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Background: One of the most common diseases in intact bitches is pyometra– a potentially life-threatening disease associated with a variety of clinical and laboratory findings. The aims of the present study were to describe complications of the disease and to investigate clinically useful indicators associated with peritonitis and/or prolonged postoperative hospitalization.
Results: A retrospective study was performed using records from 356 bitches diagnosed with pyometra during the years 2006–2007 at the University Animal Hospital, Swedish University of Agricultural Sciences, Uppsala, Sweden. Of the 356 bitches, 315 were surgically treated by ovariohysterectomy, nine were medically treated and 32 were euthanized without treatment. In the surgically treated bitches, univariable associations between clinical and laboratory data, risk for prolonged hospitalization (≥ 3 days) and/or signs of peritonitis, were analysed by Chi-square and Fisher’s exact test. Logistic regression models were used to assess multivariable associations. The most common complication observed in surgically treated bitches was peritonitis (40 bitches), followed by urinary tract infection (19 bitches), wound infection (eight bitches), uveitis (six bitches), and cardiac arrhythmia (five bitches). Leukopenia and fever/hypothermia were associated with increased risk for peritonitis (18-fold and three-fold, respectively). Moderate to severe depression of the general condition, pale mucous membranes and leukopenia were associated with increased risk (seven-fold, three-fold, and over three-point-five-fold, respectively) for prolonged postoperative hospitalization.
Conclusions: Several clinically useful indicators were identified. Leukopenia was the most important marker, associated with 18-fold increased risk for peritonitis and an over three-point-five increased risk for prolonged hospitalization. Fever/hypothermia, depression and pale mucous membranes were associated with increased risk for peritonitis and/or prolonged hospitalization. The results of the present study may be valuable for identifying peritonitis and predicting increased morbidity in surgically treated bitches with pyometra.
Keywords: Bitch, Uterine inflammation, Surgical treatment, Hospitalization, Peritonitis, Risk, Outcome, Dogs
Normal = Within the reference range for healthy bitches and for laboratory variables at the Clinical chemistry laboratory, University Animal Hospital, Swedish University for Agricultural Sciences, Sweden.
Data listed includes the number of bitches/the total number of bitches with data recorded and proportion (%) with respective finding.
Case history, physical and laboratory examination data as recorded in 356 bitches with pyometra.
Overall, the most common signs of disease, present in > 50% of the bitches, included vaginal discharge, anorexia, depression, polydipsia, and polyuria, reflecting systemic involvement of the disease in the majority of bitches.
Multivariable logistic regression model of association between clinical signs, physical examination findings and laboratory data and the risk of prolonged postoperative hospitalization (≥ 3 days) in bitches with pyometra (n = 184)
a Normal = Within the reference range for healthy bitches and for laboratory variables at the main Clinical chemistry laboratory, University Animal Hospital, Swedish University for Agricultural Sciences, Sweden; WBC = White blood cell count (ref. range 5.8-16 ×109/L);
b The variable is not statistically significant (p > 0.05), but included as a confounder in the model.
A striking result of the study was that leukopenia was associated with a 3.5-fold increased risk of having prolonged hospitalization compared to normal WBC and also an 18-fold increased risk of peritonitis. These results make leukopenia the most important clinical biomarker identified.
* This paper originally appeared in the BMC Veterinary Research 2014, 10:6. (doi:10.1186/1746-6148-10-6) and was proposed by the Swedish Small Animal Veterinary Association
Supranee Jitpean obtained her DVM from Khon Kaen University in Thailand in 1999. After two years working as a clinician in a private companion animal hospital, she moved to Chang Mai where she became instructor in small animal surgery, ultrasonography and radiology at the Faculty of Veterinary Medicine. Since 2004, she is assistant professor in small animal soft tissue surgery at the department of surgery and theriogenology of the Faculty of Veterinary Medicine at Khon Kaen University. In 2011, she moved to the Department of Surgery and medicine, Small Animal Unit of the Swedish University of Agricultural Sciences in Uppsala where she obtained her PhD (on finding a useful marker for the diagnosis and predictive outcome of pyometra in dogs) in 2015. She has now returned to Khon Kaen University
Supranee Jitpean DVM PhD
Department of Clinical Sciences
Faculty of Veterinary Medicine and Animal Science
Swedish University of Agricultural Sciences
SE-750 07 Uppsala
Volume 26(2), Summer 2016
Outcome of pyometra in female dogs and predictors of peritonitis and prolonged postoperative hospitalization in surgically treated cases
by Supranee Jitpean, Bodil Ström-Holst, Ulf Emanuelson, Odd V Höglund, Ann Pettersson, Caroline Alneryd-Bull and Ragnvi Hagman
Moderate to severe depression and pale mucous membranes in dogs with pyometra were associated with increased risk of prolonged postoperative hospitalization.
Overall, the most common signs of disease, present in >50% of the bitches, included vaginal discharge, anorexia, depression, ...
... Read more
Fever or hypothermia, present in merely a third of the pyometra cases, was associated with a three-fold increased risk of peritonitis, indicating a prognostic value for this variable.
Background: One of the most common diseases in intact bitches is pyometra– a potentially life-threatening disease associated with a variety of clinical and laboratory findings. The aims of the present study were to describe complications of the disease and to investigate clinically useful indicators associated with peritonitis and/or prolonged postoperative hospitalization. ...
... Read more
A striking result of the study was that leukopenia was associated with a 3.5-fold increased risk of having prolonged hospitalization compared ...
... Read More