Monday, May 27, 2013

What is a pyometra?


Meet Zjayla, a 4 year old female who visited the emergency room after three days of eating poorly and hiding. She started vomiting earlier in the day and her owners became concerned. She was mildly dehydrated and had a mild fever. At the ER, the doctor noted that she had a large amount of pus coming from her vulva. Without any further diagnostics, the doctor was able to tell the owners that Zjayla had a dangerous infection in her uterus called a "pyometra". She needed emergency surgery in order to save her life.

Zjayla arrived at Exclusively Cats Veterinary Hospital as a transfer patient for surgery. She had been given some fluids to rehydrate her and an antibiotic to start treatment for the infection. Once at our hospital, she had an IV catheter placed and after some pre-surgical bloodwork, she was prepped for surgery.

Patients with this type of infection can be very fragile and unstable. One of the reasons that we recommend spaying cats is that we hope that the spay surgery can be performed when the cat is young and healthy so that the surgery is safer, the incision smaller and the recovery quicker. While Zjayla was under anesthesia, her blood pressure dropped dramatically, despite the presurgical medications given to help stabilize her, and a healthy dose of pain medications. We had to quickly administer additional supportive fluids to help support
Culture plate with bacterial growth from a uterine infection or pyometra
The bacteria growing on this culture plate are from Zjayla's infection
her blood pressure. Fortunately, she responded well to the additional medication and her blood pressure returned to normal. The rest of her surgery was fairly "routine" for an emergency surgery. Dr. Bailey carefully removed the infected uterus, making sure that no pus or bacteria entered the abdomen, and closed the incision. Because she was older, and because of the complicated surgery, Zjayla's incision was larger than it would have been if she was just being spayed. This cute little girl recovered well from surgery and was able to go home the next day. We did have to administer a tube feeding of a high calorie diet by placing her under anesthesia for a short period, placing a tube down her esophagus into her stomach and squirting a small meal into her stomach. She had not eaten in over 4 days, and needed the nutrition to kick-start her recovery. She went home with some strong antibiotics and recovered quickly.

Her owners felt terrible. They thought that since she was such a shy cat, they were saving her from being traumatized by not bringing her in to a veterinary hospital have a spay surgery done. However, in the end, she was more traumatized by her serious illness and emergency surgery than she would have been by the spay surgery. Many people don't realize that a pyometra or serious uterine infection can be a consequence of having a female cat that is un-spayed and un-bred.

Incidentally, Zjayla had also been urinating around the house off and on for several years. This probably coincided with her heat cycles. It takes about 6 weeks after a spay surgery for the hormones to stop circulating in the body, so we will have to wait a little longer to see if this behavior resolves. At her appointment for her suture removal, her owners reported that she was doing great! She was active and happy and much more chatty than she had been in the past.  Fortunately for Zjayla, this story has a happy ending!

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