Closed-cervix Pyometra Research Articles

Expression patterns of inflammatory and oxidative stress-related genes in the uterine and ovarian tissues of dogs diagnosed with pyometra based on cervical patency status

This study aimed to investigate the expression patterns of genes associated with inflammation and oxidative stress in ovarian and uterine tissues of dogs with pyometra, categorized by cervical status (open cervix or closed cervix), which influences disease severity. The control group comprised healthy animals undergoing elective ovariohysterectomy. Tissue inflammatory gene expression and Malondialdehyde (MDA) levels were determined while microbial and histopathological examinations were conducted, along with immunohistochemical evaluations. In the closed-cervix group, uterine TNF and IL6 were upregulated approximately 10-fold while IL10 was upregulated nearly 5-fold. TNF expression differed remarkably between the pyometra groups. In the closed-cervix group, PTGS2 and HMOX1 were upregulated approximately 5-fold whereas NFE2L2 expression was downregulated. The closed-cervix group also had the highest uterine MDA levels. Regarding ovarian tissue, MDA levels were higher in the closed-cervix group than in the open-cervix group while IL10 expression was lower in the closed-cervix group than the open-cervix group. In the closed-cervix group, NFE2L2 was downregulated whereas HMOX1 was upregulated. Uterine TNF levels were positively correlated with IL6, IL10, PTGS2, and HMOX1, but negatively correlated with NFE2L2. IL6 was positively correlated with IL10, PTGS2, and HMOX1. NFE2L2 was negatively correlated with IL6 and HMOX1. IL10 was positively correlated with PTGS2 and HMOX1. MDA was positively correlated with TNF, IL6, IL10, PTGS2, NFE2L2, and HMOX1. TNF levels were positively correlated with ovarian PTGS2, and with IL6 and NFE2L2. MDA was positively correlated with PTGS2 and HMOX1. MDA could be an important biomarker for understanding the severity of pyometra. Moreover, TNF expression and its relationships with various studied parameters such as IL10 may contribute to treatment and prognostic biomarker studies in closed-cervix pyometra pathology.

Expression patterns and distribution of aquaporin water channels in cervix as a possible mechanism for cervical patency in bitches affected by pyometra

Pyometra is a life-threatening disease, the severity of which depends on cervical patency status. This study investigated cervical inflammation status as well as the expression patterns and localization of aquaporin (AQP1, AQP2, AQP3, AQP5, and AQP9), and hormone receptors in cervical tissue that influences canine pyometra. Of the 36 animals enrolled in the study, 24 were diagnosed with pyometra and separated into two groups: open cervix pyometra and close cervix pyometra, while 12 healthy animals presented for elective ovariohysterectomies were allocated into the control group. Surgical treatment was performed for treatment of pyometra. After each operation, cervix samples were collected and analyzed for AQP and hormone receptor expression patterns determined by qPCR and protein expression by means of immunohistochemistry. Blood samples were also collected to determine serum progesterone concentrations. AQP9 expression was downregulated approximately 3-fold while and PGR expression was downregulated more than 2 fold in both pyometra groups compared to the control group. AQP3 and AQP5 gene expression levels were upregulated more than 3 fold in the open-cervix pyometra group than the closed-cervix pyometra group (P < 0.05). This is the first study to describe the expression patterns and immunolocalization of AQPs in canine cervical tissue based on pyometra patency status and to report AQP3 and AQP5 expression in cervical tissue linked to cervical patency.

