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PubMedDate not supplied

Uterine oestrogen and progesterone receptor expression in experimental pyometra in the bitch.

Pyometra was induced in five bitches by the intraluminal inoculation of a ligated uterine horn in metoestrus with an Escherichia coli suspension, the other horn serving as an uninoculated control. Histologically, the inoculated horns resembled those with naturally occurring pyometra, while the uninoculated horns had an inactive appearance instead of the normal metoestrus appearance. Immunohistochemically, the expression of sex hormone receptors in the inoculated horns corresponded with that in natural cases of pyometra. In the uninoculated horns, virtually no expression of sex hormone receptors was observed, in contrast to such expression in normal metoestrus. Bacteria-associated ovario-uterine interactions may have been responsible for the hyperplastic (inoculated horn) and inactive (uninoculated horn) uterine changes observed in this experiment.

Animals↗

PubMed1997

Bacteriological findings, blood chemistry profile and plasma endotoxin levels in bitches with pyometra or other uterine diseases.

Uteri from 60 bitches with a clinical diagnosis of pyometra, or with an enlarged uterus as revealed radiographically or ultrasonographically, underwent histopathological examination, at which a diagnosis of pyometra was established in 48 of the 60 (80%) cases. Escherichia coli was isolated from 43 (90%) of the 48 uteri with pyometra. In 8 of the 60 cases, other pathological uterine conditions, such as endometrial hyperplasia, adenomyosis, mucometra or hydrometra, were diagnosed histopathologically. No bacterial growth was observed in the uteri of these 8 cases. Four of the 60 bitches (6%) showed no pathological changes in the uterus, and in 3 of these no bacteriological growth was seen in the uterus, while in one case a sparse growth of mixed culture was found. Blood samples from bitches with uterine infection caused by gram-negative bacteria showed marked hematological changes. These included higher total WBC counts and a more marked left shift in the differential WBC count than among the other bitches. Toxic degeneration of neutrophils was present among the bitches with gram-negative uterine infection and the serum ALP level was slightly higher than in the other groups of bitches. The plasma endotoxin concentration was determined in 53 bitches before surgery, in 28 bitches after surgery and in 11 control dogs. Only in 7 of the samples was endotoxin detected. The general condition of the bitches included in the present study was only mildly to moderately affected, and in no case indicated severe endotoxemia.

Animals↗

PubMed2006

Steroid receptor expression and HER-2/neu (c-erbB-2) oncoprotein in the uterus of cats with cystic endometrial hyperplasia-pyometra complex.

The presence of oestrogen-alpha receptor (ER), progesterone receptor (PR), and HER-2/neu (c-erbB-2) oncoprotein in the uterine walls of 10 healthy cats and 20 subjects with cystic endometrial hyperplasia-pyometra (CEH-P) were evaluated. Lesions were graded according to the severity of cystic dilation, hyperplasia and inflammation, and were classified as normal, mild uterine hyperplasia and severe uterine hyperplasia. The ER, PR and c-erbB-2 expression in the endometrium, glandular epithelium, stromal fibroblasts and myometrial smooth muscle cells was quantified by immunohistochemistry. The ER, PR and c-erbB-2 staining patterns differed between normal uteri and uteri with CEH-P. The ER expression was tended to be higher in the endometrial surface and glandular epithelium in the severe hyperplasia group (P > 0.05) and significantly lower in the mild hyperplasia cases compared with normal endometrium (P < 0.05), whereas the PR expression in both severe and mild hyperplasia cases tended to be higher in stromal cells and glandular epithelium than those in the normal uteri. C-erbB-2 immunoreactivity was observed only in the endometrial surface and glandular epithelium of the uterine wall and immunostaining was found to be highest in cases with severe hyperplasia. As a conclusion, we suggest that c-erbB-2 oncoprotein may play a role in the pathogenesis of the CEH together with the ER and PR in cats, and that ER does not have a role in the mechanism of pyometra, whereas PR plays a role in the pathogenesis of both CEH and pyometra.

