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Metritis
Introduction
Metritis is the medical term used to describe an acute or chronic inflammation of the uterus. This uterine disease is similar to pyometra but it has some differences. Unlike pyometra, metritis is most often a bacterial uterine infection that develops in the immediate post partum (after giving birth) period and occasionally after abortion or breeding. It is most often associated with retained fetuses or placentas.
A normal uterus. The body of the uterus (a) and both uterine horns (a and b).
Right photo: The female reproductive tract
Etiology
Metritis usually results from infection acquired at the time of parturition or estrus, or shortly thereafter. retained fetal membranes, dead fetuses, blood and exudate provide suitable substrates for bacteria which gain entry through the open cervix. Sometimes, infection is introduced by careless use of instruments, and it may also occur at the time of breeding, being introduced either by the stud or attempts to dilate a small vagina.
Signs
Acutely ill animals exhibit fever, polydipsia (drinking excessive amounts of water), depression, vomiting, dehydration and sometimes diarrhea. There is decreased appetite and often a fast heart rate.
The signs of chronic metritis are not constant. A persistent or intermittent uterine discharge may be apparent. Failure to conceive or the delivery of dead or weak pups, which die soon after birth, is suggestive. Sometimes the condition is asymptomatic.
Diagnosis A history of abortion, dystocia or even normal parturition accompanies most cases of acute metritis. Occasionally a thickened, indurated uterus can be palpated through the abdominal wall. Radiography may reveal a uterus of abnormal size or density.
Ultrasound may show fluid accumulation within the uterus, retained fetuses and/or placentas, as well as fluid within the abdominal cavity in the cases of uterine rupture.
Complete blood count shows an elevated white blood cell count. A leukocytosis is usually found, especially in acute metritis. A history of frequent or prolonged estrual bleeding indicates endometrial changes that can be regarded as chronic metritis.
Treatment
Ovariohysterectomy is most often the treatment of choice, once the patient is stabilized (Intravenous fluid and electrolyte therapy).
Treatment of acute metritis includes supportive therapy, such as parenteral fluids, and a prolonged course of antibiotic therapy. Very small repeated doses of oxytocin may increase uterine tone and help it to discharge the contents. Prostaglandins are drugs that also stimulate contraction of the uterus. This is, however, contraindicated if the uterus is grossly distented..
The treatment of chronic metritis is the same except that hormone therapy is contraindicated and prolonged treatment with antibiotics is often necessary.
Prevention
Metritis may become chronic and cause infertility in breeding bitches. Since metritis is a uterine disease, spaying your dog is the only way to prevent disease.
