Pyometra is one of the most important and common disorders in canine. The disease results in life threatening condition associated with septicemia and toxemia. The condition commonly occurs during luteal phase of estr...Pyometra is one of the most important and common disorders in canine. The disease results in life threatening condition associated with septicemia and toxemia. The condition commonly occurs during luteal phase of estrous cycle, generally 4 weeks to 4 months of estrous cycle. The age, parity, breeds, administration of hormones are some predisposing factors of the condition. However, interaction between potentially pathogenic bacteria and hormonally primed uterus is believed to result in pyometra. The disease is initiated in the form of cystic endometrial hyperplasia, which later progresses into purulent uterine content following bacterial infection resulting in pyometra. The disturbance in antioxidant and pro-oxidant balance succeeding bacterial infection results in oxidative stress. The resultant stress further induces endometrial degeneration, immunosuppression and additionally aggravates the condition. An important clinical sign is malodorous, sanguineous or mucopurulent vaginal discharge with general symptoms such as vomiting, polyuria, polydipsia, depression, anorexia and occasionally fever. Till date, ultrasonography is the best diagnostic method while radiology and serological test are also helpful. Recently, the estimation of inflammatory mediators (acute phase proteins and prostaglandin metabolites) has appeared as marker for diagnosis of the pyometra. Determination of levels of inflammatory mediators has emerged as an important diagnostic method because it can be helpful in prognosis of the condition. The pyometra can be best treated by surgical manipulation (ovariohysterectomy);however, hormonal treatment can be given in less severe cases which aimed at reducing the effect of progesterone on the reproductive tract. Together, provision of antioxidants could be helpful in disease recovery along with the determined treatment. In this review, incidence, predisposing factors, etio-pathogenesis, oxidative stress associated with condition, diagnostic methods and treatment are discussed.展开更多
The aim of this report was to describe a clinical case of chronic atrophic endometritis as a complication of cystic endometrial hyperplasia-pyometra complex in a non-spayed ferret. The ferret was presented with a slig...The aim of this report was to describe a clinical case of chronic atrophic endometritis as a complication of cystic endometrial hyperplasia-pyometra complex in a non-spayed ferret. The ferret was presented with a slight abdominal distension and odorless purulent vulvar discharge after unsuccessful medical treatment with enrofloxacine and aglepristone 2 months ago in another clinic. Ultrasonography revealed enlarged uterine horns filled with fluid and blood laboratory analysis showed anaemia and leukocytosis, so diagnosis of pyometra was made. Laparotomy and ovariohysterectomy were performed. Histopathological and microbiological examination of the uterus revealed the presence of purulent atrophic endometritis caused by Staphylococcus spp. In conclusion, this is a very rare case of endometrial atrophia after chronic uterine inflammation in a ferret.展开更多
Pyometra is one of the most common uterine pathologies of intact bitch at middle to advanced age. In the early stages, the disease shows subtle changes, making diagnosis a challenge. In contrast, at later stages, it m...Pyometra is one of the most common uterine pathologies of intact bitch at middle to advanced age. In the early stages, the disease shows subtle changes, making diagnosis a challenge. In contrast, at later stages, it manifests as potentially life-threatening systemic inflammatory response syndrome. Ultrasonographic examination of the uterus aids in the diagnosis, although it has limitation in ascertaining the clinical severity of pyometra. Moreover, differentiation of cystic endometrial hyperplasia from pyometra could not be discerned with greater accuracy. Therefore, false negative diagnosis of pyometra patients leads to development of systemic inflammatory response, which delays administration of therapies and results in deaths during early course of treatment. Further, indiscriminate use of broad-spectrum antimicrobials at higher dose in false positive cases considerably contributes to the rising pool of drug resistant pathogens, thereby increasing the risk of case fatality due to sepsis in a long-term. Monitoring the circulating pro-inflammatory cytokines, acute phase proteins, endotoxin, growth factors and inflammatory mediators is the current trend in pyometra research, especially for developing diagnostic and prognostic biomarkers. The present review deals with the prospects of developing diagnostic and prognostic biomarkers in the canine pyometra.展开更多
