METRITIS

Metritis
Similar to pyometra but metritis usually occurs postpartum and is associated with dystocia, obstetrical manipulation, or retained fetus or placenta.

Signs
anorexia, depression, vomiting, vaginal discharge, fever, mastitis. (Differs from pyometra in that there is no PU/PD.)

Diagnosis
Signalment and history - usually occurs immediately postpartum.

Physical exam - fever. malodorous, mucopurulent vaginal discharge

Lab data - usually have leukocytosis with degenerative left shift. see degenerate PMNs and bacteria on cytology of the discharge.

Surgical Treatment
OHE is recommended if not a breeding animal or if she has severe systemic signs. Perform surgery and post op care as for pyometra.

Medical Treatment
consider if she is not too sick and is a breeding animal. Use systemic antibiotics and drain the uterus daily. A soft rubber catheter can be passed if the cervix is dilated. If a catheter cannot be passed, the uterus can be drained by laparotomy and hysterotomy. You can also use ergonovine maleate or PGF2α as for pyometra.


Metritis is the medical term used to describe inflammation of the uterus. This uterine disease is similar to pyometra but it has some differences. Unlike pyometra, metritis is most often a bacterial uterine infection that develops in the immediate post partum (after giving birth) period and occasionally after abortion or breeding. It is most often associated with retained fetuses or placentas.

What to Watch For



Fever

Dehydration

Depression

Decreased appetite

Vomiting

Diarrhea

Fast heart rate

Vulvar discharge

Diagnosis

Tests may include:


Complete blood count that shows an elevated white blood cell count


Biochemical profile that may be normal or show elevations in liver and kidney values, hypoglycemia (low blood sugar), and/or electrolyte abnormalities


Radiographs (X-rays) that reveal retained fetuses or an enlarged uterus


Ultrasound that may show fluid accumulation within the uterus, retained fetuses and/or placentas, as well as fluid within the abdominal cavity in the cases of uterine rupture


Vaginal cytology and culture that often reveal a multitude of white blood cells and bacteria

Treatment


Intravenous fluid and electrolyte therapy


Antibiotics


Evacuation of uterine contents


Medical options include oxytocin or prostaglandins, which are drugs that stimulate contraction of the uterus.


Surgery, specifically ovariohysterectomy, is most often the treatment of choice, once the patient is stabilized and a good candidate for general anesthesia.

Home Care and Prevention

There is no home care for metritis; this condition requires veterinary care. After diagnoses, make sure your dog receives all prescribed medication. Dogs that are spayed as part of the treatment usually do quite well.

Metritis may become chronic and cause infertility in breeding bitches, when ovariohysterectomy is not an option and medical therapy is not properly instituted.

Since metritis is a uterine disease, spaying your dog is the only way to prevent disease.