Evaluation of calcium, phosphorus and some biochemical parameters in dogs with open and closed cervix pyometra

The aim of this study was to evaluate the changes in calcium, phosphorus and some biochemical parameters in dogs with open and closed cervix pyometra, which was then compared with a control group. A total of 62 bitches of age group 5-10 years old irrespective of breed were enrolled into the study. Control group consisted of 22 bitches which were clinically healthy and in luteal phase of the estrus cycle. On clinical examination, pyometra was diagnosed in 40 bitches while 23 out of 40 bitches had open-cervix pyometra and 17 of 40 bitches had closed-cervix pyometra. Evaluation of haematological changes revealed that there was increased white blood cell (WBC), total protein (TP), globulin, alkaline phosphatase (ALKP) while decreased glucose (Glu), albumin (Alb) and albümin globulin ratio in pyometra cases (p&amp;lt;0.001). The highest WBC and ALKP levels were detected in closed-cervix pyometra group (p&amp;lt;0.001). Calcium (Ca+2) levels had significant rise in open-cervix pyometra cases (p&amp;lt;0.05) while phosphorus (Phos) levels had tend to increase in closed-cervix pyometra cases (p=0.08). Also, Ca was directly correlated with Glu, Alb and TP while inversely correlated with WBC and blood urea nitrogen/creatinine (BUN/Crea). However, Phos was significantly associated with BUN and Crea (p&amp;lt;0.001; R=0.915 and R=0.860, respectively). As a result of this study, it was observed that the increased Ca levels in open-cervix cases and the elevated Phos levels in closed-cervix cases, were associated with the biochemical parameters related to hepatic and renal dysfunction in dogs with pyometra.

Relationships between haptoglobin and inter-alpha trypsin inhibitor heavy chain 4 levels inlocal and peripheral blood and systemic inflammatory response syndrome in bitches withpyometra.

We aimed to assess the usefulness of monitoring inter-alpha trypsin inhibitor heavy chain 4 (ITIH4) and haptoglobin (Hp) in peripheral and local blood in canine pyometra, and evaluation the relationships among acute phase proteins (APPs), systemic inflammatory response syndrome (SIRS) and the presence of bacteria. The material was collected from bitches with pyometra and from healthy ones. Blood was taken from the cephalic and uterine veins. APPs levels were quantified by ELISA. In the peripheral circulation, the Hp was higher in animals with open-cervix pyometra (OCP) than in the closed-cervix pyometra (CCP) and the control group. The Hp concentration was not correlated with age, with the presence of SIRS or with the type of bacteria (Gram-negative, Gram-positive or mixed flora). The ITIH4 concentrations in the peripheral blood did not differ significantly in the cases of pyometra. The Hp concentration in the local circulation increased in the OCP but not in the CCP groups, although the histopathological changes in the endometrium were similar. Peripheral Hp concentrations may be a useful tool in differentiating between the types of pyometra.

Renal biomarkers, clinical parameters, and renal Doppler velocimetry in bitches with cystic endometrial hyperplasia-pyometra complex.

