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Pyometra in Dogs
Written By Darlene Stott
Published: 01/10/2016Updated: 10/06/2021
Veterinary reviewed by Dr. Linda Simon, MVB MRCVS
What is Pyometra?
Pyometra is an infection of the uterus, the reproductive organ of a female dog. The uterus becomes filled with pus and the infection can spread systemically leading to sepsis. Pyometra occurs commonly in older intact female dogs and will begin several weeks after a heat cycle. It develops due to an increase in hormonal stimulation from the uterus combined with introduced bacteria. Pyometra can be identified by abnormal discharge from the vulva, excessive thirst, panting,  weight losslethargy, and on occasion abdominal distention. Underlying causes of pyometra include previous misalliance injections, urinary tract infections and poor hygiene.
Treatment for pyometra can be either medical or surgical and is dependent on the severity of the disease. Pyometra can be prevented with elective ovariohysterectomy (spay surgery), which is recommended in young dogs unless the dog is intended for breeding.
Pyometra refers to a purulent (pus-filled) infection in the uterus. It occurs in older intact female dogs, but can occur in unspayed dogs of any age. Left untreated, the infection can spread systemically and is potentially fatal.
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Average Cost
$1,200

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Symptoms of Pyometra in Dogs
The following symptoms can be seen with pyometra:
Pyometra should always be considered in older intact female dogs, even if only one or two of the above clinical signs are exhibited.
Types
There are two types of pyometra - open and closed.
  • Open pyometra is named for the condition in which the cervix stays open and the infection drains out from the uterus through the vagina. A classic sign of open pyometra is purulent, foul-smelling discharge from the vulva.
  • In closed pyometra, the cervix is sealed and the infection is trapped in the uterus. Closed pyometra will progress quicker and is more severe because the infectious discharge accumulates within the uterus with no escape. As no discharge is visible, it is easier to miss a diagnosis. 
Causes of Pyometra in Dogs
Pyometra develops through the assistance of hormonal stimulation from progesterone and oestrogen in the uterus. Progesterone and oestrogen are hormones that are naturally produced in the ovaries. If bacteria is introduced into the uterus at a certain time during the hormonal cycle, the hormonal action will facilitate the spread of bacteria leading to an infection.
Factors that contribute to the development of pyometra include:
  • Injections of oestrogen (for prevention of pregnancy following mating)
  • Administration of progesterone to delay oestrus
  • Urinary tract infections
  • Poor hygiene and faecal contamination into the vagina
  • Postpartum metritis (inflammation of the uterine wall after giving birth)
Diagnosis of Pyometra in Dogs
Pyometra is suspected upon presentation of the above clinical signs as well as signalment. It has common incidence in older, unspayed female dogs, but will be suspected in unspayed females of any age. Several diagnostic tests may be performed including palpation, vaginal cytology, evaluation of blood parameters, urinalysis, radiography, and ultrasonography.
Palpation (feeling for an enlarged uterus) is more useful in closed pyometra where uterine enlargement and distension are prevalent. Vaginal cytology is helpful in open pyometra as it evaluates the contents of the vaginal discharge. Cytology is performed by taking a sample of the discharge and examining the components under a microscope. The veterinarian will look for abnormalities such as the presence of bacteria and a high white blood cell count.
While the pyometra infection begins in the uterus, it will eventually spread systemically leading to septicaemia (blood poisoning). Therefore, blood tests and urinalysis are performed to help determine the severity of the infection. Certain blood value abnormalities are characteristic of pyometra.
Radiography is more useful in the case of closed pyometra as the enlarged fluid filled uterus can be visualised on x-rays. Ultrasound can definitively diagnose the fluid filled uterus of closed pyometra as well as reveal increased thickness in the uterine wall that is seen in cases of open pyometra.
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Treatment of Pyometra in Dogs
The most effective treatment for pyometra is surgical removal of the uterus and ovaries (ovariohysterectomy). Medical management can be considered in less severe cases of open pyometra if the owner wants to use the dog for breeding. If an owner chooses this route, they must be made aware of the potential complications and lower success rate when compared to the surgical approach.
Surgical treatment is always indicated in cases of closed pyometra, especially if the infection has spread systemically. It is also indicated in older dogs that are not intended for breeding. Ovariohysterectomy is performed as soon as possible when the dog is in a stable condition. There is an increased anaesthetic risk in elderly or compromised patients. Recovery is relatively quick and the dog is usually sent home with medications for inflammation and pain, as well as a course of antibiotics to counteract the spread of infection.
Medical management is indicated in cases of open pyometra that are less critical, as well as if the dog is younger and has particularly valuable genetics for breeding. Medical management involves injections of hormone prostaglandins, concurrent antibiotics, and fluid therapy. Depending on the preferred protocol, the prostaglandin injections are given for 3 - 7 days and the antibiotics for at least 2 weeks. Side effects that may be seen include excessive panting, diarrhea, and vomiting. Dogs will need a recheck following completion of treatment.

