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Scott Nimmo
Scott Nimmo, Dog Veterinarian
Category: Dog
Satisfied Customers: 15303
Experience:  BVMS, MRCVS.
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what are the antibiotics given to treat pyometra

Resolved Question:

what are the antibiotics given to treat pyometra
Submitted: 4 years ago.
Category: Dog
Expert:  Scott Nimmo replied 4 years ago.
Thanks for the question

In direct answer to your question : In almost all cases the answer would be no antibiotics are suitable to treat pyometra as they are rarely effective in the face of this disease and immediate surgery is the normal course of action. The following is an excerpt from an article I wrote on the subject of pyometra which has been published elsewhere.

Pyometra is a potentially fatal very serious disease which can easily be treated with surgery and this is almost always the only way forward. Ultrasound would be a reliable way to come to a diagnosis. I will tell you what I know of the condition, the following is from an article I wrote about this disease which was published elsewhere ...

Cause: The cause of this disease is quite complex, it usually follows cystic endometrial hyperplasia which is a type of womb disease, this changes the internal environment of the womb and makes it prone to bacterial infections. Once the bacterial infection is established it goes wild and a full blown pyometra is the result. Other contributory factors would be the use of drugs to postpone or control the dog’s seasons. Pyometra can also occur in stumps left after spaying and on occasion following womb infection after the animal has given birth.

 

Clinical Signs: [Symptoms] These dogs will be lethargic, will have no appetite and will be drinking much more than normal. Some will have a vaginal discharge which cases are called an open pyometra, others will have no vaginal discharge and these are termed closed pyometras. Obviously these dogs are not spayed, they are usually more than six years of age in my experience and they will have been in season just prior to the onset of symptoms.

 

Diagnosis: The above clinical signs would on their own be very suggestive of pyometra. I found ultrasound very useful to confirm the diagnosis in these cases, X-rays could be used as well, and a high white cell count is also indicative.

 

Treatment: The main treatment for this disease is an immediate hysterectomy operation [ Spay ]. It differs from a normal spay operation in that as the dog is usually quite sick you need to provide additional support like putting it on a drip and a higher level of post operative care.

 

If I have not covered your question fully enough or you would like to ask more I will be online for the next hour or so and I will be at your disposal.

Scott Nimmo BVMS MRCVS
Customer: replied 4 years ago.
my 5yr old 6lb chihuahua had a slight bloody discharge and was not eating. it was taken to the vet and vet gave IV drip with vit B and ampiccilin. Also gave baytril and .25ml clavamox. Had 27000 WBC. After 3 days WBC was 35000 and it was not having appetite. Took it to another vet who gave Eurofloxacin 1ml and Clavamox 1ml twice a day. In 5 days the WBC was 34000, fever normal, normal appetite, not at all lethargic wants to play and jumps on things and looks completely normal. Did ultrasound but there is pus in the uterus. The antibiotic is for 14days so I am wondering if I should finish the course so dog maybe more stable for surgery than surgery with infection?
Expert:  Scott Nimmo replied 4 years ago.
Hello again,

Thanks for the further information ...

I have the picture now, it is very encouraging that your dog is now acting normally but the ultrasound imaging of a distended uterus is a cause for concern as is your dog's previous symptoms.

At the end of the day you have to be guided by the vet in charge of the case. However if I was presented with such a case my approach might well be to continue the antibiotics for a total of a five day course and then carry out a hysterectomy. You see pyometra has a track record of recurring in the at some future point so it would be best to carry out surgery now while your dog is fit and healthy and a five day course of antibiotics would go along way to pre-empting any possible post surgery infections.

Good luck and regards,

Scott
Customer: replied 4 years ago.

7 days of the 14 day antibiotic course has gone...there is a remaining 7 more days. I thought of finishing the 7 more days and then do surgery. I wonder if the pus will suddenly increase?

 

Also once an open pyometra can it close? I know it was open due to discharge but can it just close up?

Expert:  Scott Nimmo replied 4 years ago.
Hello again,

While there are no guarantees I can tell you the following :

1. As long as your dog seems bright, happy and acting normally then you would be taking very little risk in waiting a further seven days before having surgery carried out.

2. In my experience open pyometras usually stay open and would rarely become closed ones. However the closed pyometra is a more serious situation than the open one so if this happened you would soon pick it up as your dog would be obviously quite sick ...

Regards,

Scott
Customer: replied 4 years ago.

is 1ml clavamox the regular dose for a 6lb chihuahua and

 

does the pus stay in the uterus even after the infection is gone?

Expert:  Scott Nimmo replied 4 years ago.
Hello again,

1. Clavamox is a very good broad acting antibiotic and is often used in the dog. It comes in different strengths and formulations such a tablets and suspensions but a normal dose range would be between 5 to 12 mg per pound of your dog's bodyweight twice a day.

2. Yes, there is a danger that some pus could be left in the uterus after treating a minor open pyometra with antibiotics and this of course would be a risk factor as regards recurrence.