Cystic endometrial hyperplasia (CEH)-pyometra complex is the most common uterine infection in adult and elderly bitches and can cause renal dysfunction. The aim of this study was to measure and compare urinary creatinine, urea, symmetric dimethylarginine (SDMA), urinary protein-creatinine ratio (UPC), measurement of systolic blood pressure (SBP), and Doppler velocimetry of renal arteries in patients with CEH-pyometra complex before and after an average of 6 months of treatment, evaluating the possibility of the changes persisting. The evaluation was conducted at two moments: M1 (at the diagnosis of CEH-pyometra, n = 36) and M2 (after an average of six months of treatment, n = 16). For the control group, eight bitches with no changes in blood tests or history of conditions underwent Doppler ultrasound evaluation of the renal arteries. At both M1 and M2, we measured creatinine, urea, and serum SDMA, UPC, SBP, and Doppler ultrasound of the renal arteries. Patients were evaluated according to the following groups: azotemic (AZO) and non-azotemic (NAZO), and open and closed cervix pyometra. The parameters were compared between animals present in both moments presented as M1R (bitches that were in M1 and M2) and M2. Statistical significance was considered when p < .05. The medians found for creatinine in M1 were as follows: 1.15 mg/dL, being 1.8 mg/dL for AZO (12/36) and 0.95 mg/dL for NAZO (24/36); and in M2: 0.85 mg/dL (16/16), being 1.15 mg/dL for AZO (4/16) and 0.8 mg/dL for NAZO (12/36). For urea, in M1 it was 36 mg/dL (32/36), with AZO being 103 mg/dL (11/32) and 33 mg/dL in NAZO (21/32); and in M2 32 mg/dL (16/ 16), being 29 mg/dL for AZO (4/36), and 31 mg/dL for NAZO (3/15). The median SDMA measured in M1R was 17 μg/dL (15/16), with AZO being 31 μg/dL (3/15), and NAZO being 16.5 μg/dL (12/15); and in M2, SDMA was 12 μg/dL (16/16), with AZO being 12.5 μg/dL (4/16), and NAZO being 12 μg/dL (12/16). The median UPC measured in M1 was 1.15 (10/36), with AZO being 0.25 (1/10), and NAZO being 1.38 (9/10); and in M2, it was 0.2 (13/16), being 0.1 in AZO (4/13), and 0.2 (9/16) in NAZO. For SBP, in M1, it was 118 mmHg (30/36), with AZO being 102 mmHg (10/30) and 133 mmHg in NAZO (20/30); and in M2 142.5 mmHg (12/16), being 155 mmHg for AZO (4/12), and 140 mg/dL for NAZO (8/12). When comparing animals with open and closed cervixes, a difference was found between SDMA measurements (p = .001). There was a distinction between PI and RI of the left and right kidneys consecutively (p = .007; p = .033; p = .019; p = .041). Correlations found in M1: SDMA × PI RIM DIR (r = 0.873; p = .002), SDMA × PSV RIM ESQ (r = 0.840; p = .004), SDMA × EDV RIM ESQ (r = 0.675; p = .046). With this study, we conclude a return to normality of renal biomarkers and clinical parameters after six months. Yet, there is a persistence of Doppler velocimetric measurements between the two moments. Thus, this parameter is not suitable for identifying and classifying chronic kidney injury in bitches with pyometra.

Microbiological and hematological aspects of canine pyometra and associated risk factors

Canine Pyometra, also known as cystic endometrial hyperplasia complex, is a common reproductive issue in bitches. This study aimed to identify associated risk factors, hematological variation, bacteria involved, and the most potent anti-bacterial against bacterial isolates of canine pyometra. Forty-five bitches of different habitats, breeds, and ages infected with pyometra were included in the study. The samples were cultured to isolate bacteria associated with the pyometra and antibiotic sensitivity was done for each bacterial isolates to get antibiogram. The study findings showed that potential risk factors such as age group, medroxyprogesterone acetate administration, and changes in the white blood cells parameters were significantly associated (P < 0.05) with the type of pyometra. Closed cervix pyometra in dogs showed significantly higher prevalence of clinical signs including depression, vomiting, abdominal enlargement, and fever compared to the open cervix pyometra. Low levels of red blood cells, pack cell volume, and hemoglobin indicated that the pyometra-infected dogs were more likely to have normocytic, normochromic, and non-regenerative anemia. Pyometra was attributed to an increase in AST (Aspertate aminotransferase), ALT (Alanine transaminase), ALP (Alkaline phosphatase), BUN (Blood Urea Nitrogen), and Creatinine while a decrease in serum albumin. Of the all bacterial isolates, E. coli (35.55%) was the most common pathogen isolated from canine pyometra, followed by Pseudomonas spp. (26.66%). E coli and Pseudomonas spp. were susceptible to Imipenem, Amikacin, and Gentamicin while highly resistant to Ampicillin and Erythromycin. Imipenem, Amikacin, and Gentamicin were the most sensitive antibiotics, while Ampicillin and Erythromycin were the most resistant antibiotics for the bacterial strain isolated from canine pyometra. Multidrug resistant was observed in 26 of the isolated bacteria, indicating acquired resistance due to improper and uncontrolled use. Hence early diagnosis and close monitoring of antimicrobial susceptibility before therapeutic intervention is indispensable in preventing the global threat of antimicrobial resistance.