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Recovery of Pyometra in Dogs
There is a high risk of reoccurrence after medical management of pyometra. In some cases, this risk can be decreased by mating the dog in the next oestrus cycle following treatment. If pyometra reoccurs or if the patient does not initially respond to medical management, surgical removal of the uterus will be required. Once breeding goals have been met, dogs should be spayed to prevent reoccurrence of pyometra.
With ovariohysterectomy surgery, the uterus is completely removed so once the patient is fully recovered, there is no risk of reoccurrence. Oral antibiotics are usually prescribed for 1-2 weeks following surgery. Dogs will require a post-operative check approximately 14 days after surgery to check for adequate recovery and healing of the wound site. Exercise should be limited in this period immediately following surgery to allow for optimal healing.
Cost of Pyometra in Dogs
Treatment cost will depend on the severity of the infection and whether medical management or surgical treatment is necessary.
Medical management with prostaglandin injections will cost between $200 - $500 depending on the amount required and duration of treatment. Antibiotics will cost approximately $60 - $150 for a two-week course. If intravenous fluid therapy is deemed necessary by the veterinarian, this will be an additional $150 - $300. In some cases, subcutaneous (under the skin) fluid therapy will be sufficient, which is usually around $60 - $90.
Surgical removal of the uterus is a more intensive treatment and thus incurs a higher cost. An ovariohysterectomy including all surgical and anaesthetic fees will be around $1200 - $2800. The cost in a pyometra spay (compared with an elective spay in a healthy animal) is higher due to the presence of infection and increased risk; the surgery is more complex and takes more time.
Pyometra Average Cost
From 22 quotes ranging from $750 - $5,000
Average Cost
$1,200
Top
Pyometra Questions and Advice from Veterinary Professionals
English Bulldog
Eight Years

12 found this helpful

12 found this helpful

My pet has the following symptoms:
Bloody Discharge
We had to have emergency spay yesterday for Pyometra and this evening we noticed bloody discharge after she got up from sleeping, on the bedding and when I cleaned her after she went to pee. I was told discharge was normal but should it be bloody and clot like?
Sept. 24, 2020
Answered by Dr. Michele K. DVM
12 Recommendations
Thank you for your question. I apologize for the delay, this venue is not set up for urgent emails. That kind of discharge would not be completely surprising after a surgery like that. If they are still having problems, It would be best to have your pet seen by a veterinarian, as they can examine them, see what might be going on, and get any testing or treatment taken care of that might be needed.
Oct. 23, 2020
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Pit Bull
Five Years

10 found this helpful

10 found this helpful

My pet has the following symptoms:
Pyrometra
Can a male dog cause a female dog to get pyrometra?
Aug. 7, 2020
Answered by Dr. Michele K. DVM
10 Recommendations
Thank you for your question. Female dogs typically get pyometra on their own due to fluctuations in hormone cycles, but if the dogs were mating, there may have been bacteria introduced that caused a problem, yes.
Aug. 8, 2020
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Chihuahua
Fifteen Years

7 found this helpful

7 found this helpful

My pet has the following symptoms:
Panting
My female chihuahua had emergency surgery this afternoon for pyometra. She is home now and resting some but I can't get her to eat or drink anything. She has had her first dose of pain medicine at home and she still won't even drink water. She is panting pretty fast and I'm concerned. What should I do?
July 24, 2020
Answered by Jessica N. DVM
7 Recommendations
Hello- Thank you for your question. I would give your veterinarian a call and speak with them. It may be pain causing her to pant like that, it could be a side effect of the medication, or it could be something more serious going on. It is not uncommon for dogs not to want to eat or drink immediately after a major surgery like that, but if her breathing is ab normal I would make sure she is seen by your veterinarian immediately. I hope she feels better soon.
July 24, 2020
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Labrador Retriever
dixie
16 Years

12 found this helpful

12 found this helpful

My pet has the following symptoms:
Odor
Urinating In House
Clear Urine
hi, my 16 year old lab just was diagnosed with pyometra 15 hours after we had the first visable symptoms of something wrong. Because she is so old, I am worried more about surgery and want to do agressive antibiotics first. She is on Amoxicylin now and will start additional meds tomorrow. What are her risks for surgery at her age and am I making the wrong or right decision?
July 11, 2018
12 Recommendations
Surgery is the treatment of choice in cases of pyometra not just to remove the uterus but there is a high recurrence rate in cases treated with antibiotics; surgery is more risky in older dogs and the decision to go ahead with surgery would be down to the discretion of the Veterinarian performing the surgery as they need to be confident that Dixie is stable enough for surgery. You may try aggressive antibiotic therapy to make improvement in the overall condition. Regards Dr Callum Turner DVM
July 11, 2018
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Mixed
Dixie
11 Years

