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Know the Warning Signs of Pyometra

Few things strike fear in me, as a breeder and as the owner of one intact bitch, more than the thought of pyometra.

I had an experience several years ago with one of my older champion bitches who developed pyometra, and afterward I discovered that lots of people who breed and show dogs have never experienced it. It is something you want to recognize immediately when it happens because it can be fatal.

My Toy Poodle bitch was just over 6 years old. She had whelped one litter without any problems and didn’t take the next time I bred her. I hadn’t done much breeding for a while and was just enjoying having three older champions and one young bitch as house pets. Two of the girls had been in season just a few weeks before I noticed one day that one of them was listless and not interested in her dinner. This wasn’t one of those dogs that ate sometimes and not other times – she was one who always looked forward to her supper and never failed to clean her plate. But aside from skipping dinner, she just wasn’t herself. She always carried one of her dollies around in her mouth, and she was a big tail wagger. But not that afternoon. She just laid there with her head on her paws when I put down the food bowls.

Thank goodness I had worked for my vet for a few years and had seen pyometra. I immediately suspected the worst. So I took her to the vet right away, and at the time I was fortunate to live near Dr. John Hamil, in Laguna Beach, who as many readers will know is married to Susan Hamil; they breed and show Bloodhounds. Marcie was diagnosed immediately and Dr. Hamil let me know how grave the situation was – she needed to get to surgery quickly.

Marcie survived her bout with pyometra, but it was a very serious situation, and, had I waited even overnight, I am fairly sure I would have lost her. The key to knowing that you’ve got a bitch with pyometra is the connection between the fact that she’s recently been in season, and that she doesn’t feel well, or is not herself in some way. You always want to err on the side of caution if these two circumstances exist.

So what is pyometra, and what’s the connection with the reproductive cycle? Pyometra is an infection in the uterus that typically happens in middle-aged to older females. When a bitch comes into season, hormonal changes in her system, specifically an increase in progesterone levels, lead to a thickening of the lining of the uterus in preparation for the pregnancy. Progesterone levels remain elevated for eight to 10 weeks following the season, and the thickening of the walls of the uterus continues.

Also during the heat cycle, the cervix is open so that the sperm, if she’s bred, can travel up the reproductive tract to fertilize the eggs.

But when a bitch does not become pregnant, or if she hasn’t been pregnant for several heat cycles, the uterine lining continues to thicken until cysts begin to form. One reason it happens more often in older bitches – usually those that are 6 years of age or older – is because they’ve had more exposures to high levels of progesterone. The cysts that form in the uterine lining produce fluid that becomes an ideal breeding ground for bacteria to grow.

With the cervix open during the season, bacteria can enter the uterus, into the perfect environment created by the cysts. The bacteria then begin to multiply. This leads to the development of infection and pus.

Further complication results because high progesterone levels lead to a weakening of the muscles in the wall of the uterus, which means it can’t contract. This would be good if there were puppy fetuses forming — you wouldn’t want the litter to be aborted by uterine contractions. However, if the muscles of the uterus are too weak to contract with pyometra, the dangerous infection can’t be expelled. Pyometra typically progresses quickly, one reason it is life-threatening.

A bitch can have either of two types of pyometra: closed or open. In an open case,the cervix is not yet closed when the infection and pus develop, and they lead to a foul-smelling vaginal discharge that will alert you to the problem. A closed pyometra occurs when the cervix closes as the heat cycle ends, and the pus and infection are contained within the closed organ, which of course eventually leads to a very sick animal, since the infection is now trapped in the body. Very often dogs will exhibit no overt signs of illness until the infection reaches a dangerous level.

One sign to watch out for may be an increase in the frequency of urination, although many bitches already want to go out a little more frequently as they get older, so this may not seem unusual to you. A lack of appetite, drinking large amounts of water, listlessness or lethargy, or vomiting should all be cause for concern for a bitch that has recently been in season. Other signs may include a distended or swollen abdomen and the bitch washing around her vaginal opening more than usual.

Diagnosis and Treatment of Pyometra

A vet who has seen pyometra will likely diagnose it symptomatically on seeing an intact bitch that has recently been in season and is lethargic and exhibiting any of the other symptoms. The diagnosis can be verified using X-rays, ultrasound or blood tests. With an open pyometra, your veterinarian might take a swab to examine the discharge under a microscope.

