Pyometra

Dear Dr. Jody:  Friends of ours have urged us to have our six year old Rottweiler, “Harley”, spayed.  Their unspayed golden retriever recently had to have surgery for pyometra.  We would really like to breed “Harley”, and would rather not have her spayed if we can avoid it.  What is pyometra and how risky is it to keep “Harley” intact rather than spaying her?

Pyometra by definition is an infection of the uterus.  In healthy female patients, the cervix provides a tight seal between the sterile environment of the uterus and the bacteria-ridden outside world.  During a heat cycle, changes in the blood flow and structure of the uterine lining and cervix can allow bacteria to ascend the reproductive tract and gain a foothold inside the uterus.  Once inside, the bacteria flourish and rapidly multiply in the warm and moist environment.  If the cervix remains partly open, the dog may have a purulent (full of pus) discharge.  If the cervix closes after the bacteria have entered the uterus, the organ becomes rapidly distended with pus and bacteria and fills up like a tight balloon.

Clearly, such a situation can make the dog incredibly ill.  As bacteria quickly multiply (many species are capable of doubling in number every twenty minutes), they produce toxic waste products that leak into the dog’s bloodstream.  These toxins can significantly depress the dog’s appetite and lead to vomiting, diarrhea, weakness, and an insatiable appetite for thirst. Without aggressive and immediate treatment, the condition is essentially 100% fatal.

The most widely accepted and effective treatment for a pyometra is an emergency spay.  In this surgical procedure, the ovaries and the uterus (and all the pus within) are removed and discarded.  Although the end result is the same as if the dog had been spayed as a puppy, there are many complicating factors during a pyometra spay that make the procedure significantly more difficult and dangerous.  Firstly, most pyometra patients are systemically ill.  They are dehydrated, weak, and may have a compromised and ineffective cardiovascular system due to toxic shock.  This makes them higher anesthetic risks.  Secondly, a uterus that is filled with pus can easily be so full of the horrible infection that it weighs tens and sometimes hundreds of times its normal weight.  Its walls are stretched thin and are very fragile from being so infected.  If any of the pus leaks through the walls and into the abdomen, the patient can experience a potentially life-threatening abdominal infection called peritonitis.  Thirdly, most affected patients are mature and have been through several heats over the years.  This makes the blood vessels going to and from the uterus extremely large and typically wrapped in layers of fat.  They are hard to find and if accidentally torn, severe bleeding can occur.  All of these potential complications mean the veterinary team must take extraordinary measures to ensure the best outcome possible for the patient.  Often, a few days of hospitalization are required to stabilize the patient following the procedure.  The average cost of a pyometra spay can easily be at least five times that of an uncomplicated puppy spay, and certainly carries at least that much extra risk.

So how do we prevent pyometra?  The only proven method to 100% guarantee that your pet will never experience this dreadful disease is to spay your puppy before her first heat.  Unlike pyometra spays, healthy puppy spays are generally quick, uncomplicated, and result in speedy recoveries.  Whereas a pyometra spay can take upwards of two hours to perform and weeks to recover from, a puppy spay is often completed in fewer than twenty minutes.  Following such a procedure, the puppy is generally back on her feet and feeling fairly comfortable by the following day.

Spaying your puppy at a young age can significantly extend her expected healthy lifespan.  I urge all of my clients to offer their puppy this faster, safer, less painful, and significantly cheaper alternative to the ugly pyometra spay.