Extended patient care report for anaesthetic management of a patient undergoing ovariohysterectomy for pyometra

The patient presented with a 3 day history of anorexia, polydipsia and lethargy. The owner reported that the dog had been in oestrus approximately 4 weeks previously. A physical examination revealed pink but tacky mucous membranes, slight skin tenting and obtunded mental state. There was a small amount of serosanguinous vaginal discharge. Palpation of the abdomen was challenging due to the patient's level of obesity. A body condition score of 8/9 was recorded (WSAVA, 2011). The patient was pyrexic with a core temperature reading of 39.1°C. The patient's heart rate was 90 beats per minute. The patient was panting on initial examination so a respiratory rate was not noted. The veterinary surgeon suggested a differential diagnosis of pyometra and admitted the patient for diagnostic tests and treatment.

Species: Canine

Breed: Pug

Age: 8 years

Sex: Female (entire)

Weight: 8.5 kg

A full blood profile was performed to assess biochemistry, haematology and electrolyte parameters. The results of these along with an abdominal ultrasound confirmed the diagnosis of pyometra. There was a marked leucocytosis of 46.1 K/ul (reference range: 5.05–16.76 K/ul) where 55% were shown to be neutrophils. An elevated packed cell volume of 62% (reference range: 35–55%), hyperproteinaemia of 89 g/litre (reference range: 55–75 g/litre) and hypernatraemia at 168 mmol/litre (reference range: 135–150 mmol/litre). These parameters are highly suggestive of an inflammatory response to an infection and dehydration, commonly found in cases of pyometra (Beck, 2007). The abdominal ultrasound confirmed the diagnosis by revealing multiple distended, tubular structures containing hypoechoic fluid in the caudal abdomen. The veterinary surgeon, after discussion and consent from the owner, planned to proceed with surgical treatment of the pyometra via general anaesthetic and ovariohysterectomy (Figure 1).