What is pyometra?
Pyometra literally means 'pus in the womb' and is seen a lot
less commonly these days due to increased awareness about
neutering. But it is still found in any vet's consulting room the
length and breadth of the UK all year round.
This is one of the most well-known and serious life-threatening
conditions for any bitch to endure.
How can I tell if my bitch has pyometra?
Pyometra, or 'pyo' for short, can present from the obvious:
thick, brownish pus seeping from the bitch's vulva, to the much
vaguer symptoms of being a bit quiet and perhaps just off her food.
The reason for this wide spectrum of clinical signs boils down to
both how long the pyo has been established and whether the creamy
festering pus is being allowed to drain out from the womb or
For example, a classic scenario would be an unspayed bitch with
a noticeably increased thirst (polydipsia) who seems to be spending
most of her time licking an abnormal (and usually smelly) discharge
from her private parts. Perhaps her abdomen is also swollen and
painful to touch and maybe she's been acting tired, depressed, and
even turning her nose up at food - including her favourite treats.
Occasionally she'll exhibit a fever, have greyish gums
(depending how advanced the pyo is) and will have been in season
between one and three months ago, with some cases even having
vomiting and diarrhoea too.
This is a classic 'open' pyo scenario, in which the bitch's
cervix is open, allowing the pus being produced in the uterus to
freely flow outside the body and thus be visible on
In a less obvious, 'closed' pyo situation, the cervix remains
tightly closed, providing an effective seal capable of withholding
the pus and making the condition slightly less obvious to diagnose.
In either case, a thorough investigation, that may include blood
tests, ultrasound, X-rays or even the decisive exploratory
laparotomy - will point to a positive diagnosis that can then be
treated safely and efficiently.
What causes pyometra?
Why all of a sudden does the bitch's uterus decide to produce
and subsequently fill up with horrid, thick pus? Unfortunately, the
answer isn't a simple one, as pyometra can be caused by one or a
combination of underlying factors. For instance, it can be the
tiny, microscopic behaviour of the womb lining itself, likely
hormonal imbalances. Or, in some cases, a source of infection -
usually 'ascending', meaning it enters the reproductive tract at
the vulva from the outside world and creeps up, or comes via the
blood stream from another infected area of the body. If the bitch
has also recently given birth to a litter, an inflamed womb with
bruised or exhausted and vulnerable tissues, can also act as a
focus for infection to set in.
How can pyometra be treated?
Treatment options vary depending on your vet, but most will
advise surgical removal of the infected uterus when it's safe to do
so. Your vet may advise that, as many patients with severe pyometra
show signs of being toxic or even shock, they may benefit from
intravenous fluids, antibiotics and pain relief first to best
prepare for the surgery.
More recently, a short course of the same injection used for
cases of 'misalliance' (mis-mating) has been shown to expel pus
effectively from an infected uterus and normalise the bitch even
further making them a safer candidate for successful treatment.
Why can't antibiotics be used to fight this infection?
Due to the thickness and amount of pus, any antibiotics injected
or ingested orally are delivered to the diseased tissues via the
bloodstream and rarely penetrate the infection effectively.
Even if they did, the bitch's underlying medical conditions
(such as abnormal hormone levels), would normally mean a recurrence
post-treatment. So to cure a bitch with pyometra, your vet may
surgically removal the infected uterus and also remove the bitch's
ovaries at the same time (i.e. carry out a bitch spay).
What is the difference between pyometra spay and a normal
The main differences operation-wise between pyometra spay and a
normal routine spay can be an increased risk of abdominal
contamination to the patient (due to infected tissues that may be
fragile and break down when touched), and cost for the owner, as
many pyometras will present at night in emergency hours, requiring
full clinical investigation, including perhaps a couple of days
hospitalisation on fluids.
Pyometra is certainly one of the biggest reasons vets advise you
to get your bitch spayed if you're not planning to breed from her.
Spaying a bitch with pyometra is usually 100% successful, with the
patient typically making a full and uneventful recovery with a good
Who can I contact for further advice?
The Kennel Club is not a veterinary organisation and is unable
to provide general or case specific veterinary advice. If you
have any questions regarding any of the issues discussed in this
article then please contact your local veterinary practice for
This article was written by Marc Abraham and was originally
published in the Crufts Magazine - www.thecruftsmagazine.com.
Marc Abraham is a vet based in Brighton. He regularly
appears on UK television. For more information about Marc
please visit www.marcthevet.com.