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Saturday, November 17, 2007

Pyometra in a cat

Cats and dogs that are not spayed are susceptible to a uterine infection called pyometra. It is commonly diagnosed in most veterinary practices. After a cat's or dog's oestrus (heat) cycle, the uterine lining becomes less able to fight off colonization by bacteria, and can rapidly lead to a severe infection. Pyometra literally means 'uterus of pus.' Gross. And dangerous: These pets often are brought to hospital for generalized lethargy, malaise, fever, lack of appetite, and excessive thirst.
In severe cases, these dogs and cats are often septic (bacteria in the blood) and in shock. These cases must be handled as a medical emergency. Treatment involves correcting the animal's dehydration (sometimes aggressively), antibiotics, and surgically removing the infected uterus and ovaries (i.e., spaying the pet). This disease can also be medically treated (more often in Europe) with antibiotics and a class of drugs called prostaglandins, but it is my opinion that pyometra should be treated surgically, and not medically.

I am posting photos of a case that I saw recently, of a cat that had the most severe pyometra I (and my colleagues) have ever seen. With the owner's permission, I am sharing this case: This was a darling older unspayed cat, about twelve years old, that presented to me with a decreased appetite and a massively distended belly. I took two radiographs (x-rays) of her belly, and this is what I found:

X-ray on her side

X-ray on her back

Without advanced knowledge of radiology, one can appreciate the distended abdomen. For those wtih some understanding, there is a large (massive actually) tubular soft-tissue opacity taking up much of the abdominal cavity that is consistent with pyometra. Keep this in mind when having a look at the following photos. These were taken while in surgery. What you see is the cat's uterus (and ovaries) that has almost completely been removed. It is huge.

This is the uterus after surgery. Take special note of the normal cat uterus to the right, which was removed that same morning during a routine spay. Astounding.

The very sad news is that the cat died two days later. We were all saddened by this.
Please everyone, this is one very good reason to have your female pet spayed.


TONurse said...

My pup is now 7 months old, not yet spayed....I found this on the internet and wondered if you could comment on it -
Also, is it not in the interest of the dog, obviously taking a chance (much like everything in life), to allow them to complete their growth intact due to hormone production?

TorontoVet said...


Thank you very much for that link. I think that these findings should not be discounted and warrant further studies. It would be incumbent on the veterinary medical community to provide some good long-term studies looking at all of the issues raised in this paper.
I am still a fan of spaying females prior to their first heat (oestrus cycle). As for neutering males, it is more difficult to make the same arguments.

Tayaki said...

That was a really interesting case. Thanks so much for sharing. I'm sorry that the cat passed away, but I really appreciate the radiographs you put up. I've never seen anything like them! Well, it's back to studying, but I thank you for keeping me inspired. :)

TorontoVet said...


Thanks for the comment. Inspiration, no matter what you do, is always good.
Even after seeing dozens of pyometra cases, we still learned from this one. We were so sad (but not shocked) that she died. Good luck in your studies.


Mel said...

I've spent most of my 13+ years in practice doing emergency med, and that's still one impressive pyo. Of course, in saying that I should probably add that I've never been much of a pyo magnet, or maybe it's just that most of the ones I get can't afford surgery.

Mel said...

In the Dec. 1 issue of Journal of the AVMA, there's a good review article on optimal age of gonadectomy in dogs and cats that goes over the pros/cons of spay/neuter. I was particularly interested because it was written by a former instructor, but it's also very relevant to this little discussion.

TorontoVet said...


Thanks for the very relevant comment. I don't have a subscription to JAVMA, so I don't know how to get the article, but will try to find it somehow. Your blogs are very interesting and look great. Funny, we're both knitting vets.

CJ said...

My baby girl *bangle cat* 4.5 years old just died of this. she had gotten really sick very suddenly, and i took her to the vet as soon as i could get her there. she had pyometra, well they started surgery right away and she made it through the surgery but never woke up from the antistethic, she had a iv drip with antibiotics as well but she died later that night in the vets office. i feel as if i lost half my body. i loved her so very much, and i strongly suggest to everyone to spay their females. cats and dogs both. IT causes to much pain when your loved pet dies. i wish that I could have known sooner, but the infection growes so fast and is hard to detect. please everyone for the love of my squeeker get your animals spayed.

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Anonymous said...

First off, fascinating blog, even for a non-pro like me:)

I had to leave a comment here because after reading your post from a few years back about the worst case of feline pyometra you've ever seen, I'm currently sitting next to one that rivals it.

Over the last handful of days, one of my rescue cats, a 9-10 year old indoor only, very petite feline named Tookus, went from looking like a normal cat to looking as if she were carrying a litter of at least ten. Other than the grossly distended abdomen, there were no other obvious signs of either pregnancy OR pyometra. She was eating normally, drinking normally, purring and affectionate, her nipples weren't 'pinked up', nor were her mammary glands enlarged. No fever, no vomiting, no lethargy, no anemia, no signs of pain when I touched her abdomen, yet no movement in the adomen, either. If it hadn't been for the sudden appearance of pus from her vagina, I still wouldn't have had a clue.

Way too long story short... yesterday, my vet did a double take when I brought this cat in, was sure she had to be pregnant due to the symptoms and lack of symptoms, did another double take at seeing the x-ray, then did another double take when they performed an ovariohysterectomy on her yesterday, and removed what just about every employee there has personally told me was 'the hugest feline uterus they'd ever seen in all their years in veterinary medicine'. The head vet, Dr. Pruitt, took a photo or two to document it.

Tookus is currently on the couch beside me right now, purring and kneading at my leg in her recovery. It's just a little over 24 hours post-surgery, and the only sign that she just had the equivalent to a bowling ball removed from her abdomen is the much-longer-than-your-usual-spay scar,looser than normal skin around the abdomen, and a tiny bit of a cough from having been intubated. No fever, is eating, drinking, color's good, etc.

I'm worried despite things, though, because in your post, you stated that the cat you'd seen passed away two days later. It didn't say by what, though, or if the cat had been doing well initially post-surgery, then suddenly crashed, or if things were touch and go from the get-go, if there were other pre-existing factors. So I'm watching Tookus like a hawk until I'm as convinced that she's doing as well as my vet tells me.

In any case, just had to share how and why I found your blog, and if by any chance you'd like to contact my veterinarian and compare notes about this case, I'd be happy to give you his contact information:)

Paula Prouty Creacy