosis and ultrasonogram confirmed a cystic mass. At laparotomy a pyometra was found. Needle aspiration and washout of the uterine cavity were performed but a second procedure was required to place a drain into the cavity. CONCLUSION: Pyometra occurs rarely in childhood. A review of cases associates a hypoestrogenized endometrium exposed to transient bacteremia with obstruction to uterine drainage. Treatment should include continuous drainage of the uterus.

Perforación uterina espontánea por piometra secundaria a estenosis cervical / Spontaneous uterine perforation due to pyometra secondary to cervical stenosis

Se presenta un caso de perforación uterina espontánea secundaria a piometra. La perforación uterina es una rara entidad que afecta principalmente a mujeres posmenopáusicas debido a la retención de las secreciones de la cavidad uterina por obstrucción del canal cervical. Su presentación clínica es inespecífica, con dolor abdominal bajo, fiebre, vómitos y datos analíticos de infección, y sus complicaciones potencialmente graves, como peritonitis o shock séptico, de ahí la importancia de su diagnóstico precoz mediante técnicas de imagen (AU)

This paper reports a case of spontaneous perforation due to pyometra. Spontaneous uterine perforation is a rare event that usually affects postmenopausal women. It is secondary to retention of purulent secretions in the uterine cavity caused by obstruction of the cervical canal. The diagnosis is difficult to establish because the clinical presentation is nonspecific and includes abdominal pain, fever, vomiting and laboratory data indicating infection. An early imaging diagnosis is mandatory due to the potentially severe complications of this event such as peritonitis and septic shock (AU)

Casein hydrolysate for uterine infection treatment: a patent evaluation (WO2011132191).

Metritis, endometritis and pyometra are common uterus inflammatory diseases, occurring mainly in the early postpartum period of livestock and farm animals. These infections are primarily associated with contamination of the reproductive tract, in particular uterine. Uterine infections bring to uterine and cervical involution as well as sub-fertility; the high economic loss, due to costs for treatment, milk withdrawal, reduced reproductive performance and premature culling, clearly demonstrate that uterine health in the postpartum period requires substantial medical veterinary attention. A wide variety of therapies for endometritis have been reported, including mainly antibiotics administered either by systemic or local somministration. Here, the patent application WO/2011/132191, which describes an alternative treatment for uterine infection, using casein peptides, is evaluated and discussed.

HER-2/neu (c-erbB-2) oncoprotein in hyperplastic endometrial polyps detected in two cats.

The presence of HER-2/neu (c-erbB-2) oncoprotein, oestrogen-alpha receptor (ER), and progesterone receptor (PR) in hyperplastic endometrial polyps (EPs) of two cats with cystic endometrial hyperplasia-pyometra (CEH-P) complex was investigated. Immunohistochemistry assay for ER, PR and c-erbB-2 oncoprotein in the glandular and stromal tissue of the EPs was performed. ER and c-erbB-2 immunoreactivity was observed in the glandular epithelium of the EPs whereas PR immunoreactivity was detected only in the stromal fibroblasts. The c-erbB-2 oncoprotein may play a role with the ER in the pathogenesis of the hyperplastic EPs, although the role of this oncoprotein in the pathogenesis of EPs has yet to be determined.