Contributors: Prof Gary England, Rob Lofstedt, Mushtaq Memon

 Species: Feline   |   Classification: Diseases

Introduction Pathogenesis Diagnosis Treatment Outcomes Further Reading


  • 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.

Presenting Signs

  • 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.

Cost Considerations

  • Expensive with fluid therapy and hysterectomy.

Special Risks

Uterus may be easily damaged - care with hysterectomy.



Predisposing Factors




  • 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).


Presenting Problems

  • Vulval discharge.
  • Agalactia.

Client History

  • Usually develops within 1 week of parturition or abortion.
  • Kittens restless and crying.
  • Recent history of mating or normal estrus.

Clinical Signs

  • Vaginal discharge: sanguinous to purulent.
  • Pyrexia.
  • Anorexia.
  • Depression.
  • Tenesmus.
  • Agalactia and neglect of kittens.

Diagnostic Investigation



Vaginal cytology

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


  • Gram-negative bacteria.


  • Uterine enlargement.
  • Retained fetus.


  • See uterine ultrasonography Ultrasonography: uterus.
  • Uterine enlargement   Abdomen: normal pregnancy - ultrasound 01    Abdomen: normal pregnancy - ultrasound 02
  • 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.

Differential Diagnosis

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


Initial Symptomatic Treatment

Standard Treatment


  • 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.

Subsequent Management


Allow approximately 30 days of sexual rest and monitor vaginal cytology  Cytology: vaginal cytology from a queen in estrus  Cytology: vaginal cytology from diestrus queen for normalcy before re-breeding.

Advise ovariohysterectomy if not breeding queen.



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

Expected Response to Treatment

Reasons for Treatment Failure

Further Reading


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.

Other Sources of Information