A Clinical Study on Canine Pyometra

Pyometra is an important gynaecological disorder of canine females along with dystocia and transmissible venereal tumor. Canine pyometra is problematic for canine owner and sometimes fatal in canines in severe cases. So, this study was aimed to know the incidence of pyometra among different gynaecological disorders, breed-wise, and factors affecting incidence of pyometra. A total 178 female dogs, presented with gynaecological disorders at VCC, Meerut, were included in this clinical study. Maximum incidence of canine pyometra was observed in five to six years age group. The incidence was found more in nulliparous (intact) animals and in Labrador breed. Incidence of open cervix pyometra was more common than closed cervix pyometra. USG can be used as a tool for the diagnosis of closed cervix pyometra. Mifipristone, Cabergoline, Misoprostol/Dinoprostone (oral/vaginal prostaglandin) along with antibiotic and other supportive therapy was found very effective in canine pyometra.

Expression of prostaglandin F2 alpha receptors (PTGFR) and C-reactive protein (CRP) in the canine uterus and cervix with opened- and closed-cervix pyometra

Expression of prostaglandin F2 alpha receptors (PTGFR) and C-reactive protein (CRP) in the canine uterus and cervix with opened- and closed-cervix pyometra

Electrocardiography and hematological findings of closed cervix pyometra in bitches

Pyometra is one of the most common diestral disorders, especially in middle-aged intact bitches, due to bacterial infection in the uterus. It usually causes mild to severe septicemia that may eventually end up in the animal's death. In certain cases, septicemia may induce myocardial cellular damage depending upon the disease's course and outcome, which may even alter the Electrocardiographic (ECG) parameters, which is the significance of this study. A total of 6 bitches of various breeds affected with closed cervix pyometra were included and evaluated for haemato-biochemical parameters before treatment. The ECG recordings were compared before and after treatment by paired t-test. The study revealed mild anemia, leukocytosis, lymphopenia, increased immature neutrophils, mild increase in creatinine value, and alterations in the heart rate. However, there were no significant changes in the ECG parameters in the pre and post-treatment of closed cervix pyometra except for the heart rate. Early diagnosis and treatment resulted in reduced myocardial damage leading to a better prognosis in all the bitches studied.

Haemato-biochemical studies in medically managed open and closed-cervix pyometra in dogs

Six dogs each with open and closed-cervix pyometra (Group I and II) were medically managed with mifepristone @ 2.5mg/kg body weight orally twice daily for five days, followed by cloprostenol @ 5?g/kg body weight subcutaneously on every alternate day after ensuring cervical patency, till complete evacuation of uterus was assessed by ultrasonography. Haematological and serum biochemical values were estimated on the day of presentation. The treatment response was assessed by reviewing both haematological and serum biochemical values further on days 3, 7, 14 and 21 of treatment. The mean total erythrocyte count (TEC), haemoglobin concentration and volume of packed red cells (VPRC) were significantly lower and mean total leucocyte count (TLC) was significantly higher in all animals of both groups during the day of presentation. The values significantly improved after initiation of treatment. Total thrombocyte count, serum total protein, albumin, BUN and serum creatinine levels were within the normal range. TEC, TLC, Hb concentration, VPRC could be used for prognostic markers of treatment evaluation in canine pyometra.

