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Bertero A, Corrò M, Spagnolo E, Nervo T, Rota A. Antimicrobials administration, treatment outcome and bacterial susceptibility in canine pyometra cases subjected to ovariohysterectomy. Vet J 2024; 306:106157. [PMID: 38866074 DOI: 10.1016/j.tvjl.2024.106157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 06/03/2024] [Accepted: 06/04/2024] [Indexed: 06/14/2024]
Abstract
Pyometra is a bacterial uterine infection that frequently affects intact older bitches. The treatment of choice is ovariohysterectomy, often associated with perioperative antimicrobial therapy. The aim of this retrospective investigation was to evaluate the antibiotic choice at different administration times (pre-surgery, at surgery/during hospitalization, and post-surgery) against complications and outcomes, considering the susceptibility profile of bacteria. The medical records of 51 bitches referred to the Veterinary Teaching Hospital of the University of Turin (January 2021-November 2023) and subjected to ovariohysterectomy and bacteriological examination (bacterial culture and susceptibility tests) of the uterine exudate, were analysed. All animals had a positive outcome without surgical site infections, with a longer hospitalization time in case of peritonitis or sepsis; antimicrobials were administered for an average of 7 days. Comparing the susceptibility of the isolated bacteria towards the antimicrobials administered before, during and after surgery, complete efficacy was observed in 42 %, 46 % and 50 % of cases, respectively. In addition, 5/16 peritonitis cases were treated with an in vitro ineffective antimicrobial, and 30 % of the bitches never received a fully effective antibiotic, according to susceptibility tests using the minimum inhibitory concentration method (MIC). Cephazolin resulted the best option for Escherichia coli, the most frequently isolated bacterium. Our study confirms that pyometra has a good prognosis following ovariohysterectomy and antibiotic administration. Monitoring the clinical evolution without changing the antibiotic according to bacterial susceptibility could represent the right choice in uncomplicated cases. Evaluation of outcomes without postoperative antibacterial treatment or with a shorter course would be another topic worth investigating, with the aim to judiciously reduce the use of antibiotics.
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Affiliation(s)
- A Bertero
- Department of Veterinary Sciences, University of Turin, Largo Braccini 2, Grugliasco 10095, Italy.
| | - M Corrò
- Istituto Zooprofilattico Sperimentale delle Venezie, Viale dell'Università 10, Legnaro 35020, Italy
| | - E Spagnolo
- Istituto Zooprofilattico Sperimentale delle Venezie, Viale dell'Università 10, Legnaro 35020, Italy
| | - T Nervo
- Department of Veterinary Sciences, University of Turin, Largo Braccini 2, Grugliasco 10095, Italy
| | - A Rota
- Department of Veterinary Sciences, University of Turin, Largo Braccini 2, Grugliasco 10095, Italy
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Demeli A, Meyer JC. The assessment of haematologic and serum chemistry parameters in canine pyometra: a systematic review and meta-analysis. J Small Anim Pract 2023; 64:543-551. [PMID: 37691297 DOI: 10.1111/jsap.13641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 01/27/2023] [Accepted: 05/01/2023] [Indexed: 09/12/2023]
Abstract
OBJECTIVES Pyometra is common in non-spayed adult female dogs requiring early diagnosis and treatment to increase the survival rate. The diagnosis of pyometra is mainly based on clinical examination and anamnesis. Radiography, ultrasonography and laboratory analyses are recommended to support a diagnosis. The aim of this study was to assess blood parameters associated with pyometra by performing a systematic review and meta-analysis. MATERIALS AND METHODS The review was conducted in accordance with PRISMA guidelines. A search of three databases (PubMed, Google Scholar and CAB abstracts) was performed in July 2022. Studies providing information about laboratory parameters for both the pyometra group and healthy control group dogs were eligible for inclusion. Data extraction included the first author's name, publication year, country, number of participants in both groups, mean values of selected studies, standard deviation values, and blood parameters. The risk of bias for each study was evaluated, and a random-effects meta-analysis was performed. RESULTS We included 44 studies which investigated 12 blood parameters. High heterogeneity was detected in all parameters in these meta-analyses. The following blood parameters were increased in dogs with pyometra: white blood cell (mean=27.75×109 L-1 , mean difference (MD)=17.16, 95% confidence interval (CI) 14.85 to 19.47), monocytes (mean=2.06×1012 /L, MD=1.37, 95% CI 0.99 to 1.74), blood urea nitrogen (mean=41.42 mg/dL MD=18.06, 95% CI 12.26 to 23.85), alkaline phosphatase (mean=212.78 IU/L, MD=137.51, 95% CI 81.81 to 88.62), and aspartate aminotransferase (mean=48.31 IU/L, MD=16.96, 95% CI 10.61 to 23.30). The following parameters were reduced: red blood cell (mean=5.42 1012 /L, MD=-1.37, 95% CI -1.68 to -1.05), haemoglobin (mean=121.20 g/L, MD=-30.57, 95% CI -39.70 to 21.45), albumin (mean=23.71 g/L, MD = -8.16, 95% CI -11.46 to -4.86). Lymphocyte, creatinine, urea, and alanine transaminase parameters were increased in some studies and decreased in others. CLINICAL SIGNIFICANCE In canine pyometra, some blood parameters are consistently increased, some consistently decreased, and some increased or decreased depending on the study.
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Affiliation(s)
- A Demeli
- Genreal Directorate of Food and Control, Ankara, Turkey
| | - J C Meyer
- Equine Sport Science, East Hampton, New York, USA
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Ylhäinen A, Mölsä S, Grönthal T, Junnila J, Rantala M, Laitinen-Vapaavuori O, Thomson K. A double-blinded randomized placebo-controlled non-inferiority trial protocol for postoperative infections associated with canine pyometra. BMC Vet Res 2023; 19:77. [PMID: 37340459 DOI: 10.1186/s12917-023-03629-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 06/02/2023] [Indexed: 06/22/2023] Open
Abstract
BACKGROUND Pyometra is a common infectious condition, especially in elderly bitches. In addition to an infected uterus, dogs may have concurrent urinary tract infection (UTI). The preferred treatment is surgical removal of the ovaries and uterus, whereupon the general prognosis is excellent. In addition, antimicrobial therapy is frequently prescribed for postoperative treatment. However, no research exists on the benefit of postoperative antimicrobial treatment in uncomplicated canine pyometra. Antimicrobial resistance has become a major challenge in treatment of bacterial infections. Diminishing overuse of antimicrobial agents is essential for controlling the development of antimicrobial resistance in both animals and humans. METHODS This double-blinded, randomized, placebo-controlled two-arm clinical trial is designed to compare the incidence of postoperative infections associated with surgical treatment of uncomplicated pyometra followed by two different treatment protocols. For the study, 150 dogs presenting with an uncomplicated pyometra and that are to undergo surgical treatment will be recruited. Dogs with body weight < 3 or > 93 kg, complicated pyometra, primary disease increasing the risk of infection, or immunosuppressive medication will be excluded. All dogs will receive one dose of sulfadoxine-trimethoprim intravenously as an antimicrobial prophylaxis. Postoperatively, dogs will be randomized to receive either a five-day course of placebo or an active drug, sulfadiazine-trimethoprim orally. During the surgery microbiological samples will be taken from urine and uterine content. The follow-up includes a control visit in 12 days and an interview of the owner 30 days after surgery. If bacteriuria is detected at the time of surgery, a urinary sample will be cultured for bacterial growth at the control visit. The primary outcome is the incidence of a postoperative surgical site infection (SSI), and the secondary outcome is the occurrence of clinical UTI with bacteriuria. Intention-to-treat and per-protocol analyses will be performed to compare outcome incidences between the treatment groups. DISCUSSION Research-based evidence is necessary to create treatment guidelines for judicious use of antimicrobials. The goals of this study are to provide evidence for reducing the use of antimicrobials and targeting the treatment to patients proven to benefit from it. Publishing the trial protocol will increase transparency and promote open science practices.
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Affiliation(s)
- Anna Ylhäinen
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Viikintie 49), P.O. Box 57, Helsinki, FI-00014, Finland
| | - Sari Mölsä
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Viikintie 49), P.O. Box 57, Helsinki, FI-00014, Finland.
