Introduction

Pyometra is a potentially life‐threatening condition seen in both dogs and cats and results in the accumulation of pus in the uterine lumen.¹ The cervix can be open or closed in this condition. If the cervix is open, purulent material can be seen coming from the vulva (Figure 27.1); however, the absence of discharge does not rule out pyometra, as the more dangerous of the two options, a closed pyometra, will not result in leaking of discharge. Treatment options include both medical and surgical management, though primary consideration is given to surgery. A range of other issues can be present and impact the systemic health of the animal secondary to the uterine infection, such as the infection systemically affecting the patient in cases of closed pyometra. This condition develops under the influence of progesterone, and Escherichia coli is the most common bacteria seen.¹ Lipopolysaccharides (endotoxin) associated with Gram‐negative bacteria can lead to fever and systemic dysfunction.¹

Cystic endometrial hyperplasia often precedes pyometra development. Cystic endometrial hyperplasia occurs during the diestrual phase of the heat cycle and results in cyst formation from secretory endometrial glands.²

Indications/Preoperative Considerations

Clinical signs at presentation vary but can include vulvar discharge, fever, polyuria/polydipsia, and vomiting.³

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