Uterine artery hemodynamics in female dogs with open- and closed-cervix pyometra

Although pyometra is a common disease, the mechanisms that determine cervical opening remain unknown. Knowing that the vascular structures are crucial in pathophysiology, it was observed need for hemodynamic studies assessing uterine artery of female dogs with pyometra and its relation to the neck opening. Thirty-five female dogs were selected and separate into three groups: control group (CG) (n = 12), open-cervix pyometra group (OCG) (n = 11) and closed-cervix pyometra group (CCG) (n = 12), with the objective of evaluating and comparing the hemodynamic changes of the uterine artery [peak systolic velocity (PSV), end diastolic velocity (EDV), and resistance index (RI)] in female dogs with open- and closed-cervix pyometra and correlate them with measurements of uterine diameter (UD) and endometrial thickness (ET). The correlation analysis showed that, with the exception of PSV, the hemodynamics indices were associated with UD and ET, presenting a moderate and positive correlation between UD and EDV (r = 0.62; P&lt;0.01), a moderate and negative correlation between UD and RI (r =-0.68; P&lt;0.01) and also moderate and negative correlation between ET and RI (r = -0.62; P&lt;0.01). These results suggest that alterations of uterine artery hemodynamics are similar in dog females with open- or closed-cervix pyometra, although the UD and the ET can influence in the uterine perfusion.

Electrocardiographic Findings in Bitches Affected by Closed Cervix Pyometra.

Pyometra is considered the most common disease in intact bitches, being associated with potentially life-threatening disorders. Myocardial damage is a potentially life-threatening consequence of pyometra. The aim of this study was to describe the electrocardiographic patterns in bitches affected by closed cervix pyometra, to assess the clinical relevance of electrocardiographic changes with the occurrence of pyometra, and to relate their severity with laboratory and clinical findings. A total of 39 bitches with closed cervix pyometra and 10 healthy female dogs were included in this study. During the hospitalization, bitches underwent a complete physical examination. An electrocardiographic examination before the ovariohysterectomy was performed. Blood samples for biochemical and hematological analysis were also evaluated. Bitches suffering pyometra at least one arrhythmia 31/39 (79.4%), sinus tachycardia (22/39, 56.4%), ventricular premature complexes (9/39, 23%), increased amplitude of T wave (7/39, 17.9%), ST depression (4/39, 10.2%), second-degree atrioventricular block (2/39, 5.1%), increase of QT interval (2/39, 5.1%), sinus bradycardia (2/39, 5.1%), and first-degree atrioventricular block (1/39, 2.5%). Some bitches were also detected with low wave amplitude (17/39, 43.5%). Cardiac arrhythmias associated with canine pyometra are frequent events. These data suggest that arrhythmias may be the consequence of one or more factors that can occur during pyometra, such as myocardial damage, electrolyte/metabolic disorders, and/or sepsis.

Pyometra in Bitches: A Review of Literature

Pyometra is a frequently diagnosed bacterial infection of the uterus in intact, sexually mature bitches, leading to the accumulation of purulent material in the uterine lumen. Approximately one third of the anoestrous bitches can be diagnosed with pyometra. Closed-cervix pyometra is particularly dangerous, because septicaemia and toxaemia may develop rapidly and if left untreated can result in death of the patient. Due to the insidious nature of the disease and its sometimes equivocal clinical signs, patients are often presented in poor condition for anaesthesia and surgery. Keywords: Pyometra, uterus, bitches Cite this Article Prasad VD, Kumar PR, Sreenu M. Pyometra in Bitches: A Review of Literature. Research & Reviews: Journal of Veterinary Science and Technology. 2017; 6(2): 12–20p.

A Retrospective Study of Canine Pyometra in Segar Veterinary Hospital, Kuala Lumpur, Malaysia Year 2012-2016

