Pyometra in a 5 year Newfoundland bitch.Keywords : canine, pyometra, uterus, luteal, progesterone
A five year old nulliparous Newfoundland bitch was submitted approximately 30 days after the end of estrus with a history of PU/PD of one week duration. The day before submission, a hemorrhagic-purulent was seen. On presentation, the patient was febrile (39.8 deg C) but was bright, alert and responsive.
CBC showed a mild neutrophilia (21 x 10/9 per ml) with a moderate left shift (26% bands) and mild monocytosis. There was also a mild non-regenerative, normocytic and normochromic anemia. Serum chemistry values were within normal limits. Interestingly, despite reports of PU/PD, urine values (including SG) were normal. A diagnosis of pyometra was made and an ovariohysterectomy was performed. Culture of the uterine contents revealed a pure growth of hemolytic E coli. The bitch was treated with 1500 mg cephalexin p.o. b.i.d for 14 days. Recovery was uneventful.
Macroscopically. the uterine horns and body were symmetrically distended by large amounts of malodorous, thick, red-brown, cloudy exudate. Macroscopic evaluation of a cross section prepared for histology appeared as follows.
"The tissues in the photomicrograph in the case have characteristic features of pseudo-placentational endometrial hyperplasia (PEH). The endometrial changes is this form of endometrial hyperplasia develop in a highly organized manner and bear a striking resemblance to remodeling changes that occur in the endometrium of pregnant bitches in the area beneath the placental labyrinth.
Microscopic features of PEH resemble those found at normal canine placental sites but no fetal tissues or labyrinth is present.
In the photomicrograph above, one can see that there is a very uniform band of cystic segments of the deeper portions of endometrial glands. This band goes all the way around the endometrium. Note the uniform the size of the distended deep gland segment. In contradistinction, the endometrial glandular cysts of classic CEH vary in size, location and number within the endometrium.
For addtional detail see:
Schlafer, D.H. 2012. Diseases of the Canine Uterus. Reprod Domest Anim. Suppl 6:318-22
McEntee, K. 1990. Reproductive Pathology of Domestic Mammals ISBN-10: 0124833756. See photomicrograph, Fig 11.6, p174
Jubb, Kennedy & Palmer's Pathology of Domestic Animals 2007. ISBN: 978-0-7020-2786-4 Volume 3. Chapter 4. The female genital system. (p463)"