Pyometra in Cats: Medical Versus Surgical Treatment

Abstract

Pyometra is not a common disease in cats however in Egyptian veterinary clinics where owners do not usually go for elective neutering become a more common affection. It is an acute or chronic purulent endometritis, a sequel to progesterone stimulation. The traditional therapy for pyometra is ovariohysterectomy however medical treatment may be requested by owners or cat condition may not permit surgical treatment. The aim of the present study is to characterize the pyometra in cats and compare between ovariohysterectomy and medical treatment using PGF2α alone or PGF2α in combination with dopamine agonist. 45 cats were diagnosed with pyometra. Cats divided into 3 groups. Group 1 (n= 23): animals received PGF2α, Group 2 (n= 15): cats received PGF2α plus oral administration of Bromocriptine. Group 3 (n=7): went for ovariohysterectomy. Survival analysis of cats was performed in this study for 2 years after diagnosis. In G1 we censored 14 animals, eight of them returned with recurrent pyometra. The first recurrent case was recorded 3 months post-treatment. In G2 we censored 12 cats, four of them were returned with recurrent pyometra, the first recurrent case was met 8 months post-treatment. After 24 months, both G1 and G2 have no difference in the survival rate which reach for both treatment about 60% success in both groups. However, G3 survival rate was 100% success. Using dopamine agonist in medical treatment my delay the recurrences of pyometra for a short term however ovariohysterectomy whenever possible may be the best choice for treatment of pyometra.

Effectiveness of a Modified Administration Protocol for the Medical Treatment of Feline Pyometra

“…Pyometra is a potentially life-threatening uterine inflammation affecting intact female cats [ 8 , 10 ]. Although most authors report a higher incidence in animals over 7–10 years old [ 1 , 6 , 7 , 9 ]. There are also some reports of cases in younger animals [ 5 ].…”

“…Ovariohysterectomy was not an acceptable solution in treated patients, as they were intended for breeding or with a high anesthetic risk due to previous renal damage [ 1 , 8 , 9 , 10 , 11 , 20 ]; therefore, the authors preferred an aglepristone-based medical treatment [ 20 , 27 , 28 ]. Aglepristone competes for uterine progesterone receptors, with an in vitro affinity, in cats, nine times higher than that of endogenous progesterone; its bioavailability is reduced due to particular pharmacokinetics [ 22 ], thus requiring a higher dose than the bitch [ 8 , 20 , 28 , 29 ].…”

“…Affected patients are generally intact cats over 4–7 years old [ 4 ], with a range of 1–20 years [ 5 , 6 , 7 , 8 , 9 ].…”

“…Clinical signs of pyometra in cats are generally absent or mild and mostly non-specific, with anorexia and lethargy being the most common [ 8 , 9 , 13 ]. Other signs have been reported, such as hyperthermia and vomiting [ 7 ], and, in severe cases, also sepsis [ 14 ], peritonitis and death [ 9 ]. Stanley et al [ 15 ] even reported a uterine torsion following a pyometra.…”

“…Traditionally, surgical ovariohysterectomy was considered the elective treatment for pyometra [ 17 ]; however, since this technique results in permanent sterility and has some anesthesiologic risks [ 9 ], several alternative pharmacological treatments have been proposed in the last decade.…”