‘Princess’ the cat is special and not like other cats… At least, that’s how Mrs Jones views her cat-child.

This is plain to see as the vet has to immerse their entire upper torso into a ‘cat carrier’ that really would put some London flats to shame in order to peel ‘Princess’ from her furnished pad.

However, Princess’s ease of extraction from the TARDIS sized carrier fits with Mrs Jones’ dramatic wails of concern for her dear cat’s lack of lust for life and recent decline in management of the local wildlife population.

A thorough exam brings the vet to one conclusion … Princess is indeed special, but not in the way her owner thinks. For this cat has a pyometra. The response to which from most cat owners is either ‘a pyo-what?’ or ‘that’s a dog thing! Are you even qualified?’.

Isn’t pyometra a dog thing?

As vets, we do see this condition significantly more frequently in dogs than in cats, occurring in approximately 25% of intact female dogs by the age of 10. Unfortunately, cats are not immune to this condition, with approximately 2.2% of intact female cats developing a pyometra before the age of 13. 

The development of pyometra in a cat or a dog is a potentially life-threatening condition. It is caused by an infection within the uterus (womb), causing it to become filled with pus. This can progress to blood poisoning, kidney failure, rupture of the infected uterus into the abdominal cavity causing peritonitis, and ultimately death.

Is my cat at risk?

Any intact (non-neutered) female cat is at risk of pyometra, but there are certain other risk factors:

  • Breed – Certain breeds are at a significantly higher risk of developing pyometra including Sphynx (highest risk), Siberian, Siamese, Ragdoll, Maine Coon and Bengal
  • Age – The condition typically occurs in middle aged to older cats (>5-7 years old), usually within 4 weeks of being in season 
  • Medications – The use of certain medications including progesterone medications (progestins) and methylprednisolone acetate can increase the risk of developing pyometra

What are the clinical signs?

Unfortunately, the clinical signs of pyometra in cats are often non-specific, with some cats showing only very mild clinical signs, but can include:

  • Quiet demeanour
  • Reduced appetite
  • Vomiting
  • Weight loss
  • High temperature
  • Vaginal discharge 

How is it diagnosed?

Given that clinical signs of pyometra in cats can be quite non-specific, it should be considered as a possibility in any unwell female entire cat. If you are concerned that your cat is unwell, get them assessed by your vet.

Your vet will do a full clinical exam which in cases of pyometra may identify a high temperature, vaginal discharge, or possibly your vet may be able to feel an enlarged uterus in their abdomen. Your vet may perform other tests including:

  • Blood testing – to assess for other complications such as dehydration, changes in the white blood cell count and effects on other organs 
  • Imaging (ultrasound scan/x-rays) – to assess for an enlarged, fluid-filled uterus

What is the treatment?

Prevention is better than cure. As well as avoidance of pyometra, there are a number of benefits to neutering your cat, including preventing unwanted pregnancies. 

Pyometra may be treated either medically or surgically. In some cases, medical treatment (including antibiotics, IV fluids) may be needed prior to surgery in patients who are particularly unwell and need to be stabilised before they are safe to have an anaesthetic.

  • Surgical management – ovariohysterectomy/spay surgery is usually the treatment of choice for pyometra. It involves the removal of the ovaries and the uterus, removing the source of infection in your cat’s body. It is essential in cases where the uterus has ruptured and infection has leaked from the uterus into the abdominal cavity or in cases not responding to medical therapy.
  • Medical management without surgery – may be considered in some cases. Often this requires your cat to be hospitalised at the clinic for IV fluids, antibiotics and hormone medications to reduce the effects of hormones associated with her being in season on her uterus. It is not always effective and some cats will require surgery as medical management is not effective. If pyometra is treated medically without surgical removal of the uterus, there is a risk of pyometra development after future seasons.

What is the prognosis?

Pyometra is a potentially life-threatening condition. However, the prognosis for survival is good with early treatment (92% survival rates). The prognosis is poorer if the uterus has ruptured, with 30-50% of cats not surviving. 

You’ll be relieved to hear that Princess went on to make a full recovery after a few days of top private hospital care, courtesy of her personal health insurance. She is now back to feasting on Harrods finest cured meats and local wildlife. There is news she is getting an even larger mobile condo to make future trips to the vet even more luxurious. Everyone’s happy – except the vet who will need to carry the carrier from the car into the clinic.

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