| | - Thomas Grönthal
- Animal Health Diagnostics Unit, Finnish Food Authority, Mustialankatu 3, Helsinki, FI-00790, Finland
| | - Jouni Junnila
- EstiMates Oy, Tykistökatu 4, Turku, FI-20520, Finland
| | - Merja Rantala
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Viikintie 49), P.O. Box 57, Helsinki, FI-00014, Finland
| | - Outi Laitinen-Vapaavuori
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Viikintie 49), P.O. Box 57, Helsinki, FI-00014, Finland
| | - Katariina Thomson
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Viikintie 49), P.O. Box 57, Helsinki, FI-00014, Finland
- Evidensia Eläinlääkäripalvelut Oy, Tammiston Kauppatie 29, Vantaa, FI-01510, Finland
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Yazlık MO, Mutluer İ, Kaya U, Özkan H, Müştak İB, Çolakoğlu HE, Altınbaş YF, Vural MR. The role of nutritional-immunological indices in estimating serum LPS and antioxidant enzyme activity and sepsis status in female dogs with pyometra caused by E. coli. Anim Reprod Sci 2023; 255:107276. [PMID: 37300916 DOI: 10.1016/j.anireprosci.2023.107276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 05/18/2023] [Accepted: 06/05/2023] [Indexed: 06/12/2023]
Abstract
The aim of this study was to diagnose pyometra and related sepsis status using cost-effective nutritional-immunological indices, antioxidants, and toxin levels in dogs and to investigate the utility of the indices in predicting toxin and antioxidant status. A total of 29 dogs were enrolled into the present study. Among these, 9 female dogs in their diestrus stages, were allocated for elective ovariohysterectomy. The pyometra group was also separated into two subgroups as Sepsis (+) and Sepsis (-). Blood samples were collected into two tubes containing EDTA for hematological analysis; without anticoagulant for serum progesterone, LPS concentration, and antioxidant levels at the time of diagnosis. Bacteriological and tissue samples of the uterus were collected after the ovariohysterectomy. Antioxidant activity, progesterone, and toxin concentration were determined by using commercial ELISA kits. Statistical analyses were performed using Stata version 16.1 and MedCalc 16 statistical software. Receiver operating characteristics curves were used for the threshold for evaluating pyometra and sepsis status. Pairwise comparisons were carried out of the area under the curve (AUC) for thresholds of nutritional immunologic indices (hemoglobin, albumin, lymphocyte, platelet (HALP) score; prognostic nutritional index (PNI); Albumin hemoglobin index (AHI)), serum LPS and antioxidant activity. Linear regression model was used for the estimation of serum LPS and antioxidant activity by using indices. Mean serum progesterone, LPS concentrations, and Nitric Oxide (NO) production were greater, while serum superoxide dismutase (SOD), tissue SOD, and glutathione peroxidase (GPx) activities were lower in dogs with pyometra. All nutritional-immunologic indices were lower in pyometra cases. Nutritional-immunologic indices (AUC of HALP:0.759; PNI:0.981; AHI 0.994), NO (AUC: 0.787) and SOD (AUC: 0.784) levels were useful for pyometra diagnosis. AHI and LPS were useful for the determination of sepsis status with the AUC values of 0.850 and 0.740, respectively. While AHI was useful for the estimation of serum LPS and NO concentration (p < 0.001), PNI was useful for serum SOD concentration (p = 0.003). In conclusion, PNI, HALP and AHI can be used in the diagnosis of pyometra, however, only AHI and LPS levels can be used in the diagnosis of sepsis. SOD and NO can be used to determine pyometra but have no effect on determining sepsis status. Additionally, the estimation of the levels of serum LPS, NO, and SOD activities can be done using the AHI and PNI values.
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Affiliation(s)
- Murat Onur Yazlık
- Ankara University, Faculty of Veterinary Medicine, Department of Obstetrics and Gynecology, 06110 Ankara, Turkiye.
| | - İpek Mutluer
- Ankara University, Faculty of Veterinary Medicine, Department of Obstetrics and Gynecology, 06110 Ankara, Turkiye
| | - Ufuk Kaya
- Hatay Mustafa Kemal University, Faculty of Veterinary Medicine, Department of Biostatistics, 31060 Hatay, Turkiye
| | - Hüseyin Özkan
- Hatay Mustafa Kemal University, Faculty of Veterinary Medicine, Department of Genetics, 31060 Hatay, Turkiye
| | - İnci Başak Müştak
- Ankara University Faculty of Veterinary Medicine Department of Microbiology, 06110 Ankara, Turkiye
| | - Hatice Esra Çolakoğlu
- Ankara University, Faculty of Veterinary Medicine, Department of Obstetrics and Gynecology, 06110 Ankara, Turkiye
| | - Yunus Furkan Altınbaş
- Ankara University, Faculty of Veterinary Medicine, Department of Obstetrics and Gynecology, 06110 Ankara, Turkiye
| | - Mehmet Rıfat Vural
- Ankara University, Faculty of Veterinary Medicine, Department of Obstetrics and Gynecology, 06110 Ankara, Turkiye.
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Hagman R. Pyometra in Small Animals 3.0. Vet Clin North Am Small Anim Pract 2023:S0195-5616(23)00071-2. [PMID: 37270345 DOI: 10.1016/j.cvsm.2023.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Pyometra is a common disease in intact bitches and queens and occurs, although less frequently, in most other female pets. In bitches and queens, the illness is generally diagnosed within 4 months after estrus, in middle-aged to older individuals. Complications such as peritonitis, endotoxemia, and systemic inflammatory response syndrome are not uncommon and associated with more severe illness. Ovary-sparing surgical options such as hysterectomy could be considered in individuals with high-risk for detrimental side effects of spaying or without infection of the uterus but has not yet been evaluated for safety in pyometra.
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Affiliation(s)
- Ragnvi Hagman
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, PO Box 7054, Uppsala SE-75007, Sweden.
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Phylogeny and Virulence Factors of Escherichia coli Isolated from Dogs with Pyometra. Vet Sci 2022; 9:vetsci9040158. [PMID: 35448656 PMCID: PMC9025573 DOI: 10.3390/vetsci9040158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 03/14/2022] [Accepted: 03/15/2022] [Indexed: 11/16/2022] Open
Abstract
We aimed to investigate the occurrence, phylogeny, and virulence of E. coli in the uterine contents and urine of female dogs with pyometra, through the presence of virulence genes and their genetic similarity. Uterine secretions and urine samples from 52 female dogs with pyometra were collected and cultured. Strains identified as E. coli from 25 uterine and 7 urine samples were tested for virulence genes by PCR. Genetic similarity between the isolates was studied using RAPD-PCR. E. coli was observed in 48.07% uterine samples with pyometra and 20.0% urine samples. The strains showed high percentages for the presence of virulence genes: 96.9% had the gene sfa, 59.4% afa, 46.9% pap, 53.1% hly, and 68.75% cnf. Even with the high prevalence of virulence genes, the samples were not submitted to DNA sequencing to confirm the results. Analysis showed high genetic diversity in E. coli, however, strains isolated from the same animal indicate that cystitis and pyometra could be related. Our study indicated the association between E. coli in dogs with pyometra and cases of urinary tract infection and the pathogenic potential of strains increasing with animal age.
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Chylkova T, Zwicker L, Moore C, Whitty J, Sadar MJ. Diagnostic challenge. J Exot Pet Med 2019. [DOI: 10.1053/j.jepm.2019.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Rautela R, Katiyar R. Review on canine pyometra, oxidative stress and current trends in diagnostics. ASIAN PACIFIC JOURNAL OF REPRODUCTION 2019. [DOI: 10.4103/2305-0500.254645] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Singh LK, Patra MK, Mishra GK, Singh V, Upmanyu V, Saxena AC, Singh SK, Das GK, Kumar H, Krishnaswamy N. Endometrial transcripts of proinflammatory cytokine and enzymes in prostaglandin synthesis are upregulated in the bitches with atrophic pyometra. Vet Immunol Immunopathol 2018; 205:65-71. [PMID: 30459003 DOI: 10.1016/j.vetimm.2018.10.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 10/16/2018] [Accepted: 10/21/2018] [Indexed: 10/28/2022]
Abstract
Inflammatory markers of endometrial origin are valuable in order to differentiate the pyometra from cystic endometrial hyperplasia in the bitch. In the present study, we hypothesized that histological categorization would distinguish the differential regulation of the proinflammatory genes in the endometrium of bitches with pyometra. Ovariohysterectomy was done on bitches with confirmatory diagnosis of pyometra (n = 18). Using endometrium to myometrium ratio of 0.79 as threshold, the uteri (n = 8/group) were categorized into hyperplastic pyometra (HP) and atrophic pyometra (AP). Two samples were excluded as the diagnosis was inconclusive. In parallel, endometrial tissue was collected for total RNA extraction to study the differential expression of TLR4, IL-6, IL-8, COX-2 and PGFS through real time PCR. Diestrus uterus of non-pyometra bitches (n = 6) served as control. The mean fold change (2-ΔΔCt) for the target genes was determined using β-actin as endogenous control and non-pyometra uterus as calibrator group. Except TLR4, other inflammatory genes were upregulated significantly by 1.82 to 3.74 times in the AP as compared to HP with maximum upregulation of COX-2 and PGFS. Further, correlation matrix with Spearman's rho revealed that IL-8 had strong positive correlation with COX-2 and PGFS in the AP group (P < 0.05). It is concluded that histological grading of pyometra into HP and AP revealed differential regulation of inflammatory cytokines and enzymes in the PG synthetic pathway in the canine endometrium that has diagnostic potential under clinical settings.
