Uh ................ speaking of pyometra

I think this may be a record for me. 8 days ago, I wrote in my blog about a disease called pyometra that is seen in older female dogs. Yesterday I did surgery on an 8 year old female dog with perhaps the largest uterus I have ever personally taken out of a dog. The dog's presurgery weight was 55 lbs and the uterus weighed 8.2 lbs.. Wow! Quite impressive! Remember, "pyo" means "pus" so this was a uterus filled with 8 lbs of pus. I just have to share the photo with everyone so if you don't like surgery pictures don't look below.

I'm going to re-post the picture taken of a normal 70 lb dog's uterus first. The second picture will be the 8.2 lb uterus from yesterday's surgery.

Oh and the dog that had pyometra surgery yesterday is doing very well and went home today.

Lucky the clinic cat 9/8/09 update

Just thought I would give everyone an update on how Lucky the clinic cat is doing. If you don't remember, Lucky was diagnosed with kidney disease back in mid July. For the full blog on cats and kidney disease visit the July 2009 blog archive or click on this link.

There is some good and some bad in this update. Unfortunately Lucky has chronic kidney disease that is mostly stable, but in an advanced stage. He is hovering around Stage III to IV of four stages under the International Renal Interest Society (IRIS) classification. His current treatment is Hill's feline k/d diet, subcutaneous fluids given Monday, Wednesday and Friday, Azodyl, Epakitin and benazepril. By the way, all these treatments including giving the fluids can be done at home by any cat owner. We have been able to improve some of his blood values, but not all. I guess the best part is that he is eating good and his weight is stable. Maintaining body weight is one of the best ways to monitor how a cat is feeling. Eating good = feeling good. Cats with kidney disease that eat some and lose weight may appear to be ok, but the weight loss speaks for itself. So I am thrilled that for right now Lucky is maintaining body weight. That's the best we can ask for right now.

To spay or not to spay ...........

This is the sad part of veterinary medicine. This is the part where a dog dies from a nearly 100% preventable disease. This is where I (or another veterinarian) have counselled someone how to prevent this death and it happens anyway. It always leaves me asking why. Did the dog's owner even hear what I said? Was money an issue? (when isn't it in veterinary medicine?) Did I state the facts, but fail to stress the importance? To me, this shows how communication is the key to much of what I do on a day to day basis. I have learned a lot about communication in my 23 years as a veterinarian, but I am still learning every day. Times like this make me think "how could I have communicated better?". Life makes you realize that there is always something new to learn.

The disease I am talking about is pyometra or literally translated "pus in uterus". This disease of female dogs will occur in nearly every older unspayed female dog if it doesn't die from something else first. Since spaying involves removing the ovaries and uterus, a spayed dog cannot get pyometra. I say it is nearly 100% preventable because I will occasionally see a pyometra in a young breeding bitch, but this is the exception. And because the whole disease process starts with hormonal changes to the uterus that occur over time, pyometra almost always occurs in older female dogs. Female dogs do not go through menopause like humans do and will continue to come into heat throughout their lifetime. If bacteria gets into the uterus, this can set the stage for a severe and possibly life threatening infection that is pyometra. The treatment for pyometra in nearly every case is to do surgery and spay the dog. Of course, now we are talking about doing a spay surgery on a sick dog with a greatly enlarged uterus. This is not the ideal time to do surgery. Many dogs will live through surgery and do well. A few will die.

"They" say a picture is worth a thousand words. So now through the magic of our digital world, I can show you all what I am talking about. The following pictures were taking during spay surgery from two different female dogs. Both dogs weighed about 70 pounds. Female dog #1 was young (about 10 months old) and healthy. She will never have to live through the horror of what pyometra can be. Female dog #2 was older and sick with pyometra. She died about 14 hours after surgery.

Female dog #1 uterus during spay surgery



Female dog #2 uterus during pyometra surgery



BIG difference eh? This is why I recommend having female dogs spayed. Female dogs can be spayed early if the owner does not want a litter of puppies or later if a bitch is to be used for breeding. I see the consequences of what can happen when older female dogs are not spayed. I do not recommend surgery lightly. I am the pet advocate. Whatever is in the pet's best interest is what I am going to recommend. Dog #1 is alive and happy. Dog #2 is dead. Sad isn't it?