L.G.C. Trautwein1; L.G.P. Giordano2; M.C. Sant'Anna1; R.C. Justino1; K.K.C. Flaiban2; M.I.M. Martins1
Pyometra is a uterine disorder resulting from bacterial interaction with cystic endometrial hyperplasia. The aim of this study was to determine the bacterial strains isolates from uterine secretion under aerobic and anaerobic conditions, and compare the presence of systemic inflammatory response syndrome (SIRS), patency of the cervix, peritonitis and biochemical tests (urea, creatinine, alkaline phosphatase - AP and alanine aminotransferase - ALT) with disease prognosis. Were used 15 bitches with pyometra, submitted to ovariohysterectomy as treatment. Blood was collected before the surgery for blood count and biochemical tests. After removal of the uterus, intrauterine contents were collected by aseptic puncture and culture performed aerobically and anaerobically. The animals were divided into two groups, G1 (discharged within 48 hours) and G2 (discharged after 48 hours or death), and were classified as positive or negative SIRS. Of 15 samples of uterine contents, 11 (73.3%) had bacterial growth aerobically and anaerobically. Escherichia coli was isolated in 2 samples (13.3%), in each condition. There were differences in the growth of the bacterial strains in aerobic and anaerobic conditions, but nothing that highlights the high rate of negative cultures. There was no difference between SIRS and peritonitis variables with bitches' prognosis, but there were differences in cervix patency, urea, creatinine, and AP variables (Table 1 and 2) when compared with the prognosis of pyometra. The presences of SIRS, and measurement of ALT, were not good prognostic makers. It was concluded that the elevation of creatinine, urea, AP, beyond the cervix patency were predictors of morbidity and/or mortality of canine pyometra.
Table 1. Frequency and association of the variables SIRS, peritonitis, and patency of the cervix with the need for prolonged hospitalization or death using the Fisher's exact test with a significance level of 5% (Londrina, 2013)
|
Variables
|
G1
|
G2
|
Value of p
|
|
SIRS
|
0.57
|
|
- Yes
|
4/13 (30.77%)
|
9/13 (69.23%)
|
|
- No
|
1/2 (50%)
|
1/2 (50%)
|
|
Peritonitis
|
0.4
|
|
- Yes
|
2/4 (50%)
|
2/4 (50%)
|
|
- No
|
3/11 (27.27%)
|
8/11 (72.73%)
|
|
Patency of the cervix
|
0.04*
|
|
- Open
|
5/9 (55.56%)
|
4/9 (44.4%)
|
|
- Closed
|
0/6 (0%)
|
6/6 (100%)
|
*Significant association
Table 2. Values of urea, creatinine, ALT and PA expressed as median and compared between groups using the Mann-Whitney test with a significance level of 5% (Londrina, 2013)
|
Variables
|
G1
|
G2
|
Value of p
|
|
Median
|
Median
|
|
Urea (mg/dl)
|
27
|
83
|
0.01*
|
|
- (minimum–maximum)
|
(21–45)
|
(23–264)
|
|
Creatinine (mg/dl)
|
0.8
|
2.2
|
0.01*
|
|
- (minimum–maximum)
|
(0.3–1.4)
|
(1–8.7)
|
|
PA (UI/L)
|
74
|
249
|
0.03*
|
|
- (minimum–maximum)
|
(16–198)
|
(55–2009)
|
|
ALT (UI/L)
|
23
|
23.5
|
0.9
|
|
- (minimum–maximum)
|
(18–36)
|
(12–464)
|
*Significant association