It was unusual that Rosie hadn’t eaten her breakfast, and she seemed a little down in the dumps when her owner, Sue, left for work in the morning. But apart from not being her usual hyperactive self, Sue noticed nothing else untoward. After all, Rosie was nine now and, being a bouncy Springer Spaniel, Sue thought that maybe it was time she slowed down a little. 

By that afternoon, the dog walker called and said Rosie was reluctant to go on a walk, and Sue was a little worried. She returned from work in the evening to a horrible scene: Rosie had drunk all her water and then vomited all over the living room. Now she was curled up in bed, limp and refusing to stand. Sue immediately called the local vet, who told her to bring Rosie to the surgery immediately.

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Getting a diagnosis

At the vet’s, the nurses checked Rosie over and made her comfortable until the vet was free. The vet found that Rosie was severely fluid depleted (there was not enough fluid in her blood system – known as hypovolaemia), which sent her body into shock. Hypovolaemic shock is a serious condition; it can lead to a rapid heart rate, low blood pressure and collapse.

Rosie also had a high temperature, a painful tummy, and a small amount of smelly brown discharge from her vulva. She had all the signs of an infected uterus. Ultrasound of her abdomen showed a very large, fluid-filled uterus. The vet’s suspicions were confirmed; Rosie had pyometra.

Making a treatment plan

Pyometra is a life-threatening condition that, if left untreated, will lead to sepsis and prove fatal. In the majority of cases, the uterus must be surgically removed to cure a dog of pyometra entirely. The odds of survival post-surgery are extremely high, so the condition carries a very good prognosis. 

In the short term, medical management is an option using antibiotics and hormonal treatment, but only if the cervix is open to release pus from the uterus. If the cervix is closed, the uterus will eventually burst. Medical treatment should always be followed up by surgery a few weeks later, so the benefits are questionable. It might be possible to resolve a low-grade pyometra without surgery, but the chances of recurrence are incredibly high.

Sue felt that the best course of action was to proceed to surgery. However, Rosie was extremely sick and needed to be stabilised first.

Preparing for Surgery

By now, it was getting late, and the clinic was about to close. The vet emphasised that they must prioritise Rosie’s shock before transferring her to the out-of-hours clinic for surgery later that night. Rushing to perform surgery immediately was not the safest option for her. 

Rosie’s vet ran a blood screen which showed that she had signs of dehydration, electrolyte imbalance (due to vomiting) and high white blood cells (due to infection). She was started on short, rapid bursts of intravenous fluids to treat hypovolaemia. Once the shock resolved, fluids were given more slowly to rehydrate her. Rosie was also started on intravenous antibiotics, anti-sickness medications, pain relief and potassium supplementation.

Rosie was already starting to feel a little better and was beginning to lift her head and slowly wag her tail at Sue. But she wasn’t out of the woods yet – major surgery still lay ahead of her.

Transferring to the out-of-hours vets

Sue had been to the out-of-hours practice once before, when Rosie ate a load of easter eggs, so it was not entirely unfamiliar. Her vet checked she was as stable as possible before travel, and the emergency team had a bed ready for her arrival.

Once there, the night vet explained that she would go to surgery when they were confident that she was stable. Rosie would be very closely monitored in the meantime. They discussed Rosie’s aftercare, hoping she would be discharged in the next couple of days if there were no complications. Rare complications might include rupture of the uterus, excessive internal bleeding, or unexpected findings such as a tumour in the genital tract. 

Sue knew that her total treatment cost would be several thousand pounds. Luckily, she had continued Rosie’s insurance policy despite her getting a bit older, so Sue didn’t have to worry too much, apart from finding the initial funds. Right now, she could focus on getting Rosie the best care possible.

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A long night of waiting

Just after midnight, Sue received a text saying surgery had commenced. Sue was so worried she asked for a call when the surgery was completed. So, she put the kettle on and turned on Netflix to take her mind off everything.

At the vet’s, the surgery was going well. The uterus was enormous and ready to burst, which made its removal challenging. The blood vessels to the uterus were chunky and pulsating, so tying them off carefully was of utmost importance. But once the uterus was removed, everyone felt rather relieved. The remaining cervix was thoroughly flushed to reduce the risk of an abscess forming. Stump pyometra is a possible postoperative complication following pyometra surgery.

At 2.30am, the phone rang, and, to Sue’s relief, the vet said Rosie was out of surgery and starting to wake up. Sue could finally get some rest.

Recovering from surgery

The first day following surgery was a little rocky for Rosie. Her tummy was still very sore, there was some oozing from the surgical wound, and she felt nauseous. She spent the day in the hospital, having her medications tweaked and being closely monitored. By day two, she was starting to eat some cooked chicken and looking much more sprightly.

Sue visited Rosie in the afternoon and felt ready to take over her care. In fact, Rosie made it very clear she was ready to go home. She led the nurses to her car in the car park and sat there with her tail wagging, refusing to budge.

The vet went through medications and feeding, but most importantly, she was on strict rest and was adorned with ‘the cone of shame’ to stop her from licking the stitches. Rosie was not impressed.

Back to her old self

Back at home, Rosie was the model patient. She took her tablets hidden in tasty putty treats and managed to rest despite it not really being in her nature. Sue played lots of scent games with Rosie and bought her a puzzle feeder. She also took Rosie for trips in the car (being careful to lift her in and out) and to friends’ houses to stop her from going stir-crazy.

A couple of weeks after surgery, Rosie went for her final post-op check. Her vet was delighted to see her looking so well, and Rosie was still furiously wagging her tail despite what she had been through.

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