Pyometra: The Expensive, Emergency Spay

As a veterinarian, I hear all the excuses for not wanting to spay or neuter a family pet. Some pet owners think it devalues, or "de-sexes" their pet. Others want to breed their dog or cat to allow their children to experience the "miracle of life." Others have had a bad experience with a previous spay, neuter, or anesthesia, making them gun-shy about an elective surgery.

When it comes down to it, most veterinary professionals and animal advocates tout the benefits of spaying and neutering. Some advocate it to reduce problems with pet overpopulation, while others advocate it to minimize the risks of mammary (i.e., breast) or prostate cancer; studies have shown that you can reduce a bitch’s incidence of breast cancer by over 90 percent if you have her spayed before her first heat. There’s strong veterinary scientific evidence about the health benefits of spaying and neutering. (That said, there’s also recent information stating otherwise, but that’s for another blog entry!)

As an emergency specialist, why do I recommend spaying or neutering early in life? Because at some point, you’ll likely end up doing it due to medical reasons in your dog or cat … and you don’t want to wait until your pet is geriatric or is facing a medical emergency (when it’s also more costly). First, an older pet has a slightly higher risk of anesthesia complications due to underlying metabolic problems (e.g., their kidneys or liver may not be functioning as well as a younger pet’s). The other reason? The dreaded pyometra

Pyometra, a severe infection of the uterus, can be life-threatening without medical or surgical attention. In cats and dogs that aren’t spayed, the chronic affect of sex hormones can result in cystic endometrial hyperplasia (CEH), which results in pus accumulation (usually secondary to the bacteria E. coli) within the uterus. This hormonal effect typically takes place several weeks after a heat cycle, followed by a massive infection thereafter.

Pyometras can be either "open" or "closed," which refers to whether or not the cervix is open (draining out pus), or closed (keeping all the pus hidden away in the uterus, but not dripping out of your pet’s end). Open pyometras are easy to diagnosis; after all, your pet is draining foul, malodorous, bloody green discharge from her vulva. Closed pyometras can be life-threatening, because they aren’t as obvious to pet owners. As pets often hide their signs until they are very severe, pet owners may not realize their pet has a life-threatening infection in its uterus. Without treatment (which is almost always surgically treated), the uterus can rupture, resulting in septic peritonitis (bacteria within the abdomen) and sepsis.

Clinical signs to look for include:

  • Excessive thirst or urination
  • Inappetance or lack of appetite
  • Lethargy
  • Vomiting
  • Abdominal enlargement
  • Pus dripping from the vulva
  • Constant licking of the vulva
  • Collapse
  • An elevated heart rate

Diagnosis is based on blood work, X-rays, and abdominal ultrasound, and while medical management has been reported, I never recommend it; after all, the problem will just reoccur. Ideally, surgical removal of the pus-filled uterus is necessary. In other words, an emergency, middle-of-the-night spay, which often can run you several thousand dollars. While it may seem unfair to have to pay so much for an emergency spay, the procedure is much more complicated than a traditional ovariohysterectomy. After all, your critically ill dog or cat requires more extensive anesthesia and surgery. Keep in mind that the uterus is much larger and more difficult to remove, and post-operative hospitalization is longer (and typically includes intravenous antibiotics, fluids, pain medications, etc.).

The cheaper option: spay before your pet’s first heat. You’ll save money in the long run, minimize the risks to your pet, and help prevent accidental breedings and secondary pet overpopulation at the same time.

Dr. Justine Lee

Pic of the day: "Cone of Shame" by avrene

 dog in cone, dog after surgery, dog after spay, cone of shame, spaying pets

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