I can’t emphasize enough that if you have even the slightest suspicion that a bitch who fits the profile is not feeling well, take her to the vet. Getting there and finding out that she has a urinary tract infection or something less harmful is far better than waiting and potentially losing her. The infection that builds up in the uterus can lead to its rupture, at which point the pus and bacteria spill into the abdominal cavity, causing a grave situation from which she might not be saved.

In most cases of pyometra, the optimum treatment is to remove the infected uterus and the ovaries. It is crucial that during the surgery, the uterus is not ruptured, as that will release the infection into the abdominal cavity. After the bitch is spayed and has had IV therapy and antibiotics at the vet hospital, she will typically need several weeks of recovery at home on antibiotics before she’ll be herself again.

Having her front leg shaved for the IV wasn’t the only evidence post-op that my Toy Poodle had been very ill. It took several weeks for her to fully recover from having pyometra.

Some vets will consider not spaying a bitch with pyometra – depending of course on the circumstances – if her owner intended to breed her again in the future. This requires much more complicated treatment, and in a closed pyometra, an attempt to drain the infection from the uterus. This is done using hormone therapies to attempt to decrease levels of progesterone, dilate the cervix and cause contraction of the uterus so that the infection will drain out. Antibiotic therapy is also in order.

However, there is no guarantee that treatment will work. With a closed pyometra, there is still the danger that the uterus will rupture, and in many cases the dog is too ill to survive until the treatment works fully. The infection may recur with subsequent seasons. Fertility is also reported to be lower in the future for bitches that have had pyometra.

In our case, Dr. Hamil’s staff took a photo of Marcie’s infected uterus after it was removed in surgery, and we compared it to a photo of a normal one. It was unbelievable how distended that small organ became. Instead of looking like a wrinkled, deflated balloon, it looked like a sausage casing that had been grossly overstuffed. Her entire uterus was obviously filled almost to bursting with infection. I’m glad I got to see it because it really cemented in my mind how dangerous the situation was, and how life-threatening.

Today I believe that most bitches should be spayed after they’ve had their last litter. I know from experience that on occasion people can believe they’ve bred a bitch for the last time, then later regret that they can’t breed her again for one reason or another. But pyometra was as frightening an experience as I’ve had with one of my dogs, and the only real way to prevent it is to spay them after they’ve had their last litter. In the meantime, keep an eye on your bitches after their seasons, I would say for four to six weeks, just in case any trouble occurs. And err on the side of caution if you see any unusual signs or behavior. No vet who has experienced pyometra would blame you if you came in with a false alarm.

Written by

Christi McDonald is a second-generation dog person, raised with a kennel full of Cairn Terriers. After more than a decade as a professional handler’s apprentice and handling professionally on her own, primarily Poodles and Cairns, she landed a fortuitous position in advertising sales with the monthly all-breed magazine ShowSight. This led to an 11-year run at Dogs in Review, where she wore several hats, including advertising sales rep, ad sales manager and, finally, editor for five years. Christi is proud to be part of the editorial team for the cutting-edge Best In Show Daily. She lives in Apex, N.C., with two homebred black Toy Poodles, the last of her Foxfire line, and a Norwich Terrier.
  • Judy Higgins Kasper June 6, 2012 at 12:38 PM

    Christi this is a very good article, one that all should read and pay close attention. I had a bitch who we saved her uterus and she did produce a litter post treatment but I am not so sure I would do it again. I watch my girls very closely all the time.

  • Jeri Stephens June 6, 2012 at 12:54 PM

    Very good article! My 10.5 year old bitch is just recovering from an open pyometra. We were very lucky in that we caught it early. She did not have many of the classic signs; she didn’t drink copious amounts of water, she had a slight discharge that was dark but not fowl-smelling and her temp was 100.9. Still I knew she wasn’t right. It was late on a Friday night so rather than the emergency clinic, got her in to her regular vet at 7:30 the next morning. After rushed bloodwork, she was taken into surgery. All went well, her uterus was not extremely enlarged but did have a lot of cysts. She’ll finish her course of Doxy this weekend and is doing very well. My seven year old had her last litter in October and will soon be spayed.

    • Christi McDonald
      Christi June 7, 2012 at 7:24 AM

      Jeri, I’m so glad you had a good outcome with your bitch.

  • Christi McDonald
    Christi June 6, 2012 at 1:15 PM

    Judy, I appreciate hearing about your experience. I want everyone to be aware of the warning signs of pyometra. You and I were so fortunate that our girls came through it!

