Findings and prognostic indicators of outcomes for bitches with pyometra treated surgically in a nonspecialized setting.

OBJECTIVE: To determine the rate of survival to hospital discharge and identify indicators associated with poor outcomes among female dogs (bitches) with pyometra treated with ovariohysterectomy (OHE) in a nonspecialized setting. ANIMALS: 405 bitches diagnosed with pyometra at the American Society for the Prevention of Cruelty to Animals Animal Hospital from January 1, 2017, to February 8, 2019. PROCEDURES: For this retrospective study, medical records were searched and data collected including patient history, clinical signs, serum biochemical analyses results, and outcome (survival to hospital discharge, length of hospital stay, and uterine rupture). Logistic regression models were used to assess multivariable associations and identify potential predictive variables. RESULTS: The rate of survival to hospital discharge for bitches with pyometra treated with OHE was 97% (394/405); 44% (174/394) stayed in the hospital ≥ 2 nights, and 3% (11/390) had a ruptured uterus. Bitches with a high BUN concentration or heart murmur had greater odds of death after OHE; however, the model had low predictive power. Those with uterine rupture, inappetence, high concentrations of BUN or serum creatinine, low PCV, or dehydration had greater odds of hospitalization ≥ 2 nights. There were no significant predictors of uterine rupture. CLINICAL RELEVANCE: The rate of survival to hospital discharge was high for bitches with pyometra treated with OHE in a nonspecialized setting; therefore, general practitioners could expect similar outcomes. With this important procedure widely available in general practices, more pets can receive treatment for this life-threatening disease.

Findings and prognostic indicators of outcomes for queens with pyometra treated surgically in a nonspecialized hospital setting.

OBJECTIVE: To describe findings, determine the rate of survival to hospital discharge, and identify prognostic indicators of poor outcomes for female cats (queens) with pyometra treated with ovariohysterectomy (OHE) in a nonspecialized setting. ANIMALS: 134 queens with pyometra diagnosed between January 1, 2017, and December 31, 2019. PROCEDURES: The medical records were retrospectively searched and data including patient history, clinical signs, blood work results, and outcome (survival to hospital discharge, length of hospitalization, and uterine rupture) were collected from medical records. Logistic regression models were used to assess potential predictors of outcomes. RESULTS: Dehydration (69% [83/121]) and absolute neutrophilia (83% [52/63]) were commonly reported. The rate of survival to hospital discharge was 100% (126/126; 95% CI, 97% to 100%) for queens treated with OHE; 33% (41/126) were hospitalized ≥ 2 nights, and 4% (5/120) had uterine rupture. Queens with abnormal serum ionized calcium concentration or signs of depressed mentation had greater odds (OR of 4.64 and 2.26, respectively) of ≥ 2 nights' hospitalization. Queens with high rectal temperature, closed pyometra, or heart murmur had greater odds (OR of 35.66, 17.37, or 16.06, respectively) of uterine rupture. CLINICAL RELEVANCE: Our findings indicated that OHE for pyometra in queens was highly successful even when performed in a nonspecialty hospital with high-quality basic supportive care, and we believe most general practitioners who offer OHE could expect to see similar outcomes. With more general-practice veterinarians comfortable treating pyometra in their clinics, OHE for pyometra will be available to more pets, ultimately saving more lives.

Uterine perforation secondary to metritis and placenta percreta in a postpartum bitch.

A 3-year-old intact female Labradoodle bitch was referred due to fever and lethargy 4 days postpartum. The dog was reported to have had prolonged labor that required assistance and fetal membranes were retained. Physical examination and diagnostics led to a suspicion of metritis and uterine perforation. Ovariohysterectomy was performed. Gross and histopathology findings revealed multifocal uterine perforation, necrosuppurative metritis, and placenta percreta. Post-operative antibiotic therapy and supportive care resulted in an uneventful clinical recovery. This is the first reported case of placenta percreta in a bitch. It is presumed that this pathology was paramount in the patient's development of metritis and subsequent uterine rupture. Key clinical message: Placenta percreta may lead to more severe clinical consequences of metritis, including uterine rupture.

