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Pyometra is the term used to describe a pus-filled uterus. Treatment for this infection typically involves the surgical removal of the female cat's reproductive organs. The operation removes both ovaries, the uterine horns, and the body of the uterus, thus removing the infection.
This operation is indicated whenever pyometra is diagnosed. Some people who wish to avoid sterilization may try antibiotics and prostaglandin medications in an attempt to treat the cat's infection. Frequently, medical therapy is not successful and the patient's health worsens. Without prompt and appropriate treatment, there is a risk of uterine rupture and peritonitis, both life threatening. Surgical removal of the infected uterus is considered the treatment of choice.
Preoperative tests are typically necessary to diagnose pyometra. Blood work, including a complete blood count and biochemical profile are commonly done. Radiographs (X-rays) of the abdomen to evaluate the uterus are also performed. In some cases, an abdominal ultrasound may be necessary. Urinalysis, chest X-rays and an EKG may also be performed. These recommendations vary on a case-by-case basis, and depend on the overall health of the pet. Pets with pyometra are usually not healthy and the degree of illness will determine the necessary preoperative tests.
As in human patients, the procedure in dogs and cats requires general anesthesia to induce complete unconsciousness and relaxation. In the usual case, the pet receives a pre-anesthetic sedative-analgesic drug to help her relax, a brief intravenous anesthetic to allow placement of a breathing tube in the windpipe, and subsequently inhalation (gas) anesthesia in oxygen during the actual surgery.
Following anesthesia, the pet is placed on a surgical table, lying on her back. The hair is clipped over the middle of the abdomen and the skin is scrubbed with surgical soap to disinfect the area. A sterile drape is placed over the surgical site. A scalpel is used to incise the skin at the middle of the abdomen, and then the abdominal cavity is opened. The organs of the female reproductive tract are identified and the major blood vessels supplying the ovaries and the uterus are ligated (tied off). This must be done before these organs can be removed. Extreme care is used when removing the uterus to prevent rupture of the pus filled organ, which would result in contamination of the abdomen. Sutures (stitches) that dissolve over time are used to tie off the blood vessels and also to close the uterus above the cervix. The abdominal incision is then closed with one or two layers of self-dissolving sutures (stitches). The outer layer of skin is closed with sutures or surgical staples; these need to be removed in about 10 to 14 days.
The procedure takes about 45 minutes to an hour to perform in most cases, including the needed time for preparation and anesthesia. In some cases, especially in obese or large-breed dogs the procedure can take longer and may require two surgeons.
The overall risk of this surgery is moderate to low. The major risks are those of general anesthesia, bleeding (hemorrhage), postoperative infection, peritonitis and wound breakdown (dehiscence) over the incision. Overall complication rate is low, but serious complications can result in death or the need for additional surgery.
Postoperative medication should be given to relieve pain, which is judged in most cases to be mild to moderate and can be effectively eliminated with safe and effective pain medicines. Intravenous fluids and antibiotics are typically recommended to help improve the overall health of the pet following surgery. The home care requires reduced activity until the stitches are removed in 10 to 14 days. The incision line should be inspected daily by the pet owner for signs of redness, discharge, swelling, or pain.
Depending on the severity of illness, some pets may be hospitalized for two to five days.