RESUMO

A piometra é uma infecção supurativa do útero, aguda ou crônica, com grande acúmulo de pus na cavidade uterina. O seu desenvolvimento é precedido pela hiperplasia cística endometrial, que é uma resposta exagerada e anormal do endométrio à estimulação da progesterona crônica e repetidamente, levando ao acúmulo de fluído no lúmen uterino e glândulas endometriais. Normalmente afeta animais de meia idade ou idosos, mas animais jovens também podem apresentar essa patologia, em decorrência a tratamentos hormonais. Essa patologia resulta de uma infecção bacteriana no endométrio, principalmente por Escherichia coli, após hiperplasia cística em decorrência de uma prolongada estimulação hormonal. A insuficiência renal aguda (IRA) é a principal complicação da piometra canina e ocorre secundária a glomerulonefrite por deposição de imunocomplexos, sendo diretamente ligada a longos períodos de internamento e ao óbito em cadelas com piometra. O presente relato tem por objetivo descrever um caso de piometra em uma cadela com complicações renais, atendido na Clínica Veterinária Bullmastiff.(AU)

Pyometra is a suppurative infection of the uterus, acute or chronic, with large accumulation of pus in the uterine cavity. Its development is preceded by endometrial cystic hyperplasia, which is an exaggerated and abnormal response of the endometrium to stimulation of chronic progesterone and repeatedly, leading to fluid accumulation in the uterine lumen and endometrial glands. It usually affects middle aged or elderly animals, but young animals may also present this pathology a result of hormonal treatments. This pathology results from a bacterial infection in the endometrium, mainly by Escherichia coli, after cystic hyperplasia due to a prolonged hormonal stimulation. Acute renal failure (ARF) is the main complication of canine pyometra and occurs secondary to glomerulonephritis by deposition of immunocomplexes, being directly linked to long periods of hospitalization and death in bitches with pyometra. The present report aims to describe a case of pyometra in a dog with renal complications, attended at the Veterinary Clinic Bullmastiff.(AU)

Assuntos

RESUMO

A piometra é uma infecção supurativa do útero, aguda ou crônica, com grande acúmulo de pus na cavidade uterina. O seu desenvolvimento é precedido pela hiperplasia cística endometrial, que é uma resposta exagerada e anormal do endométrio à estimulação da progesterona crônica e repetidamente, levando ao acúmulo de fluído no lúmen uterino e glândulas endometriais. Normalmente afeta animais de meia idade ou idosos, mas animais jovens também podem apresentar essa patologia, em decorrência a tratamentos hormonais. Essa patologia resulta de uma infecção bacteriana no endométrio, principalmente por Escherichia coli, após hiperplasia cística em decorrência de uma prolongada estimulação hormonal. A insuficiência renal aguda (IRA) é a principal complicação da piometra canina e ocorre secundária a glomerulonefrite por deposição de imunocomplexos, sendo diretamente ligada a longos períodos de internamento e ao óbito em cadelas com piometra. O presente relato tem por objetivo descrever um caso de piometra em uma cadela com complicações renais, atendido na Clínica Veterinária Bullmastiff.

Pyometra is a suppurative infection of the uterus, acute or chronic, with large accumulation of pus in the uterine cavity. Its development is preceded by endometrial cystic hyperplasia, which is an exaggerated and abnormal response of the endometrium to stimulation of chronic progesterone and repeatedly, leading to fluid accumulation in the uterine lumen and endometrial glands. It usually affects middle aged or elderly animals, but young animals may also present this pathology a result of hormonal treatments. This pathology results from a bacterial infection in the endometrium, mainly by Escherichia coli, after cystic hyperplasia due to a prolonged hormonal stimulation. Acute renal failure (ARF) is the main complication of canine pyometra and occurs secondary to glomerulonephritis by deposition of immunocomplexes, being directly linked to long periods of hospitalization and death in bitches with pyometra. The present report aims to describe a case of pyometra in a dog with renal complications, attended at the Veterinary Clinic Bullmastiff.

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RESUMO

Cystic endometrial hyperplasia (CEH), mucometra, and pyometra are common uterine diseases in intact dogs, with pyometra being a life threatening disease. This study aimed to determine the gene expression profile of these lesions and potential biomarkers for closed-cervix pyometra, the most severe condition. Total RNA was extracted from 69 fresh endometrium samples collected from 21 healthy female dogs during diestrus, 16 CEH, 15 mucometra and 17 pyometra (eight open and nine closed-cervixes). Global gene expression was detected using the Affymetrix Canine Gene 1.0 ST Array. Unsupervised analysis revealed two clusters, one mainly composed of diestrus and CEH samples and the other by 12/15 mucometra and all pyometra samples. When comparing pyometra with other groups, 189 differentially expressed genes were detected. SLPI, PTGS2/COX2, MMP1, S100A8, S100A9 and IL8 were among the top up-regulated genes detected in pyometra, further confirmed by external expression data. Notably, a particular molecular profile in pyometra from animals previously treated with exogenous progesterone compounds was observed in comparison with pyometra from untreated dogs as well as with other groups irrespective of exogenous hormone treatment status. In addition to S100A8 and S100A9 genes, overexpression of the inflammatory cytokines IL1B, TNF and IL6 as well as LTF were detected in the pyometra from treated animals. Interestingly, closed pyometra was more frequently detected in treated dogs (64% versus 33%), with IL1B, TNF, LBP and CXCL10 among the most relevant overexpressed genes. This molecular signature associated with potential biomarkers and therapeutic targets, such as CXCL10 and COX2, should guide future clinical studies. Based on the gene expression profile we suggested that pyometra from progesterone treated dogs is a distinct molecular entity.

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To describe the effect of the third-generation gonadotropin-releasing hormone antagonist acyline in the treatment of 4 diestrous bitches with the cystic endometrial hyperplasia-pyometra complex. The 4 bitches were treated with 330 µg/kg of subcutaneous acyline on day 0 and antibiotics, and followed up for 2 weeks. One closed-cervix case showed cervical dilatation 36 hours after treatment, and all the 4 animals showed resolution of clinical signs starting on day 3 posttreatment. Ultrasonographic uterine diameters and luminal contents decreased in the bitches having high progesterone serum concentrations before treatment but not in those with low levels. Serum progesterone importantly decreased from high to basal concentrations in the 3 "ultrasonographically cured" animals. No local or systemic side effects related to the treatment were observed. The gonadotropin-releasing hormone antagonist acyline may have a promising place for the medical treatment of cystic endometrial hyperplasia-pyometra complex in dogs.

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RESUMO

Treatment with cloprostenol, a prostaglandin synthetic analogue, was evaluated in five queens with open-cervix pyometra. Cloprostenol was administered (5 µg/kg body weight SC) on 3 consecutive days and amoxicillin (20 mg/kg body weight IM) on 7 consecutive days. Transient post-injection reactions caused by cloprostenol administration included diarrhea, vomiting and vocalizations. Reactions began as quickly as 10 mins after cloprostenol administration and lasted as long as 30 mins. All queens improved clinically after cloprostenol treatment and remained healthy until the end of the study, 1 year after treatment. All queens resumed normal estrous cycles without further treatment and two (40%) delivered a normal litter. In conclusion, use of cloprostenol is an acceptable treatment for open-cervix pyometra in queens.

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