Your dog having to undergo surgery is scary. Anesthesia is scary. No matter the veterinary advancements, you will always worry about your dog having to go under; I do. There is always some degree of risk involved. With age, the risk does increase.
Every time I'm making a medical decision for my dog, I do my best to arrive at a comprehensive risk versus reward assessment. What are the options? What will happen if I go ahead with one of them? What will happen if I do nothing?
Sometimes there is enough good data to mull over, sometimes there isn't. In case of pyometra, though, there is.
Pyometra is a serious and frequently life-threatening bacterial infection of the uterus. The infection is secondary to hormonal changes during estrus. It requires quick and aggressive treatment if the dog is to survive. Dr. Ward's article is the best explanation of pyometra I have read.
The symptoms depend on the stage and type of pyometra. It can start by a dog acting a little off, picking at their food, grumpy, lethargic and drinking more than usual. If this happens to your intact female dog any time between two to eight weeks after the last estrus, take it seriously.
Later stage symptoms include fever, lethargy and weakness, loss of appetite, vomiting, excessive panting, and excessive drinking.
Luna's parents were very concerned about her. She is 12 years old. What if she didn't survive the surgery? Was it inevitable that she'd die?
The other way one ought to look at it, though, is whether or not she could survive the pyometra. Luna had what is referred to as closed-cervix pyometra. Which means that not only there is a massive infection, but the pus is not draining. The success rate of medical treatment of this type is only about 25-40%, and the likelihood that even if treated successfully it would come back is high.
There are steps that can be taken to make her anesthesia as safe as possible. A comprehensive pre-anesthesia work-up, protocol choice and dosage, careful monitoring during and after ... all these things make it safer.
In spite of their worry, Luna's parents eventually decided to go through with the surgery. Waiting to hear how things went while Luna was in for the operation was excruciating. But finally, the phone call came, telling them that Luna made it through the surgery.
Two days later, Luna was released to home care. She was still in a bit rough shape but started eating and could stand and walk on her own with a bit of support.
Luna's parents feared the worst. They could have lost her one way or another. But Luna is now recovering and already looks much better than before the surgery.
Related articles:
Congratulations, It's an Infected Uterus: Miku's Story
Pyometra: Happy Ending for Phoenix
Further reading:
Pyometra in Dogs
Anesthesia for the Geriatric Dog and Cat
Risk versus reward assessment
Every time I'm making a medical decision for my dog, I do my best to arrive at a comprehensive risk versus reward assessment. What are the options? What will happen if I go ahead with one of them? What will happen if I do nothing?
Sometimes there is enough good data to mull over, sometimes there isn't. In case of pyometra, though, there is.
Luna's pyometra
Pyometra is a serious and frequently life-threatening bacterial infection of the uterus. The infection is secondary to hormonal changes during estrus. It requires quick and aggressive treatment if the dog is to survive. Dr. Ward's article is the best explanation of pyometra I have read.
The symptoms depend on the stage and type of pyometra. It can start by a dog acting a little off, picking at their food, grumpy, lethargic and drinking more than usual. If this happens to your intact female dog any time between two to eight weeks after the last estrus, take it seriously.
Later stage symptoms include fever, lethargy and weakness, loss of appetite, vomiting, excessive panting, and excessive drinking.
Luna was diagnosed with pyometra, and the veterinarian strongly recommended surgery.
Luna's parents were very concerned about her. She is 12 years old. What if she didn't survive the surgery? Was it inevitable that she'd die?
The other way one ought to look at it, though, is whether or not she could survive the pyometra. Luna had what is referred to as closed-cervix pyometra. Which means that not only there is a massive infection, but the pus is not draining. The success rate of medical treatment of this type is only about 25-40%, and the likelihood that even if treated successfully it would come back is high.
Luna's chances were better with surgery than without it.
There are steps that can be taken to make her anesthesia as safe as possible. A comprehensive pre-anesthesia work-up, protocol choice and dosage, careful monitoring during and after ... all these things make it safer.
In spite of their worry, Luna's parents eventually decided to go through with the surgery. Waiting to hear how things went while Luna was in for the operation was excruciating. But finally, the phone call came, telling them that Luna made it through the surgery.
They have removed 2 kg of an infected uterus; Luna is a small dog.
