Believe it or not, this insanely infected uterus was from a tiny 3kg Pomeranian… That’s my hand next to it!
The patient presented with an incredibly bloated abdomen, although did not seem in too much pain when palpated, although slight discomfort was evident. The patient had not eaten for several days, was dehydrated, but walking around, bright, alert and responsive, even wagging her tail when I walked up to her in the hospital cage, although apparently not as bright as usual.
She had two radiographs taken, a right lateral and a ventro-dorsal view. What appeared on the radiographs was not consistent with pyometra (the veterinarian’s initial thought), as two round masses appeared to be present. This was actually just due to the uterine horns wrapping around their already bloated selves. 450mL of fluid was also extracted from the abdominal cavity, again not consistent with pyometra.
The owners were called and the worst was assumed, two large abdominal carcinomas in this tiny 14 year old dog. The risks of surgery were put forward, and the clients decided to chance the surgery in order to give their pet a bit more comfort.
There were minimal complications, and maintaining anaesthesia with a good heart rate and respiratory rate was a breeze. During induction the patient stopped breathing and so I assisted with manual inflation of the lungs via the breathing bag, and Dopram was administered, allowing the patient to resume normal breathing immediately.
We went in to theatre expecting to do a full exploratory laparotomy, but as soon as the initial incision was made, it was clear that it was an incredibly swollen and infected uterus.
The uterus was removed, with a few extra ligatures in places that wouldn’t usually be necessary due to the increased size of the blood vessels, and the patient stitched up as per usual.
Recovery was excellent, with the patient extubated easily and quickly, and she was already responsive and alert within a short amount of time. Onsior was given for analgesia, and Clavulox as an antibiotic.
This dog was 5.0kg before her surgery. Afterwards, just over 3kg.
Cleaning up, and moving the uterus into this temporary container, were uneventful (I was afraid it’d explode pus all over me at the smallest movement, it was so full and taught), and the patient is still on IV fluids until she’s being picked up tomorrow afternoon, with another injection of methadone tomorrow morning (we use methadone in our premeds so didn’t want to overdo it this afternoon), going home with a course of antibiotics and pain killers.
The owners were incredibly glad that their pet did not have cancer, and that the surgery was completely successful.
And we thought today would be boring; it was my first time assisting with a pyo, and the biggest uterus any of us had ever seen!