We are SO excited to start contributing content to our new blog! Since we see such interesting and unique cases coming in to our facility every day, we thought we'd highlight and share some of our more fascinating cases to promote education and emphasize health topics amongst our clients and other pet owners.
*Warning*: This post contains graphic surgical photos from an actual surgical procedure.
Our first 'Case of the Week' highlights a case of an older female dog who was diagnosed with a condition called Pyometra. So what is “pyometra”? We’re so glad you asked! To break the word down for a better understanding, the root ‘pyo-‘ means pus, and ‘-metra’ means uterus. So pyometra is quite literally a "pussy uterus." This condition is usually found in unspayed older female dogs and cats. Female animals with pyometra get severely ill with septicemia and bacteremia, making this condition a medical emergency that requires IMMEDIATE surgical intervention to physically remove the source of the infection, the uterus. Pyometra metabolically compromises the affected animal, so the emergency spay is itself considered a higher-risk surgical procedure that warrants additional precautions in pre- and postoperative treatments and observations.
Preoperatively, we do a thorough head-to-toe physical exam, draw a CBC (complete blood count) and a blood chemistry, and we also perform an ultrasound. The patient in this week’s case was an older unspayed female dog that hadn’t had a heat cycle in several years, and suddenly started having a particularly heavy heat cycle, with a very heavy, bloody flow and noticeably foul-smelling vaginal discharge. The dog was lethargic, and she wasn’t eating. We drew her CBC, which showed evidence of an elevated white blood cell count, indicating the presence of an infection. Her blood chemistry was normal, but her RBC (red blood cells) and hematocrit levels showed evidence of dehydration. We then performed an ultrasound, which revealed a grossly distended uterus full of fluid, confirming a pyometra diagnosis.
Before we performed her spay, we pre-medicated her with two different kinds of antibiotics, two different types of pain medications (a narcotic and an NSAID), fluids, and a nutritional supplement. Standard pre-anesthetic medications, including a sedative and a narcotic pain medication, were also given. We administered sevoflurane, a unique anesthetic that’s so gentle that it’s actually commonly used on critically ill newborns in human neonatal intensive care units, by using a computerized anesthetic machine. The superior anesthetic qualities of sevoflurane combined with the accuracy of our computerized anesthetic machine allows for the safest administration of anesthesia during every single one of our surgeries. Furthermore, our surgical laser was a particularly instrumental surgical tool in ensuring the success of this case because of its exceptional ability of cauterizing nerve endings and blood vessels. As evidenced by the following photographs of the procedure, this particular type of spay is an exceptionally vascular type of surgery, with a significant increase of blood flow to the uterus as well as grossly distended uterine and ovarian blood vessels. The cauterization effects of our laser significantly helps with hemostasis, decreases hemorrhaging that may potentially occur during surgical procedures, prevents the formation of post-operative blood clots, minimizes post-operative pain and swelling, and ultimately drastically increases the overall safety of every surgery we perform.
The primary form of the prevention of pyometra is to spay females before they reach 2 years of age. Spaying not only prevents the formation of pyometra later in life, but it’s also used as an extremely effective way of decreasing the risk of developing breast cancer in female dogs and cats. Traditionally, our culture has emphasized the importance of spaying and neutering pets with the goal of preventing the overpopulation of feral animals. While this has been advantageous in promoting responsible breeding and pet ownership, the preventative medical benefits of spaying and neutering have gotten lost over the years. Consequently, we’ve found that many of our clients are unaware of the overwhelmingly significant health benefits that spaying and neutering cats and dogs offers animals later in their lives. While neutering male dogs and cats prevents the development of prostate cancer in older age, the primary medical preventative reasons to spay is to prevent the development of both breast cancer and uterine infections (aka pyometra) in older female animals.
We’re happy to say this surgery went exceptionally well, and we were able to successfully remove the infected uterus in its entirety. The uterine tissue was particularly friable and fragile, indicating toxicity and extensive tissue damage. Post-operatively, we administered fluids and additional pain medication to the patient. We’re happy to say the patient survived this high-risk procedure and was able to go back home with her parents the following day! We sent her home with some antibiotics, pain medications, as well as some nutritional supplements.
Again, this case reiterates why we promote the importance of spaying and neutering dogs and cats before they reach 2 years of age: to prevent the development of pyometra and breast cancer in females, and to also prevent prostate cancer in males. This precious little gal was quite a trooper and we couldn't be happier that she successfully pulled through and is back home with her parents!!
The infected uterus at the beginning of the operation.
You can see the extent of the tissue damage evidenced by the severely engorged blood vessels surrounding the infected uterus.