Hysterectomy leads to fast improvement of haematological and immunological parameters in bitches with pyometra

OBJECTIVES: To investigate whether a combination of hysterectomy and antibiotic treatment leads to an improvement of altered haematological and immunological parameters in bitches affected by pyometra. METHODS: Blood samples obtained from 13 bitches affected by pyometra were investigated before hysterectomy and seven days later for a total and differential leucocyte count, activity of neutrophils and lymphocytes, and quantification of total serum immunoglobulins, lysozyme and circulating immune complexes. RESULTS: The parameters most affected included changes in blood profile (leucocytosis because of neutrophilia or leucopenia) and inhibition of lymphocyte activity. Seven days after hysterectomy, all affected parameters returned to normal levels comparable to clinically healthy dogs. CLINICAL SIGNIFICANCE: Application of immunostimulating therapy is not necessary to manage changes in blood cell counts and suppression of lymphocyte activity in bitches with pyometra. Removal of the infected uterus, being the source of infection, leads to improvement.     

Quantity of IL‐2, IL‐4, IL‐10, INF‐γ, TNF‐α and KC‐Like Cytokines in Serum of Bitches With Pyometra in Different Stages of Oestrous Cycle and Pregnancy

The occurrence of the pyometra is most common in the first half of the dioestrus when there is decreased cellular immunity associated with increased serum concentration of progesterone in females. The aim of this study was to determine the immunological profile of bitches with pyometra, studying serum levels of IL‐2, IL‐4, IL‐10, IFN‐γ, KC‐like and TNF‐α and comparing them with those of healthy bitches in anoestrus, dioestrus and pregnant. Forty females were divided into four experimental groups: group 1 (G1): with pyometra (n = 10); group 2 (G2): bitches in the second week of gestation (n = 10); group 3 (G3): in anoestrus (n = 10); and group 4 (G4): in dioestrus (n = 10). The serum levels for IL‐2, KC‐like, INF‐γ and TNF‐α were similar for all experimental groups. The values obtained for IL‐10 were found increased (p < 0.001) in animals in dioestrus and pyometra compared with females in anoestrus and pregnant, and the levels of IL‐4 observed were significantly greater (p < 0.001) in bitches with pyometra when compared with others. The cytokine profile in animals with pyometra is similar to bitches in dioestrus for IL‐10 and had increase in IL‐4 for bitches with pyometra, which represents an anti‐inflammatory these cases. This suggests the presence of an immunosuppressive state in both cases, which may explain the propensity of bitches in dioestrus to be affected by pyometra and the severity of the disease on these animals.     

International disease surveillance. International disease monitoring, October to December 2004

To assess whether the rates of antimicrobial susceptibility in bacteria isolated from the urine of dogs with urinary tract infections are similar to those of bacteria isolated from bitches with pyometra, the antimicrobial resistance of Escherichia coli isolated from the two groups were determined and compared. The samples were collected in Sweden between April 2002 and March 2003, and potential changes over time were assessed by comparing the results with corresponding data from 1991 to 1993. Among 80 isolates of E coli from cases of pyometra, the proportions that were resistant to the antimicrobials used in canine practice were generally low (ampicillin 10 per cent, enrofloxacin 4 per cent, gentamicin 0 per cent, streptomycin 5 per cent, sulfamethoxazole 8 per cent, tetracycline 4 per cent and trimethoprim 2 per cent) and similar to the proportions reported previously. Significantly lower proportions of resistance were recorded among the pyometra isolates than among 92 isolates from urine samples submitted by animal hospitals to ampicillin (P=0.04), streptomycin (P=0.002) and tetracycline (P=0.03), but there were no differences between the pyometra isolates and 113 isolates from urine samples submitted by animal clinics.     

Lactoferrin in Canine Sera: A Pyometra Study

The concentration of lactoferrin was measured in canine sera from groups of healthy male dogs as well as pregnant and non-pregnant female dogs and was compared with that of bitches with pyometra. Lactoferrin concentrations were higher in bitches with pyometra. The role of elevated lactoferrin concentrations in the suppression of lymphocyte activity was examined in sera from bitches with pyometra in a series of investigations. Although the sera from bitches with pyometra were capable of suppressing lymphocyte activity, lactoferrin was not found to be involved in this action.     