Regards,

Scott
Customer: replied 4 years ago.

how do i know if the pus is just pus or infected pus when pus shows up on ultrasound? my dog was given liquid forms of both eurofloxacin and clavamox.

 

is 1mg stilvestrol effective in dogs with pyometra to get the pus out?

Expert:  Scott Nimmo replied 4 years ago.
Hello again,

1. The only way you would know with any degree of certainty what was going inside your dog's uterus would be by repeated ultrasound sessions at regular intervals. Really any distension of the uterus or abnormal fluid levels such as pus within the uterus is always a cause for concern even if your dog seems healthy. The danger here is that any pus left in the uterus could trigger another pyometra attack following your dog's next season. { or sooner }

2. While the use of stilboestrol seems logical in the treatment of some types of pyometra I personally would not recommend it's use because of potential side effects. In any case such medical treatment alone is rarely effective long term in treating pyometra.

Regards,

Scott
Customer: replied 4 years ago.

last questions...

1.can parasites cause pyometra and is clavamox effective in treating parasites?

 

2.is WBC count a good indication of progress or does WBC count drop if pyometra is advancing?

 

3.where should i look to find a good vetinary hospital in massachusetts?

Expert:  Scott Nimmo replied 4 years ago.
Hello again,

Please ask as many questions as you want related to your dog's pyometra, this is no problem I am glad to chat back and forth with you on the subject ...

1. Pyometra is never related to parasites in any way, please see my first answer for a detailed explanation or check out this article which covers the topic both in depth and in an accurate fashion : LINK

2. Clavamox is an antibiotic, as such it will kill bacteria but it has no effect on parasites I am afraid.

3. If pyometra is advancing then you would expect to see the white blood count rising as well.

4. Unfortunately I am not based in the USA so I cannot help you in your quest for a vet hospital in Massachusetts. { I am from the UK } However the pyometra operation in a relatively healthy dog would be just like a bitch spay so most local vets would be able to carry this out with no problem. Other than that all you can do is to ask about locally as to where the best facility is.

Good luck,

Scott
Customer: replied 4 years ago.

I always have more faith in UK vets...maybe bias as i lived there longer. Here the problem is the vets i have gone to have lied just to make me do the surgery and one asked for $6000. I have no problem doing the surgery and would do it with a vet who gives me facts properly. I like your answers very much as you are giving facts and not just keeping on saying to cut the dog up.

 

One vet said that the reason WBC is going down is that pyometra is advancing and blocking WBC from getting into bloodstream? is this true. when i asked if the pus had decreased from the last ultrasound the vet said she is in no position to tell that information...

 

But earlier the dog had dehydration and now it doesn't. All kidney, liver etc are fine. Only WBC has come down to 34000 from 35000 and netraphils have also slightly decreased. So, I want to try giving the full antibiotic course while I search for a vet for surgery.

 

if i need to ask a question at a later time can i ask for you?

Expert:  Scott Nimmo replied 4 years ago.
Hello again,

1. While I do not want to contraindicate any other vet particularly one who has examined your dog hands on I have to say that my experience is that the worse the pyometra gets the higher the white count would becomes. I have always checked the white count when I diagnosed pyometra even when I used ultrasound as well as it is a good indicator how bad things are.

2. While it is very easy to visualise large amounts of pus via ultrasound when a dog has a full blown pyometra when there just small amounts of pus it can be difficult to be certain as the appearance of the uterus changes with your dog's cycle anyway.

3. Your approach of keeping your dog on antibiotics while you search for a vet to carry out surgery in the very near future would rarely be wrong.

4. You can ask for me online whenever you want, I am usually about ...

Good luck,

Scott
Customer: replied 4 years ago.

what level should the WBC generally be for me to consider immediate operation? and the level of NEU is 23.54 K/ul

MONO 2.67 K/ul

PLT 628 K/ul

CREA 1.9, PHOS 9.6 , CA 4.9, TP 12.0 AMYL 442 U/L, GLU 220 mg/dl

Expert:  Scott Nimmo replied 4 years ago.
Hello again,

The white count is only part of the diagnostic picture and you also have to take into account the scan results if that has been run, the extent of the vaginal discharge and the animal's general condition on clinical examination and any other concurrent conditions such as heart disease. So you would not take the white count alone as a decisive factor.

However high counts 30,000 - 40,000 range would confirm tend to confirm what is going on and would make me personally press to carry out surgery if presented with such a case. What is going on with your dog is a bit different though because she now seems bright and healthy but really if pyometra has been confirmed then that is all the more reason to go for surgery in the very near future while the dog is bright and feeling good and so can come through surgery better. There is far more risk in pyometra surgery when the dog is already [ and sometimes very quickly has become ] quite ill at some future point.

Regards,

Scott
Scott Nimmo, Dog Veterinarian
Category: Dog
Satisfied Customers: 15303
Experience: BVMS, MRCVS.
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