Perforation utérine secondaire à une métrite et un placenta percreta chez une chienne en période post-partum. Une femelle Labradoodle intacte âgée de 3 ans fut référée pour cause de fièvre et léthargie 4 jours post-partum. Il fut rapporté que la chienne avait eu un travail long qui demanda de l'assistance et qu'il y avait eu rétention des membranes foetales. L'examen physique et le diagnostic mena à un doute de métrite et de perforation utérine. Une ovario-hystérectomie fut réalisée. Les trouvailles de pathologie macroscopique et d'histopathologie révélèrent des perforations utérines multifocales, une métrite nécro-suppurative et un placenta percreta. Une antibiothérapie post-opératoire et des soins de support ont résulté en une guérison clinique sans conséquence. Ceci représente le premier cas rapporté de placenta percreta chez une chienne. Il est présumé que chez cette chienne cette pathologie était vitale dans le développement de la métrite et de la rupture utérine subséquente.Message clinique clé :Un placenta percreta peut mener à des conséquences cliniques plus sévères de métrite, incluant la rupture utérine.(Traduit par Dr Serge Messier).

UTERINE RUPTURE AND CESAREAN SURGERY IN THREE RIO CAUCA CAECILIANS (TYPHLONECTES NATANS).

A uterine rupture of unknown etiology during gestation causing the death in a Rio Cauca caecilian ( Typhlonectes natans ) and successful anesthesia using tricaine methanesulfonate and cesarean section in three occasions in two other specimens because of suspected dystocia are described. One of the surgeries was performed at an early stage of embryo development, thereby preventing the survival of the neonates.

A case of feline ectopic abdominal fetuses secondary to trauma.

A multiparous adult cat with a history of prior trauma but no presenting clinical signs was admitted for routine ovariohysterectomy. Uterine abnormalities indicative of trauma were found in addition to 2 ectopic fetuses wrapped in omentum. The ovariohysterectomy was completed and the ectopic fetuses were removed. Recovery was uneventful.

Cas de fœtus abdominaux ectopiques félins secondaires à un traumatisme. Une chatte adulte multipare ayant une anamnèse de traumatismes antérieurs mais ne présentant aucun signe clinique a été admise pour une ovario-hystérectomie de routine. Des anomalies utérines indiquant un traumatisme ont été trouvées en plus de deux fœtus ectopiques enveloppés dans l'omentum. L'ovario-hystérectomie a été réalisée et les fœtus ectopiques ont été enlevés. Le rétablissement s'est effectué normalement.(Traduit par Isabelle Vallières).

Traumatic uterine rupture in three felids.

OBJECTIVE: To describe 3 near-full-term, young-adult felids (2 domestic shorthair cats, and 1 bobcat [Lynx rufus]) that experienced uterine rupture following trauma. SERIES SUMMARY: Two of the animals had motor vehicular trauma and 1 had abdominal bite wounds. The 2 domestic cats that were treated with surgical exploration and ovariohysterectomy recovered uneventfully. The bobcat died during hospitalization prior to surgical intervention, and necropsy identified uterine rupture and associated peritonitis. UNIQUE INFORMATION PROVIDED: Traumatic uterine rupture should be considered in known or suspected pregnant animals that experience blunt or penetrating trauma, particularly if they are in late-term pregnancy.

Uterine Rupture in a Common Marmoset (Callithrix jacchus).

A 5-y-old multiparous female common marmoset (Callithrix jacchus) presented with acute weight loss of approximately 25% over a 1-wk period. An abdominal mass was apparent on physical examination, and radiographs suggested peritoneal effusion. Exploratory laparotomy revealed hemoperitoneum and an enlarged, gray, hemorrhaging uterus; ovariohysterectomy was performed, and the marmoset recovered. Histologic evaluation of the ovaries and uterus revealed uterine rupture, with invasion of placental villi lined by trophoblasts through the myometrium to the serosal layer. Primary uterine rupture is a rare but serious obstetric event in humans and has been reported only rarely in NHP. This report is the first description of primary uterine rupture during early pregnancy in a common marmoset.

