Short Communication

Haryana Vet. (April, 2019) 58 (S.I.), 106-107

SURGICAL MANAGEMENT OF CYSTIC ENDOMETRIAL HYPERPLASIA-PYOMETRA

COMPLEX IN CANINES: STUDY OF TEN CASES
1* 2 2 1 1
SANDEEP SAHARAN , RIBU VARGHESE MATHEW , SANDEEP KUMAR , NEELESH SINDHU and V. K. JAIN
1
Department of Veterinary Clinical Complex, College of Veterinary Sciences.
2
Department of Veterinary Surgery and Radiology, College of Veterinary Sciences
Lala Lajpat Rai University of Veterinary and Animal Sciences, Hisar-125004 (Haryana), India
Received : 02.03.2019; Accepted : 25.03.2019
SUMMARY
Cystic endometrial hyperplasia Pyometra complex is a diestrus disorder of intact female dogs which occur due to continuous exposure of
progesterone. Ten intact she dogs with variable age and parturition status brought to Veterinary Clinical Complex were diagnosed with cystic
endometrial hyperplasia-pyometra complex based on history, clinical examination, haemato-biochemical findings and ultrasonographic imaging.
Ovariohysterectomy is the treatment of choice and all the ten she dogs underwent the same under general anaesthesia. Postoperatively antibiotics
and analgesics were administered parenterally and the animals showed an uneventful recovery. Early diagnosis and surgical management is essential
to save the life of the animal.

Key words: Pyometra, Progesterone, She dogs, Uterus

The cystic endometrial hyperplasia-pyometra to surgery, prepared for aseptic surgery and premedicated
complex earlier called the endometritis-pyometra complex with Inj. Atropine sulphate @ 0.04mg per kg b.wt
which is one of the most serious and most common uterine subcutaneous. Inj. Xylazine hydrochloride @ 1mg per kg
diseases in female dogs (Kida et al., 2006). Pyometra b.wt was used for sedation and the anaesthesia was induced
commonly known as cystic endometrial hyperplasia- with Inj. Ketamine hydrochloride @ 5-10mg per kg b.wt
pyometra complex is a common uterine disorder of intact and maintained with Inj. xylazine-ketamine combination
female dogs seen during the diestrus period under intravenous for the rest of the procedure. A ventral midline
progesterone hormone in#uence coupled with bacterial skin incision was made, the linea alba and peritoneum was
infection. The action of progesterone on canine uterus incised to enter into the abdominal cavity. The distended
consist of decreasing the local immune reactivity, uterus was identi!ed (Fig.3.), exteriorized outside the
promotion of secretion in the endometrial glands, a abdominal cavity (Fig.4) and ovariohysterectomy was
decrease in its motility and closing of the uterine cervix performed as per standard surgical procedure (Fig.5). The
(Kempisty et al., 2013). It is of two types: open and closed laparotomy wound was closed in three layer suture
cervix pyometra out of which the latter one is life technique.
threatening and requires early diagnosis and surgical Postoperatively antibiotic Inj. Ceftriaxone @
treatment to prevent death by septicaemia and toxaemia 20mg per kg b.wt and analgesic Inj. Meloxicam @ 0.3mg
(Kumar et al., 2016). per kg b.wt was administered parenterally for !ve days
Ten intact she dogs of variable age and parturition along with per oral administration of multivitamin syrup..
status were brought to Veterinary Clinical Complex with Animals were maintained on intravenous #uids for the
the complaint of anorexia, polydipsia, polyuria, recurrent next three days. Daily wound dressing and application of
vomiting and lethargy since many days. All the animals #y repellent spray was also advised to the owner. Skin
had the history of recent oestrus and clinical examination sutures were removed 10th day postoperative. All the she
revealed a slightly distended abdomen Radiographic dogs recovered uneventfully without any complications.
examination revealed distended #uid dense tubular uterine Pyometra is de!ned as acute or chronic
horns (Fig.1) in the ventral and caudal abdomen which was polysystemic, di-oestroul disorder of the adult female dog,
further con!rmed by ultrasonography that disclosed a characterised by hyperplasia of the endometrium and
distended uterus with multiple cystic structures having in!ltration of the in#ammatory cells and it may occur in all
anechoic to hypoechoic contents suggestive of cystic the layers of the uterus (Kempisty et al., 2013). In the
endometrial hyperplasia-pyometra complex (Fig.2). present case, the uterine walls were thick and hyperplastic
Haemato-biochemical examination revealed an elevated and was !lled with purulent material. Increased levels of
total leucocyte count with increased neutrophils, elevated progesterone after ovulation will cause growth of the
blood urea nitrogen and serum creatinine levels but within endometrium and secretions into the lumen which is a
the normal clinical limit (Table.1). Thus based on clinical, good media for the bacterial growth (Kumar et al., 2016).
radiographic, ultrasonographic and laboratory All the ten she dogs were had history of oestrus after which
examinations, all the she dogs were diagnosed with cystic the clinical signs appeared suggesting diestroul disorder
endometrial hyperplasia-pyometra complex (closed cervix under the in#uence of progesterone. Decreased local
pyometra) and immediate surgical intervention was immune reactivity and promotion of secretions in
undertaken. endometrial glands and ascending E.coli infections from
All the she dogs were fasted for twelve hours prior the vagina will increase the in#ammation of the organ and
*
result in the present condition (Johnston et al., 1985). The
Corresponding author : [email protected]
 1 2(a) 2(b) 2(c)

