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Pyometra: The Expensive, Emergency Spay

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August 31, 2011 / (6) comments

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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COMMENTS (6)
1
Speuter
by TheOldBroad on 08/31/2011 05:51am

I agree so heartily that early spay/neuter is important for so many reasons.

There are readers of this blog that are against elective speuter and are vigilant about not allowing their pets to breed. I wonder how miserable it must be for a pet to go through a heat time after time. I don't know anything about dogs, but I know that kitties surely sound miserable.

2
speuter
by chienblanc4csi on 08/31/2011 09:23am

Dogs not so much, and I don't believe it is misery, just crying for a mate. But the choice to spay or neuter should be done with all the information available. "OldBroad" - me too! ;-) I grew up with intact dogs, but yes, cats are not so easy to live with intact. With all the intact dogs in my youth, we NEVER had a litter, because we practiced good management - Fence, Door and Leash = Dog Birth Control. Except for one dog who escaped the gate (neighbor kid) and was hit by a car, all our intact dogs died of old age. One had mammary tumors, operated on, died of old age. Never even considered neutering the males, but I don't like the skunky smell of intact dog urine in my garden, on my hostas, have a smallish yard. Small dogs, not such an issue, but neutering, even the males, is mostly for MY CONVENIENCE. For females, the closed pyo truly is the most frightening thing, hands down. My SAR tracking bitch was spayed at 4 yrs., young and healthy, but again, for my convenience. Her heat periods interfered with performance events, and I didn't like the spotting on the carpet (mostly she cleaned herself, so not the biggest concern). Twenty years ago I did things differently, and had my bitch spayed at 6 months. She had two health issues that are now correlated with early spay - Hypothyroid, and the dreaded Hemangiosarcoma, of which she died at age 10. (Talk about expensive surgery . . . for 29 days to say goodbye, I still cry about her.)

Current research has been finding out all kinds of health BENEFITS from late speuter (or not at all), and since my current dogs are working and performance dogs, one is a finished champion, might have a litter in a couple of years, I am very thoughtful about this decision. All the info I have is in pdf form, inconvenient to share here, but if you Google "SN Behavior Bone Data" phrases, you will find the new stuff. A study of aged Rottweilers turned up a surprising correlation to intact dogs of both sexes and longevity, closely tied to a very reduced rate of bone cancer, which kills a lot of very young Rottweilers. It is worth looking into, especially if you have large breed dogs.

Friends of mine have a large and well run breed rescue group for golden retrievers - they S/N every dog of every age that comes through their rescue. We attend a fund raising event or two every year, and even a novice observer could notice the preponderance of long-legged, weedy goldens. Lots of cruciate ligament injuries and serious hip dysplasia surgeries amongst the group. (The vet expense for the group is in the $30,000 to $60,000 range per year.) I'm sure there are many layers of extenuating circumstances, but excessive bone growth (which affects joint angles, etc.) in S/N goldens is an issue, as is cancer. If I had a golden I would NOT S/N early. Earliest I would do it is 3 yrs. old, after what I have been reading. These are not small studies, these are extensive, and many overlap. The Rottweiler study is world wide, and was intended to look at longevity and bone cancer, didn't expect to find the connection to speuter - but it became obvious.

Not as easy a decision as it used to be. There are still plenty of folks who don't "like" the new info for political reasons. It is hard to change firm beliefs, especially when the lives of our pets are at stake.

3
Speuter
by Dr Justine Lee on 08/31/2011 10:11am

Great comments Speuter. I do agree that early-spay neuter is not as recommended as it used to be - esp. if the pet is a performance or working dog, or rapidly growing pet.

I am aware of the Rottie paper which recently came out, but have to admit that most veterinarians don't quite "buy into it" quite yet. That said, I can say that there are some breeds that I don't believe in neutering or spaying for medical reasons... that's for another blog though!

To clarify, hypothyroidism and hemangiosarcoma are NOT associated with spaying or neutering. While the prevalence of these diseases are more commonly seen in spayed or neutered pets, that is because of the prevalence of neutered pets in America. People who spay and neuter are the same responsible pet owners who visit veterinary clinics to diagnose hypothyroidism or treat their dog for hemangiosarcoma (vs. letting them die at home). It represents a different patient population (and pet owner population).

I work with a lot of sled dogs who live a full, long life as intact animals. I'm not anti-"intact" animals, provided the pet owner is responsible and preventing pet overpopulation/accidental. That said, not everyone is as responsible as you!

Spaying and neutering has been proven to help with many medical AND behavioral problems, and in generally, highly recommended before a first heat. I think that early spaying and neutering is falling out of favor except with shelter situations, due to the affects on bone growth, etc.

When in doubt, talk to your vet about it - if your vet is inflexible, find another vet!

4
signs of early spay?
by ualagirl on 08/31/2011 01:54pm

If a dog (or cat) is spayed before their first heat (I'm guessing that would be about 6-8 months?) do they not develop nipples? Or do nipples show up only when pregnant? We got our Pupper as an adult, with an unknown history (except that she was already spayed when she arrived at the shelter) and she has no evidence of nipples, not even little spots where they should be. She was quite the fetcher when younger, and I used to worry that she would tear an ACL, but she never has. She's probably a lab-shepherd mix; not especially leggy, but not stumpy, either.

5
by Dr Justine Lee on 08/31/2011 04:15pm

Great question. If a pet was spayed BEFORE her first heat, or never was pregnant, the nipples/mammary glands don't grow much. Likely your dog was spayed early! :)

6
Get Her Spayed
by Cameron Wood on 04/08/2013 10:13am

never again will I not spay another dog, from an owner who is currently sitting and waiting and praying for my beautiful girl to pull through a closed pyometra emergency operation as I type,she's septic and in a bad way, it happens all too fast. If your pondering on whether to spay your girl or not, don't think about for too long, as too long could be enough! , Owner of Bailey 9 Yr Old Cocker Spaniel

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