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PubMed1992

[The diagnostic value of sonography in the clinical picture of pyometra in the dog].

Experiences of the diagnostic value of ultrasonography of pyometra in the bitch are reported. The different ultrasound scans of the uterus are illustrated. Results are compared with clinical diagnosis and pathophysiological findings after laparotomy and surgical removal of the uteri. Very close correlation (r: 0.985, p < 0.001) was found between the postoperative macroscopic and the ultrasound scan measurements of the uterus. Accuracy of the ultrasound diagnosis and reasons for false and questionable results are discussed. In summary, ultrasonography is an accurate procedure for the qualitative and quantitative examination and diagnosis of canine pyometra.

Animals↗
PubMed2006

[Pyometra as a complication of invasive endocervical cancer].

We present a case of pyometra due to cervical cancer in a 62 years-old female with purulent discharge, abdominal pain and vaginal bleeding. At the examination we found the cervix with a cupula form, an ulcer in the external orifice, and normal vaginal fornixes and parametria. During an attempt of edometrial biopsy we noticed the output of 150 mL of pus from the uterine cavity. The endocervical channel and orifice biopsy reported invasive epidermoid carcinoma, thus it was clinically classified as IBI. We began antibiotic treatment and asked for extension and preoperatory studies, which were normal. Three weeks after draining the purulent material we made radical hysterectomy. The histopathological report showed a moderately different epidermoid carcinoma, of two centimeters, endocervical, obstructive, and of 30 resected nodes; one of them had metastasis, for which it was sent to radiotherapy. Pyometra can be a complication of invasive endocervical cancer.

Carcinoma, Squamous Cell↗
PubMed2006

[Bradycardia and cardiac asystole immediately after abdominal incision for removal of a huge pyometra].

We report a patient who developed cardiac asystole, which may have been caused by Bezold-Jarisch reflex as a result of hypovolemia and compression of the inferior vena cava by a huge pyometra. A 61-year-old woman with a huge pyometra with occasional supine hypotension, tachycardia, and oliguria was scheduled for removal of the tumor. The systolic blood pressure decreased from 80 mmHg to 55 mmHg with simultaneous development of bradycardia 5 minutes after incision of the abdominal wall. Atropine was given but cardiac asystole occurred. Intravenous epinephrine restored systemic blood pressure and heart beats. There was no postoperative cardiorespiratory complication.

Bradycardia↗
PubMed1979

Pyometra in the dog. III.--A pathophysiological investigation. III. Plasma progesterone levels and ovarian morphology.

The peripheral plasma progesterone levels in bitches with spontaneously developed pyometra did not differ significantly from those in normally cycling or pregnant bitches. The macroscopic ovarian morphology gave no indication of an increased corpus luteum activity. Ovarian follicular cysts were found in 4 out of 31 cases. There was no detectable difference of results between 14 bitches that had received hormonal medication 10 years to 1 week previous to the pyometra diagnosis, and the other patients.

Animals↗
PubMed1982

Treatment of canine pyometra and endometritis with prostaglandin F2 alpha.

Seventeen bitches with pyometra or postpartum endometritis were treated with prostaglandin F2 alpha. Response to the treatment included cessation of uterine discharge, decrease in uterine diameter, reduction in plasma progesterone concentration, and return of a normal leukogram. Treatment of 14 bitches was successful, and 13 of these bitches subsequently experienced estrus. Of those 13 bitches, 11 were bred and 9 became pregnant. In 2 bitches, pyometra developed again, within 6 weeks of the following estrus, illustrating that bitches so affected are susceptible to recurrence of the disease. Of 4 bitches with closed cervix, one failed to respond to treatment, and two bitches with closed cervix required ovariohysterectomy shortly after instituting treatment.

Animals↗
PubMed1981

Pyometra.

Pyometra is a potentially lethal disease. Eighteen cases, all but one in postmenopausal women, were diagnosed at the Ottawa General and Ottawa Civic hospitals between 1974 and 1978 inclusive. A review of this series and of the literature demonstrates that a large proportion of cases (72% in this series) are associated with or follow radiotherapy for a malignant disease of the uterus and that anaerobic bacteria are frequently isolated from the uterine cavity (in 56% of the patients in this series). Because pyometra is potentially lethal (one patient in our series died) it should be considered as an abscess and treated promptly and vigorously by evacuation and continued drainage of the uterine cavity. Curettage of the cavity and the endocervical canal after dilatation is essential to rule out associated malignant disease as well as to debride the necrotic tissue. Antibiotics effective against aerobic and anaerobic bacteria should be given to all patients with signs of systemic infection. Once the infection is controlled, the underlying problem can be treated.

Adult↗
PubMed1980

Pyometra in the dog--a pathophysiological investigation. IV. Functional derangement of extra-genital organs.