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Affiliation(s)
- Laishram Kipjen Singh
- Animal Reproduction Division, ICAR - Indian Veterinary Research Institute, Izatnagar, Uttar Pradesh, 243 122, India
| | - Manas Kumar Patra
- Animal Reproduction Division, ICAR - Indian Veterinary Research Institute, Izatnagar, Uttar Pradesh, 243 122, India.
| | - Girish Kumar Mishra
- Animal Reproduction Division, ICAR - Indian Veterinary Research Institute, Izatnagar, Uttar Pradesh, 243 122, India
| | - Vidya Singh
- Pathology Division, ICAR - Indian Veterinary Research Institute, Izatnagar, Uttar Pradesh, 243 122, India
| | - Vikramaditya Upmanyu
- Division of Biological Standardization, ICAR - Indian Veterinary Research Institute, Izatnagar, Uttar Pradesh, 243 122, India
| | - Abhishek C Saxena
- Division of Veterinary Surgery, ICAR - Indian Veterinary Research Institute, Izatnagar, Uttar Pradesh, 243 122, India
| | - Sanjay Kumar Singh
- Animal Reproduction Division, ICAR - Indian Veterinary Research Institute, Izatnagar, Uttar Pradesh, 243 122, India
| | - Goutam Kumar Das
- Animal Reproduction Division, ICAR - Indian Veterinary Research Institute, Izatnagar, Uttar Pradesh, 243 122, India
| | - Harendra Kumar
- Animal Reproduction Division, ICAR - Indian Veterinary Research Institute, Izatnagar, Uttar Pradesh, 243 122, India
| | - Narayanan Krishnaswamy
- Animal Reproduction Division, ICAR - Indian Veterinary Research Institute, Izatnagar, Uttar Pradesh, 243 122, India
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Trautwein LGC, Sant'Anna MC, Justino RC, Giordano LGP, Flaiban KKMDC, Martins MIM. PIOMETRAS EM CADELAS: RELAÇÃO ENTRE O PROGNÓSTICO CLÍNICO E O DIAGNÓSTICO LABORATORIAL. CIÊNCIA ANIMAL BRASILEIRA 2017. [DOI: 10.1590/1089-6891v18e-44302] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo Piometra é uma afecção resultante da interação bacteriana com a hiperplasia cística do endométrio. O objetivo deste estudo foi identificar bactérias em condições de aerobiose e anaerobiose da secreção intrauterina de cadelas com piometra, presença da síndrome da resposta inflamatória sistêmica, status da cérvix, peritonite, dosagens bioquímicas séricas e comparar com o prognóstico de cadelas tratadas cirurgicamente. Utilizaram-se 15 cadelas com piometra, submetidas à ovariohisterectomia. Hemogramas e dosagens séricas de ureia, creatinina, FA e ALT foram realizados no pré-operatório imediato. Coletou-se urina por cistocentese. Após a remoção do útero e ovários, a secreção intrauterina foi aspirada; as amostras foram então cultivadas em aerobiose e anaerobiose, as amostras de urina em aerobiose. Os animais foram divididos em dois grupos, G1 (alta hospitalar em até 48 horas) e G2 (alta hospitalar após 48 horas ou óbito). Onze amostras de conteúdo intrauterino (73,3%) apresentaram crescimento bacteriano em aerobiose e anaerobiose e em uma amostra isolou-se Arizona hinshawii. Quatro amostras de urina (26,6%) tiveram crescimento bacteriano. Houve diferença significativa das variáveis status da cérvix, ureia, creatinina e fosfatase alcalina entre G1 e G2. Embora a diversidade etiológica encontrada nas culturas de conteúdo intrauterino tenha sido alta, a avaliação da azotemia, status da cérvix e dosagem de FA sérica mostraram-se bons marcadores prognósticos em cadelas com piometra.
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Jitpean S, Ambrosen A, Emanuelson U, Hagman R. Closed cervix is associated with more severe illness in dogs with pyometra. BMC Vet Res 2017; 13:11. [PMID: 28056957 PMCID: PMC5217653 DOI: 10.1186/s12917-016-0924-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Accepted: 12/10/2016] [Indexed: 11/21/2022] Open
Abstract
Background Pyometra, a life-threatening bacterial infection of the uterus, is classified as open or closed depending on the functional patency of the cervix i.e. presence or absence of vaginal discharge. In closed cervix pyometra, pus and bacterial products accumulate in the uterus, which is thought to induce a more severe illness. The aim of this study was to investigate whether disease severity or outcome differed in dogs with open or closed cervix pyometra. Results Prospectively collected data from 111 female dogs diagnosed with pyometra at the University Animal Hospital, Swedish University of Agricultural Sciences, Uppsala, intermittently during 2005–2012 was analyzed. Seventy-two dogs (65%) had open cervix, whereas 39 dogs (35%) had closed cervix. Differences between the two groups were explored by Wilcoxon Two Sample Test for continuous variables and Chi-square or Fisher’s exact test for categorical variables. P < 0.05 was considered significant. In dogs with open cervix the median age was 9.0 years and the median weight 26.0 kg. In dogs with closed cervix the median age was 9.6 years and the median weight 25.0 kg, with no significant differences between the groups (p = 0.69 and 0.24, respectively). Five dogs (4.5%) died, all with open cervix, and 16 dogs (14%) had complications. The general physical condition was moderately or severely depressed in 30% (21/71) of dogs with open cervix (severely depressed in 4 dogs, moderately depressed in 17 dogs) and in 56% (22/39) of dogs with closed cervix (severely depressed in 3 dogs, moderately depressed in 19 dogs). The general physical condition was mildly depressed in 41 dogs with open cervix and 16 dogs with closed cervix, whereas it was normal in nine dogs with open cervix and one dog with closed cervix. None of the included dogs had very severely depressed general physical condition or were non-responsive. Leukocytosis, neutrophilia, monocytosis and moderately to severely depressed general condition was more commonly found in dogs with closed cervix (p = 0.003, p = 0.008, p = 0.003 and p = 0.006, respectively). Sepsis was more commonly present in closed cervix pyometra (77%, 30/39 dogs) compared to open cervix pyometra (51%, 36/71 dogs) (p = 0.007). Presence of prolonged postoperative hospitalization did not differ significantly between the two groups. Conclusions In dogs with closed cervix, sepsis was more common, the general physical condition more often moderately to severely depressed and leukocytosis, neutrophilia and monocytosis more frequently found. The results showed that closed cervix was associated with a more severe illness than open cervix at admission but not with poorer outcome as measured by postoperative hospitalization. These findings may be clinically valuable for optimizing monitoring and treatments in dogs with the disease.
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Affiliation(s)
- Supranee Jitpean
- Department of Surgery and Theriogenology, Faculty of Veterinary Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand. .,Department of Clinical Sciences, Swedish University of Agricultural Sciences, Box 7054, SE-750 07, Uppsala, Sweden.
| | - Aime Ambrosen
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Box 7054, SE-750 07, Uppsala, Sweden
| | - Ulf Emanuelson
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Box 7054, SE-750 07, Uppsala, Sweden
| | - Ragnvi Hagman
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Box 7054, SE-750 07, Uppsala, Sweden
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Identifying diagnostic endocrine markers and changes in endometrial gene expressions during pyometra in cats. Reprod Biol 2016; 16:174-80. [PMID: 27288342 DOI: 10.1016/j.repbio.2015.12.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Revised: 12/04/2015] [Accepted: 12/27/2015] [Indexed: 11/22/2022]
Abstract
Pyometra is a significant reproductive problem in cats. The aims of this study were to evaluate (i) the immunological profile of queens by studying plasma concentrations of metabolites of prostacyclin I2 (6-keto-PGF1α), leukotriene B4 (LTB4) and leukotriene C4 (LTC4); and (ii) the gene transcription profiles of Toll-like receptors (TLRs) 2 and 4 (TLR2/4), PGE2-synthase (PGES), PGF2α-synthase (PGFS) and prostaglandin-endoperoxide synthase 2 (PTGS2) in the feline endometrium throughout the estrous cycle, after medroxyprogesterone acetate (MPA) treatment and during pyometra. The concentration of plasma 6-keto-PGF1α in pyometra was increased in comparison to other groups studied (p<0.01). Endometrial mRNA coding for TLR2 was up-regulated in cats suffering from pyometra compared to other groups (p<0.001). Expression of mRNA for TLR4 was up-regulated in endometria originating from MPA-treated cats, pyometra and late diestrus cats, compared with tissues from cats during estrus and anestrus (p<0.05). As expected, endometrial mRNA for PTGS2 was up-regulated only in pyometra, compared with other groups (p<0.001). Similarly, endometrial mRNA for PGFS was up-regulated in pyometra, compared with endometria from anestrus, late diestrus and from MPA-treated cats (p<0.05), or from cats during estrus (p<0.01). Overall, these results indicate that plasma concentrations of LTB4 and LTC4 are not useful diagnostic markers since they were not increased in queens with pyometra, in contrast to 6-keto-PGF1α. In addition, treatment with MPA evoked neither endocrine nor molecular changes in endometria of cats.
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Dąbrowski R, Pastor J, Szczubiał M, Piech T, Bochniarz M, Wawron W, Tvarijonaviciute A. Serum IL-6 and IL-10 concentrations in bitches with pyometra undergoing ovariohysterectomy. Acta Vet Scand 2015; 57:61. [PMID: 26410584 PMCID: PMC4584008 DOI: 10.1186/s13028-015-0153-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Accepted: 09/21/2015] [Indexed: 11/29/2022] Open
Abstract
Background Pyometra is a serious bacterial infection of the uterus affecting female dogs and manifests as an accumulation of pus in the uterine lumen. The aim of the study was to assess changes in serum interleukin (IL)-6 and IL-10 concentrations in bitches with pyometra undergoing ovariohysterectomy. Findings Blood samples were collected from healthy bitches (controls) and bitches with pyometra before surgery, and 3 and 10 days after ovariohysterectomy. Before surgery, bitches with pyometra had significantly higher serum concentrations of IL-6 and IL-10 than the controls. After surgery, the serum concentration of IL-6 and IL-10 decreased significantly. In healthy dogs, the concentration of IL-6 and IL-10 showed a significant increase 3 days after surgery followed by a decrease on day 10. Conclusion An increase in serum concentrations of IL-6 and IL-10 was present before surgery in bitches with pyometra and 3 days after ovariohysterectomy in healthy controls. Concentrations decreased after ovariohysterectomy and/or proper healing, suggesting that these cytokines can be useful for assessment of the postoperative period in bitches.
