Closed Pyometra in Cat
Aetiology
Pathophysiology
Clinicopathological findings
When there is no pregnancy for several estrous cycle
Progesterone elevated high stimulate uterine lining to continue thicken until cyst form in uterus (cystic endometrial hyperplasia)
During estrus cycle, estrogen produce to stimulate cervix open and relaxed
Bacteria can enter into the uterus during cervix relaxed and open
When no pregnancy occur
Cystic or thickened lining condition can secretes fluid that create ideal environment for bacteria growth (pyometra)
Infection occur can cause endometritis
Endometritis lead PGF2α cannot be produce
Absence PGF2α hormone can cause no myometrial contraction
Pus remain in cervix
Close pyometra
Clinical signs
Inappetance
Abdominal pain and swelling
Lethargy and depression
Continuous licking at vaginal opening
Anorexia
Excessive drinking and urinating
Diagnostic workup
Radiography of abdomen
CBC and Serum Biochemistry
Treatment
Surgical theraphy
USG
Ultrasonography
Uterine wall thickened and uterine lumen dilated and anechoic fluid
Hyposthenuria
Small intestines pushed cranialy due to distended uterus
Large tubular structure in caudoventral abdomen
Abdominal palpation
Visible abdominal enlargement
Prevention
OHE at 6months of age
Progesterone receptor blockers or prostaglandins may prevent development pyometra in high risk patients
Post-partum reproductive system checking
Exogenous treatment with steroid hormone that increase respond to progesterone
Ultrasonography
Weight loss
Lutheal phase of estrous cycle
Progesterone-mediated uterine disorder
, Progesterone secreted
During diestrus, nongravid uterus flaccid and contain endometrial gland secretions that as growth medium for bacteria
Bacteria reach uterus via ascending infection or hematogenous spread
Decreases myometrial contractility
Stimulates endometrial gland development and activity
suppresses the leukocyte response to infectious stimuli in uterus
Bacteria (hematogenous spread)
Failure to exhibit out the bacteria from uterus after estrus
Result in pyometra. Septic inflammatory condition of uterus
Common bacteria: E.coli
Potential leakage purulent fluid through uterine rupture can cause septic peritonitis
Common bacteria
Aerobic bacteria
Anaerobic bacteria
E. coli
Klebsiella
Corynebacterium
Pseudomonas
Ureaplasma
Administer PGF2α
Risk factors
less progesterone dominance due
to seasonality and induced ovulation
Ovariohysterectomy
Luteolysis, contraction of the myometrium, relaxation of the cervix, and expulsion of the uterine exudate.
caution because of increased risk of uterine rupture
Age (over 7 years age)
Breed
Administration of longlasting progestational compounds to delay or suppress estrus
Radiography
Uterine enlargement. Tubular structure soft tissues/fluid opacity (arrows)
Both horn of uterus clearly seen multiple small nodules with mineral density
wall membrane of uterine thickness show full thickness
Multiple anaechoic endometrial cysts
Thin walled uterine horn (cystic structure are present in endometrium)
Urinalysis
Azotemia
When there is impairment of kidney function due to endotoxin effect froom bacteria lead to kidney cannot excrete nitrogen lead high level BUN in bod
Low urine specific gravity
E.coli infection
reflect nephrogenic diabetes inspidus secondary to exotoxin
Hyposthenuria: production dilute urine
due to endotoxin effect bacteria impairment to kidney renal tubular function
Serum bochem and CBC
Anemia (normocytic, normochromic, non regenerative)
Indicates iron deficiency or bone marrow exhaustion associated with uterine inflammation and toxaemia.
Hyperglobulinemia
Hypoalbuminemia
Neutrophilia
Increase granulopoiesis
Leukocytosis
stress and inflammation lead to high production and release of leukocyte
Histological findings
multifocal calcification in uterus mucous membrane
Infiltration mononuclear cells (macrophage and lymphocyte) at mucosal and submucosal layer
Atrophic endometrium
Thickened endometrium with translucent cysts
Gross lesions
Endometrial cysts and mucoid luminal content
Endometrial cystic structures fill uterine horn lumen