Results on haemoglobin, PCV, serum proteins, blood urea nitrogen, creatinine, cholesterol, bilirubin and some serum enzymes in bitches with clinical pyometra were compared with the degree of polydipsia, anorexia and dehydration in the same patients, and with their plasma progesterone levels. The findings indicate that the pyometra syndrome includes a liver derangement--i.e. cholestasis--in addition to changes in bone marrow activity and renal function as shown previously. Autopsic results also indicate the presence of an endotoxic influence upon the lung function.

Alkaline Phosphatase↗
PubMed1978

Peripheral plasma concentrations of progesterone in the bitch with pyometra.

In the present study, 35 bitches (various breeds and ages) with pyometra were involved. Blood sampling (jugular vein) took place every day between examination and hysterectomy. All the bitches examined after 60 days post-oestrus had a low progesterone concentration (about 1 ng/ml). Along the 27 bitches observed before that time, 22 had a high mean level (about 8 ng/ml). By contrast 5 of them had low levels. As a whole these results suggest that: 1) There is no evidence of an essentially high or prolonged progesterone secretion in pyometra. 2) Luteolysis occuring normally about 60 days post ovulation is not postponed by this affection and 3) In some animals, early luteolysis seems to occur. Therefore it cannot be concluded that progesterone has an indispensalbe role in polymetra.

Animals↗
PubMed1977

Pyometra complicating radiation therapy of uterine malignancy.

This report concerns our experience with the clinical management of pyometra in 12 patients receiving radiation therapy at the University of Iowa Hospitals and Clinics for uterine epithelial malignancy. The effect of pyometra on radiation therapy is discussed. Adequate drainage is imperative, and appropriate cultures should be obtained. External radiation therapy may be continued as planned; however, intracavitary radium applications should be deferred.

Adult↗
PubMed1997

Treatment of pyometra (cystic endometrial hyperplasia) in bitches with an antiprogestin.

On the basis of a previous study showing the effectiveness of an antiprogestin treatment on the involution of the pyometric uterus and general health of bitches, in the present open clinical study seven bitches with pyometra and progesterone concentrations > or = 2 ng ml-1 were treated with the antiprogestin RU 46534. The dose selected was 5 or 6 mg kg-1 body mass s.c., on the first day of treatment and 3 mg kg-1 body mass on days 2, 3, 4, 8, 12 and 16. Antibiotics were administered until day 16. A vulval discharge was observed within 12-24 h. In one bitch the dose of the antiprogestin had to be increased after day 4. In six bitches the uterine lumen became ultrasonographically undetectable between days 8 to 12; in one bitch some luminal material could still be detected on day 28. The number of blood leucocytes tended to increase after the onset of treatment but had returned to the upper normal range by day 16. In all dogs general condition and feed consumption improved rapidly and were normal within 8 days. No side effects were noted. Two of the dogs were mated subsequently and produced two healthy litters. These observations confirm those of a preceding study and show that the treatment of pyometra with an antiprogestin may lead to a clinical recovery. These results justify further studies to enable the optimum treatment regimen to be established.

Animals↗
PubMed1993

Spontaneous perforation of pyometra presenting as generalized peritonitis in a patient with cervical cancer.

Pyometra is a relatively common event. However, it is extremely rare for this condition to perforate spontaneously into the peritoneum, and to date only 14 cases have been reported in English literature. We recently experienced such a case in a patient with cervical cancer. The clinical features, pathologic findings, diagnosis, therapy, and outcome of these 15 cases were reviewed. Only 5 cases were associated with malignant diseases, consisting of 2 cervical cancers, 2 colon cancers, and 1 endometrial cancer. All of the patients developed generalized peritonitis, and 4 patients died of this. Correct preoperative diagnosis was difficult. Therefore, immediate and appropriate therapy is important.

Abdomen, Acute↗
PubMed1987

The characteristic pattern of aspartate aminotransferase and alanine aminotransferase in the bitch with the cystic hyperplasia-pyometra complex: effect of medical or surgical treatment.

In 75 clinically normal unspayed female control dogs between two and eleven years old the average plasma level of aspartate aminotransferase (AST) was 21.6 +/- 5.7 (+/- SD) IU/l, of alanine aminotransferase (ALT) 40.4 +/- 13.0 IU/l and of the AST/ALT ratio 0.6 +/- 0.2. These values showed only minor changes over years. In 96 bitches with the cystic hyperplasia-pyometra complex there was a very significant increase of the AST, decrease of the ALT and increase of the AST/ALT ratio. The changes were more pronounced in 62 clinically ill bitches with typical endometritis post oestrum, in 18 dogs with gram negative organisms in the uterus and in 53 bitches with white blood cell (WBC) levels higher than 40 X 10(9)/1. Renal failure had no influence on the specific changed values. The changed values returned either temporarily to normal after prostaglandin (PGF2 alpha)-treatment or definitely after ovariohysterectomy.

Alanine Transaminase↗
PubMedDate not supplied

Pyometra in camels: case report.

