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Complications After Dog Pyometra Surgery

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Dog Pyometra

If your dog has developed pyometra, your vet likely told you that surgery is necessary and you may be wondering about complications after dog pyometra surgery. While complications from surgery may be scary, it's important to consider that dog pyometra is a serious condition that can turn deadly quickly if not treated on time. Complications from dog pyometra surgery are fortunately not very common, but your vet can take several steps to help reduce them. If you are worried about complications, discuss with your vet your concerns.

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"Don't Let the Sun Set on Pyometra"

Among veterinarians and veterinary staff there is a special saying: "Don't let the sun set on a pyometra." What does this saying mean exactly? It means that pyometra is a condition that needs to to be treated quickly, preferably on the same day it's diagnosed considering the fact that this condition can turn life threatening if allowed to progress.

What makes pyometra so deadly that it's risky waiting another day? If we take a peek at etymology of the word, we can deduce it's nothing good. Pyometra derives from the ancient Greek word "pyos" meaning puss and "metra" meaning womb. Indeed, pyometra consists of the condition of the dog's womb becoming infected and filling up with pus.

Pyometra typically occurs anywhere from 4 to 12 weeks following a heat cycle, explains Dr. Margaret V. Root Kustritz, a veterinarian specializing in animal reproduction.

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As the womb fills up with pus, it can cause complications such as secondary kidney disease and an enlarged womb. Death in dogs with pyometra occurs from shock due to "endotoxemia" the condition where toxins and bacteria leak from the the uterine walls and spill into to the dog's blood stream.

A Life Saving Surgery...

dog gallbladder removal surgery

Surgery to save a dog from dying from pyometra most often consists of an ovariohysterectomy (OVH) which means that the dog's womb and ovaries are removed. The surgery is basically the same as when a dog is being spayed, however, it is more complicated than a routine spay surgery done on a young, healthy dog with an intact womb.

Dogs who are ill from pyometra, will firstly need to be stabilized before going into surgery. The goal is to obtain normal perfusion (the passage of fluid through the circulatory system), and to correct any abnormal levels of electrolytes and glucose. This is often accomplished by starting IV fluid therapy.

Intravenous antibiotics are also given, and shock treatment is provided for critically ill dogs. Prior to surgery, the vet will also conduct baseline blood tests and chemistries so to check for organ function.

"In my experience, the largest percentage of dogs who have developed a pyometra will do quite well after surgery as long as that surgery isn't delayed too long and the patient had no other pre-existing health conditions."~Dr. Deb

But with Risks for Complications

life expectancy of addison disease in dogs

There are a variety of potential complications when performing an ovariohysterectomy on a dog who has pyometra. As with any other surgeries, there is always the risk for anesthetic death; however, with safer use of anesthetics, nowadays the risks for death due anesthesia are very low. Patients are hooked up to monitors (pulse oximeter, ekg, etc.) that check for any abnormalities and if any arise, they are quickly addressed by the vet and vet staff.

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The risks for pyometra surgery generally tend to be higher if the dog is very ill and septic. Complications may range from low blood pressure, to heart arrhythmia and aspiration pneumonia.

Bleeding during surgery is always a risk with any surgery, but in a dog with pyometra, the risks can increase. With the blood vessels enlarged, there's a greater risk for hemorrhaging during the surgery. If excessive bleeding occurs, the affected dog may require a blood transfusion during surgery.

Another risk derives from the fact that when the dog's uterine walls are riddled with pyometra, they become enlarged and therefore more friable, which means that they can tear during manipulation. A tear in the uterine wall would mean spillage of pus into the dog's belly (intra-abdominal rupture) which can lead to life-threatening peritonitis. Vets though take precautions to avoid this by extracting the womb from the abdomen before removing it.

"The most common complication observed in surgically treated (dogs) was peritonitis (40 dogs), followed by urinary tract infection (19 dogs), wound infection (8 dogs), uveitis (6 dogs), and cardiac arrhythmia (5 dogs)."~BMC Veterinary Research, 2014

Risks After Surgery

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The risks don't end when the dog is off the surgery table and is sent home. Dog owners must be extra vigilant on restricting the dog's activity for several days. The incision area must be monitored carefully, ensuring that the dog doesn't lick it. Bleeding, local swelling and potential signs of infections of the surgical incision, must be reported to the vet.

Generally, vets keep dogs at the hospital for a day or two following surgery so to monitor for complications. During this time, dogs are put on IV fluids and injectable antibiotics

Antibiotics that were given prior to surgery are continued to be given post-surgery. Even though the source of infection is removed (the womb) the dog still needs to fight residual bacteria in the bloodstream. For dogs who are reluctant to eat, it's important that they do so because they often need to take antibiotics with food. Vets may prescribe anti-nausea medications for nauseous dogs. Dog may be coaxed to eat by being offered diluted dog canned food or meat-based baby food without garlic or onion powder.

Vaginal discharge after pyometra can be indicative of presence of scar tissue around the neck of the dog's womb, an infection of the uterine stump (which takes place when a part of the womb is accidentally left behind during the surgery), or remnant of ovarian tissue left behind causing the dog to go into heat, explains veterinarian Dr. Laura Devlin. Any signs of complications should be promptly reported to the vet so early intervention can take place.

"Potentially life-threatening complications of pyometra, described after surgery, include sepsis, septic shock, disseminated bacterial infection, peritonitis and hemorrhage."~BMCVeterinary Research, 2014

Final Thoughts

As much as surgery for pyometra may sound scary, statistics are reassuring. According to veterinary surgeon Dr. Sara Colopy, the mortality rate following OVH for pyometra has been reported to be anywhere from 1 to 8 percent. And what about age? Many dog owners are concerned that their dogs are too old for pyometra surgery. Many vets feel that age is not a factor. If the dog has normal bloodwork and a healthy heart, the anesthesia is the least of concern in dogs especially with a deadly condition like pyometra.

"The primary treatment is surgery, and age has no bearing on surgical success... We've anesthetized older and sicker animals very successfully. If anesthesia is not done, pyometra is fatal! In this case anesthesia is the least of our worries." ~Dr. Dan veterinarian

References:

  • DMV360: Surgical and medical treatment of pyometra
  • Outcome of pyometra in female dogs and predictors of peritonitis and prolonged postoperative hospitalization in surgically treated cases, Supranee Jitpean et al. BMC Veterinary Research 2014 DOI: 10.1186/1746-6148-10-

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