8 found this helpful

8 found this helpful

My pet has the following symptoms:
Vomiting
My dog was just diagnosed with a closed pyometra and is at the vets at this very moment. We chose to treat her without surgery due to the cost. And will have her spayed at a later time. Her bloodwork was very bad. I'm second guessing our decision to go this route. Opinions. Advise. Thoughts on her chances of survival. Thank you in advance.
July 10, 2018
8 Recommendations
Typically a full ovariohysterectomy is the treatment of choice for pyometra (closed or open) however medical treatment is sometimes given for a variety of reasons; however, pyometra has a high rate of recurrence if a dog is treated medically so it is always best to go the surgical route. Without examining Dixie I cannot weigh in on the prognosis, however your Veterinarian would be able to give you specific advice; but if there is a chance, have her spayed even if you need to visit a low cost clinic. Regards Dr Callum Turner DVM
July 10, 2018
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Jack Russell Terrier
Bella
15 Years

1 found this helpful

1 found this helpful

My pet has the following symptoms:
Increased Urination
Excessive Thirst
Uncomfortable
Distended Abdomen
I just lost my sweet Bella today because of this. She was a 15-year-old Jack Russell terrier. She had been urinating a lot, even in the house sometimes, and was drinking excessive amounts of water. Also, she couldn't get comfortable when she laid down. She would groan and grumble a lot, and her abdomen was distended. We took her to the vet yesterday, and he did blood work and an x-ray because he suspected pyometra. I decided to proceed with the surgery, but when he opened her up he found a mass on her kidney that had adhered itself to her ovary. At that point, he recommended euthanasia rather than put her through anymore. I miss her so much. She was the absolute light of my life. Please if you don't plan to breed your dog, get her spayed now. Don't wait.
Golden Retriever
Sadie
6 Years

0 found this helpful

0 found this helpful

I just adopted a 6-8 year old former golden/lab mix who went through pyometra surgery at end of November. She was treated with a 2nd course of antibiotics due to frequent urination and leaking urine during recovery from surgery. She is now done with the 2 week course of meds but still leaking urine and has to wear a diaper 100% of the time. Could there be something else going on as the vular area is still very swollen and there is a flap of skin on the right side of the vulva area where the leaking is occurring. I have never encountered this with a spayed female dog before but am worried about what is causing the leaking which has increased over the 4 weeks since pyometra surgery. We started Sadie on Proin a few days ago but no improvement. Thank you!
Labradoodle
Willamina
Six Years

0 found this helpful

0 found this helpful

My pet has the following symptoms:
Vaginal Bleeding
My mom's dog was diagnosed and had surgery for pyometra about 10 days ago. The surgery went well and all seemed fine after, she had minimal discharge, was having regular bowel movements, was eating and drinking fine, and even began to play (which we tried to keep to a minimum). Three days ago she started bleeding out of her vagina, so much so that we had to get her diapers. We took her back to the vet and they prescribed a coagulant (For some reason my mom didn't give her that). This morning she went through three diapers worth of blood. The blood had clots in it as well as normal blood. We called the vet and they said there was nothing more to do and to monitor her and let them know if she starts throwing up or has any other changes. She acts like nothing's wrong but we are concerned something has happened internally either from the surgery or post op. Any advice on what may be causing this or what we can do to help her get better would be GREATLY appreciated. This is my mom's first dog, which I got her for Christmas last year, and it would absolutely destroy her is she passed away ):
Chihuahua
Pebbles
16 Years

1 found this helpful

1 found this helpful

Hi. I had a chihuahua that was roughly 16 years old. She weighed 3 1/2 pounds. She had bloody discharge, she wouldn't eat, she vomited and was so weak that she couldn't get off of the couch. I brought her to an emergency vet. They did some blood work and they said her kidneys were failing. They tried antibiotic treatment and they said she looked worse after the treatment and didn't think she would make it through the rest of the day. She had two very large fluid filled sacs in her uterus that caused belly distension. The doctor told me that she wasn't a good candidate for surgery. She recommended Euthanasia. I had never heard of Pyometra and didn't want her to be in pain. I agreed to it and I miss her every day. I am wondering if I made the right decision. I am not a vet and I am wondering if more could have been done for her.
Chihuahua
Tiny
9 Years

0 found this helpful

0 found this helpful

My pet has the following symptoms:
Panting
My 9 year old chihuahua had pyometra surgery On Saturday May 18, the first days were extremely hard she wasn’t eating or drinking water and didn’t want to walk. By Wednesday she started to eat and drink water but we noticed that her breathing wasn’t normal. She won’t stop panting and it gets worse at night, we’ve been back and forth from different animal hospitals and they say that her X-rays are normal, she’s gaining weight and her gums are pink but they don’t know why she is constantly breathing so fast and loud. Her meds aren’t making anything better and we are very concerned that something is wrong. Has anyone else experienced this with there animal and if so what helped?
Pyometra Average Cost
From 22 quotes ranging from $750 - $5,000
Average Cost
$1,200

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