Contributors: Mushtaq Memon
Species: Canine | Classification: Diseases
- Cause: usually develops within 1 week of whelping (also abortion, mating, artificial insemination (AI) or normal estrus).
- Signs: vaginal discharge: sanguinous to purulent.
- Diagnosis: signs, imaging.
- Treatment: broad-spectrum antibiotics, supportive, follow-up hysterectomy.
- Prognosis: guarded depending on condition of bitch, potentially fatal if uterus ruptures.
- Vulval discharge: odiferous, sanguinous to purulent.
- Usually within 1 week of whelping (abortion, mating, artificial insemination (AI) or normal estrus).
- Gastrointestinal signs.
- Agalactia and neglect of pups.
- Peritonitis following uterine rupture.
- Expensive with fluid therapy, and hysterectomy.
Uterus may be easily damaged - care with hysterectomy.
- Usually ascending bacterial infection: gram-negative, eg E. coli, Staphylococcus spp, Streptococcus spp and Corynebacterium spp.
- Non-sterile manipulation of dystocia.
- Retained placentae Retention of fetal membranes and fetus /puppies.
- Fetal death.
- Uterine infection caused by:
- Bacteria normally found in → uterus → proliferate in lochia → endotoxin release → :
- Interference with ADH (see pyometra complex Pyometra ) → dehydration, uremia.
- Pathogen chemotaxis → neutrophilia → pooling of neutrophils in uterus → left shift leukogram.
- Usually within 1 week of whelping (or other predisposing event).
- Vulval discharge.
- Usually develops within 1 week of whelping or abortion.
- Puppies restless and crying.
- Agalactia and neglect of pups.
- Recent history of mating, AI or normal estrus.
- Vaginal discharge: sanguinous to purulent.
- Abdominal pain/shock if peritonitis.
- Elevated PCV Hematology: packed cell volume.
- Neutrophilia Hematology: leukocyte (WBC) and shift to left.
- Elevated total protein Blood biochemistry: total protein.
- Vaginal smears show cellular debris and mucus, clusters of endometrial cells, bacteria, hypersegmented and degenerate neutrophils.
- Gram-negative bacteria.
- Abdominal radiography Radiography: abdomen indicated:
- Uterine enlargement.
- Retained fetus.
- Uterine distension - may be flocculent material visible in uterus.
- Other systemic illness.
- Hypocalcemia Primary maternal dystocia.
- Mastitis Mastitis.
- Urinary tract infection Cystitis.
Initial Symptomatic Treatment
- May ultimately require ovariohysterectomy Ovariohysterectomy.
Uterus may be friable and liable to rupture (particularly if receiving oxytocin) → peritoneal contamination.
Restoration of uterine tone
- Calcium plus oxytocin Oxytocin : 0.5 iu/kg repeated in 1 hour or more often (maximum dose 40 iu); if no response then:
- Calcium Calcium borogluconate plus ergonovine : 0.2 mg/15 kg for 3 days.
- Broad-spectrum antimicrobial Therapeutics: antimicrobial drug.
Culture and sensitivity seldom if ever useful due to mixed population.
- Irrigation of uterus twice daily with oestrogen/antibacterial combination.
- Continuous therapy for 7-10 days with 2 antibiotics according to sensitivity.
Management of post-partum bitch
- Give puppies supplementary feeding until clinical response to therapy.
- 5% glucose Glucose with electrolyte replacement.
- Decreased fever.
- Improved demeanor.
TreatmentAllowing one normal estrus before mating if breeding bitch probably not required due to the spacing of ovulatory periods in this species.
- Advise ovariohysterectomy if not breeding bitch.
- Depends on condition of bitch.
- Potentially fatal following uterine rupture.
Expected Response to Treatment
Reasons for Treatment Failure
- Recent references from PubMed and VetMedResource.
- Watts J R & Wright P J (1995) Investigating uterine disease in the bitch: uterine cannulation for cytology, microbiology and hysteroscopy. JSAP 36 (5), 201-206 PubMed.
Other sources of information
- Magne M L (1986) Acute metritis in the bitch. In: Current Therapy in Theriogenology. 2nd edn. Morrow D A (ed). London: W B Saunders (a good review).