Uterine Flushing in Dogs

When an unspayed dog goes into heat, the uterine lining swells to prepare for pregnancy. If swelling persists after the heat cycle and becomes infected, a condition known as pyometra occurs, which is a serious uterine bacterial infection that can be fatal. In addition, infections or retained tissues can occur in the uterine lining after parturition of puppies. When tissue is retained in the uterus, it requires flushing to remove necrotic tissue, bacteria, and retained tissues for treatment of the infection. Without removal of these infected materials, treatment will not be successful and a fatal infection can develop. Uterine flushing is performed under anesthesia by your veterinarian.

When retained uterine lining occurs, spaying is usually considered as a primary solution. However, when infection is extensive preventing spay or when other considerations are present, flushing of the uterus may need to be performed in conjunction with administration of antibiotics to combat infection, prior to a spay procedure or to preserve reproductive function in some dogs. Prior to uterine flushing, your dog will need to be fasted from food for 12 hours to allow for safe administration of general anaesthetic. In emergency situations, as is often the case when uterine infection is present, fasting may not always be possible. After sedation and anesthetization, the perineal area is antiseptically cleaned prior to the procedure. A catheter or pipette is passed through the cervix into the uterus to drain pus and provide a vector for flushing with sterile solution. A bovine insemination pipette may be used for this procedure. A laparotomy, midline abdominal incision, may be made to aid in the procedure and locate the uterus and cervix and ensure location of the pipette or catheter for flushing procedure. Solution used for uterine flushing may include saline containing prostaglandin which causes cramping in the uterus, which helps slough off retained materials in the uterus as flushing is being conducted. Other solutions such as povidone-iodine an antibacterial cleanser or Betadine saline may be used. In these cases, prostaglandin will be injected to induce uterine cramping to aid in the flushing process. Fluid is infused into the uterus carefully so as not to cause undue pressure on the fallopian tubes, which could cause infection solution to enter the bloodstream. Access to the uterus through a laparoscopy will allow the veterinary surgeon to manipulate your dog's uterus as required to ensure adequate placement of flushing device and that flushing material is infused throughout the uterus, including the uterine horns, by gentle manipulation of the uterus during the procedure. The uterus can be massaged this way to mix exudate with the flushing materials. Uterine flushing material and infected materials are then aspirated out of the uterus with a syringe attached to the inserted catheter or pipette. The process of introducing flushing material, manipulating uterus and aspirating contents is repeated as necessary to remove all infected material and exudate. The pipette is then removed from the vagina and the vagina irrigated to flush any infected uterine content out The surgical incision for the laparoscopy, if performed, will be closed. Supportive care will be provided as needed during recovery from anesthesia. Intravenous fluids and antibiotic to address pyometra are provided.

Treatment of uterine infection requires the removal of retained tissues and bacteria in the uterus by flushing for successful treatment. Antibiotics alone will not resolve the condition. This condition is very serious and if left untreated the animal’s condition will dissolve quickly, putting her at risk for serious complications that may prove fatal. Success of treatment and recovery depends on prompt treatment to address uterine infection.

Intravenous fluids and antibiotics will be administered for 24 hours post surgery and antibiotics may be given for several days afterward. Dogs with this serious condition may remain hospitalized for 24 hours to several days or more prior to release home, depending on their condition. Vaginal discharge should be monitored for signs that infection is dissipating. If infection remains, or worsens, further procedures may be required. Vaginal discharge should cease within 10 to 14 days. Any sutures from laparoscopy may need to be removed 10 to 14 days post-procedure. Observe your dog for any signs of hemorrhaging or increased illness and seek veterinary attention immediately should these occur.

The cost of uterine flushing will depend on the extent of illness in your dog, and whether a laparoscopy is performed in conjunction with the insertion of a pipette for flushing. The cost of the procedure, including anesthesia, can, therefore, range from $500 to $1500 or more. Medications and antibiotics used to address systemic and uterine infections may incur additional costs.

Care must be taken not to injure or penetrate the uterine wall or other abdominal structures while placing and handling the pipette inserted through the vagina. Care not to use too much pressure and force infected solutions through the fallopian tubes into the abdominal cavity, thereby spreading infection, needs to be taken. A veterinarian with extensive experience treating breeding animals may be better able to ensure precautions are taken with the procedure to prevent injury to the reproductive system and spread of infection to other organ systems. 

Spaying of female dogs prevents problems associated with retained uterine tissues and uterine infections. Careful observation and veterinary treatment for female dogs undergoing heat cycles, breeding, and parturition to resolve any uterine disorders immediately mitigates widespread infection, resulting in complicated uterine flushing procedures with extensive bacteria and infected tissues present.