ABDOMINAL PREGNANCY IN A SERVAL (LEPTAILURUS SERVAL) SECONDARY TO UTERINE RUPTURE.

A 14-yr-old female serval (Leptailurus serval) died unexpectedly after 2 wk of inappetence and lethargy. Necropsy revealed a pyoabdomen with a full-term, well-developed fetus in the caudal abdomen covered by a mesenteric sac. The mesenteric sac communicated with a tear in the wall of the right uterine horn, supporting a diagnosis of secondary abdominal pregnancy. The uterine wall had evidence of adenomyosis at the rupture site with no evidence of pyometra. The fetus, supporting mesentery, and peritoneum were coated with mixed bacteria, which may have ascended through an open cervix to the site of uterine rupture. This is the first case of abdominal pregnancy related to uterine rupture reported in a large felid species.

Estabilização da microcirculação após procedimento cirurgico em animal com peritonite / Stabilization microcirculation after surgical procediment in animal with peritonitis

A peritonite séptica é quando ocorre inflamação da cavidade peritoneal associado a um micro-organismo (D, AVILA, 2012). A detecção e correção da hipóxia tecidual são fundamentais para pacientes doentes, sendo o lactato de grande importância para a avaliação da microcirculação nesses pacientes (RENIKER et al., 2006). O objetivo desse trabalho é descrever um caso de um animal com peritonite séptica secundária a ruptura uterina por piometra e correção do valor microcirculatório após realização do procedimento cirúrgico.

Ruptura de cornos uterinos decorrente de piometra – relato de caso / Uterine corpus rupture decorrente of pyometra – case report

A piometra canina pode ser conhecida também como hiperplasia endometrial cística, sendo mais comum em cães na fase adulta da vida, caracterizado com a inflamação do útero e acúmulo de pus (VOLPATO et al., 2012). Geralmente, está relacionada às alterações hormonais e é comumente observada em cães idosos ou de meia-idade (SHIA et al., 2011). O acúmulo de substância purulenta dentro do lúmen do útero de cadelas ocorre comumente durante ou posterior a uma temporada de predominância da progesterona, que age estimulando a secreção das glândulas do endométrio, eliminando as contrações do útero, criando assim um ambiente intra-uterino benéfico para o crescimento bacteriano (PATIL et al., 2013).

Uterine prolapse with associated rupture in a Podengo bitch.

A case of uterine prolapse coexisting with uterine horn rupture in a 3-year-old Portuguese Podengo bitch, which is an uncommon occurrence, is described. The female was presented with a history of recent parturition, with delivery of four healthy puppies that were normally tended and nursed. The situation developed after an uneventfully pregnancy, and no direct causative factor was identified. The duration of the prolapse was unknown, but considered to be recent because of the swollen reddish appearance of the tubular everted mass. No foetus was found in the uterus or the abdominal cavity. The female was presented in good physical condition, without signs of shock or haemorrhage. During surgical treatment, the uterus was replaced to its normal position followed by ovary-hysterectomy at 12 h from admittance.

Uterine rupture and septic peritonitis following dystocia and assisted delivery in a Great Dane bitch.

A Great Dane bitch was treated for presumed primary uterine inertia with repeated doses of oxytocin and manually assisted whelping. She was diagnosed with uterine rupture and septic peritonitis the following day. The uterine rupture is hypothesized to have occurred as a result of the management strategy used to treat dystocia. The dog underwent ovariohysterectomy, and the septic peritonitis was managed with open peritoneal drainage. The dog recovered well and was discharged 5 days later. No previous reports of canine uterine rupture associated with manual intervention appear to have been published. This report highlights the potential dangers involved in such an approach.

Comparison of surgical and medical treatment of 49 postpartum mares with presumptive or confirmed uterine tears.

