Surgery in a veterinary outpatient community medicine setting has a good outcome for dogs with pyometra

Abstract

OBJECTIVE To compare the outcome of canine pyometra surgeries performed at referral hospitals with those performed at community clinics (outpatient settings), and to evaluate factors that impact outcome. ANIMALS 133 client-owned dogs with pyometra treated with ovariohysterectomy (OHE) at 2 community clinics or 2 referral hospitals between July 1, 2017, and June 30, 2019. PROCEDURES A retrospective electronic medical record search was used to identify eligible cases. Data about patient demographics and clinical characteristics were collected and analyzed for factors that could have impacted outcome. RESULTS Eighty-three dogs were treated at referral hospitals; 50 dogs were treated at community clinics. Survival to hospital discharge for all dogs was 97% (129/133) and did not differ between treatment facility type. Dogs treated at both types of facilities were similar in age, body weight, and clinical signs. Median duration between diagnosis and OHE was significantly shorter for dogs treated at referral hospitals (0 day; range, 0 to 0.7 days) versus community clinics (1.0 day; range, 0 to 14.0 days); however, delay was not related to survival to hospital discharge. Duration of hospitalization did not impact survival to hospital discharge nor survival for at least 1 week after surgery. CLINICAL RELEVANCE Results indicated that OHE for pyometra in dogs has a good outcome and that, although prompt surgical treatment remains a goal, in cases where limitations to performing surgery exist, a delay until surgery or discharging patients the same day is still associated with a high degree of success.

Promoting access to care in pyometra treatment: pathways to collaboration between high-quality, high-volume spay-neuter clinics and private practices

“…Previous research has demonstrated no difference in mortality or long-term outcome between patients treated in an outpatient clinic as compared to an inpatient clinic, indicating that some additional treatments may be unnecessary for patient survival and long-term return to function. [11][12][13][14][15] Of those pyometra cases declined treatment at a HQHVSNC or PP, poor prognosis was a common reason for euthanasia. While the surveys used for the current study and other research indicate a high survival rate for patients that undergo surgical treatment for pyometra, [11][12][13][14][15]18,19 animals euthanized before surgery may not be included in these statistics.…”

“…18 Two settings for pyometra treatment are highquality, high-volume spay-neuter clinics (HQHVSNCs) and private practices (PPs). 12,18,19 High-quality, highvolume spay-neuter clinics specialize in efficient, cost-effective sterilization surgeries, including ovariohysterectomies, 12,19,21 whereas PPs offer a wider array of care options for both sick and well pets. 18 This manuscript compares results from 2 previously published surveys aimed at determining how pyometra is treated in HQHVSNCs 19 and PPs.…”

Epidemiological indicators of canine piometra: An analysis of main components in the case of cases assisted in the northeast region of Pará

“…For the type of treatment used, it was observed that in all cases the ovariohysterectomy technique was recommended. This fact may be related to the number of patients in severe condition and the lack of interest in maintaining reproductive activity, moreover, this surgical technique is considered the treatment of choice for cases of pyometra (Fieni et al, 2014;McCobb et al,…”

Focusing on reproductive medicine in practice

“…Both sets of authors also found that for canine pyometra cases, a surgical delay was not necessarily associated with a change in patient outcome. 2,4 The ability to delay canine pyometra surgery without compromising patient care is advantageous as clinics manage increasingly busy days. Pailler et al 3,4 also define prognostic markers for feline and canine pyometra cases that are associated with longer hospitalization times, thereby improving the ability to identify cases that need extended care.…”