  • Judy McNamara June 6, 2012 at 1:40 PM

    Thanks for a great article. I lost a very precious pet many years ago when I was very new in dogs. It was so hard to lose her. You are so lucky to have made it your vet in time.

  • Rebecca Pentecost, DVM June 6, 2012 at 1:57 PM

    Working as a veterinarian in a reproductive practice we treat more cases of pyometritis than we spay. We are highly successful with treating, as much as 85-90% or better. This is a very treatable condition if you are comfortable with the protocols.

    • Judy Higgins Kasper June 7, 2012 at 6:37 AM

      My case was in the very early ’90s, a Bouvier bitch. I drover from a small town in central California to Santa Rosa for Randy Popkin DVM to treat. Her case was open luckily and the treatment worked, though expensive even then. I am sure that the protocols have been refined since. It is luck to have an option but you need an experienced vet close by, a luxury not all of us have.

    • Christi McDonald
      Christi June 7, 2012 at 7:26 AM

      Dr. Pentecost, thank you for the information. I’m sure there are other veterinarians who have established protocols for successfully treating pyometra. We appreciate your input.

  • Riverview June 7, 2012 at 5:26 AM

    Great article! It is a must read.

  • Kay June 7, 2012 at 6:58 AM

    This is an excellent article. I have a girl who is middle aged and have heard about pyometra but didn’t know the symptoms. Would a bitch who has never had a litter be more likely to develop this?

    • Christi McDonald
      Christi June 7, 2012 at 7:38 AM

      Of course, I’m not a veterinarian, and we’d be delighted if a vet would like to weigh in, but it is my understanding that the answer is yes, a bitch that has never had a litter is more prone to develop pyometra — or the inverse, a bitch that has had several litters is less likely.
      As I understand it, after numerous heat cycles without a pregnancy, the uterine wall becomes progressively thicker and more likely to develop the cysts that become the ideal environment in which bacteria can multiply. The bacteria are those that normally occur in the vaginal tract, and under “normal” circumstances, the dog’s immune system would take care of them when they enter the uterus. However, when the uterine wall has undergone these drastic changes, cysts form, and this becomes an environment where the bacteria thrive and reproduce, thus becoming the dangerous infection.

  • Virginia Wimmer June 8, 2012 at 7:45 AM

    Very good article, just thought I would add, this can actually happen in young bitches too….I just had a friend who had it happen in her 11month old bitch, luckily it was open, and they caught it very fast, it wasn’t even showing up on the blood work….no high white count etc. they treated her with meds and she is doing much better….I worry every time my girl comes into season, especially as she has had many UTI’s, so far so good. My mom also had this happen with one of her show bitches, she was older, and they had to spay her…..just another thing we have to worry about with our loving companions

  • Crystal June 25, 2012 at 11:32 AM

    My I reprint this in our club newsletter with proper credit? I think our membership would appreciate the information. Thank you for your consideration!

    • kayla
      kayla June 26, 2012 at 7:45 AM

      Hi, thank you for reading and contacting us. We are happy to provide a reprint of the story. You can always link to it from your website as well. all the best, Kayla

  • Denise Breen June 30, 2012 at 5:24 PM

    An awesome, informative article. I just about lost my beautiful bitch to it, this year. Misdiagnosed by a vet in the evening, develped toxic shock overnight, put on IV fluids overnight at an emergency vet. I had experienced pyo when another bitch was 7 and kept sayin this bitch ad the same symptoms. I had to collect her and take her to my own vet next morning. He instantly recognised it and operated. The evening vet had scanned her and showed me ” the pups” from the matng I had done 4 weeks earlier!! It is a very frightening situation

  • Christi McDonald
    Christi July 6, 2012 at 9:40 AM

    Denise, I’m so happy to hear that your bitch survived.

  • corgi June 21, 2015 at 2:21 PM

    I had a bitch, 3 years old, first time being bred, exhibit signs of pyo about 4 weeks into her pregnancy – nothing showed up on blood panels, ultrasound showed nothing, however, knowing my girl, when she refused to eat, even after a week of heavy antibiotics, I opted to have her spayed – one horn was normal with pups, the other was about to rupture with the nasty green infection it was filled with – broke my heart, but my girl was safe and now has her own “pet couch” for the rest of her life.

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