Abstract

SummaryEffects of conservative treatment on uterine blood flow and morphometric findings are still unknown in bitches. Thus, this study aimed to compare uterine changes of pyometra bitches subjected to distinct modes of treatment. Pyometra bitches were assigned to: OHE (ovariohysterectomy immediately after diagnosis), Aglepristone (days 1, 2 and 8) and Associative (aglepristone treatment coupled with cloprostenol for 7 days) groups. After 9 days, bitches were ovariohysterectomized. Before surgery, uterine area was measured ultrasonographically and the uterine artery Doppler velocimetry analyzed blood flow velocity and indexes. Uterine horns were classified according to resistance index (RI) as more compromised and less compromised. Endometrial vasculature was quantitatively evaluated by color flow Doppler. Blood samples were collected to determine nitric oxide (NO) concentrations. Histological uterine structures were quantified by stereology and VEGF-A (vascular endothelial growth factor) and eNOS were (endothelial nitric oxide synthase) immunohistochemically analyzed. Aglepristone and Associative groups had lower uterine area and vascularization, and higher blood flow velocity and indexes compared to OHE group. Less compromised horn of Associative group had higher blood flow velocity compared to OHE group. Aglepristone group presented lower inflammatory infiltrate and larger uterine stroma. Associative group had lower volume density and absolute surface of endometrial cysts and lower VEGF-A expression for glandular epithelium and stromal cells. Blood NO and e-NOS immunostaining were not different among groups. In conclusion, association between aglepristone and prostaglandin is more effective in decreasing uterine vascularization and modulating uterine blood flow. Moreover, associative therapy promotes marked morphological changes.Lay summaryThis research compared two medical protocols of treatment for uterine infection (pyometra) in bitches, using a hormone blocker (anti-progesterone aglepristone) solely or in association with a uterine contraction inducer (prostaglandin; associative therapy). After treatment, bitches were gonadectomized and a microscopic analysis of uterine blood vessel formation and uterine tissue elements were performed as well as uterine blood flow evaluation through Doppler ultrasonography. According to vascular resistance, uterine horns were additionally classified as more compromised and less compromised. Both treatment protocols led to reduction of uterine dimensions and vascularization, and higher blood flow compared to untreated bitches. Less compromised uterine horn of the associative treatment had higher blood flow compared to untreated bitches. The hormone blocker treatment had lower inflammatory cells and larger uterine histological structure, while associative treatment had less uterine pathological cysts and lower blood vessel formation. The associative therapy is effective in decreasing uterine vascularization and modulating uterine blood flow as well as reestablishing endometrium structure in bitches with uterine infection.

Highlights

  • Cystic endometrial hyperplasia-pyometra (CEH– pyometra) syndrome is the most frequent and important endometrial disorder in unneutered bitches (Bigliardi et al 2004, Smith 2006), commonly affecting females during diestrus before 10 years of age (Baithalu et al 2012)

  • The present study aimed to evaluate possible changes in uterine vascularization, blood flow and angiogenesis as well as histeromorphology of medically treated bitches for pyometra

  • Bitches were clinically diagnosed with pyometra but the uterine stereology demonstrated that the endometrium fraction volume of the OHE group (39.06 ± 1.85%) resembled the reported results of healthy bitches (35%; (Salinas et al 2017)), indicating that pyometra does not change the volume of uterus layers

Read more

Summary

Introduction

Cystic endometrial hyperplasia-pyometra (CEH– pyometra) syndrome is the most frequent and important endometrial disorder in unneutered bitches (Bigliardi et al 2004, Smith 2006), commonly affecting females during diestrus before 10 years of age (Baithalu et al 2012). CEH–pyometra is considered as an inflammatory and infectious disorder of the endometrial mucosa, leading to suppurative morphological changes, such as cystic dilation and hyperplasia of endometrial glands (Younis et al 2014). CEH–pyometra can be classified as CEH-mucometra and endometritis-pyometra, the latest characterized by a marked inflammatory reaction (De Bosschere et al 2001). A high expression of inflammatory, cell proliferation and angiogenesis markers were verified in pyometra bitches, in comparison to CEH-mucometra (Veiga et al 2017). Canine pyometra has its course marked by increased uterine blood flow and endometrial morphofunctional changes, along with important clinical signs that deserve special medical attention

Objectives
Methods
Results
Conclusion
Full Text
Published version (Free)

Talk to us

Join us for a 30 min session where you can share your feedback and ask us any queries you have

Schedule a call