Objective: To study the epidemiology, the diagnostic elements and the prognosis after laparotomy surgery, of complicated upper genital infections. Patients and method: This is a retrospective study of six cases of com...Objective: To study the epidemiology, the diagnostic elements and the prognosis after laparotomy surgery, of complicated upper genital infections. Patients and method: This is a retrospective study of six cases of complicated upper genital infections collected over a period of 20 months in the Obstetrics and Gynecology department of the Aristide Hospital Center of LEDANTEC. Results: The average age of the patients was 37.67, in two patients;a hysterosalpingography had been performed less than seven days before the start of the symptoms, a notion of multiple sexual partners was noted in two patients. All patients presented with acute abdominal-pelvic pain associated with vomiting in three patients. An infectious syndrome was found in two patients, adnexal pain caused in four patients and signs of peritoneal irritation (guarding and umbilical tenderness) in three patients. Para-clinically, a biological inflammatory syndrome was found in all patients, including an elevation of C-reactive protein in all patients and hyperleukocytosis in four patients and an elevation of CA 125 in two patients. The cytobacteriological examination of the pus taken intraoperatively was positive in two patients, the isolated germs were Pseudomonas aeruginosa and Enterobacter cloacae. Pelvic ultrasound was performed in all patients and revealed a cystic adnexal mass in five cases, a pyosalpinx and peritoneal effusion in two cases. Abdominal & pelvic computed tomography was performed in four patients and revealed a lateral-uterine adnexal mass in two cases, pyosalpinx in two cases, uretero-hydronephrosis and peritoneal effusion in one case. An exploratory laparotomy was performed in each patient and confirmed the diagnosis of tuboovarian abscess, the presence of pelvic adhesion and purulent effusion in four patients, the presence of false membranes in two patients, pyometra and isolated bilateral pyosaplinx were found in one patient. Radical surgical treatment was associated with double probabilistic antibiotic therapy and symptomatic treatment in all patients. The postoperative course was favorable in most cases;postoperative pneumopathy was noted and resolved under treatment.展开更多
文摘Pyometra is one of the most important and common disorders in canine. The disease results in life threatening condition associated with septicemia and toxemia. The condition commonly occurs during luteal phase of estrous cycle, generally 4 weeks to 4 months of estrous cycle. The age, parity, breeds, administration of hormones are some predisposing factors of the condition. However, interaction between potentially pathogenic bacteria and hormonally primed uterus is believed to result in pyometra. The disease is initiated in the form of cystic endometrial hyperplasia, which later progresses into purulent uterine content following bacterial infection resulting in pyometra. The disturbance in antioxidant and pro-oxidant balance succeeding bacterial infection results in oxidative stress. The resultant stress further induces endometrial degeneration, immunosuppression and additionally aggravates the condition. An important clinical sign is malodorous, sanguineous or mucopurulent vaginal discharge with general symptoms such as vomiting, polyuria, polydipsia, depression, anorexia and occasionally fever. Till date, ultrasonography is the best diagnostic method while radiology and serological test are also helpful. Recently, the estimation of inflammatory mediators (acute phase proteins and prostaglandin metabolites) has appeared as marker for diagnosis of the pyometra. Determination of levels of inflammatory mediators has emerged as an important diagnostic method because it can be helpful in prognosis of the condition. The pyometra can be best treated by surgical manipulation (ovariohysterectomy);however, hormonal treatment can be given in less severe cases which aimed at reducing the effect of progesterone on the reproductive tract. Together, provision of antioxidants could be helpful in disease recovery along with the determined treatment. In this review, incidence, predisposing factors, etio-pathogenesis, oxidative stress associated with condition, diagnostic methods and treatment are discussed.