A retrospective study was used to analyse canine pyometra cases in Segar Veterinary Hospital, Kuala Lumpur, Malaysia from May 2012 to May 2016 and to investigate the relationship between pyometra and breed and age of dogs. The study was done through secondary collection of data from ambulatoirs of pyometra cases which were diagnosed based on anamnesis, examination of clinical signs and ultrasonography and/or radiography. The data collected includes breed categorised into small, medium, and large breeds, whereas the age are categorised into puppies, adulthood and geriatric. The data was then analysed with tree classification analysis and CATPCA (Principal Components Analysis for Categorical Data) analysis using SPSS program. A total of 80 cases of pyometra were recovered from female dog patients over the study period. Small breed dogs at 72.5% (n=58) and geriatric dogs at 62.5% (n=50) had the highest percentage of pyometra. The breeds Mongreal, German Shepard Dog, Mini Schnauzer, Silky Terrier, Toy Poodle, Beagle, Chow Chow, Golden Retriever, Rottweiler, Cocker Spaniel, White Terrier, Siberian Husky, and Pekingese aged older than 5.5 years had 100% from 37 cases of open-cervix pyometra. Geriatric and small breed dogs are inclined to have open-cervix pyometra. However adult and medium or large breed dogs have a higher possibility to have closed-cervix pyometra. These results serve to highlight the importance of public awareness regarding canine pyometra and further researches are needed to find out the effects of hormone therapy, frequency of births, and the bacteria present in uterus with pyometra. Keywords: Canine pyometra, Open-cervix Pyometra, Closed-cervix Pyometra, Age and Breed

Ultrasonography, Affected Age, Hematology and Clinical Signs according to Open or Closed Cervix in Dogs with Pyometra

The aim of the study was to evaluate ultrasonographic findings, affected age, hematology, blood chemistry and clinical signs according to open or closed cervix in 102 bitches presented for treatment of pyometra. The prevalence of pyometra according to breed was observed in Maltese 22.5%, Yorkshire Terrier 13.7% and Shih Tzu 12.7%. The mean age of dogs was 9.6 ± 0.3 years, and open cervix pyometra was more prevalent than closed cervix pyometra. Clinical signs included anorexia, vaginal discharge, depression, polyuria/polydipsia, vomiting, and abdominal distension. The concentration of BUN and the activity of ALP in dogs with closed cervix pyometra were significantly higher than those in dogs with open cervix pyometra (p < 0.05). The white blood cell and neutrophils in dogs with closed cervix pyometra were significant higher than those in dogs with open cervix pyometra (p < 0.05). Ultrasonographic findings of the uterus with open or closed cervix pyometra showed variable patterns. The uterine wall was variable in appearance, from thick and irregular to smooth and thin. The uterine wall was thicker in open cervix pyometra than in closed cervix pyometra. The luminal cavity included smaller amount of anechoic fluid in open cervix pyometra than in closed cervix pyometra.

Closed cervix is associated with more severe illness in dogs with pyometra.

BackgroundPyometra, a life-threatening bacterial infection of the uterus, is classified as open or closed depending on the functional patency of the cervix i.e. presence or absence of vaginal discharge. In closed cervix pyometra, pus and bacterial products accumulate in the uterus, which is thought to induce a more severe illness. The aim of this study was to investigate whether disease severity or outcome differed in dogs with open or closed cervix pyometra.ResultsProspectively collected data from 111 female dogs diagnosed with pyometra at the University Animal Hospital, Swedish University of Agricultural Sciences, Uppsala, intermittently during 2005–2012 was analyzed. Seventy-two dogs (65%) had open cervix, whereas 39 dogs (35%) had closed cervix. Differences between the two groups were explored by Wilcoxon Two Sample Test for continuous variables and Chi-square or Fisher’s exact test for categorical variables. P < 0.05 was considered significant.In dogs with open cervix the median age was 9.0 years and the median weight 26.0 kg. In dogs with closed cervix the median age was 9.6 years and the median weight 25.0 kg, with no significant differences between the groups (p = 0.69 and 0.24, respectively). Five dogs (4.5%) died, all with open cervix, and 16 dogs (14%) had complications.The general physical condition was moderately or severely depressed in 30% (21/71) of dogs with open cervix (severely depressed in 4 dogs, moderately depressed in 17 dogs) and in 56% (22/39) of dogs with closed cervix (severely depressed in 3 dogs, moderately depressed in 19 dogs). The general physical condition was mildly depressed in 41 dogs with open cervix and 16 dogs with closed cervix, whereas it was normal in nine dogs with open cervix and one dog with closed cervix. None of the included dogs had very severely depressed general physical condition or were non-responsive.Leukocytosis, neutrophilia, monocytosis and moderately to severely depressed general condition was more commonly found in dogs with closed cervix (p = 0.003, p = 0.008, p = 0.003 and p = 0.006, respectively).Sepsis was more commonly present in closed cervix pyometra (77%, 30/39 dogs) compared to open cervix pyometra (51%, 36/71 dogs) (p = 0.007). Presence of prolonged postoperative hospitalization did not differ significantly between the two groups.ConclusionsIn dogs with closed cervix, sepsis was more common, the general physical condition more often moderately to severely depressed and leukocytosis, neutrophilia and monocytosis more frequently found. The results showed that closed cervix was associated with a more severe illness than open cervix at admission but not with poorer outcome as measured by postoperative hospitalization. These findings may be clinically valuable for optimizing monitoring and treatments in dogs with the disease.