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16
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Dąbrowski R, Hagman R, Tvarijonaviciute A, Pastor J, Kocki T, Turski WA. Serum tryptophan and its metabolites in female dogs undergoing ovariohysterectomy as treatment of pyometra or as elective spay surgery. Theriogenology 2015; 83:1279-86. [DOI: 10.1016/j.theriogenology.2015.01.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2014] [Revised: 11/29/2014] [Accepted: 01/09/2015] [Indexed: 10/24/2022]
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17
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Hagman R. Diagnostic and prognostic markers for uterine diseases in dogs. Reprod Domest Anim 2015; 49 Suppl 2:16-20. [PMID: 24947856 DOI: 10.1111/rda.12331] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Common uterine diseases in female dogs include cystic endometrial hyperplasia (CEH), mucometra, hydrometra and pyometra. It is important in clinical practice to recognize pyometra because it is potentially life-threatening due to the systemic illness induced by bacterial infection of the uterus. In contrast, the uterine content is sterile in CEH and mucometra/hydrometra, and clinical signs are mostly mild or absent. Optimal treatment depends on the type of uterine disease and its severity, but diagnosis and prognosis determination may be challenging and the diseases difficult to separate clinically. Diagnostic findings or biomarkers that may aid in the differentiation of the diseases are valuable, especially when several bitches are admitted with a fluid-filled uterus during night-time, and it has to be decided which patient to operate on first. Additionally, some variables may indicate outcome as measured by mortality or morbidity. If the uterus is not enlarged or fluid-filled, detection of uterine disease can be even more difficult. In this study, clinically useful variables with possible diagnostic or prognostic value for uterine diseases in dogs are discussed.
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Affiliation(s)
- R Hagman
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
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18
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Pathogenic Escherichia coli and lipopolysaccharide enhance the expression of IL-8, CXCL5, and CXCL10 in canine endometrial stromal cells. Theriogenology 2015; 84:34-42. [PMID: 25765298 DOI: 10.1016/j.theriogenology.2015.02.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Revised: 02/05/2015] [Accepted: 02/05/2015] [Indexed: 01/05/2023]
Abstract
Chemokines play a central role in cellular communication in response to bacterial infection. However, the knowledge of the chemokine responses to bacterial infections in dogs remains limited. Uterine bacterial infection (pyometra) is one of the most common bacterial diseases in dogs and causes sepsis in most of the cases. We have shown previously that dogs with pyometra have higher messenger RNA (mRNA) levels of chemokines in uterus. To assess whether the stromal part of the endometrium expresses chemokines in response to bacterial infection, we cultured endometrial stromal cells isolated from healthy dogs and exposed them to either live pathogenic Escherichia coli, isolated from the uterus of a dog with pyometra, or lipopolysaccharide. Changes in the mRNA expression of ELR(+) CXC chemokines, IL-8, CXCL5, CXCL7, and ELR(-) CXC chemokine, CXCL10, were measured after 24 hours using quantitative real-time polymerase chain reaction. Levels of IL-8, CXCL5, and CXCL10 were upregulated in endometrial stromal cells exposed to E coli and lipopolysaccharide, whereas the level of CXCL7 was decreased or unaffected. In addition, levels of IL-8 and CXCL5, but not CXCL7 or CXCL10, were significantly higher in dogs with pyometra than those in healthy dogs. Our findings show that pathogenic uterine-derived E coli induces a CXC chemokine response both in cultured endometrial stromal cells within 24 hours and in pyometra-affected uteri from dogs. Stromal cells could therefore play an important role in early neutrophil and T cell recruitment to the site of inflammation during gram-negative bacterial infection of the uterus. Further studies are needed to clarify the role of chemokines in host response to bacterial infection in dogs and the possibility of using chemokines as diagnostic parameters for bacterial infection in this species.
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19
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Jitpean S, Pettersson A, Höglund OV, Holst BS, Olsson U, Hagman R. Increased concentrations of Serum amyloid A in dogs with sepsis caused by pyometra. BMC Vet Res 2014; 10:273. [PMID: 25430894 PMCID: PMC4247870 DOI: 10.1186/s12917-014-0273-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Accepted: 11/08/2014] [Indexed: 01/21/2023] Open
Abstract
Background Sepsis is a serious and potentially life-threatening condition and early diagnosis and appropriate treatment is crucial for survival. Pyometra is one of the most common diseases in intact female dogs. The disease often leads to sepsis (systemic inflammatory response syndrome, SIRS, caused by infection). Diagnostic markers for detecting sepsis are gaining increasing interest in veterinary medicine. Acute phase proteins (APPs) such as C-reactive protein (CRP) are useful for detecting systemic inflammation in dogs. Serum amyloid A (SAA) is another major APP in dogs that is not yet as widely used. Albumin is regarded as a negative APP and has earlier been evaluated for prediction of prognosis in septic dogs. The aim of the present study was to determine SAA, CRP and albumin concentrations in dogs with sepsis and pyometra and to evaluate whether these inflammatory markers are associated with length of postoperative hospitalization. Results Thirty-one surgically treated bitches with pyometra were included, whereof 23 septic (SIRS-positive) and eight non-septic (SIRS-negative). Albumin concentrations were analyzed by routine automated methods. SAA and CRP analyses were performed with previously validated commercially available assays (ELISA and immunoturbidimetric). Mean (±SE) serum concentrations of SAA were significantly higher in septic (130.8 ± 8.0 mg/L) compared to non-septic bitches (88.5 ± 12.5 mg/L). Using a cut-off value for SAA of 109.07 mg/L (n = 31 bitches), the sensitivity and specificity for detecting sepsis was 74% and 50%, respectively. Serum albumin concentrations were not significantly different in septic compared to non-septic bitches (mean ± SE, 25 ± 1 g/L and 26 ± 1 g/L, respectively). CRP concentrations were also not significantly different in septic (mean ± SE 225.6 ± 16.0 mg/L) compared to non-septic bitches (mean ± SE, 176.0 ± 27.1 mg/L). None of these inflammatory markers were associated with the outcome as measured by length of hospitalization. Conclusions SAA concentrations were increased in dogs with sepsis induced by pyometra and may be useful as an adjunctive diagnostic marker for sepsis. To evaluate the full potential of SAA as a marker for sepsis also in other diseases, further studies are warranted.
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Affiliation(s)
- Supranee Jitpean
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, SE-750 07, Sweden.
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20
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Rubio A, Boyen F, Tas O, Kitshoff A, Polis I, Van Goethem B, de Rooster H. Bacterial colonization of the ovarian bursa in dogs with clinically suspected pyometra and in controls. Theriogenology 2014; 82:966-71. [PMID: 25127745 DOI: 10.1016/j.theriogenology.2014.07.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2014] [Revised: 05/27/2014] [Accepted: 07/10/2014] [Indexed: 11/28/2022]
Abstract
Septic peritonitis occurs relatively commonly in dogs. Secondary septic peritonitis is usually associated with perforation of intestines or infected viscera, such as the uterus in pyometra cases. The aim of this study was to evaluate the bacterial flora in the ovarian bursae of intact bitches as a potential source of contamination. One hundred forty dogs, clinically suspected of pyometra, were prospectively enrolled. The control group consisted of 26 dogs that underwent elective ovariohysterectomies and 18 dogs with mammary gland tumors that were neutered at the time of mastectomy. Bacteriology samples were taken aseptically at the time of surgery from the bursae and the uterus in all dogs. Twenty-two dogs that were clinically suspected of pyometra had sterile uterine content ("mucometra" cases); the remaining 118 had positive uterine cultures ("pyometra" cases) and septic peritoneal fluid was present in 10% of these cases. Of the 118 pyometra cases, 9 had unilateral and 15 had bilateral bacterial colonization of their ovarian bursae. However, the bacteria from the ovarian bursa were similar to those recovered from the uterine pus in only half of the cases. Furthermore, positive bursae were also seen in one mucometra dog (unilateral) and in four control dogs (two unilateral and two bilateral). The data illustrate that the canine ovarian bursa can harbor bacteria. The biological importance of these isolations remains unclear.
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Affiliation(s)
- Alejandro Rubio
- Department of Small Animal Medicine and Clinical Biology, Faculty of Veterinary Medicine, Ghent University, Belgium
| | - Filip Boyen
- Department of Pathology, Bacteriology and Poultry Diseases, Faculty of Veterinary Medicine, Ghent University, Belgium
| | - Olaf Tas
- Department of Small Animal Medicine and Clinical Biology, Faculty of Veterinary Medicine, Ghent University, Belgium
| | - Adriaan Kitshoff
- Department of Small Animal Medicine and Clinical Biology, Faculty of Veterinary Medicine, Ghent University, Belgium
| | - Ingeborgh Polis
- Department of Small Animal Medicine and Clinical Biology, Faculty of Veterinary Medicine, Ghent University, Belgium
| | - Bart Van Goethem
- Department of Small Animal Medicine and Clinical Biology, Faculty of Veterinary Medicine, Ghent University, Belgium
| | - Hilde de Rooster
- Department of Small Animal Medicine and Clinical Biology, Faculty of Veterinary Medicine, Ghent University, Belgium.
