Acute metritis

• Usually develops within 1 week of parturition (also abortion or mating).
• Cause: uterine contamination with bacteria, no underlying endocrine change (unlike pyometra Pyometra).
• Signs: vaginal discharge: sanguinous to purulent. Pyrexia, anorexia, depression, tenesmus and agalactia.
• Treatment: broad-spectrum antibiotics, supportive, follow-up hysterectomy.
• Prognosis: guarded depending on condition of queen. Potentially fatal if uterus ruptures.

• Vulval discharge: odiferous, sanguinous to purulent.

• Usually within 1 week of parturition, abortion or mating.
• Pyrexia.
• Anorexia.
• Depression.
• Tenesmus.
• Uterine enlargement.
• Gastrointestinal signs.
• Agalactia and neglect of kittens.

• Peritonitis Peritonitis following uterine rupture.

• Expensive with fluid therapy and hysterectomy.

• Usually ascending bacterial infection: gram-negative organisms, eg Escherichia coli Escherichia coli, Staphylococcus spp Staphylococcus aureus, Streptococcus spp Streptococcus spp and Corynebacterium spp Corynebacterium.

General

• Poor uterine tone (dystocia Dystocia: fetal Dystocia: maternal, large litters).

Specific

• Contamination of uterus during manipulation for relief of dystocia Dystocia: fetal Dystocia: maternal.
• Retained placenta/kittens Retained fetal membranes / retained fetus.
• Fetal death.

• Escherichia coli Escherichia coli.
• Proteus spp.
• Staphylococcus spp Staphylococcus spp.
• Streptococcus spp Streptococcus spp.
• Other gram-negative and gram-positive vaginal commensals.
• Vaginal commensals   →   uterus   →   proliferate in lochia   →   endotoxin release   →   :
  • Interference with ADH (see pyometra complex)   →   dehydration, uremia Uremia.
  • Pathogen chemotaxis   →   neutrophilia   →   pooling of neutrophils in uterus   →   left-shift leukogram.

• Usually within 1 week of parturition (or other predisposing event).

• Vulval discharge.
• Agalactia.

• Usually develops within 1 week of parturition or abortion.
• Kittens restless and crying.

• Recent history of mating or normal estrus.

• Vaginal discharge: sanguinous to purulent.

• Pyrexia.
• Anorexia.
• Depression.
• Tenesmus.
• Agalactia and neglect of kittens.

• Peritonitis Peritonitis following uterine rupture.

Hematology

• Complete blood count   Hematology: complete blood count (CBC)  Elevated PCV   Hematology: packed cell volume  , neutrophilia   Hematology: neutrophil  and shift to left.

Biochemistry

• Blood chemistry Blood biochemistry: overview Elevated TP Blood biochemistry: total protein.

Vaginal cytology

• Cellular debris and mucus, clusters of endometrial cells, bacteria, hypersegmented and degenerate neutrophils.

Bacteriology

• Gram-negative bacteria.

Radiology

• Uterine enlargement.
• Retained fetus.

Ultrasonography

• See uterine ultrasonography Ultrasonography: uterus.
• Uterine enlargement       
• Uterine fluid (usually echogenic).
• Retained placenta or remnant.
• Retained fetus.

Definitive diagnostic features

• History and clinical signs.
• Ultrasonography.
• Radiography.
• Vaginal cytology results.
• Bacteriology, culture and sensitivity.

• Other systemic illness.
• Hypocalcemia (rare post-parturient condition in cats).

• Mastitis Mastitis.

• Urinary tract infection Cystitis: bacterial.

• May ultimately require ovariohysterectomy Ovariohysterectomy or hysterotomy to remove retained fetus.
  Uterus may be friable and liable to rupture (particularly if receiving oxytocin Oxytocin)   →   peritoneal contamination.Broad-spectrum antibiotic Therapeutics: antimicrobial drug and fluid therapy Glucose.

Antibiotics

• Broad-spectrum antimicrobial Therapeutics: antimicrobial drug.
  Culture and sensitivity seldom, if ever, useful due to mixed population.
• Continuous therapy for 7-10 days with broad spectrum antimicrobial therapy.

Management of post-partum queen

• Give kittens supplementary feeding until clinical response to therapy.

Fluid therapy

• 5% glucose Glucose with electrolyte replacement.

Ecbolic agents

• Prostaglandin 2.5 ug/kg may promote uterine drainage.
• Oxytocin Oxytocin 5 iu may promote fetal/placental expulsion and elimination of uterine fluid.

• Decreased fever
• Improved demeanor.

Treatment

Allow approximately 30 days of sexual rest and monitor vaginal cytology     for normalcy before re-breeding.

Advise ovariohysterectomy if not breeding queen.

• Guarded.
• Depends on condition of queen.
• Potentially fatal following uterine rupture.

Refereed papers

• Recent references from PubMed and VetMedResource.
• Dubey J P, Lindsay D S (1989) Transplacental Neospora caninum infection in cats. J Parasitol 75 (5), 765-771 PubMed.
• Henderson R T (1984) Prostaglandin therapeutics in the bitch and queen. Aust Vet J 61 (10), 317-319 PubMed.
• Burke T J (1982) Prostaglandin F2 alpha in the treatment of pyometra-metritis. Vet Clin North Am Small Anim Pract 12 (1), 107-109 PubMed.