Expression of oxytocin, progesterone, and estrogen receptors in the reproductive tract of bitches with pyometra

Canine pyometra is considered a serious and life-threatening condition. Due to the relationship among sex steroid hormones, oxytocin receptor (OTR) expression, and canine pyometra pathogenesis, this study aimed to investigate the expression of oxytocin, progesterone, and estrogen receptors in the reproductive tissues of canines with pyometra by real-time PCR and immunohistochemistry. A total of 27 pyometra bitches were classified into open- and closed-cervix pyometra groups based on the presence of vaginal discharge. Moreover, 15 normal bitches in the luteal phase served as a control group. The results showed that OTR gene expression in the ovary of pyometra bitches was higher than that of normal bitches, whereas the level of OTR gene expression in the cervix of pyometra bitches was less than that of normal bitches (P < 0.05). Conversely, a lower OTR H-score in ovarian follicles was observed in pyometra bitches compared with normal bitches, whereas a higher percentage of OTR-positive immunostaining in uteri and cervices were found in pyometra bitches compared with normal bitches (P < 0.05). Moreover, the H-scores of estrogen receptor alpha in uteri and cervices of pyometra bitches were less than that of normal bitches (P < 0.05). However, the localization of the OTR and sex steroid receptors between groups of pyometra bitches was not different. Our findings suggest that pyometra pathogenesis is associated with a change in expression of OTR and sex steroid receptors in the canine reproductive tract. However, cervical dilation in bitches with pyometra was not influenced by the expression of OTR and sex steroid receptors.

