Felis ISSN 2398-2950
Pyometra
Synonym(s): Cystic endometrial hyperplasia
Contributor(s): Prof Gary England, Rob Lofstedt
Introduction
- Disease of the luteal phase.
- Hormonally mediated cystic hyperplastic endometritis associated with a bacterial infection.
Pathogenesis
Etiology
- Secondary bacterial infection of the material in the endometrial glands (embryotroph) may include Escherichia coli Escherichia coli, Proteus spp, B-hemolytic streptococci Streptococcus spp and occasionally anaerobes.
Predisposing factors
General
- Middle to old age.
- Successive luteal phases without pregnancy.
Specific
- Prolonged use of progestagens for the prevention or suppression of estrus.
Pathophysiology
- Successive luteal phases without pregnancy, ie following non-fertile mating-induced ovulation or occasionally spontaneous ovulation (pseudopregnancy Pseudopregnancy), or progestagen use → repeated and prolonged progesterone concentrations → cystic endometrial hyperplasia → pyometra.
- Renal disease: several aspects of the renal changes associated with pyometra are incompletely understood but some suggestions include:
Prerenal uremia
- Dehydration, shock and toxemia → poor renal perfusion → Antibody / Antigen (Ab-Ag) complexes deposited on the basement membrane of the glomerular apparatus → glomerular disease → persistent proteinuria.
- Bacterial toxins or immune complexes interfere with Na+ resorption from the distal convoluted tubule and collection ducts → tubular disease → impaired ability to concentrate urine → polyuria → dehydration and electrolyte loss.
- Concurrent renal disease may be found in older cats.
Acid base balance
- Metabolic acidosis is more common but metabolic alkalosis may develop through prolonged vomiting.
Electrolytes
- Vomiting, uterine loss and renal dysfunction → Na+/K loss.
White cells
Diagnosis
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Treatment
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Further Reading
Publications
Refereed papers
- Recent references from PubMed and VetMedResource.
- Tobias K M & Wheaton L G (1995) Surgical management of pyometra in dogs and cats. Semin Vet Med Surg (Small Anim) 10 (1), 30-34 PubMed.
- Davidson A P, Feldman E C, Nelson R W (1992) Treatment of pyometra in cats, using prostaglandin F2 alpha - 21 cases (1982-1990). JAVMA 200 (6), 825-828 PubMed.
- Potter K, Hancock D H, Gallina A M (1991) Clinical and pathologic features of endometrial hyperplasia, pyometra, and endometritis in cats - 79 cases (1980-1985). JAVMA 198 (8), 1427-1431 PubMed.
- Marretta S M, Matthiesen D T, Nichols R (1989) Pyometra and its complications. Probl Vet Med 1 (1), 50-62 PubMed.
- Schulman J & Levine S H (1989) Pyometra involving uterus masculinus in a cat. JAVMA 194 (5), 690-691 PubMed.
- Kenney K J, Matthiesen D T, Brown N O et al (1987) Pyometra in cats - 183 cases (1979-1984). JAVMA 191 (9), 1130-1132 PubMed.
- Arnbjerg J & Flagstad A (1985) Prostglandin F2 alpha treatment of feline open pyometra. Nord Vet Med 37 (5), 286-290 PubMed.
- Gillespie D & Kock N (1983) Pyometra in a Pallas's cat. JAVMA 183 (11), 1322-1323 PubMed.
- Wiessing J & Thomson K S (1980) Treatment of feline pyometra with dinoprost. N Z Vet J 28 (6), 112 PubMed.
Other sources of information
- Chandler E A, Gaskell C J & Gaskell R M (1994) Feline Medicine and Therapeutics. 2nd edn. Oxford: Blackwell Scientific Publications, pp 272-273. ISBN 0 632 03361 4.
- Christiansen I J (1984) Reproduction in the Dog and Cat. London: Bailliere Tindall, pp 243-245. ISBN 0 7020 0918 0.