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Female Chihuahua - Lethargic, Hypothermia
Written by: Shayla Warrick • 2021 Scholar
History
Stella is an 11-year-old, female chihuahua who presented to IVS as a triage (a medical emergency). Her owners reported that Stella had been lethargic for 24 hours, had diarrhea and a decreased appetite, and had been distant from her owners. She also had an episode of liquid diarrhea containing blood. At this time, the owners did not know if she was intact or spayed.
Presentation and Physical Exam Findings
Stella’s temperature was low at 95.4oF (normal for a dog is 100-102.5oF). This significant hypothermia made Stella’s case more concerning due to its severe nature and the possible detrimental effects of prolonged hypothermia. Upon further examination, Stella was obviously lethargic and depressed. Diarrhea and possible vaginal discharge were also noted.
Diagnostics
After the initial exam of the patient, Dr. Magnus performed an A-FAST (abdominal focused assessment with sonography for trauma, triage, and tracking) scan. This is an ultrasound of the abdomen to check for signs of trauma in unstable patients, which is especially important when there is concern for abdominal effusion. Multiple fluid-filled structures were discovered using ultrasound, which is highly consistent with a pyometra. A pyometra is a uterine infection resulting from hormonal changes in the female reproductive tract. The uterus fills with pus and can eventually rupture. This puts the animal at risk of becoming septic. In Stella’s case, due to this combination of signs on presentation and exam, a pyometra with possible septicemia was the greatest concern.
In this specific case, further diagnostics were declined by the owners. Besides an ultrasound, diagnostics may also include radiographs and bloodwork. Similar to findings from the ultrasound, clinicians would look for enlarged, fluid-filled uterine horns on radiographs as an indication of a pyometra. Bloodwork would also show an elevated white blood cell count that indicates severe infection in the body. White blood cells and bacteria may also be seen on a urinalysis and on a vaginal smear and cytology.
Treatment
The treatment of choice is spaying the animal, also known as an ovariohysterectomy. This surgery consists of removing the uterus and ovaries. If it is a closed pyometra (closed cervix with no drainage), then the surgery should be immediate. An open pyometra (open cervix with drainage) with a patient that is stable does not require an immediate surgery, but it is recommended as soon possible. Pre-operative treatment and recovery from surgery should include IV fluids and antibiotics to help prevent further infection.
If the patient has an open pyometra and the owner wants to breed the animal in the future, medical treatment can be attempted using prostaglandin PGF2a. This therapy is not recommended due to the high recurrence rate.
Prognosis
The prognosis for an animal with a pyometra depends on the severity of the systemic spread. It is generally poor due to the risk of the animal becoming septic. The infection from the uterus can spread through the bloodstream into other organs in the body. This causes septicemia and is a common sequela of a pyometra. The longer the uterus is infected, the more likely the animal is to become septic and the prognosis becomes graver.
Prevention
A pyometra is a life-threatening condition that can be easily prevented by spaying your animal. Spaying is the only effective way to prevent a pyometra. Spaying at a young age can also help prevent other reproductive diseases and cancers. If an animal is used for breeding, it is important to keep a close eye on reproductive cycles and behavioral changes. This may help improve the chances of the animal getting treatment before its condition worsens.
References
Plunkett, Signe J. Emergency Procedures for the Small Animal Veterinarian. Toronto: Saunders Elsevier, 2013. Print.