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Serum insulin-like growth factor-I, iron, C-reactive protein, and serum amyloid A for prediction of outcome in dogs with pyometra. Theriogenology 2014; 82:43-8. [DOI: 10.1016/j.theriogenology.2014.02.014] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Revised: 02/11/2014] [Accepted: 02/20/2014] [Indexed: 12/19/2022]
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22
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Enginler SO, Ateş A, Diren Sığırcı B, Sontaş BH, Sönmez K, Karaçam E, Ekici H, Evkuran Dal G, Gürel A. Measurement of C-reactive protein and Prostaglandin F2αMetabolite Concentrations in Differentiation of Canine Pyometra and Cystic Endometrial Hyperplasia/Mucometra. Reprod Domest Anim 2014; 49:641-647. [DOI: 10.1111/rda.12340] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Accepted: 04/23/2014] [Indexed: 11/29/2022]
Affiliation(s)
- SO Enginler
- Department of Obstetrics and Gynaecology; Faculty of Veterinary Medicine; Istanbul University; Avcılar Istanbul Turkey
| | - A Ateş
- Department of Biochemistry; Faculty of Veterinary Medicine; Istanbul University; Avcılar Istanbul Turkey
| | - B Diren Sığırcı
- Department of Microbiology; Faculty of Veterinary Medicine; Istanbul University; Avcılar Istanbul Turkey
| | - BH Sontaş
- Department of Obstetrics and Gynaecology; Faculty of Veterinary Medicine; Istanbul University; Avcılar Istanbul Turkey
| | - K Sönmez
- Department of Pathology; Faculty of Veterinary Medicine; Istanbul University; Avcılar Istanbul Turkey
| | - E Karaçam
- Department of Obstetrics and Gynaecology; Faculty of Veterinary Medicine; Istanbul University; Avcılar Istanbul Turkey
| | - H Ekici
- Department of Obstetrics and Gynaecology; Faculty of Veterinary Medicine; Istanbul University; Avcılar Istanbul Turkey
| | - G Evkuran Dal
- Department of Obstetrics and Gynaecology; Faculty of Veterinary Medicine; Istanbul University; Avcılar Istanbul Turkey
| | - A Gürel
- Department of Pathology; Faculty of Veterinary Medicine; Istanbul University; Avcılar Istanbul Turkey
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23
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Jitpean S, Ström-Holst B, Emanuelson U, Höglund OV, Pettersson A, Alneryd-Bull C, Hagman R. Outcome of pyometra in female dogs and predictors of peritonitis and prolonged postoperative hospitalization in surgically treated cases. BMC Vet Res 2014; 10:6. [PMID: 24393406 PMCID: PMC3892096 DOI: 10.1186/1746-6148-10-6] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2013] [Accepted: 01/03/2014] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND One of the most common diseases in intact bitches is pyometra--a potentially life-threatening disease associated with a variety of clinical and laboratory findings. The aims of the present study were to describe complications of the disease and to investigate clinically useful indicators associated with peritonitis and/or prolonged postoperative hospitalization. RESULTS A retrospective study was performed using records from 356 bitches diagnosed with pyometra during the years 2006-2007 at the University Animal Hospital, Swedish University of Agricultural Sciences, Uppsala, Sweden. Of the 356 bitches, 315 were surgically treated by ovariohysterectomy, 9 were medically treated and 32 were euthanized without treatment. In the surgically treated bitches, univariable associations between clinical and laboratory data, risk for prolonged hospitalization (≥ 3 days) and/or signs of peritonitis, were analyzed by Chi-square and Fisher's exact test. Logistic regression models were used to assess multivariable associations.The most common complication observed in surgically treated bitches was peritonitis (40 bitches), followed by urinary tract infection (19 bitches), wound infection (8 bitches), uveitis (6 bitches), and cardiac arrhythmia (5 bitches). Leucopenia and fever/hypothermia were associated with increased risk for peritonitis (18-fold and three-fold, respectively). Moderate to severe depression of the general condition, pale mucous membranes and leucopenia were associated with increased risk (seven-fold, three-fold, and over three-point-five-fold, respectively) for prolonged postoperative hospitalization. CONCLUSIONS Several clinically useful indicators were identified. Leucopenia was the most important marker, associated with 18-fold increased risk for peritonitis and an over three-point-five increased risk for prolonged hospitalization. Fever/hypothermia, depression and pale mucous membranes were associated with increased risk for peritonitis and/or prolonged hospitalization. The results of the present study may be valuable for identifying peritonitis and predicting increased morbidity in surgically treated bitches with pyometra.
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Affiliation(s)
- Supranee Jitpean
- Department of Clinical Sciences, Faculty of Veterinary Medicine and Animal Science, Swedish University of Agricultural Sciences, Box 7054, SE-750 07 Uppsala, Sweden
| | - Bodil Ström-Holst
- Department of Clinical Sciences, Faculty of Veterinary Medicine and Animal Science, Swedish University of Agricultural Sciences, Box 7054, SE-750 07 Uppsala, Sweden
| | - Ulf Emanuelson
- Department of Clinical Sciences, Faculty of Veterinary Medicine and Animal Science, Swedish University of Agricultural Sciences, Box 7054, SE-750 07 Uppsala, Sweden
| | - Odd V Höglund
- Department of Clinical Sciences, Faculty of Veterinary Medicine and Animal Science, Swedish University of Agricultural Sciences, Box 7054, SE-750 07 Uppsala, Sweden
| | - Ann Pettersson
- Department of Clinical Sciences, Faculty of Veterinary Medicine and Animal Science, Swedish University of Agricultural Sciences, Box 7054, SE-750 07 Uppsala, Sweden
| | | | - Ragnvi Hagman
- Department of Clinical Sciences, Faculty of Veterinary Medicine and Animal Science, Swedish University of Agricultural Sciences, Box 7054, SE-750 07 Uppsala, Sweden
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Dąbrowski R, Kostro K, Szczubiał M. Concentrations of C-reactive protein, serum amyloid A, and haptoglobin in uterine arterial and peripheral blood in bitches with pyometra. Theriogenology 2013; 80:494-7. [DOI: 10.1016/j.theriogenology.2013.05.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2013] [Revised: 05/16/2013] [Accepted: 05/16/2013] [Indexed: 10/26/2022]
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25
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Leucocyte phagocytosis during the luteal phase in bitches. Vet Immunol Immunopathol 2013; 153:77-82. [DOI: 10.1016/j.vetimm.2013.02.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2012] [Revised: 02/01/2013] [Accepted: 02/07/2013] [Indexed: 11/19/2022]
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Momtaz H, Karimian A, Madani M, Safarpoor Dehkordi F, Ranjbar R, Sarshar M, Souod N. Uropathogenic Escherichia coli in Iran: serogroup distributions, virulence factors and antimicrobial resistance properties. Ann Clin Microbiol Antimicrob 2013; 12:8. [PMID: 23627669 PMCID: PMC3651382 DOI: 10.1186/1476-0711-12-8] [Citation(s) in RCA: 111] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2013] [Accepted: 04/21/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Urinary tract infections (UTIs) are one of the most common bacterial infections with global expansion. These infections are predominantly caused by uropathogenic Escherichia coli (UPEC). METHODS Totally, 123 strains of Escherichia coli isolated from UTIs patients, using bacterial culture method were subjected to polymerase chain reactions for detection of various O- serogroups, some urovirulence factors, antibiotic resistance genes and resistance to 13 different antibiotics. RESULTS According to data, the distribution of O1, O2, O6, O7 and O16 serogroups were 2.43%, besides O22, O75 and O83 serogroups were 1.62%. Furthermore, the distribution of O4, O8, O15, O21 and O25 serogroups were 5.69%, 3.25%, 21.13%, 4.06% and 26.01%, respectively. Overall, the fim virulence gene had the highest (86.17%) while the usp virulence gene had the lowest distributions of virulence genes in UPEC strains isolated from UTIs patients. The vat and sen virulence genes were not detected in any UPEC strains. Totally, aadA1 (52.84%), and qnr (46.34%) were the most prevalent antibiotic resistance genes while the distribution of cat1 (15.44%), cmlA (15.44%) and dfrA1 (21.95%) were the least. Resistance to penicillin (100%) and tetracycline (73.98%) had the highest while resistance to nitrofurantoin (5.69%) and trimethoprim (16.26%) had the lowest frequencies. CONCLUSIONS This study indicated that the UPEC strains which harbored the high numbers of virulence and antibiotic resistance genes had the high ability to cause diseases that are resistant to most antibiotics. In the current situation, it seems that the administration of penicillin and tetracycline for the treatment of UTIs is vain.
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Affiliation(s)
- Hassan Momtaz
- Department of Microbiology, ShahreKord Branch, Islamic Azad University, P.O. Box: 166, ShahreKord, Iran.
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Sharif H, Hagman R, Wang L, Eriksson S. Elevation of serum thymidine kinase 1 in a bacterial infection: Canine pyometra. Theriogenology 2013; 79:17-23. [DOI: 10.1016/j.theriogenology.2012.09.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2012] [Revised: 09/07/2012] [Accepted: 09/07/2012] [Indexed: 11/25/2022]
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Oestrous cycle-related changes in production of Toll-like receptors and prostaglandins in the canine endometrium. J Reprod Immunol 2012; 96:45-57. [DOI: 10.1016/j.jri.2012.07.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2012] [Revised: 06/18/2012] [Accepted: 07/01/2012] [Indexed: 01/28/2023]
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Abstract
BACKGROUND The acute phase protein, α-1-acid glycoprotein (AGP), has been proposed to have a role in immunomodulation and to be a nonspecific antimicrobial agent. We suggest that AGP may be increased in dogs with pyometra and possibly to a greater extent in dogs also manifesting signs of systemic inflammatory response syndrome (SIRS). OBJECTIVES Our objectives were to evaluate serum AGP concentrations in dogs diagnosed with pyometra compared with clinically healthy female dogs and to determine if AGP concentrations were correlated with severity of disease. METHODS Twenty-six dogs with pyometra and 18 clinically healthy intact female dogs were included in this prospective study. A diagnosis of pyometra was verified by histopathologic examination after ovariohysterectomy in the pyometra group. A commercially available single radial immunodiffusion test was used for AGP analysis. Clinical findings, laboratory variables, and hospitalization times were compared. RESULTS Mean AGP concentration in dogs with pyometra (1943 ± 913 mg/L, mean ± SD), was significantly higher (P<.001) than in healthy dogs (495 ± 204 mg/L). Mean AGP concentration in dogs in the pyometra group with (n=18) or without (n=8) SIRS did not differ. Animals with a prolonged hospital stay had higher AGP concentrations. CONCLUSIONS Pyometra was associated with increased serum concentrations of the acute phase protein AGP. AGP concentrations were associated with severity of disease as measured by duration of hospitalization. As AGP binds basic drugs, further studies of its pharmacokinetic and pharmacodynamic propreties in cases of pyometra may be of clinical interest.
