You know your own dog and you know when something isn’t normal. Megan’s owners realised she had not been ‘quite right’ since her season started 3 weeks previously.
Megan was a bit quiet and off her food. She was drinking more and had more discharge than was normal at this stage. She had a slightly raised temperature so, following discussion of the options with her owners, she was treated with antibiotics and her symptoms improved.
However, 2 weeks later Megan went completely off her food whilst drinking more and she was still discharging abnormally. Her temperature had gone back up again. A blood test confirmed an infection and she was scheduled for an ultrasound scan the next day to check her uterus for signs of a pyometra (a uterine infection which can occur in older entire female dogs).
Pyometras can be open or closed. Open pyometras have a discharge which continues or recurs after a season and dogs are often only a bit unwell. Closed pyometras where the infection is sealed within the uterus develop rapidly and dogs become unwell very quickly. Spayed bitches do not develop pyometras.
On presentation the following morning Megan’s owner reported that she had deteriorated overnight and was now very subdued. An ultrasound scan confirmed a pyometra – this shows as large pockets of fluid within the abdomen. The decision was taken to go to surgery to spay her in order to remove the infection. Megan was placed on intravenous fluids to support her during and following surgery.
On surgically incising Megan’s abdomen pus poured out of the incision and we quickly realised that the uterus was discharging directly into her abdomen and this put her at serious risk of peritonitis which is a life threatening condition.
Peritonitis is an inflammation of the lining of the abdomen which is called the peritoneum. The peritoneum lines the muscles of the abdomen and provides support for the abdominal organs. If infection gets into the abdominal cavity the organs and peritoneum quickly become inflamed, leaking fluid out into the abdomen and the blood pressure drops rapidly. Because the abdomen is a closed environment the infection progresses rapidly causing significant pain and the whole body starts to shut down.
We immediately gave Megan intravenous antibiotics to help to combat the infection and worked quickly to remove Megan’s uterus and ovaries. Once the source of infection had been removed we flushed her abdomen repeatedly with large volumes of saline to dilute the pus and removed it using a suction pump to minimise the risk of infection remaining within the abdomen.
Once the infection had been removed, as far as possible, we changed the surgical kit and gloves used during the surgery before suturing the muscle and skin layers, so that infection did not develop in the surgical incision.
Megan recovered well from the surgery and was maintained on intravenous fluids and pain relief. She refused to eat despite being offered various tasty foods. This is not unusual in bitches following this type of infection because their entire system is affected by the bacteria involved and it makes them feel very unwell.
We kept Megan on intravenous fluids for another 24 hours but she still refused to eat. Dogs are often more inclined to show normal behaviour when at home with their family so we decided to send her home to see if she would eat there. With her owners patience and perseverance she finally started to eat small amounts and gradually returned to her usual happy self with a normal appetite over the following 10 days.
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