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Dr. Coates is a veterinarian based in the other “Sunshine State” – that's Colorado to the rest of you – where she lives and plays with a varied range of animals. She shares her professional and personal experiences, Monday through Friday, here on petMD's blog, the Fully Vetted. Log in for your daily dose of her insight and wisdom.

 

Epee the Pekinese and Her Impossible Pyometra

September 29, 2006 / (0) comments


Epee is a diminutive blonde Pekinese with a sad little face and a belly-full of something mighty nasty.

This 9-year-old pooch was brought in by one of our long-time clients along with her friends, newly relocated to the area and currently lacking a trusted vet.

Epee had been acting strange ever since the move, over a week ago. She has been quiet on the long drive from up north and depressed ever since. Her parents had reasoned that their girl was stressed and upset—nothing more. Ever since her owner of seven years had died (her adoptive parents` elderly aunt), she had never been a dog that thrilled to new adventures.

When I saw her for the first time two days ago she had a low body temperature (99 degrees—normal is 101.3), a mass in her belly, and a smelly, bloody vaginal discharge. Yuck!

Because the effluence was a slow leak, as it were, her owners had brought her in for what they assumed was a nasty anal gland situation (how you confuse the anus with the vagina is beyond me but some people just don’t like to look too closely).

I asked some pertinent questions. How is her water and food intake? They assured me she was drinking very well, better than usual, in fact, but that she had not had a good appetite for many days now.

I then asked the most obvious question. When was her last heat? They countered with a remarkable answer: Epee is spayed, so she doesn’t come into heat—ever.

That seems strange—unbelievable, even. Nasty vaginal discharge, a large mass in the lower abdomen, and lots of water drinking. Sounds like a pyometra—an infection of the uterus common in older bitches. By now I was convinced that `bitch` was indeed her designation—her parents must have been misinformed. An X-ray confirmed a mass consistent with classic pyometra.

However, now her parents were more than a bit suspicious of my qualifications. Moreover, the client who had referred them was looking somewhat embarrassed by my apparent medical gaffe. What’s wrong with this vet? Can’t she tell a spayed dog from an usspayed one?

Looking to exonerate myself, I shaved her belly (to her parents` dismay, I might add, but by now I was simply trying to get my point across). Just as I suspected: no scar and an umbilical hernia. Anyone spaying this dog would have surely repaired this hernia. And no scar usually means no surgery was ever performed. But what do I know? My technician was getting pretty mad by this point and recommended I point out my diplomas for their inspection.

In spite of all the evidence in my favor, assuring them their dog needed surgery was no mean feat. They were still hung up on the no heat thing—the common occurrence of silent heats in older bitches, notwithstanding.

Gently, I led them down the path of least resistance: OK, then, let’s ultrasound her and find out what that gigantic thing is. That’ll be an extra $250—and we’ll wind up in the same place. We’ve got no choice but to get this sucker out (sucker = uterus). Along the way I had also offered to refer them to a specialist. The surgeon`s estimate led them to discard this option immediately.

So I spayed the bitch. And everyone finally went home happy, still not thoroughly convinced the offending organ (which I saved and photographed in case tangible proof was required) was, indeed, a uterus. Poor old Aunt Bessie would never have led them astray. But as long as Epee’s her old self again—who cares?

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About fully vetted

Patty Khuly, VMD, MBA

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Dr. Khuly is a former petMD blogger and small animal veterinarian in Miami, Florida, where she practices medicine at Sunset Animal Clinic and serves on the board of the South Florida Veterinary Medical Association. She is a graduate of Wellesley College, the University of Pennsylvania School of Veterinary Medicine, and The Wharton School of Business.

As a significant sideline, she writes...a lot. She authors pet health columns for USA Today, The Miami Herald and Vetstreet. She also writes a popular monthly column for Veterinary Practice News and serves as regular contributor to Veterinary Economics, The Bark, and the Veterinary News Network.

Dr. Khuly lives in South Miami with her brood of hens, goats, dogs, cats...and humans.

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