Canine Pyometra: An Update on Pathogenesis and Treatment Washington State University–Pullman
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چکیده
Despite six decades of research, the pathogenesis of pyometra is still not completely understood. Recent investigations question whether the previous concept of considering cystic endometrial hyperplasia (CEH)–pyometra as a complex is correct. The pathogenesis of CEH appears to have a strong hormonal component, whereas the etiology of pyometra might be more influenced by the bacterial component. However, CEH may predispose bitches to develop pyometra. Critically ill pyometra patients should be monitored for clinical criteria of systemic inflammatory response syndrome. Closed-suction abdominal drains and a different administration route for prostaglandin F2α are promising enhancements in the treatment of pyometra. Canine pyometra is a disease syndrome that affects adult intact bitches, causing a variety of clinical and pathologic signs of genital and systemic disease. The pathogenesis of canine pyometra is not completely understood, despite decades of studies concerning the etiology of the disease. The concept of cystic endometrial hyperplasia (CEH)–pyometra, introduced by Dow, states that hormonal changes lead to CEH (Figure 1) and render the uterus susceptible to secondary infection, which leads to pyometra (Figure 2). Recently, it has been suggested that the classic CEH–pyometra complex description should be separated into two entities: CEH and pyometra. CEH may predispose for pyometra in some cases, but pyometra can also occur without CEH. Mounting evidence suggests that the development of pyometra is an entity separate from CEH, with a hormonal component in the pathogenesis but mainly triggered by bacterial infection. ETIOLOGY—THE HORMONAL COMPONENT The investigated factors of pathogenesis in CEH and pyometra are summarized in Figure 3. n Canine pyometra is not always secondary to cystic endometrial hyperplasia, and the two disorders might have different
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تاریخ انتشار 2005