Animals↗

PubMed1994

Spontaneous perforation of pyometra: a case report.

Spontaneous perforation is a rare complication of pyometra and is usually associated with uterine cervical occlusion. We report a very rare case of spontaneously perforated pyometra without cervical occlusion. A 56-year-old woman with severe abdominal pain was admitted to our hospital. Exploratory laparotomy was performed because of suspicion of gastro-intestinal perforation with generalized peritonitis. There was no perforation of the stomach, gallbladder, or bowels, but examination of the uterus revealed a perforation of the uterine fundus. A total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed. Pathological investigation of the surgical specimen revealed endometritis and myometritis of the uterus; but there was no evidence of malignancy, and the cervical canal was patent. Although spontaneously perforated pyometra is rare, the condition must be born in mind with regard to elderly women with acute abdominal pain.

Abdominal Pain↗

PubMed2004

Decreased apoptotic polymorphonuclear leukocyte rate in dogs with pyometra.

Polymorphonuclear neutrophil (PMN) apoptosis was examined in three dogs with pyometra by TUNEL assay in a 24-hr incubation period and compared with that in healthy control dogs (n=5). The incidence of apoptotic PMNs in dogs with pyometra was 26.4 +/- 5% and that in healthy dogs was 54.3 +/- 7%. The results indicated that apoptotic PMN rates in dogs with pyometra were significantly lower than those in control dogs (p<0.05), suggesting the prolongation of PMN survival.

Animals↗

PubMed2001

Incidence of pyometra in colony-raised beagle dogs.

Incidence of pyometra observed in our colony-raised beagle dogs over a 12-year period is described. Pyometra was observed in 25 female dogs of more than 4 years old, frequently at 8-11 years, with the average age of onset 9.36 +/- 0.38 years. The incidence of the disease was 15.2% of the female dogs (n = 165) more than 4 years old. Clinical findings useful in the diagnosis of this disease included an excretion of pus from the cervix, rapid increase in leukocyte count, and enlarged uterus as revealed by radiography. The relationships of delivery, estrus cycles to this disease are discussed. Ovariohysterectomy or uterectomy was the only effective method of treatment. In conclusion, the results indicated that pyometra might be an age-related disease because it occurred particularly in aged dogs.

Age Factors↗

PubMed1999

Intravenous administration of hypertonic sodium chloride solution with dextran or isotonic sodium chloride solution for treatment of septic shock secondary to pyometra in dogs.

OBJECTIVE: To determine effects of i.v. administration of hypertonic saline (7.5% NaCl) solution with 6% dextran 70 (HSSD) or isotonic saline (0.9% NaCl) solution (ISS) to dogs with septic shock secondary to pyometra. DESIGN: Prospective, randomized, clinical study. ANIMALS: 14 client-owned dogs with septic shock secondary to pyometra. PROCEDURE: Prior to emergency ovariohysterectomy, catheters were placed in pulmonary and femoral arteries of each dog to evaluate hemodynamic and oxygenation status. Immediately prior to surgery, 7 dogs received HSSD (4 ml/kg [1.82 ml/lb] of body weight, i.v.) and 7 dogs received ISS (32 ml/kg [14.54 ml/lb], i.v.) during a 5-minute period. Measurements of hemodynamic and oxygenation variables were obtained before and 5 and 20 minutes after administration of fluids. RESULTS: Mean arterial pressure (MAP) increased significantly 5 and 20 minutes after administration of HSSD, whereas ISS did not affect MAP. However, cardiac output, cardiac index, and oxygen delivery increased and hematocrit decreased after both treatments. Oxygen consumption and extraction rate and degree of acidosis did not improve after either treatment. CONCLUSIONS AND CLINICAL RELEVANCE: Intravenous administration of small volumes of HSSD to dogs with septic shock secondary to pyometra resulted in improvement of hemodynamic and oxygenation status. Although cardiac output, cardiac index, and oxygen delivery improved after administration of a volume of ISS equal to 8 times that of HSSD, MAP increased to > 80 mm Hg only after treatment with HSSD. Administration of HSSD may be an effective treatment for septic shock in dogs.