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Affiliation(s)
- Ragnvi Hagman
- Department of Clinical Sciences, Division of Small Animals, Faculty of Veterinary Medicine and Animal Science, Swedish University of Agricultural Sciences, Uppsala, Sweden.
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30
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Dąbrowski R, Kostro K, Lisiecka U, Szczubiał M, Krakowski L. Usefulness of C-reactive protein, serum amyloid A component, and haptoglobin determinations in bitches with pyometra for monitoring early post-ovariohysterectomy complications. Theriogenology 2009; 72:471-6. [DOI: 10.1016/j.theriogenology.2009.03.017] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2009] [Revised: 03/06/2009] [Accepted: 03/22/2009] [Indexed: 11/27/2022]
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Pelander L, Hagman R, Häggström J. Concentrations of cardiac Troponin I before and after ovariohysterectomy in 46 female dogs with pyometra. Acta Vet Scand 2008; 50:35. [PMID: 18786242 PMCID: PMC2546406 DOI: 10.1186/1751-0147-50-35] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2008] [Accepted: 09/11/2008] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Canine pyometra is a common disease in countries where routine spaying of young dogs is not common practice. This disease is known to lead to systemic inflammation potentially affecting multiple organs in the body, including the heart. Cardiac-specific Troponin I (cTnI) is a sensitive marker of myocardial cell damage, which can result from ischemia, trauma, toxins or inflammation. Dogs with pyometra are also exposed to anaesthesia which can potentially result in myocardial cell damage. The aims of the study were 1) to evaluate the occurrence of myocardial cell damage as indicated by increased serum concentrations of cTnI in dogs with pyometra and relate these to presence of systemic inflammation and 2) to evaluate the change in cTnI-concentrations after anaesthesia and surgery. METHODS Serum cTnI concentration was measured preoperatively and one day after surgery in 46 female dogs with pyometra and 15 female dogs that underwent surgery for other reasons (ovariohysterectomy and mammary tumours). RESULTS Forty-six female dogs of different breeds diagnosed with pyometra were included. The dogs had a median age of 8.5 years (IQR 7.5-10) and a median weight of 29 kg (IQR 9-32). Of the 46 dogs, 37 (80%) fulfilled the chosen criteria for systemic inflammatory response syndrome (SIRS) at inclusion. Thirteen (28%) of the dogs had increased cTnI concentrations (> 0.2 microg/l) before surgery and 18 (39%) had increased cTnI-concentrations the day after surgery. The cTnI concentrations in the 13 dogs with increased preoperative cTnI concentrations decreased in 8 dogs, increased in 4 dogs, and was unchanged in one dog. Seven dogs with nondetectable preoperative cTnI concentrations had increased postoperative concentrations. The only significant association between the studied laboratory or clinical variables (including SIRS) and cTnI concentration was preoperative percentage band neutrophils (PBN) and postoperative cTnI concentration (P = 0.016). In total, 20 dogs (43%) had increased pre- or postoperative cTnI concentrations. Seven dogs (15%) had pre-or postoperative concentrations of cTnI of 1.0 microg/l or higher. CONCLUSION Mild to moderate increases in cTnI appears to be common in dogs with pyometra before and after surgery, but the clinical importance of this finding is uncertain. None of the studied clinical variables were found to reliably predict increased preoperative cTnI concentrations. Because of the pre- and postoperative variation in cTnI concentrations, it was not possible to identify a negative effect of anaesthesia and surgery on myocardial cell integrity.
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Affiliation(s)
- Lena Pelander
- University Teaching Hospital, Swedish University of Agricultural Science, Uppsala, Sweden
- Department of Clinical Sciences, Swedish University of Agricultural Science, Uppsala, Sweden
| | - Ragnvi Hagman
- Department of Clinical Sciences, Swedish University of Agricultural Science, Uppsala, Sweden
| | - Jens Häggström
- Department of Clinical Sciences, Swedish University of Agricultural Science, Uppsala, Sweden
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Abstract
Cystic endometrial hyperplasia (CEH) in the bitch can result in either pyometra, hematometra, or hydrometra, and many facets of these uterine diseases can make them difficult to differentiate. The conditions differ in their systemic effects, since pyometra, particularly closed-cervix pyometra, can be a life-threatening condition that must be recognized, managed, and treated expeditiously. Mucometra is an accumulation of sterile intraluminal mucoid fluid, hematometra is an accumulation of sterile, bloody fluid, and hydrometra is an accumulation of sterile, watery fluid; none of which have any significant systemic outward clinical signs. This paper will describe the definitions, signalment, historical findings, incidence, clinical signs, physical exam findings, and diagnostic findings in canine pyometra and mucometra, and hematometra and hydrometra.
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Affiliation(s)
- S D Pretzer
- Abilene Animal Hospital, P.A., 320 NE 14th Street, Abilene, KS 67410, USA.
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Fransson BA, Lagerstedt AS, Bergstrom A, Hagman R, Park JS, Chew BP, Evans MA, Ragle CA. C-reactive protein, tumor necrosis factor α, and interleukin-6 in dogs with pyometra and SIRS. J Vet Emerg Crit Care (San Antonio) 2007. [DOI: 10.1111/j.1476-4431.2006.00203.x] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Bartoskova A, Vitasek R, Leva L, Faldyna M. Hysterectomy leads to fast improvement of haematological and immunological parameters in bitches with pyometra. J Small Anim Pract 2007; 48:564-8. [PMID: 17617161 DOI: 10.1111/j.1748-5827.2007.00345.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES To investigate whether a combination of hysterectomy and antibiotic treatment leads to an improvement of altered haematological and immunological parameters in bitches affected by pyometra. METHODS Blood samples obtained from 13 bitches affected by pyometra were investigated before hysterectomy and seven days later for a total and differential leucocyte count, activity of neutrophils and lymphocytes, and quantification of total serum immunoglobulins, lysozyme and circulating immune complexes. RESULTS The parameters most affected included changes in blood profile (leucocytosis because of neutrophilia or leucopenia) and inhibition of lymphocyte activity. Seven days after hysterectomy, all affected parameters returned to normal levels comparable to clinically healthy dogs. CLINICAL SIGNIFICANCE Application of immunostimulating therapy is not necessary to manage changes in blood cell counts and suppression of lymphocyte activity in bitches with pyometra. Removal of the infected uterus, being the source of infection, leads to improvement.
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Affiliation(s)
- A Bartoskova
- University of Veterinary and Pharmaceutical Sciences Brno, Palackeho 1/3, 612 42 Brno, Czech Republic
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35
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Heiene R, Kristiansen V, Teige J, Jansen JH. Renal histomorphology in dogs with pyometra and control dogs, and long term clinical outcome with respect to signs of kidney disease. Acta Vet Scand 2007; 49:13. [PMID: 17480218 PMCID: PMC1868749 DOI: 10.1186/1751-0147-49-13] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2007] [Accepted: 05/04/2007] [Indexed: 11/24/2022] Open
Abstract
Background Age-related changes in renal histomorphology are described, while the presence of glomerulonephritis in dogs with pyometra is controversial in current literature. Methods Dogs with pyometra were examined retrospectively for evidence of secondary renal damage and persisting renal disease through two retrospective studies. In Study 1, light microscopic lesions of renal tissue were graded and compared in nineteen dogs with pyometra and thirteen age-matched control bitches. In Study 2, forty-one owners of dogs with pyometra were interviewed approximately 8 years after surgery for evidence ofclinical signs of renal failure in order to document causes of death/euthanasia. Results Interstitial inflammation and tubular atrophy were more pronounced in dogs with pyometra than in the control animals. Glomerular lesions classified as glomerular sclerosis were present in both groups. No unequivocal light microscopic features of glomerulonephritis were observed in bitches in any of the groups. Two bitches severely proteinuric at the time of surgery had developed end stage renal disease within 3 years. In five of the bitches polyuria persisted after surgery. Most bitches did not show signs of kidney disease at the time of death/euthanasia. Conclusion Tubulointerstitial inflammation was observed, but glomerular damage beyond age-related changes could not be demonstrated by light microscopy in the dogs with pyometra. However, severe proteinuria after surgery may predispose to development of renal failure.