Uterine Torsion with a 1080° Rotation in a Queen with Closed-cervix Pyometra

Background: Uterine torsion is a rotation of one or both uterine horns around its longitudinal axis, associated to vascular compromise that may lead to necrosis and both metabolic and hematological disorders, rarely reported in cats. The etiology has not been established and it has most frequently been associated to pregnancy, although its occurrence in non-pregnant animals in association with uterine diseases (e.g. pyometra, mucometra and hematometra) has been reported. The aim of this work is to report a case of 1080° uterine horn torsion in a cat with closed-cervix pyometra.Case: A five-year-old, weighing 4.2 kg, female queen was referred to the Ambulatório de Pequenos Animais do Departamento de Reprodução Animal e Radiologia Veterinária in the Veterinary Hospital of Universidade Estadual Paulista “Júlio de Mesquita Filho”, Botucatu, SP with a three-day history of an evident abdominal distension, anorexia, polydipsia and lethargy. The owner reported that the queen had delivered a litter of kittens three years ago and, since then, medroxyprogesterone acetate has been administrated in order to inhibit the oestrus cycles. Physical examination revealed pale mucous membranes, dehydration, cachexy, abdominal distension with no vaginal discharge and a large uterus with irregularities, detected by abdominal palpation. Hematological examination revealed anemia, thrombocytopenia, leukocytosis, hyperglycemia and metabolic acidosis. Ultrasonographic examination revealed hypoechogenic fluid uterine content, suggesting closed-cervix pyometra associated to clinical signs of sepsis. An exploratory laparotomy was performed; the uterus was externalized and revealed a 1080° torsion of the congested and distended left uterine horn with vascular compromise and some foci of necrosis; the right uterine horn had a normal appearance but was also distended. Ovariohysterectomy was performed and the diagnosis of pyometra was confirmed by the evaluation of uterine content. Pre- and postoperative medical supportive therapy were performed and the queen recovered successfully.Discussion: The administration of medroxyprogesterone acetate predisposed the queen to cystic endometrial hyperplasia/ pyometra complex and the absence of vaginal discharge characterized a closed-cervix pyometra, the more severe form of the disease, thus leading to severe sepsis. In this case, abdominal palpation should be careful because of the uterine wall fragility, which could lead to uterine rupture and peritonitis; therefore ultrasonography is the technique of choice to confirm this pathology, although the uterine torsion cannot be diagnosed with this exam. This disease can only be confirmed by exploratory laparotomy. The etiology has not been established, but this case can be associated with stretching of both the ovarian pedicle and broad ligament by a previous pregnancy and by the uterine distension provided by pyometra. The degree of uterine torsion identified in this case is an uncommon finding. It may potentially cause severe complications in the queen, including peritonitis, septicemia, endotoxemia and disseminated intravascular coagulation and may lead to death if the cat does not have a prompt surgical intervention with an effective pre- and postoperative medical supportive therapy. Therefore the establishment of a prognosis of uterine torsion cases in the queen is correlated with these aspects.Keywords: feline, uterine torsion, contraceptive, endometrial cystic hyperplasia.

Molecular Expression Profile Reveals Potential Biomarkers and Therapeutic Targets in Canine Endometrial Lesions.

Cystic endometrial hyperplasia (CEH), mucometra, and pyometra are common uterine diseases in intact dogs, with pyometra being a life threatening disease. This study aimed to determine the gene expression profile of these lesions and potential biomarkers for closed-cervix pyometra, the most severe condition. Total RNA was extracted from 69 fresh endometrium samples collected from 21 healthy female dogs during diestrus, 16 CEH, 15 mucometra and 17 pyometra (eight open and nine closed-cervixes). Global gene expression was detected using the Affymetrix Canine Gene 1.0 ST Array. Unsupervised analysis revealed two clusters, one mainly composed of diestrus and CEH samples and the other by 12/15 mucometra and all pyometra samples. When comparing pyometra with other groups, 189 differentially expressed genes were detected. SLPI, PTGS2/COX2, MMP1, S100A8, S100A9 and IL8 were among the top up-regulated genes detected in pyometra, further confirmed by external expression data. Notably, a particular molecular profile in pyometra from animals previously treated with exogenous progesterone compounds was observed in comparison with pyometra from untreated dogs as well as with other groups irrespective of exogenous hormone treatment status. In addition to S100A8 and S100A9 genes, overexpression of the inflammatory cytokines IL1B, TNF and IL6 as well as LTF were detected in the pyometra from treated animals. Interestingly, closed pyometra was more frequently detected in treated dogs (64% versus 33%), with IL1B, TNF, LBP and CXCL10 among the most relevant overexpressed genes. This molecular signature associated with potential biomarkers and therapeutic targets, such as CXCL10 and COX2, should guide future clinical studies. Based on the gene expression profile we suggested that pyometra from progesterone treated dogs is a distinct molecular entity.

A Critical Case of Closed Cervix Pyometra in a Bitch

Pyometra is accumulation of purulent material within the uterus, which manifests in both local and systemic symptoms, and demands costly surgical or medical intervention (Hagman et al. 2011). Pyometra is typically a post-oestral syndrome in adult bitches associated with a variety of clinical and pathological manifestations of genital and multisystemic disease (Chaffaux and Thibier 1978). Parity and age are significant risk factors in the development of pyometra (Niskanen and Thrusfield 1998). This paper communicates with successful management of a critical case of closed cervix pyometra in a German shepherd bitch.