Pyometra was recorded in five camels and Actinomyces pyogenes (Corynebacterium pyogenes) was isolated from pus of the affected camels.

Actinomyces↗
PubMed1994

'Forgotten' intrauterine device leading to actinomycotic pyometra--13 years after menopause.

A case of a 'forgotten' intrauterine device (IUD) in a postmenopausal woman leading to Actinomyces israelii infection and pyometra is described. The patient was asymptomatic for 22 years after IUD insertion and developed the complications 13 years after menopause. To prevent such serious complications, it is important to ensure that intrauterine devices, once they have served the purpose and even if they are asymptomatic, are removed.

Actinomycosis↗
PubMed2004

Serum estradiol-17 beta, progesterone and respective uterine cytosol receptor concentrations in bitches with spontaneous pyometra.

The role of serum estradiol-17 beta (E(2)) and progesterone (P(4)) in relation to uterine estrogen (ER) and progesterone receptors (PR) was investigated in canine cystic endometrial hyperplasia-pyometra (CEH-P). Blood and uterine samples were collected pre- and post-ovariohysterectomy, respectively, from 54 bitches presenting spontaneous CEH-P and 25 healthy control bitches. Competitive enzyme immunoassays (EIA) and enzyme ligand immunoassays (ELIA) were applied to estimate serum hormones and uterine cytosol active receptors, respectively. Animals were classified in the stages of first half of diestrus, second half of diestrus and early anestrus on the basis of reproductive history, clinical signs, uterine and ovarian macro- and microscopic inspection and serum P(4) concentration. Bitches with CEH-P, compared to their respective stage controls, exhibited (a) similar P(4) fluctuations, (b) higher E(2) concentrations, (c) lower PR concentrations during diestrus first and second half and (d) lower ER concentrations during diestrus first half and early anestrus. Negative correlation was detected between P(4) and ER within both CEH-P and control groups. It was concluded that P(4) was the main uterine receptor regulator for both PR and ER during diestrus and early anestrus in healthy and affected uteri. However, in CEH-P bitches, high P(4) levels in diestrus appeared to over-activate uterine PRs, leading to stronger PR self-down regulation and ER suppression. These findings indicate an increased sensitivity of CEH-P uterus to P(4) action. During early anestrus, a complementary role of endogenous E(2) was considered, since reduction of P(4) action appeared to permit uterine ER replenishment and activation by relatively high E(2) levels.

Animals↗
PubMed2002

Estrogen-alpha and progesterone receptor expression in cystic endometrial hyperplasia and pyometra in the bitch.

Estrogen-alpha receptor (ER) and progesterone receptor (PR) were examined immunohistochemically in uteri of normal bitches, in uteri of bitches with cystic endometrial hyperplasia-mucometra (CEH-M) and in uteri of bitches with endometritis-pyometra (E-P), under exogenous progesterone treatment. In the CEH-M group, the ER- and PR-scores of all uterine cell types were higher than the ER- and PR-scores of normal uteri, although these differences were not always statistically significant. The ER-scores of E-P group were significantly lower than the ER-scores of the normal uteri and CEH-M group. The PR-scores of the E-P group tended to be higher than the PR-scores of the normal uteri, except for the surface epithelium, although these differences were not statistically significant. Exogenous progesterone treated bitches with CEH-M or E-P showed reduced ER- and PR-scores in the different uterine cell types, compared with the corresponding nontreated CEH-M or E-P group. The differences in ER and PR expression between CEH-M and E-P suggest different factors in the pathogenesis of both entities. Although, these changes in ER and PR expression do not seem to be directly involved in the pathogenesis of CEH-M and E-P. It is suggested that for CEH-M and progestin induced CEH-M a hormone dependent pathway is responsible. For P, the trigger may be bacterial infection.

Anestrus↗
PubMed2001

Calculation of urinary enzyme excretion, with renal structure and function in dogs with pyometra.

The urinary enzyme markers of renal damage, alkaline phosphatase (AP), gamma-glutamyl transferase (GGT) and N-acetyl-beta-glucosaminidase (NAG), glomerular filtration rate (GFR) and renal biopsies were studied to evaluate renal status in dogs with pyometra. After ovariohysterectomy, urinary enzymes were measured daily for 12 days in 55 dogs, and again at a later follow-up visit. Thirteen dogs had high levels of at least one enzyme at initial presentation. Seventeen dogs had a transient increase in urinary enzyme values between one and five days after surgery. Enzyme values usually declined to low activities within 12 post-operative days. Renal biopsies demonstrated tubular abnormalities in many dogs. Mean GFR was 2.4 and 2.0 ml min(-1) kg(-1), respectively on day 1 post-operatively and at the follow-up visit 1-4 months later. High urinary enzyme values often reflected extensive lesions in renal proximal tubular cells and sometimes reduced GFR.

Acetylglucosaminidase↗