Pyometra advice please

[Loralee]

Hello,

I haven't been on in a while, my girl Molly is 6 six now and is not spayed and has never had a pregnancy, but has been a very health girl. This site has helped me quite a bit with her and for that I thank you all. I wanted to get some advice and opinions from I place I trusted. We took our girl in today and they told us she has Open Pyometra,

So she just finished this last heat cycle about 2 weeks ago and it was a lighter cycle usual, and I didn't think to much about it. But I noticed the last week that she was drinking more water then normal, not a huge amount but more then normal. Yesterday evening, I noticed a small drop of a yellowish/whitish discharge from her girly bits, it didn't have a smell that I could tell. I remembered the post by Nettle a few years ago, explaining about the heat cycle and she mentioned Pyometra, so I called the vet and took her in this afternoon.

They did a urine simple and the PH was 7.5, her temp was 101.7 F, which they said was normal for dogs. The vet said he thought it was most likely Open Pyometra and probably a UTI as well, and suggested a 30 day course of antibiotics, and keeping an eye on her to make sure she continued to drain, and to get her spayed in December, as that is the best time in her cycle to spay, which we were planning on doing regardless.

Now at first we were happy that she didn't need emergency surgery, but as I thought about it and read online, I don't see any mention of antibiotics being an option for Pyometra. I was hoping to get some thoughts on this, and if this is something that is an acceptible treatment option for open Pyometra. This was a different vet in the practice then we've seen before, so I think I'll call tomorrow and talk with our regular vet as well. I just don't want to take a chance with her life.

Thank you in advance for any advice.

Loralee

[Erica]

I agree with your getting a second opinion! Emergency spaying has been the only treatment I've heard of. This isn't to say that antibiotics isn't an option, as I'm not a vet and don't have that sort of training and knowledge, but it seems an uncommon choice and asking a vet I knew and trusted would definitely be my next step. It could be that you caught it very early so it's not as serious as the cases requiring emergency spays, but again, not a vet, just making guesses here!

[Loralee]

Thanks Erica,

I'm definitely going to get a second opinion. Maybe it's me, and because I don't know the vet we saw, but I don't think he really did anything to check her over. He didn't feel abdomen or her girly bits, heart rate or anything. She's never had to go to the vet for a sick visit, just her regular check up, so maybe that is normal? All he did was check her urine sample, and asked what we feed her, which is currently FROMM, so he didn't think the PH level was from that. And then we told him I saw a small discharge the day before, that was milky/yellow color, he said it was Pyometra, but it was good because it was open, and we wanted it to drain, and put her on antibiotics for 30 days, he put her on 500mg of Cephalexin 2x a day.

Maybe we did catch it early and the antibiotics is a normal thing to do, but we'll see what our normal vet says. Molly has been acting normal, her appetite and energy has been fine, just the small water increase and that small discharge, she has been licking herself, but I haven't noticed more discharge. Part of me is hoping he was wrong and she just has UTI, but then I worry that if she does, and I don't want her to get into a dangerous situation.

Thanks,

[Suzette]

Pyometra is life-threatening. You are such a great owner that you noticed the symptoms so early. Most do not. I would get her into a new vet appointment today and get that second opinion as quickly as possible. Wishing your sweet pup well and hoping she is soon on the mend. Let us know how it goes.

[Nettle]

Yes: well done you, and I think a second opinion would be useful. Pyo is very serious; my vet will sometimes treat it with antibiotics, but most go for the spay simply because it is easier and 100% successful. Sometimes it returns after ABs so you can see the reasons for going for a full spay.

The final decision is yours. Respect to you for getting as much information as possible. If she does have to be spayed, ask the vet to leave one ovary, then you have less likelihood of her developing incontinence from reduction in female hormone. She may still show a season-type cycle, but she won't get pyo once the uterus is out, as long as every bit of it is taken (research stump pyometra, which is rare but can happen with a careless spay).

Good luck and keep us posted.

[Loralee]

Hi,

I wanted to give an update. Molly is doing well so far. I'm a nervous wreck, but we saw our vet, and I talked to her a few times over the last couple days. She agreed and said she has a mild Pyo, it could be a UTI as well, her urine did have bacteria and the gravity was low and with my description of her symptoms and what they saw, they think it's mild Pyometra.

The most important thing is that she has been responding to the antibiotics. She's not 100%, but she's more herself, she's eating well has been drinking her normal amount of water, bathroom has been normal too. I've been concerned that I haven't seen any more discharge since the little bit I saw on Tuesday, but she told me that she thinks the antibiotics are working, and that she would have showed serious signs by now. I still need to keep an eye on her for any change in behavior, eating and drinking habits. So I'm watching her like a hawk. As long as she is doing well they want to get her as close to the 3 month mark( DEC) of in-between her cycles to spay her, because her hormones are more leveled out and blood vessels are at their smallest, that sounded reasonable. As long as I continue to see her improving I think I'm ok, the slightest inkling of her not doing well I will be taking her in.

Nettle, I did ask about when we do get her spayed, if they can leave an ovary, she said they only did full spays there, and that the full was the most commonly used method in the country, with some other things about risks of leaving it in, hormones and cancer, which I expected. I think that is the normal thinking for most vets around here. I'm going to call around thought to see if I can find a vet that does do that type of spay, but if it comes down to her needing it done quickly, I'm not going to worry about it. I didn't ask about the risk of the stump pyo, but I absolutely will when I talk to her again.

Thank you all again for your advice and support...going to try and relax this evening and not drive my husband crazy with my worrying.

[rnor1120]

If your dog has a pyometra, she needs a full spay. Leaving an ovary in a dog with a pyo will almost certainly ensure a stump pyo. Pyometras, in part, develope because of hormones (among other factors), and leaving the hormone source in is setting her up for problems. If she's six and has been through several cycles, the risk of incontinence is low.

This is just me, but if I have a patient with a pyometra (even an open one), I'm getting her to surgery ASAP regardless of where she is in her cycle. The bacteria most commonly found in pyos release an endotoxin that targets the kidneys, which may explain her low USG and increased water intake. I don't want to step on your vet's toes, obviously they have examined your dog thoroughly and have a good handle on her risk vs benefit of waiting, I'm speaking from my own personal experience. Ultimately your vet will have the best handle on your dog's health.

Has your vet done any type of imaging, like X-rays or ultrasound, to confirm or refute a pyometra?

[Suzette]

I'm with you on this one Rnor. I have been down the Pyo road many times (once as a pet owner, many times as a vet tech) and this is one diagnosis that I feel needs an immediate response, and that is a full spay.