A rare radiographic appearance of a calcified uterus in a queen with pyometra: a case report

Abstract

This report describes the clinical presentation, diagnosis and treatment of a queen with open pyometra. Lethargy, anorexia and previous treatment failure were the main reasons resulting in referral for diagnostic evaluation. The history, haematological and biochemical profiles and abdominal radiographs revealed open pyometra. Following ovariohysterectomy and antibiotic therapy there was total resolution of clinical signs. Histopathology of the uterus showed severe calcification. The unique part of this report was the rare appearance of multiple opacities in the radiographs. To the authors' knowledge, this is the first report of radiographic opacities in a domestic short-haired queen with open pyometra.Keywords: queen; pyometra; radiology; uterus; calcification Pyometra is the most frequent and important endometrial disorder in intact, sexually mature queens and is characterised by uterine infection by ascending vaginal bacteria as a consequence of progesterone stimulation of the endometrium. It may involve diffuse or segmental enlargement of the uterus. Histological lesions range from simple cystic endometrial hyperplasia to endometrial atrophy (Nak et al. 2009).Pyometra is classified as open-cervix or closedcervix based on cervical patency for drainage of purulent uterine fluid. Although medical management may be attempted, surgical intervention to prevent uterine rupture and septicaemia is the treatment of choice for any open-cervix pyometra where the bitch is systemically ill, or any case of closed-cervix pyometra (Adamovich-Rippe et al. 2013).In this paper, we describe an unusual feature of open pyometra in a queen, and its radiographic and histopathological change. Case descriptionA 4.3 kg, approximately six-year-old sexually intact female Domestic short-haired cat was presented to the Small Animal Hospital, University of Tehran, Tehran, Iran because of a history of anorexia and lethargy. The cat had lived indoors for approximately five years and had not been bred during this period of time. Two weeks prior to presentation she had the same clinical signs (lethargy and anorexia) and the owner referred her to a private pet clinic. The veterinarian prescribed antibiotics and intravenous lactated Ringer's solution, which initially resulted in improvement before a subsequent return of the clinical symptoms.On initial physical examination, the cat was mildly dehydrated and lethargic. Rectal temperature was normal (38.1 °C) and no abnormalities in mucous membrane colour were noted. Heart and respiratory sounds and rates were normal. Vaginal discharge was not observed and abdominal palpation revealed no abnormal organs. Polyuria and polydipsia were noted by the owner.Diagnostic procedures included a complete blood count (CBC), serum biochemical profile and abdominal radiographs. The CBC showed mild nonregenerative normocytic normochromic anaemia, leucocytosis with neutrophilia and the presence of immature WBCs in a peripheral blood sample.

Calcified uterine leiomyoma: A rare association with inguinal hernia in a dog

“…Dystrophic mineralisation has also been described in a canine uterine leiomyosarcoma 11 ; furthermore, generalised endometrial mineralisations related to long‐term progesterone administration have been reported in a bitch with pyometra 12 and in other bitch with cystic endometrial hyperplasia–pyometra complex and an ovarian granulosa cell tumour 13 . However, in these cases, mineralisations appeared on ultrasonography as echogenic pinpoint or straight endometrial foci or stippled hyperechoic lesions, accompanied by mild acoustic shadowing and comet tail artefact rather than C‐shaped structures.…”