Gender, age and breed pattern of diagnoses for veterinary care in insured dogs in Sweden during 1996

More than 200,000 dogs insured for veterinary care by one Swedish company at the beginning of 1996 were included in a retrospective cross-sectional study. Data from receipts for visits to veterinarians that were part of reimbursed veterinary care events, whose cost exceeded the deductible cost, were used to calculate the risk of cause-specific morbidity, both in total and stratified by gender, age and breed. Diagnoses were described by organic system, for example, cardiovascular, and by disease process, for example, neoplastic The most commonly affected system was the integument followed by the gastrointestinal and genital systems. The genital system was the most commonly affected system in females, within which 50 per cent of the affected bitches had pyometra. Inflammatory processes were most common, followed by symptomatic conditions, traumatic injuries and neoplastic conditions.     

Risk of pyometra in bitches treated for mismating with low doses of oestradiol benzoate

A review of the literature concerning the effect of oestrogens for treating mismating in bitches on the occurrence of pyometra indicated that low doses of oestradiol benzoate substantially increase the incidence of pyometra. A retrospective study of the clinical records of a UK general practice found that the incidence of pyometra in the four months after administration of low doses of oestradiol benzoate was 8.7 per cent, whereas the incidence in the practice's untreated at-risk population was estimated to be less than 1.32 per cent per interoestrus interval, suggesting that more than 85 per cent of pyometras occurring within four months of treatment are iatrogenic.     

Safety and efficacy of mid-term pregnancy termination using aglepristone in dogs

O bjectives : To investigate effects and side effects of aglepristone in terminating pregnancy in bitches.
M ethods : Twenty-two bitches were treated in mid-pregnancy with subcutaneous injections of aglepristone at a total dose of 20 mg/kg. Short-term follow-up (one to two weeks after treatment) included clinical examination and abdominal ultrasonography in 18 of the dogs. Long-term telephone follow-up was recorded for all 22 dogs.
R esults : Pregnancy was terminated in 21 bitches (95 per cent). Signs of abortion occurred one to eight days after treatment. Vaginal discharge was evident in 17 (77 per cent) dogs. Obvious signs of parturition were seen in nine (41 per cent) dogs. Eight dogs (36 per cent) developed anorexia, and in two (9 per cent) of the dogs a local reaction at the injection site was evident. Two dogs developed pyometra two and four years after treatment, respectively.
C linical S ignificance : Aglepristone, when administered in mid-gestation, is effective in terminating pregnancy. Side effects are few and transient.     

Follow-up examinations of bitches after conservative treatment of pyometra with the antigestagen aglepristone

The aim of this study was to determine the therapeutic success of the medical treatment of canine pyometra with the antigestagen aglepristone and to document the recurrence rate in relation to the time interval after treatment with antigestagens. In 48 (92.8%) of the 52 treated bitches, healing could be achieved within the first 3 weeks after the treatment had been started. One bitch died as a result of renal insufficiency; in three bitches there was no emptying of the uterus, so ovariohysterectomy became necessary. In these three patients, ovarian and endometrial cysts were present. Forty-one bitches could be followed up for 3 months. Four animals developed a recurrence (9.8%). In three bitches ovarian cysts and cystic endometrial hyperlasia could be found intra operationem. The development of 37 bitches could be followed for at least 1 year. Seven animals developed a pyometra again (18.9%). Two received a repeated treatment with aglepristone and have been free from recurrence for over 12 months. In 37 animals data on the subsequent sex cycles are available. In 22 bitches next heat started at the expected time, in seven animals heat started too early. In eight bitches the period of anoestrus was prolonged. Five of the six bred bitches delivered at least one litter. The presented data show that treatment of pyometra by aglepristone results in a high healing rate. The recurrence rate can be minimized by the selection of bitches without ovarian cysts and cystic endometrial hyperplasia.     

Staphylococcal infections in rabbit does on two industrial farms

The main reasons for culling adult rabbit does on two Spanish rabbit farms were investigated for a year. The most important conditions were mastitis (33.3 per cent), followed by subcutaneous abscesses (9.9 per cent) and pyometra (8.7 per cent). Staphylococcus aureus infections were the most severe problem, the organism being isolated from 69.2 per cent of infected animals. Pasteurella species were more prevalent in cases of pyometra and pneumonia. Two strains of S aureus were identified by using polymorphism of the coagulase gene as the criterion. One of these strains was responsible for the majority of the staphylococcal infections and was isolated from several pathological processes.     