文摘The aim of this report was to describe a clinical case of chronic atrophic endometritis as a complication of cystic endometrial hyperplasia-pyometra complex in a non-spayed ferret. The ferret was presented with a slight abdominal distension and odorless purulent vulvar discharge after unsuccessful medical treatment with enrofloxacine and aglepristone 2 months ago in another clinic. Ultrasonography revealed enlarged uterine horns filled with fluid and blood laboratory analysis showed anaemia and leukocytosis, so diagnosis of pyometra was made. Laparotomy and ovariohysterectomy were performed. Histopathological and microbiological examination of the uterus revealed the presence of purulent atrophic endometritis caused by Staphylococcus spp. In conclusion, this is a very rare case of endometrial atrophia after chronic uterine inflammation in a ferret.
基金The review article was a part of the work supported by Department of BiotechnologyGovernment of India funded project on "Identification of diagnostic and prognostic biomarkers in cystic endometrial hyperplasia and pyometra led systemic inflammatory response syndrome in dog"(Reference BT/ADV/Canine Health/GADVASU 2017-18, Project Code: OXX04211)
文摘Pyometra is one of the most common uterine pathologies of intact bitch at middle to advanced age. In the early stages, the disease shows subtle changes, making diagnosis a challenge. In contrast, at later stages, it manifests as potentially life-threatening systemic inflammatory response syndrome. Ultrasonographic examination of the uterus aids in the diagnosis, although it has limitation in ascertaining the clinical severity of pyometra. Moreover, differentiation of cystic endometrial hyperplasia from pyometra could not be discerned with greater accuracy. Therefore, false negative diagnosis of pyometra patients leads to development of systemic inflammatory response, which delays administration of therapies and results in deaths during early course of treatment. Further, indiscriminate use of broad-spectrum antimicrobials at higher dose in false positive cases considerably contributes to the rising pool of drug resistant pathogens, thereby increasing the risk of case fatality due to sepsis in a long-term. Monitoring the circulating pro-inflammatory cytokines, acute phase proteins, endotoxin, growth factors and inflammatory mediators is the current trend in pyometra research, especially for developing diagnostic and prognostic biomarkers. The present review deals with the prospects of developing diagnostic and prognostic biomarkers in the canine pyometra.
文摘Objective: To study the epidemiology, the diagnostic elements and the prognosis after laparotomy surgery, of complicated upper genital infections. Patients and method: This is a retrospective study of six cases of complicated upper genital infections collected over a period of 20 months in the Obstetrics and Gynecology department of the Aristide Hospital Center of LEDANTEC. Results: The average age of the patients was 37.67, in two patients;a hysterosalpingography had been performed less than seven days before the start of the symptoms, a notion of multiple sexual partners was noted in two patients. All patients presented with acute abdominal-pelvic pain associated with vomiting in three patients. An infectious syndrome was found in two patients, adnexal pain caused in four patients and signs of peritoneal irritation (guarding and umbilical tenderness) in three patients. Para-clinically, a biological inflammatory syndrome was found in all patients, including an elevation of C-reactive protein in all patients and hyperleukocytosis in four patients and an elevation of CA 125 in two patients. The cytobacteriological examination of the pus taken intraoperatively was positive in two patients, the isolated germs were Pseudomonas aeruginosa and Enterobacter cloacae. Pelvic ultrasound was performed in all patients and revealed a cystic adnexal mass in five cases, a pyosalpinx and peritoneal effusion in two cases. Abdominal & pelvic computed tomography was performed in four patients and revealed a lateral-uterine adnexal mass in two cases, pyosalpinx in two cases, uretero-hydronephrosis and peritoneal effusion in one case. An exploratory laparotomy was performed in each patient and confirmed the diagnosis of tuboovarian abscess, the presence of pelvic adhesion and purulent effusion in four patients, the presence of false membranes in two patients, pyometra and isolated bilateral pyosaplinx were found in one patient. Radical surgical treatment was associated with double probabilistic antibiotic therapy and symptomatic treatment in all patients. The postoperative course was favorable in most cases;postoperative pneumopathy was noted and resolved under treatment.
