Prognostic markers of canine pyometra

Abstract

The pyometra is a disease that affects middle age and elderly female dogs during diestrus. Hormonal, microbiological, biochemical and hematological aspects are well described. However, few studies have evaluated the role of each in the prognosis of canine pyometra. The aim of this study was to identify markers associated with clinical worsening of dogs with pyometra. We prospectively evaluated 80 dogs with pyometra treated surgically. Group 1 consisted of dogs that were discharged within 48 hours after surgery and Group 2 consisted of those who required prolonged hospitalization or died. The findings of hematological, biochemical and blood lactate levels were compared between groups and variables such as bacterial multidrug resistance, systemic inflammatory response syndrome (SIRS), hyperlactatemia and increased creatinine were analyzed through the dispersion of frequencies between groups. Among the variables studied, the presence of SIRS and elevated serum creatinine >2.5mg/mL were effective in predicting the worsening of the disease and can be used as prognostic markers of canine pyometra. Palavras-chave: cadela, hiperplasia endometrial, SIRS, multirresistência bacteriana, hiperlactatemia

Köpeklerde Endotoksik Pyometranın Klinik, Bakteriyolojik ve Histopatolojik Özellikleri

“…It has been established that if E. coli migrates to the uterus, it binds with higher affinity to the endometrium and myometrium layers and constitutes a resistance to the uterus' defense mechanisms such as lactoferrin and mucin-1 [24][25][26][27] . As reported in previous studies [4,11,23,28] , gram negative bacteria (75%) such as E. coli, Klebsiella spp. and Ps.…”

“…aeruginosa, Proteus spp., Pasteurella spp. could also been detected [11,22,23] . It has been established that if E. coli migrates to the uterus, it binds with higher affinity to the endometrium and myometrium layers and constitutes a resistance to the uterus' defense mechanisms such as lactoferrin and mucin-1 [24][25][26][27] .…”

“…If pyometra is allowed to continue untreated, death may occur due to bacterial toxic shock and multiple organ failure [4,9,11] . However, bacterial endotoxins damage the vascular endothelial structure and cause a prothrombin-antithrombin imbalance; this situation could lead to disseminated intravascular coagulation (DIC) and clinical findings may be severe in bitches with endotoxic pyometra.…”

“…It is well known that changes in levels of liver and kidney enzymes could be caused by the effects of gram negative bacterial endotoxin [2,11,29,30] . Furthermore, bacterial endotoxins induce a marked increase in the number of circulating polymorphonuclear phagocytes (regenerative left shift).…”

“…Renal dysfunction and hepatocellular damage caused by septicemia and/or diminished hepatic circulation and cellular hypoxia in a dehydrated bitch can lead to alteration in variety of serum biochemical parameters. In addition, suppression in bone marrow activity which leads to anemia and remarkably increased leukocytes can occur due to the toxin effect in bitches with pyometra related to endotoxemia [11,12] . Besides, the prognosis of pyometra may vary according to the absorption of bacterial toxin and the histomorphological alterations of the uterus [2,[13][14][15][16] .…”