Escherichia coli strains isolated from the uterus and urinary bladder of bitches suffering from pyometra: comparison by restriction enzyme digestion and pulsed-field gel electrophoresis.

Pyometra (uterine inflammation with accumulation of pus in the uterus) is regarded as one of the most common illnesses in bitches. The ethiology and pathogenesis are complex with both hormonal and bacterial elements. The bacteria most frequently isolated from the uterine content is Escherichia coli.In this study, 84 E. coli strains from the uteri of 70 bitches suffering from the disease were examined and their DNA-profiles compared by restriction enzyme analysis and pulsed-field gel electrophoresis (PFGE). Through variations in DNA-profiles of the E. coli isolates, this study indicates that pyometra is caused by E. coli originating from the normal flora of the dogs and not by certain clones spread between animals.E. coli strains from the urinary bladder and the uterus of six of the bitches suffering from simultaneous urinary tract infection and pyometra were examined and compared as above. The DNA-profiles of the isolates from each of the six bitches were 100% identical. This study supports the theory suggesting that in cases of simultaneous urinary tract infection and E. coli pyometra, the urinary tract and uterus are infected with the same bacterial strain.To evaluate whether the uterus was infected with a single clone of E. coli or if multiple clones were present, eight to 16 colonies of E. coli isolated from pyometra samples from a further 10 bitches were examined. All bacterial colonies from the culture of the same bitch showed identical DNA-profiles.In 14 of the 70 bitches, two macroscopically different but biochemically identical E. coli colony types were isolated. The two colony types from the same bitch proved to have identical DNA-profiles in 13 cases and almost identical in the remaining bitch.     

Use of a low dose prostaglandin F2 alpha in bitches

The dosage of Prostaglandin F2 alpha used until the present (100, 250 and 1000 micrograms/kg bw), in order to treat pyometra in the bitch, was accompanied with side effects such as salivation, vomiting and diarrhea. In the present work, the efficiency of low dose Prostaglandin (20 micrograms/kg bw) was examined in two different groups of patients: Group 1: Included 9 bitches pregnant for a period of 5-7 weeks duration. Initially the bitches were treated 3 or 4 times per day with Prostaglandin F2 alpha. In these cases abortion took place within 4 to 11 days. Group 2: 12 dogs, suffering from pyometra, were treated 3 times per day with PGF2 alpha for 8 days. In 9 dogs the pyometra resolved and the bitches came in estrus 2-5 months after treatment. 7 bitches have been mated and 6 of these gave birth to healthy litters. During a follow-up period of at least 10 months there has not been a reoccurrence of pyometra. In 3 out of the 12 dogs the uteri were still enlarged after 8 days of treatment. These bitches underwent ovariohysterectomy and a cystic hyperplasia of the endometrium was diagnosed histologically. The low dose (20 micrograms/kg BW) Prostaglandin F2 alpha induced in all dogs the expulsion of the uterine contents. Side effects during the treatment were not observed.     

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.     

Intravaginal prostaglandin F2 alpha for the treatment of metritis and pyometra in the bitch

The purpose of this study was to determine whether intravaginal prostaglandin F2 alpha (PGF2 alpha) would be effective for the treatment of metritis or pyometra in the bitch. Seventeen bitches with metritis or pyometra were treated with PGF2 alpha. Prostaglandin F2 alpha (150 micrograms/kg body weight) was administered once or twice daily by infusing 0.3 ml per 10 kg body wt into the vaginal lumen. Bitches were also treated with amoxicillin (15 mg/kg body wt/48 h) and/or gentamicin (4 mg/kg body wt/day) administered as intramuscular (i.m.) injections. Fifteen bitches were treated successfully with intravaginally administered PGF2 alpha for 3 to 12 days and with intramuscularly administered antibiotics for 4 to 12 days. Success of treatment was judged by cessation of vaginal discharge, the absence of fluid in the uterus as determined by ultrasonography, and the overall health status of the animal. As two bitches with pyometra showed clinical deterioration in spite of medical treatment, ovariohysterectomy was performed after the first and the second treatment, respectively. No side effects (salivation, vomiting, diarrhoea, hyperpnoea, ataxia, urination, anxiety, pupillary dilatation followed by contraction) were observed after PGF2 alpha treatment. The disease did not recur during the subsequent oestrous cycles within 12 months after the initial treatment. The results demonstrate that intravaginal administration of PGF2 alpha was effective in 13 dogs (86.6%) with metritis or pyometra, and caused no side effects. Although the study was based on a relatively small number of cases, it is concluded that prostaglandin F2 alpha can be a useful means of treating bitches with metritis or pyometra. However, in severe cases of pyometra ovariohysterectomy is needed.     