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Affiliation(s)
- Reidun Heiene
- Department of Companion Animal Clinical Sciences, Norwegian School of Veterinary Science, PO Box 8146 Dep., N-0033 Oslo, Norway
| | - Veronica Kristiansen
- Department of Companion Animal Clinical Sciences, Norwegian School of Veterinary Science, PO Box 8146 Dep., N-0033 Oslo, Norway
| | - Jon Teige
- Department of Basic Science and Aquatic Medicine, Norwegian School of Veterinary Science, PO Box 8146 Dep., N-0033 Oslo, Norway
| | - Johan Høgset Jansen
- Department of Basic Science and Aquatic Medicine, Norwegian School of Veterinary Science, PO Box 8146 Dep., N-0033 Oslo, Norway
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Byers CG, Williams JE, Saylor DK. Pyometra with inguinal herniation of the left uterine horn and omentum in a Beagle dog. J Vet Emerg Crit Care (San Antonio) 2007. [DOI: 10.1111/j.1476-4431.2006.00212.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Dabrowski R, Wawron W, Kostro K. Changes in CRP, SAA and haptoglobin produced in response to ovariohysterectomy in healthy bitches and those with pyometra. Theriogenology 2007; 67:321-7. [PMID: 16962655 DOI: 10.1016/j.theriogenology.2006.07.019] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2005] [Revised: 07/28/2006] [Accepted: 07/30/2006] [Indexed: 11/21/2022]
Abstract
The aim of the study was to assess changes in serum C-reactive protein (CRP), serum amyloid A component (SAA) and haptoglobin (Hp) concentrations in healthy bitches and in those with pyometra undergoing ovariohysterectomy, and to establish the usefulness of such determinations for monitoring the postoperative period. Our results indicate that CRP and SAA determinations serve to evaluate the severity of the inflammatory process in pyometra since the concentrations of these acute phase proteins were increased immediately after surgery and diminished thereafter. The CRP and SAA response was rapidly produced while Hp concentrations increased in a more gradual manner. Thus, postoperative concentrations of CRP and SAA provide valuable information on the subsidence of the inflammatory response during the uneventful postoperative period. Our findings also suggest that acute phase proteins might be useful diagnostic markers of early postoperative complications.
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Affiliation(s)
- Roman Dabrowski
- Department and Clinic of Animal Reproduction, Faculty of Veterinary Medicine, Agricultural University, 30 Głeboka St., 20-612 Lublin, Poland.
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Hagman R, Kindahl H, Lagerstedt AS. Pyometra in bitches induces elevated plasma endotoxin and prostaglandin F2alpha metabolite levels. Acta Vet Scand 2006; 47:55-67. [PMID: 16722306 PMCID: PMC1618961 DOI: 10.1186/1751-0147-47-55] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2004] [Accepted: 01/31/2006] [Indexed: 11/15/2022] Open
Abstract
Endotoxemia in bitches with pyometra can cause severe systemic effects directly or via the release of inflammatory mediators. Plasma endotoxin concentrations were measured in ten bitches suffering from pyometra with moderately to severely deteriorated general condition, and in nine bitches admitted to surgery for non-infectious reasons. Endotoxin samples were taken on five occasions before, during and after surgery. In addition, urine and uterine bacteriology was performed and hematological, blood biochemical parameters, prostaglandin F2alpha metabolite 15-ketodihydro-PGF2alpha (PG-metabolite), progesterone and oestradiol (E2-17beta) levels were analysed. The results confirm significantly increased plasma levels of endotoxin in bitches with pyometra and support previous reports of endotoxin involvement in the pathogenesis of the disease. Plasma concentrations of PG-metabolite were elevated in pyometra bitches and provide a good indicator of endotoxin release since the concentrations were significantly correlated to the endotoxin levels and many other hematological and chemistry parameters. The gamma-globulin serum protein electrophoresis fraction and analysis of PG-metabolite can be valuable in the diagnosis of endotoxin involvement if a reliable, rapid and cost-effective test for PG-metabolite analysis becomes readily available in the future. Treatment inhibiting prostaglandin biosynthesis and related compounds could be beneficial for bitches suffering from pyometra.
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Affiliation(s)
- R Hagman
- Department of Small Animal Clinical Sciences, Faculty of Veterinary Medicine, Swedish University of Agricultural Sciences, Box 7037, SE-75007 Uppsala, Sweden
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Hagman R, Kindahl H, Fransson BA, Bergström A, Holst BS, Lagerstedt AS. Differentiation between pyometra and cystic endometrial hyperplasia/mucometra in bitches by prostaglandin F2alpha metabolite analysis. Theriogenology 2005; 66:198-206. [PMID: 16375957 DOI: 10.1016/j.theriogenology.2005.11.002] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2004] [Revised: 11/02/2005] [Accepted: 11/04/2005] [Indexed: 11/19/2022]
Abstract
Bitches with pyometra are potential emergency cases which may be clinically difficult to differentiate from cases of cystic endometrial hyperplasia (CEH) in combination with mucometra. In the present study plasma prostaglandin F(2alpha), as measured by its main metabolite 15-keto-13,14-dihydro-PGF(2alpha) (PG-metabolite) concentrations, blood biochemical and hematological parameters were measured in 59 bitches with pyometra, 10 bitches with CEH and nine controls to determine if PG-metabolite could differentiate between the three uterine conditions. Bitches with pyometra had significantly higher plasma levels of PG-metabolite than bitches with CEH (P=0.002) and the controls (P=0.002). PG-metabolite analysis alone had a high sensitivity (98.3%) and a high specificity (80.0%) for the differentiation of pyometra versus CEH in bitches where fluid in the uterus was diagnosed. When a combination of PG-metabolite and percentage band neutrophils (PBN) was used for differentiation of the two diagnoses, a sensitivity of 100% and specificity of 90.0% was obtained. This means that the combination of PG-metabolite and PBN analysis allows for differentiation between cases of pyometra and CEH. If the PG-metabolite level in a bitch is >or=4,524 pmol l(-1), there is a 99% probability of the diagnosis pyometra versus CEH. Levels of PG-metabolite >or=3,054 pmol l(-1), >or=2,388 pmol l(-1) or>or=1,666 pmol l(-1) indicates a 95%, 90% or 80% probability of pyometra, respectively. At high PG-metabolite levels (above about 3,000 pmol l(-1)), PG-metabolite alone is enough for differentiation of pyometra versus CEH. The results of the present study showed that PG-metabolite analysis is valuable in the diagnosis and prediction of severity of uterine diseases.
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Affiliation(s)
- R Hagman
- Department of Small Animal Clinical Sciences, Faculty of Veterinary Medicine, Swedish University of Agricultural Sciences, Box 7037, SE-75007 Uppsala, Sweden
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Aroch I, Klement E, Segev G. Clinical, Biochemical, and Hematological Characteristics, Disease Prevalence, and Prognosis of Dogs Presenting with Neutrophil Cytoplasmic Toxicity. J Vet Intern Med 2005. [DOI: 10.1111/j.1939-1676.2005.tb02660.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Fransson BA, Karlstam E, Bergstrom A, Lagerstedt AS, Park JS, Evans MA, Ragle CA. C-reactive Protein in the Differentiation of Pyometra From Cystic Endometrial Hyperplasia/Mucometra in Dogs. J Am Anim Hosp Assoc 2004; 40:391-9. [PMID: 15347619 DOI: 10.5326/0400391] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Hematological parameters, plasma C-reactive protein (CRP), and tumor necrosis factor αwere analyzed in 64 dogs with a presumptive diagnosis of pyometra. Final diagnosis (i.e., pyometra or cystic endometrial hyperplasia [CEH]) was determined by histopathology. As a single test, the percentage of band neutrophils had the highest sensitivity in the prediction of pyometra (sensitivity, 94%). The combination of percentage of bands and CRP had the highest sensitivity (97.7%; specificity, 75%) in predicting the presence of pyometra. The most common clinical signs noted in the study were vaginal discharge, polyuria, polydipsia, lethargy, and gastrointestinal signs. A combination of three or more of these clinical signs was significantly associated with pyometra.
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Affiliation(s)
- Boel A Fransson
- Departments of Veterinary Clinical Sciences, Washington State University, Pullman, Washington 99164-7060, USA
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Heiene R, van Vonderen IK, Moe L, Mølmen GS, Larsen NH, Kooistra HS. Vasopressin secretion in response to osmotic stimulation and effects of desmopressin on urinary concentrating capacity in dogs with pyometra. Am J Vet Res 2004; 65:404-8. [PMID: 15077680 DOI: 10.2460/ajvr.2004.65.404] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine vasopressin (VP) secretory capacity during osmotic stimulation and the response to desmopressin treatment in dogs with pyometra and control dogs. ANIMALS 6 dogs with pyometra before and after ovariohysterectomy and 6 control dogs. PROCEDURE Urine osmolality (Uosm) was measured during 12 hours. Values measured on the first day defined the basal Uosm pattern. On the second day, dogs were given desmopressin to induce a desmopressin-stimulated Uosm pattern. On day 3, the VP response to osmotic stimulation was examined. RESULTS Median Uosm on day 1 was 340 mOsm/kg (range, 104 to 1,273 mOsm/kg) and 807 mOsm/kg (range, 362 to 1,688 mOsm/kg) in dogs with pyometra before and after surgery, respectively, and 1,511 mOsm/kg (range, 830 to 1,674 mOsm/kg) in control dogs. Median Uosm during desmopressin treatment was 431 mOsm/kg (range, 168 to 1,491 mOsm/kg) and 1,051 mOsm/kg (range, 489 to 1,051 mOsm/kg) in dogs with pyometra before and after surgery, respectively, and 1,563 mOsm/kg (range, 1,390 to 2,351) in control dogs. In dogs with pyometra, threshold for VP secretion was lower before surgery (median, 340 mOsm/kg; range, 331 to 366 mOsm/kg) than after surgery (median, 358 mOsm/kg; range, 343 to 439 mOsm/kg) or in control dogs (median, 347 mOsm/kg; range, 334 to 360 mOsm/kg). Highest maximum plasma VP values were found in dogs with pyometra. CONCLUSIONS AND CLINICAL RELEVANCE Dogs with pyometra had increased urine concentration in response to desmopressin but not to the degree of control dogs, whereas VP secretory ability was not reduced.