Animals↗

PubMed1975

Pathogenesis of canine pyometra.

Escherichia coli strains associated with pyometra in 85 of 100 bitches investigated had an affinity for urinary tract epithelium and smooth muscle as well as for progesterone-stimulated endometrium and myometrium. The adherence via K-antigen seemed to be important for colonization of the pathogen during development of pyometra. urinary tract infection was detected in 23 of 32 bitches from which urine specimens were obtained. In these bitches, a strain of E coli identical to the strain in the infected uterus was isolated. It was concluded that subclinical urinary tract infection is associated with pyometra and that the uterus will be infected at early metestrus, when receptors for E coli are developed in the endometrium and myometrium, thus enhancing the colonization of bacteria in the uterus.

Animals↗

PubMed1992

Treatment of pyometra in cats, using prostaglandin F2 alpha: 21 cases (1982-1990).

Treatment with prostaglandin F2 alpha (PGF2 alpha) was evaluated in 21 queens with open-cervix pyometra. The PGF2 alpha was administered (0.1 or 0.25 mg/kg of body weight, sc, q 12 to 24 h) for 3 or 5 days. Transient postinjection reactions caused by PGF2 alpha administration included vocalization, panting, restlessness, grooming, tenesmus, salivation, diarrhea, kneading, mydriasis, emesis, urination, and lordosis. Reactions began as quickly as 30 seconds after PGF2 alpha administration and lasted as long as 60 minutes. All queens improved clinically after PGF2 alpha treatment. One month after completion of the initial series, 1 queen required a second series of PGF2 alpha injections before pyometra resolved. Of 21 queens, 20 (95%) resumed normal estrous cycles without further treatment and 17 (81%) delivered normal litter(s). Use of PGF2 alpha is an acceptable treatment for open-cervix pyometra in queens.

Animals↗

PubMed2005

[Spontaneous uterine perforation secondary to pyometra: a report of three cases].

We performed a retrospective observational review-based study of the medical records of consecutive women with diagnosis of spontaneous uterine perforation, between 1995 and 2003. During this period 3 patients with an average age of 76.2 years and with acute abdominal pain attended to the emergency department. Physical examination revealed signs of peritoneal irritation, as a result emergency laparotomy was performed, where uterine perforation was not found in the preoperative diagnosis. All patients had purulent fluid in the abdominal cavity and uterine perforation. A total abdominal hysterectomy with bilateral salpingooophorectomy was carried out under the diagnosis of generalized peritonitis caused by spontaneous perforation of pyometra. They also required cavity lavage, drainages placement, and antibiotics. Histological examination revealed uterine perforation and pyometra without evidence of malignancy. Prognosis was good and they were discharged on postoperative day 8.5 without complications. Spontaneous uterine perforation, secondary to pyometra, should be considered in the differential diagnosis of acute abdomen in postmenopausal patients, still without gynecological signs.

Aged↗

PubMed1991

[The age and stage of estrus in bitches with pyometra. Statistical inquiry and interpretive study of the understanding of variability].

Using anamnestic data, pyometra in the bitch is shown to be particularly a disease of the older bitch in the metestral phase of cycle. Most of the patients are presented during the first four weeks after their last heat. In individual cases the disease may occur in any other stage of the cycle. The occurrence of pyometra in young bitches is discussed. An attempt is undertaken to show the pyometra endometritis complex and glandular cystic hyperplasia of the endometrium to be a similar response to different disturbances of the cycle regulation in dogs.

Age Factors↗

PubMed1990

[Pyometra without accompanying malignant uterine disease].

Twenty-two cases of non-malignant pyometra which were observed during a period of 15 years are described. 22% were recurrences. All of the women were postmenopausal with discharge and haemorrhage as the commonest symptoms. Pyrexia was rare. Pyometra cannot be excluded or diagnosed by means of gynaecological examination. In cases of suspected pyometra, thorough cervical dilatation and curettage are recommended. Antibiotics should only be administered if there is evidence of invasive infection, in the form of pyrexia, generalised malaise or altered laboratory parameters. In cases such as these, preparations which are effective for aerobic and also anaerobic bacteria should be employed. Follow-up control every six months is recommended on account of the great tendency to recur.