Effect of bovine horn cancer serum on E-rosetting capacity of peripheral blood lymphocytes from normal unaffected animals

The effect of serum from horn cancer affected bullocks and cows on E-rosetting capacity of peripheral blood lymphocytes (PBL) from unaffected control animals was examined. The E-rosette counts were made using 2-aminoethyl isothiouronium bromide (AET) treated sheep red blood cells. A significant decrease in the percentage of EAET rosette forming cells was noticed when PBL were incubated with 50 per cent serum from animals affected with horn cancer. However, no such effect was noticed when PBL were treated with 50 per cent serum from unaffected control animals. A linear relationship was observed between percentage of EAET rosette forming cells of animals affected with horn cancer and E-rosette inhibitory activity of the corresponding serum on PBL from control animals.     

Treatment of spontaneous pyometra in 22 bitches with a combination of cabergoline and cloprostenol

Twenty-two bitches with ultrasonographically diagnosed spontaneous pyometra were treated with a combination of 5 microg/kg cabergoline per day and 5 mug/kg cloprostenol every third day, and potentiated sulphonamide twice a day. Bitches with either open-cervix or closed-cervix pyometra showed a rapid clinical improvement, associated with a reduction in plasma progesterone concentration, increased vulval discharge and a reduction in the diameter of the uterus. The haematological profiles of 21 of the bitches returned to normal within six days of treatment, and their biochemical profiles returned to normal within nine days; 19 of the bitches were managed successfully by a 10-day period of treatment. Two bitches required a further three days of treatment, and in one bitch with a partial uterine torsion the treatment was not successful. Adverse effects of the treatment were limited to the 60 minutes immediately after the administration of prostaglandin, and included retching, vomiting, mild abdominal straining, diarrhoea and panting. The incidence of adverse effects was reduced after each successive dose of prostaglandin. Eleven of the 21 successfully treated bitches were mated at the next oestrus, and seven became pregnant; their litters were smaller than the published breed averages. In four of the bitches the pyometra recurred after the next oestrus.     

子宫蓄脓犬与健康犬子宫内膜基质细胞的分离比较

通过分离子宫蓄脓犬与健康犬子宫内膜基质细胞,观察其生长特性并对其进行细胞免疫荧光鉴定,分析比较该细胞在病犬中是否异常。结果显示,轻度子宫蓄脓犬和健康犬的子宫内膜基质细胞形态和特性基本一致,前者的细胞活性更强,增殖速度较快,可在接种后4 d融合成片,细胞多数呈梭形,少数呈多角状。经细胞免疫荧光鉴定,该细胞表达波形蛋白,阳性率98%以上。结果表明本试验所分离的细胞为犬子宫内膜基质细胞,该细胞在轻度子宫蓄脓犬和健康犬中无明显变化。     

Age‐Related Pregnancy Results and Further Examination of Bitches after Aglepristone Treatment of Pyometra

The cystic endometrial hyperplasia and pyometra complex is one of the most common uterine diseases in bitches. The appearance of pharmacological preparations containing anti‐progestagens created new possibilities for pyometra treatment. The aim of this study was to evaluate the curative effect of the anti‐progestagen aglepristone treatment of pyometra in bitches of different ages. Twenty four bitches of different breeds, aged from 0.8 to 9.5 years (21–48 kg) exhibiting clinical pyometra symptoms (two groups – I ≤ 5 years, n = 14 and II >5 years, n = 10) were evaluated. Information about the general reproductive health was collected up to 54 months after anti‐progestagen treatment. Remission of clinical symptoms and return of blood chemistry results and total leucocyte count to referential values were achieved in all cases within 14 days of treatment. Bitches were naturally mated at the first, and when unsuccessful, the second oestrus after treatment. In group I, no recurrence of pyometra symptoms was observed during following cycle(s). Eight bitches (57.1%) had a full‐term pregnancy and the number of newborn pups ranged from 1 to 12. None of the bitches from the group II became pregnant. In conclusion, the basic indication for conservative pharmacological treatment of pyometra is preserving female fertility and obtaining offspring. The important conditions for successful aglepristone treatment are: the young age (up to 5 years) and the lack of detectible ovarian cysts. It seems necessary to mate bitches in the first or second oestrus after finishing treatment. The efficacy of treatment can be measured by the after‐treatment pregnancy rate.     

