Pyometra in Dogs

Depending on the stage and severity of the condition, your dog will display various symptoms. Initially, pyometra is not easy to catch since the dog will be eating and behaving quite normally. However, as the infection progresses, your dog will exhibit the following signs:

• Vaginal discharge: In the case of open pyometra, you will notice a smelly discharge from the vagina. Any form of discharge from the vagina should prompt you to see your vet.
• Inappetance: Pyometra is a strong infection that is often painful for the dog. A tell-tale sign that something is amiss if your dog avoids food and eats significantly less. 
• Lethargy: Your dog will likely be a lot less active and subdued. The infection will cause temperature to spike and a fever to develop and make your dog feel quite sick.
• Distention of the stomach: In some cases, the stomach will look visibly larger and will feel fuller to the touch. 
• Vomiting: This is also seen quite frequently in the case of pyometra as the dog tries to rid its body of toxins. 
• Excessive thirst and panting are also seen in dogs suffering from pyometra.

As pyometra progresses, the owner will notice that their dog is very clearly in distress. In general, if there are sudden behavioural changes then a visit to the vet is warranted.

Pyometra is seen overwhelmingly in older, intact females since their uterine walls have grown in size. If the swollen walls become infected with pus and infection, the condition is known as cystic endometrial hyperplasia.

Spaying - if it involves completely removing the ovaries - prevents pyometra from happening. This means that excessive hormones produced by the ovaries, specifically progesterone, can become problematic in dogs that are not routinely fertilized during estrus.

Pyometra is likely to set in 1-2 months after the dog is in heat. In ‘open pyometra’, the cervix is open and there is a creamy, smelly discharge from the vagina. In ‘closed pyometra’, the cervix is sealed and the toxins remain inside the tissue. This is a more severe form of the infection since the toxins are contained in the body and there is a higher likelihood of a rupture. 

The likelihood of pyometra is why vets often suggest getting females neutered before their first cycle. While an emergency surgery addressing pyometra performs the same function as sterilization, it is a much more complicated surgery to perform as the dog may not be stable and the uterine wall is fragile. If it is breached, the pus and infection can spread to other parts of the body. 

Contrary to conventional wisdom, older dogs are viable candidates for spaying as well. It is a good idea to consult your vet about the cost-benefit analysis of the procedure. Operating on a healthier dog offers a better prognosis than the alternative and for a condition as serious as pyometra, it may be the right decision for your pet.

You must provide your vet with your dog’s complete history, mention if she has been spayed, was last in heat and if she is on any medications. 

Routine blood work and a physical examination will be conducted; the blood work will show if there is any infection or, if the situation is more dire, changes in the overall composition of salts will be noted and the physical exam may reveal a distended uterus.

Radiography should show the uterus distended with gas or pus - if it does not show up then an ultrasound may be conducted to get a more accurate picture.

Hysterectomy, which is the surgical removal of the ovaries and uterus, needs to be performed especially if it is a case of closed pyometra.

• The procedure will ensure that there is no repeat of pyometra; getting rid of the ovaries means that estrogen and progesterone are not produced. The uterine wall will therefore not get engorged and there will be no scope for infection.
• Strong antibiotics will be administered intravenously and after the surgery to ward off any infection. Drugs for cell growth and hormone regulation may also be given, depending on the situation of the dog.
• The area from where the tissue is excised will also be thoroughly sterilized to eliminate the possibility of further infection. Care must be taken to completely remove the ovaries and uterus, otherwise there is a likelihood, albeit slim, of stump pyometra.
• If a small, microscopic section of the uterus remains and relevant hormones are present in the economy, there is a chance that it will develop the infection again.

Alternative treatments do exist which involve medicine, but they are reserved for situations in which the dog is required for breeding. Recovery time is longer and there is a high likelihood of recurrence, especially if the dog is not fertilized in the next cycle. This option is therefore more rarely taken.

Since emergency hysterectomies are complicated surgeries, the initial days after surgery are crucial. Strong antibiotics will be given to ward off infection, while painkillers will alleviate some of the distress following surgery. Your dog may be kept in hospital overnight to monitor the situation. 

Initially, a soft diet will be recommended as the dog slowly recovers from surgery. Exertion will be discouraged as it could stretch and break the stitches. Your dog should feel quite relieved after surgery if all goes well as the source of infection is out of its body.

It is a good idea to discuss prophylactically neutering your dog with your vet. You should also ask about breeding your dog if you don’t want to opt for spaying - dogs that have never been pregnant have a higher likelihood of contracting pyometra.