Aged↗

PubMed1989

Urinary gamma-glutamyl transferase and the degree of renal dysfunction in 75 bitches with pyometra.

In 75 bitches with pyometra single urine samples were examined for gamma-glutamyl transferase (gamma-GT), protein, glucose, specific gravity, bacteria, red blood cells and white blood cells. Serum samples were examined for urea, creatinine, inorganic phosphate and gamma-GT. Biochemical findings were compared with the degree of illness (clinical signs). Twenty one bitches had no signs of renal disease. Seventeen showed only glomerular damage indicated by proteinuria without signs of proximal tubular damage. Thirty seven bitches had increased urinary gamma-GT levels, indicating proximal tubular lesions, which were associated with proteinuria in 35 and renal failure in 16 of them, and worse clinical findings. In all bitches with pyometra serum levels of gamma-GT were comparable to values in control bitches. Glomerular dysfunction seemed to precede proximal tubular lesions, so that gamma-GT-uria in bitches with pyometra was not an early but rather a late indication of a more profound degree of renal dysfunction, that is, proximal tubular renal damage developed after glomerular dysfunction and preceding renal failure.

Animals↗

PubMed1987

Pyometra in cats: 183 cases (1979-1984).

Pyometra was diagnosed in 183 cats. The most common signs detected by owners included vaginal discharge, anorexia, and lethargy. Main clinical findings on physical examination were vaginal discharge, abdominal distention, dehydration, palpable uterus, and pyrexia. Abdominal radiography revealed a large uterus in 138/169 cats. Most cats had leukocytosis with a left shift. Diagnosis of pyometra was confirmed at surgery in all cats on the basis of finding a large uterus containing purulent material. Clinical signs resolved in 168 cats after surgery; 15 cats (8%) died or were euthanatized. Postoperative complications in 20% generally resolved within 2 weeks after the cats were sent home. Signs detected by owners and results of physical examination in cats with pyometra were similar, but not as conspicuous as those reported in the dog. Mortality (8%) was similar to that seen in dogs.

Animals↗

PubMed1986

Spontaneous rupture of pyometra due to leiomyomata. A case report.

Pyometra, an accumulation of purulent material in the uterus, is a rare pathologic entity. Spontaneous rupture of pyometra occurred secondary to degenerating leiomyomata; that is an extremely rare complication. Pyometra, the diagnosis of which is based on the classic symptoms of uterine enlargement, vaginal discharge and acute abdomen, requires rapid supportive therapy and surgical intervention.

Adult↗

PubMedDate not supplied

Prostaglandin F2 alpha treatment of feline open pyometra.

Pyometra is not a very common problem in feline practice. When it occurs it often results in sterility in spite of proper medical treatment. Prostaglandins have been used in the treatment of reproductive abnormalities including pyometra in different animal species (Boothe 1984). Therefore it was taken in as a treatment of the pyometra in five breeding cats, where ovariohysterectomy was undesirable.

Animals↗

PubMed1993

Postpartum pyometra: a case report.

Pyometra is an uncommon result of endometritis. The diagnosis of pyometra is made when a collection of pus is found within the endometrial cavity. Antibiotic administration and drainage of the pus are essential to resolve this condition. A report of a case of pyometra is presented and a technique for drainage is described. This case demonstrates the use of office-based diagnostic ultrasonography to narrow the differential diagnosis and guide the drainage procedure, as well as the use of simple ingenuity to improve patient care.

Adult↗

PubMed1976

Pyometra.

Thirteen cases of pyometra without preoperative diagnosis in which vaginal or abdominal surgery was performed, are analysed in the present paper. The histologic examination revealed endocervicitis in all cases, while positive cultures for bacteria were found preoperatively in only eight of the above cases, thus, pyometra was considered to be a symptom of obstruction of the cervical canal.

Female↗