OBJECTIVE: To determine outcome after medical or surgical treatment of postpartum mares with confirmed or presumptive uterine tears. STUDY DESIGN: Case series. METHODS: Postpartum mares were included if foaling had occurred within 7 days and uterine tear was confirmed surgically or, in medically treated mares, by palpation or presumed based on peritonitis. Information (age, breed; physical examination, laboratory and abdominocentesis findings; treatment, survival rates, length of hospital stay, treatments costs, and breeding performance after discharge) was obtained from the medical records (1990-2007). The influence of variables was compared between medical and surgical treatment, and between survivors and nonsurvivors. RESULTS: For 49 mares, survival was 75%, with no significant difference between medical (11/15; 73%) or surgical (26/34; 76%) treatment. Admission variables, treatment cost, duration of hospital stay, and likelihood of foaling after discharge were not significantly different between treatment groups. Nonsurvivors were significantly more likely to have gastric reflux, higher heart rate, anion gap, lower total CO(2), and leukocyte count, compared with survivors. Tears were significantly (P=.018) more likely to occur in the right uterine horn than in other parts of the uterus. CONCLUSIONS: Uterine tears occur more commonly in the uterine horns, more so the right horn, and survival is similar with surgical or medical treatment of uterine tears in postpartum mares. CLINICAL RELEVANCE: Medical treatment may be a reasonable alternative to surgical treatment for uterine tears, although the severity of tear that can resolve with medical treatment is unknown, and medical therapy can be as expensive as surgical treatment.

Intrapartum uterine rupture with coincidental uterine adenomyosis in an African wild dog (Lycaon pictus).

A 7-yr-old African wild dog (Lycaon pictus) multiparous bitch experienced severe dystocia and death one day after the onset of parturition. Necropsy revealed three placental attachments in the right uterine horn and one in the left. A full-thickness rupture of the right horn at the middle placental attachment and an autolysed fetus free in the abdomen were present. Death was attributed to hypovolemic and endotoxemic shock after uterine rupture. Myometrium adjacent to the rupture and in the left uterine horn was subdivided into irregular pseudolobules by fibrous connective tissue tracts containing small endometrial glandular acini suggestive of adenomyosis, which may have facilitated uterine rupture. This is the first reported case of dystocia-induced uterine rupture and of adenomyosis in a wild dog.

Abdominal pregnancies in farm rabbits.

Abdominal pregnancy is defined as the implantation and development of a fertilized ovum or a embryo in the peritoneal cavity. Although this has been reported in several species, it is considered as a low incidence process. It is classified as a primary abdominal pregnancy, if there is no evidence of uterine rupture, with presumed regurgitation of early embryos from the uterine tube and as a secondary abdominal pregnancy, when there is evidence of uterine rupture. During a necropsy study of 550 adult fertile female New Zealand white rabbits (Oryctolagus cuniculus) from two rabbit farms in Valencia (Spain), the main causes of elimination were studied. Twenty-eight abdominal pregnancies were diagnosed. Seven animals showed no lesions in their reproductive tract. The remaining twenty one animals showed acute or chronic lesions in the reproductive tract. The classification as a primary or secondary condition is discussed. It may be concluded therefore that extrauterine pregnancies would not be such an unusual finding in rabbits, and that this premise should be considered in the diagnostic approach when assessing rabbit doe pathology. New husbandry systems in rabbits such as artificial insemination are factors to be considered.

Peritonitis associated with passage of the placenta into the abdominal cavity in a llama.

Following parturition, a female llama was admitted to our hospital with a tear in the dorsal area of the vagina and peritonitis. The llama was clinically normal for 7 days after which its condition started to deteriorate, and the llama died 11 days after admission. On necropsy examination, the intact placenta was found in the abdominal cavity. Therefore, we suggest that in llamas with vaginal tears after parturition, it may be useful to immediately secure the fetal membranes with umbilical tape to the outside of the llama to ensure that the placenta will pass through the vulva. Additionally, in llamas with uterine or vaginal tears in which a retained placenta is suspected but cannot be identified in the uterus, exploratory laparotomy should be performed immediately, even if the llama appears clinically normal.