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Postpartum Fever Might Mean Metritis

Your bitch finally had her puppies. Though it was a prolonged birth, the little pups are all fine. She’s nursing them as she should. But it’s Day 2, and her temperature has spiked. You know that because you’ve checked it twice a day since she gave birth.

What now? Call your vet.

A dam’s temperature might be elevated to maybe 103 degrees Fahrenheit for the first 24 hours after whelping, but after that it should start to normalize, says Margret L. Casal, D.V.M., Ph.D., an associate professor at the University of Pennsylvania School of Veterinary Medicine in Philadelphia.

Most likely, your dam either has mastitis or acute metritis, inflammation of the uterus.

The first sign that a dam may have metritis is a postpartum fever that rises after the first 24 hours. Photo © Can Stock Photos.

If it’s the latter, it’s due to bacteria that have managed to work their way into her body, causing an infection. The bacteria will usually be E. coli, also the culprit in pyometra, but Staphylococcus aureu (staph) or Streptococcus (strep) can creep in as well. Even a dog that has a normal birth or abortion can get metritis, Casal says, “because the cervix is open, and bacteria can draw up into the uterus.”

While any dog can get it, a prolonged birth or a difficult one, known as “dystocia,” may contribute to the development of metritis. “The biggest problem with metritis is that we usually don’t know where it comes from,” Casal says. Infected placentas that aren’t expelled or any tissue that’s degrading, such as parts of a fetus that died in utero can cause it as well. “It’s because something’s there that shouldn’t be there, so tissue gets aggravated. The whole immune system doesn’t work right.” It can also be as simple as a dam that has a “heavy discharge” at some point and “nobody helps her clean it up.”

When faced with a dam that has an elevated temperature after the first day, you might also see a lack of appetite, depression and even neglect of the puppies. “Sometimes, not always, you can see a really foul-smelling discharge,” Casal says.

However, most dogs that are bred and whelped by responsible breeders will never have to deal with metritis. The condition is not, however, uncommon in kennels with what Casal calls “dismal” hygiene practices or none at all. If bedding is changed once or twice a day, and, in the absence of infected fetuses or an extremely long birth, “there really should be no reason for the dog to get metritis,” she says.

Depending on the severity of the condition, a dam may be able to continue to care for her puppies. Photo © Can Stock Photos.

Getting a Diagnosis and Treatment
How best to get a diagnosis is a “big topic of discussion among the repro people,” Casal says. Some specialists recommend taking the dam into the veterinary clinic, and some do not. “To bring the mom and the entire litter into the hospital is probably a bad idea, in my view,” she says, unless the clinic has a back entrance and a separate parking lot for postpartum cases. Even with that, she says, such a trip can stress out the dam. So, she suggests that if you have a dam with an elevated temperature on the second day after whelping, you should try to get your vet to come to your home or kennel to examine her.

Once diagnosed, many cases can be cleared up with antibiotics alone, Casal says. “But some people do recommend giving things like prostaglandin F2 alpha to empty out what’s left in the uterus. I’d go for the prostaglandin, rather than oxytocin.” She says oxytocin should always be given with caution as it always causes severe uterine contractions that can’t be controlled. Whatever has been left behind in the uterus can actually be pushed out of the fallopian tubes, rather than the vaginal canal, and it can cause death. The prostaglandin results in “more coordinated contractions” and also ensures that the cervix is open so the tissue goes out there, rather than through the tubes.

Because the teaching hospital deals with “serious breeders,” she says, “we don’t see metritis that often. If we do suspect it, we do the antibiotic treatment. If it’s very, very severe, it may cause sepsis for the dog, so we may actually recommend spaying the dog at that point.”

Another controversial point in metritis treatment is whether the puppies should be removed from the dam until she’s recovered. Casal recalls a study done in the ‘90s that showed that when puppies died after their dams contracted metritis, in some 90 percent of the cases, it wasn’t the same bacteria that killed the puppies. From her perspective, the decision should be based on the dam’s behavior. “If it’s not severe and you can put her on antibiotics that will be OK for the puppies, they can stay,” she says. However, depending on the bacteria and the severity of the metritis, a veterinarian might have to use an antibiotic that would be harmful to the litter. In that case, they have to be taken away, she says.

A bitch that’s had acute metritis after whelping is “not necessarily” more inclined to contract it again in the future.

One condition that can look like metritis is subinvolution of placental sites, or SIPS. “Usually it’s in young bitches, right after whelping. The bitches seem completely normal, but what isn’t normal is that they’ll have prolonged discharge for weeks and weeks.” It’s an infection of the spots in the uterus where the placentas attach. Each placenta has a lot of attachment points, Casal explains. The discharge in SIPS, though, is not smelly. “This has to be distinguished from metritis,” she says.

Beware of Chronic Metritis
Metritis can also be chronic. It typically comes up as a possibility when a dog isn’t cycling properly, Casal says. This is an inflammation of the inner lining of the uterus with no known cause. The condition, however, she says is “very poorly understood.” Even as a reproduction specialist, she has only seen two cases in her career.

“You would not suspect that there’s anything wrong with the dog. They just appear to be infertile.”

In both of Casal’s cases, the breeders opted for an extended course of antibiotics. “And honestly it did nothing,” she says. “If there’s not an infection there, then the antibiotics are not going to do anything. We did have one where we put the dog on an NSAID [nonsteroidal anti-inflammatory drug] for quite a while, and that seemed to help. Again, you would only do that with chronic endometritis.”

In this case, the condition is properly called “endometritis” because it’s the inner lining, which maintains a pregnancy, that’s inflamed. “Metritis means the entire uterus is inflamed,” Casal says.

While preventing endometritis isn’t possible, careful breeders who monitor their bitches carefully and follow hygienic practices are unlikely to see metritis in their dams.

Written by

Susan Chaney has been on the editorial side of publishing since 1990, starting her career as a newspaper features writer and editor. A lifelong lover of dogs, Susan has lived with German Shepherds, Labs, Yorkies, an Irish Setter, a Great Dane-Bloodhound mix, a Sheltie and currently a Chihuahua mix of unknown pedigree. She was the editor of Dog Fancy magazine, content editor of DogChannel.com and group editor of Dog World, Dogs USA, Puppies USA, Natural Dog, Cat Fancy, Cats USA and Kittens USA from March 2005 to December 2009 when she left her position to work at home, part-time. Susan lives in Long Beach, Calif., with her artist husband, Tim, that Chi mix and two big cats. As an editor and writer for Best In Show Daily, she is reveling in the amalgam of three loves: writing, editing and dogs.