PAYOH VETS PTE LTD
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PYOMETRA IN A SILKIE TERRIER
Case written: May 26, 2004. Case updated: Sep 22, 2008
Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS.
"Doc, are you sure you have
the correct diagnosis just by touching her stomach?"
"Your bitch may not survive the next two days," I had to be brutally frank on a joyous day, the day Christ was born. "Her rectal temperature had dropped to 37.3 deg C despite treatment. That is way below the normal of 38.5 deg C."
Mr Lim's aged mother had lived long enough to know about deaths. She suppressed her sorrow but tears just cascaded down. The Silkie Terrier was her constant companion as all the children had grown up and had their own families. They had no time for her now. She said, "I did not know she has this disease."
I had to inform her to prevent misunderstanding, as usually the veterinary surgeon is blamed when a dog dies after an operation. "Your son brought the bitch for her annual vaccination last month. I advised him to get the womb removed because the bitch had a persistent swollen vulva, an abnormal condition of the reproductive system."
The normal bitch usually has a swollen vulva only when she is on heat and this swelling subsides after 2 weeks. In this bitch, the swelling persisted for the past years. She would have a hormonal imbalance and would be licking her private parts frequently to clean up evidence of vaginal discharge. I advised spaying but most Singaporean owners don't want to spay the dog for various personal reason.
She had a very high fever
of 39.9 deg C two days before surgery. She was not eating and had vomited
a few times. Her abdomen was distended, as if she was pregnant. She had
passed "watery pinkish blood" in her vagina in small amounts.
I was consulted again because the bitch was not eating for 5 days and had
been vomiting. The diagnosis was pyometra, an infection of the womb.
The recommendation was surgery to remove the womb as soon as the bitch was
stabilised with fluid therapy some six hours later.
"If you don't mind paying more money,there is the blood test, the ultra scan and the X-rays to confirm the diagnosis of pyometra," I suggested, being used to such questioning.
"Or you can seek a second opinion from another veterinary surgeon, but you have to do it immediately as your bitch is very sick."
Dog owners are more sophisticated nowadays and they ask many questions but they are not willing to pay more for laboratory and other tests. In 2004, Singapore was again mired in retrenchments and cost-cutting after the Severe Acute Respiratory Syndrome (SARS) outbreak.
Every second counted in this case. I advised
further: "If the bitch is not operated, she will die soon. If
she is operated, she may die during or after the surgery."
"About 10% of survival after surgery in this
case," I estimated.
To operate or not to? It was Hobson's choice for
the dog owner.
I offered some food to her. She suddenly
snapped at my fingers. This was a "dangerous" dog. It was a
good sign that she was more active. However, it would be difficult to feed
her the nutritious food after surgery.
Would this Silkie Terrier recover better at home?
If not, Mrs Lim would still spend time with her rather than let the bitch
die away from her owners.
|For non-spayed female dogs, pyometra is easily diagnosed if she passes a lot of dirty reddish brown blood some 2-6 weeks after her heat. Some of the vaginal discharge is starchy and yellowish. Others are sticky and dark reddish brown.|
|The womb of a female dog with pyometra taken out from the abdomen and placed on the surgical drape. The uterine horns are greatly distended with pus and can be as wide as 3 - 6cm in diameter (bigger than the width of an adult's finger).|
|The womb of a normal female dog. The uterine horns are very thin, usually less than 0.5 cm in diameter.|
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