Sunday, December 15, 2013

1268. Open pyometra with uterine torsion in a 13-year-old Jack Russell X - images for video production

An unusual case in an old female dog pyometra as the uterus was twisted and entangled with omentum and intestines. Blood tests showed total white cell count as below normal as usually it is above normal.

The uterine horns were trapped inside the omentum as they had been twisted with the intestines. So time was needed by Dr Daniel to cut away the adhesions, leading to prolonged operating time and much bleeding on the operation site.

I have encountered such a torsion case and the interns had made an interesting video.
Intern Clara will need to think how to  make this video themed "Early veterinary surgery saves lives" as interesting and instructional as possible..  

The gentleman owner noted that his old dog with dirty vaginal discharge was lethargic and not eating for the past 2 days and so he sought early veterinary consultation. I diagnosed open pyometra based on abdominal pain on lower 1/3 of abdomen  and a dirty brown vaginal discharge after a recent estrus. There appeared to be swollen uterine bodies but they were not 100% bloated
"My dog had previous vaginal discharges but she was more alert and the discharge disappears, but this time, she looked very ill," the gentleman told me.

Dirty gritty dark reddish brown blood dripped all over the examination table and consultation room floor. "Open pyometra" in an old unspayed dog is usually the instant diagnosis.

I got the dog operated on the same day after around 3 hours of IV drip & medication. The dog has recovered. Many Singaporean dog owners feel that they should not spay the female dog as it is cruel to do so. This is a common mindset but as the dog ages, the owner does not bother much with her health deterioration.

When the old female dog exhibits dirty brown vaginal discharge with mucus, some procrastinate, hoping that the discharge would disappear and the dog would not have the discharge at the next heat as in this case. The womb infection gets worse at the next heat and fortunately, this dog was operated early and survives. If the dog is not operated or treatment is delayed, there will be vomiting and death on the operating table. Sometimes, the vet is blamed for the death. Spaying the female dog when she is young prevents many female reproductive problems like pyometra and breast tumours.  A kinder and better educated generation of Singaporeans may be against sterilisation but they must be caring as to seek prompt veterinary surgery when breast tumours and dirty brown mucoid vaginal discharge appears in the old companions.

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