3 4(a) 4(b) 4(c)

4(d) 5(a) 5(b) 5(c)

Fig.1. Lateral abdominal radiography showing distended #uid dense tubular uterine horns; Fig.2 (a,b,c): Ultrasonographic images showing multiple
cystic uterus with anechoic to hypoechoic contents (arrow); Fig. 3 : The highly distended uterus observed after ventral midline incision (arrow);
Fig.4(a,b,c,d): The pus !lled uterus after exteriorization from the abdominal cavity; Fig.5 (a,b,c) : After ovariohysterectomy as a surgical treatment
of pyometra in canine
Table 1:
Signalment and Haemato-biochemical values of the ten she dogs diagnosed with cystic endometrial hyperplasia pyometra complex
S.I Breed Age Hb TLC Neutrophils Lymphocytes BUN S.CRT
NO: (gm% ) (x106/µl) (%) (%) (mg/dl) (mg/dl)
1 Labrador 3yr 9.3 15.8 82 15 22.8 0.78
2 Non-Descript 4yr 10.11 22.4 78 17 26.3 1.3
3 Rottweiler 3yr 9.45 20.35 80 14 28.83 1.1
4 Labrador 5yr 11 21.85 86 12 35.23 1.4
5 Non-descript 5yr 11.33 17.65 72 21 42.21 0.87
6 Labrador 2yr 12.11 19.23 78 16 33.25 1.65
7 Labrador 3yr 10.3 14.66 74 22 37.89 1.32
8 Non-descript 5yr 9.5 18.22 84 12 33.21 1.72
9 Rottweiler 5yr 12.3 21.22 77 15 36.28 1.66
10 Rottweiler 4yr 10.35 22.33 81 15 45.56 1.78

incidence of pyometra is reported to be high in nulliparous 1635-1638.

animals (Niskanen and Thrus!eld, 1998). Similar higher Kempisty, B., Bukowska, D., Wozna, M., Piotrowska, H., Jackowska,
incidence in nulliparous she dogs were also observed in M., Zuraw, A., Ciesiolka, S., Antosik, P., Maryniak, H., Ociepa,
the present study. Ultrasonography along with E., Porowski, Sz., Brussow, K.P., Jaskowski, J.M. and Nowicki,
radiography is helpful in the diagnosis of canine M. (2013). Endometritis and pyometra in bitches: a review.
pyometra.
Veterinarni Medicina. 58(6): 289-297.
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