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Affiliation(s)
- Reidun Heiene
- Department of Companion Animal Clinical Sciences, Norwegian School of Veterinary Science, PO Box 8146 dep, 0033 Oslo, Norway
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43
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De Bosschere H, Ducatelle R, Tshamala M. Uterine oestrogen and progesterone receptor expression in experimental pyometra in the bitch. J Comp Pathol 2003; 128:99-106. [PMID: 12634085 DOI: 10.1053/jcpa.2002.0610] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Pyometra was induced in five bitches by the intraluminal inoculation of a ligated uterine horn in metoestrus with an Escherichia coli suspension, the other horn serving as an uninoculated control. Histologically, the inoculated horns resembled those with naturally occurring pyometra, while the uninoculated horns had an inactive appearance instead of the normal metoestrus appearance. Immunohistochemically, the expression of sex hormone receptors in the inoculated horns corresponded with that in natural cases of pyometra. In the uninoculated horns, virtually no expression of sex hormone receptors was observed, in contrast to such expression in normal metoestrus. Bacteria-associated ovario-uterine interactions may have been responsible for the hyperplastic (inoculated horn) and inactive (uninoculated horn) uterine changes observed in this experiment.
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Affiliation(s)
- H De Bosschere
- Department of Pathology, Bacteriology and Avian Diseases, Faculty of Veterinary Medicine, University of Ghent, Salisburylaan 133, B-9820, Merelbeke, Belgium
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Kustritz MVR. Thenogenology question of the month. Pyometra. J Am Vet Med Assoc 2002; 220:175-7. [PMID: 12126125 DOI: 10.2460/javma.2002.220.175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Margaret V Root Kustritz
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St Paul 55108, USA
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45
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Hagman R, Kühn I. Escherichia coli strains isolated from the uterus and urinary bladder of bitches suffering from pyometra: comparison by restriction enzyme digestion and pulsed-field gel electrophoresis. Vet Microbiol 2002; 84:143-53. [PMID: 11731167 DOI: 10.1016/s0378-1135(01)00449-7] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Pyometra (uterine inflammation with accumulation of pus in the uterus) is regarded as one of the most common illnesses in bitches. The ethiology and pathogenesis are complex with both hormonal and bacterial elements. The bacteria most frequently isolated from the uterine content is Escherichia coli. In this study, 84 E. coli strains from the uteri of 70 bitches suffering from the disease were examined and their DNA-profiles compared by restriction enzyme analysis and pulsed-field gel electrophoresis (PFGE). Through variations in DNA-profiles of the E. coli isolates, this study indicates that pyometra is caused by E. coli originating from the normal flora of the dogs and not by certain clones spread between animals.E. coli strains from the urinary bladder and the uterus of six of the bitches suffering from simultaneous urinary tract infection and pyometra were examined and compared as above. The DNA-profiles of the isolates from each of the six bitches were 100% identical. This study supports the theory suggesting that in cases of simultaneous urinary tract infection and E. coli pyometra, the urinary tract and uterus are infected with the same bacterial strain. To evaluate whether the uterus was infected with a single clone of E. coli or if multiple clones were present, eight to 16 colonies of E. coli isolated from pyometra samples from a further 10 bitches were examined. All bacterial colonies from the culture of the same bitch showed identical DNA-profiles. In 14 of the 70 bitches, two macroscopically different but biochemically identical E. coli colony types were isolated. The two colony types from the same bitch proved to have identical DNA-profiles in 13 cases and almost identical in the remaining bitch.
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Affiliation(s)
- Ragnvi Hagman
- Department of Small Animal Clinical Sciences, Faculty of Veterinary medicine, Swedish University of Agricultural Sciences, P.O. Box 7037, SE-750 07 Uppsala, Sweden.
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De Bosschere H, Ducatelle R, Vermeirsch H, Van Den Broeck W, Coryn M. Cystic endometrial hyperplasia- pyometra complex in the bitch: should the two entities be disconnected? Theriogenology 2001; 55:1509-19. [PMID: 11354710 DOI: 10.1016/s0093-691x(01)00498-8] [Citation(s) in RCA: 83] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The uteri of 26 clinically healthy bitches and 42 bitches with a clinical suspicion of pyometra were examined histologically using a computerized image analysis system. Histologic lesions were characterised mainly by thickening or atrophy of the endometrium and by varying degrees of cystic changes of the glands. These lesions were observed in most of the clinically healthy bitches as well as in all of the clinically ill animals. In most of the ill bitches a variable degree of inflammation also was found. Some bitches with clinical signs indicative for pyometra had no inflammatory reaction in the uterus. These bitches were misdiagnosed as suffering from pyometra, confirming the difficulty of diagnosing pyometra by simple clinical examination. Determination of sex hormone serum levels revealed that all dogs in both groups were either in metestrus or in anestrus. Based on the results of this study the cystic endometrial hyperplasia-pyometra complex can be divided in two entities: a cystic endometrial hyperplasia-mucometra complex and an endometritis-pyometra complex. Both entities bear many similarities with each other, except for the inflammatory reaction in the endometritis-pyometra complex. It is concluded from this study that the latter complex probably does not necessarily follow the former, but that both can arise de novo.
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Affiliation(s)
- H De Bosschere
- Department of Pathology, Bacteriology and Avian Diseases, Faculty of Veterinary Medicine, University of Ghent, Merelbeke, Belgium.
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47
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Oluoch AO, Kim CH, Weisiger RM, Koo HY, Siegel AM, Campbell KL, Burke TJ, McKiernan BC, Kakoma I. Nonenteric Escherichia coli isolates from dogs: 674 cases (1990-1998). J Am Vet Med Assoc 2001; 218:381-4. [PMID: 11201564 DOI: 10.2460/javma.2001.218.381] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine nonenteric sites associated with Escherichia coli isolates in dogs and the antimicrobial susceptibilities of the isolates. DESIGN Retrospective study. SAMPLE POPULATION 17,000 canine specimens. PROCEDURE Medical records of 17,000 canine specimens submitted for bacteriologic culture were examined and the number of isolations of E coli was determined. For these cases, records were further examined with respect to body system involvement, sex, concurrent infection with other species of bacteria, and antimicrobial susceptibility. RESULTS 674 E coli isolates (424 from urine, 62 from the skin, 52 from the respiratory tract, 45 from the ear, 43 from the female reproductive tract, 25 from the male reproductive tract, and 23 from other organ systems) were identified. There was a significantly higher proportion of isolates from urine specimens from spayed females than from sexually intact females or males. Escherichia coli was isolated in pure culture from 65.9% of the specimens. Most E coli isolates were susceptible to norfloxacin (90%), enrofloxacin (87.5%), gentamicin (90.7%), and amikacin (85.9%). CONCLUSIONS AND CLINICAL RELEVANCE Most nonenteric E coli infections in dogs involve the urinary tract. Amikacin, gentamicin, norfloxacin, and enrofloxacin have the highest efficacy against canine E coli isolates. For E coli isolates from dogs, in vitro susceptibility to commonly used antimicrobial agents has remained fairly stable during the past decade.
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Affiliation(s)
- A O Oluoch
- Department of Veterinary Biosciences, College of Veterinary Medicine, University of Illinois, Urbana 61801, USA
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Abstract
The function of the immune system was studied in 34 bitches affected by pyometra. The mean age of the animals was 8.1 +/- 2.8 years. Samples of peripheral blood were examined using a battery of immunological tests. Data obtained from four sets of animals, grouped according to the severity of their disease, were compared. Leucocytosis (neutrophilia and partial monocytosis) and lymphopenia were detected in 62 per cent and 35 per cent of the bitches, respectively. The increase in the number of leucocytes was higher in the severely affected bitches. Inhibition of mitogen-driven lymphocyte proliferation was the characteristic feature of the immunological profile in bitches affected by pyometra, and this corresponded with the impairment of the general state of health. Sera from bitches showing functional inhibition of lymphocytes suppressed the activity of lymphocytes isolated from normal dogs. Sera from bitches affected by pyometra also had higher levels of immunoglobulins, lysozyme and circulating immune complexes. It can be concluded that pyometra is associated with an inflammatory response, but also with a marked suppression of immune system activity.
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Affiliation(s)
- M Faldyna
- Veterinary Research Institute, Brno, Czech Republic
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Schultheiss PC, Jones RL, Kesel ML, Olson PN. Normal bacterial flora in canine and feline uteri. J Vet Diagn Invest 1999; 11:560-2. [PMID: 12968746 DOI: 10.1177/104063879901100618] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- P C Schultheiss
- Department of Pathology, Colorado State University, Fort Collins, CO 80523, USA
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50
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Okano S, Tagawa M, Takase K. Relationship of the blood endotoxin concentration and prognosis in dogs with pyometra. J Vet Med Sci 1998; 60:1265-7. [PMID: 9853312 DOI: 10.1292/jvms.60.1265] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The blood concentrations of endotoxin in dogs with pyometra (n = 45) were compared with those in healthy dogs (n = 17). The blood endotoxin concentrations in the healthy dogs (n = 17), in those with good prognosis (n = 41) and those with poor prognosis (n = 4) were 3.4 +/- 2.8 pg/ml, 9.5 +/- 11.3 pg/ml and 74.2 +/- 18.3 pg/ml, respectively. The concentrations in the dogs with good prognosis and poor prognosis were significantly (p < 0.01) higher than those in the healthy dogs. The dogs with poor prognosis had significantly (p < 0.01) higher endotoxin concentrations than those with good prognosis. Blood endotoxin concentrations were measured in 9 dogs after surgery, and were found to be decreased. These results suggest the possible involvement of endotoxin in the pathophysiological changes due to pyometra in dogs, and also that the blood endotoxin concentration could be used as a marker to determine prognosis.
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Affiliation(s)
- S Okano
- Department of Small Animal Medicine, School of Veterinary Medicine and Animal Sciences, Kitasato University, Aomori, Japan
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