Oestrus control in bitches with chlormadinone acetate

A clinical study of oestrus control in bitches with chlormadinone acetate (CMA) is reported. The commercial 1-0 per cent crystalline suspension of CMA was injected subcutaneously at a dose of 3 mg/kg, or somewhat lower for the largest animals. Treatment was initiated always in anoestrus and was repeated twice annually for as long as requested. The longest, 9-year, period of anoestrus was achieved by twenty repeated treatments. A total of 2,471 treatments were given to 568 bitches (an average of 4-4 treatments per bitch) during a period of over 10 years, with an efficacy of 98 per cent. The incidence of false pregnancy, uterine inflammatory disorders and mammary nodules in the treated group were compared to those of an age-related control group of 487 bitches that did not receive hormonal treatment. A lower incidence of false pregnancy and the two clinical entities was observed in the group of treated animals. It is concluded that CMA can be used safely and reliably for oestrus control in bitches and is therefore, an appropriate alternative for ovariohysterectomy.     

Acquired urinary incontinence in bitches: its incidence and relationship to neutering practices

A five-year cohort study was conducted on bitches chosen by a sample of 233 randomly selected practising veterinary surgeons in the UK, to estimate the incidence of acquired urinary incontinence (AUI) in neutered and entire animals, and to investigate possible risk factors associated with neutering practices. Information was collected using questionnaires, and data on 809 bitches, of which 22 developed AUI, were obtained. The estimated incidence rates in neutered and entire animals were 0·0174 and 0·0022 per animal-year, respectively (95 per cent confidence intervals: 0·0110, 0·0275 and 0·0009, 0·0058, respectively). The relative risk, neutered vs entire, was 7·8 (95 per cent confidence interval: 2·6, 31·5). The attributable proportion_exposed and population attributable proportion were 87·1 per cent and 63·1 per cent (95 per cent confidence intervals: 61·9 per cent, 95·6 per cent, and 28·3 per cent, 88·5 per cent, respectively). An increased risk, significant at the conventional 5 per cent level, was not demonstrated in animals neutered before, vs after, first heat (relative risk: 3·9, 95 per cent confidence interval: 0·8, 10·4), although the result was significant at the 10 per cent level. Removal of the cervix was not shown to be a risk factor in neutered dogs.     

Prostaglandin F2 alpha treatment of canine pyometra

Immediate and long-term outcomes of prostaglandin F2 alpha treatment for canine pyometra were studied in 10 bitches. Examination of pretreatment uterine biopsy specimens, taken for histopathologic diagnosis and classification of disease severity, revealed either type III or IV pyometra. Dinoprost tromethamine (0.25 or 0.5 mg/kg of body weight, SC) was given once daily for 3 days. Bitches were bred at the first posttreatment estrus and monitored for a minimum of one year. When pure cultures of Escherichia coli (n = 3) or Staphylococcus aureus (n = 1) were obtained from the vagina, these bacteria also were found in the uterus. Pretreatment WBC counts often did not reflect the severity of histopathologic findings in the uterus, but posttreatment WBC counts were useful in monitoring response to treatment. Four bitches produced a litter within one year of treatment. Four bitches (40%) had recurrence of pyometra within one year of treatment, and these same bitches had another recurrence after an additional prostaglandin treatment. Three additional bitches had a recurrence by 27 months after therapy, establishing a total recurrence rate of 77% (7/9). Results suggested that subclinical disease may persist after treatment, with clinical recurrence during diestrus. Despite the high recurrence rate, it was concluded that this treatment is a practical treatment for canine pyometra when reproduction is desired.