Two days later, Luna was released to home care. She was still in a bit rough shape but started eating and could stand and walk on her own with a bit of support.
Luna's parents feared the worst. They could have lost her one way or another. But Luna is now recovering and already looks much better than before the surgery.
Related articles:
Congratulations, It's an Infected Uterus: Miku's Story
Pyometra: Happy Ending for Phoenix
Further reading:
Pyometra in Dogs
Anesthesia for the Geriatric Dog and Cat
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My peeps worry 'bout us every time we have to "go under," too. They're usually callin' the doctor THE MOMENT the time arrives when the doctor says we should be out of surgery, and when I say moment, I MEAN MOMENT, like right down to the second. PURRS
ReplyDeleteYes, "going under" is always scary and it is important to take it seriously. But there are things where the risk of NOT doing that is higher than doing it.
DeleteLayla has glucoma in her one eye and with her age I am afraid of her having surgery. Having discussed this in length with the vet we both came to the conclusion to leave it as either way she would eventually go blind so am letting nature take its course but monitoring it also very carefully.
ReplyDeleteIt is my understanding that the biggest problem with glaucoma is not blindness but pain ... ?
DeleteI'm glad Luna is recovering well. Yes, always important to weigh the options especially when it comes to an older dog. About five years ago, we faced this decision with our senior cat. He needed a dental but was 14 and I feared putting him under. His blood work was fine and we went ahead with the surgery. Fortunately, he was fine.
ReplyDeleteWhen you take all the step, such as pre-op blood work and examination, following the right protocol ... anesthesia is quite safe. Pain (and it can be a substantial amount with oral disease, as well as potential systemic infection weighs against anesthesia concerns.
DeleteAt 3.5 pounds I always fear surgery. The under 5 pound dogs ... it's an added risk. But yes ... i think in this scenario it's absolutely the best situation. Always so hard.
ReplyDeleteYes, the smaller the critter the riskier it is. It is always about balancing risk and reward.
DeleteGlad she's recovering well. It is difficult to make medical decisions when the patient can't talk and you don't always know how they feel. Sounds like you're on the right track! ~ Dear Mishu
ReplyDeleteI am quite sure than having pyometra the patient feels absolutely horrid and would agree to anything to feel better.
DeleteI believe Brulee's mom kitty developed pyometra after her second litter of kittens and our breeder almost lost her. It was touch and go for a while, but we're happy to say that Mikayla is doing well now, living as a retired queen at the beach.
ReplyDeleteI know how it feels to be concerned about anesthesia since Truffle just underwent surgery to remove stones from her bladder. She is doing better, but I hate seeing her so quiet without her sassiness.
I hear you. It's kind of good that Truffle is quiet, though, easier to heal. But it is always hard. Some things, though, are so painful and/or dangerous, that a surgery is the only sensible option.
DeleteIt's always a hard decision to make about surgery - of any kind. Sometimes it's obvious that surgery is necessary and we take our chances, but then there are things like dental cleanings that you wonder if it is worth it for a senior dog - usually it is. I've never had a problem with anesthesia.
ReplyDeleteWe had some post-anesthesia and post-sedation issues. The urgency of dental does depend on the state of the mouth. Serious infection or disease, naturally, does call for dental work.
DeleteWow I've never heard of pyometra but am very familiar with hearing stories of pet owners surrendering their pets for health reasons. Its so sad to know some people dump their pets when they get ill. :( So glad to hear Luna's on the mend and improving. Looks like she's beating the odds!
ReplyDeleteCost was not the issue for Luna's parents; the concern about her prognosis with the anesthesia was.
DeleteIt is helpful see an article like this when the different risks and options are discussed. I have seen cases of pyometra when I worked at a vet clinic and it can be devastating. As you state, if you are concerned and female dog is just "off" or funny, have her checked quickly. The lurking infection can get really bad really fast. Trust your gut and your knowledge of your pet.
ReplyDeleteYes, some very bad things can be brewing under the guise of "just being off," particularly shortly after heat in an intact female.
DeleteGracie having to have surgery at her age is something I am afraid of happening. I do not know how she will handle it! She hasn't had surgery since she was spayed as a puppy. Of course, if she needed surgery I would have it done, but I would be very worried for her and how she would be after the surgery.
ReplyDeleteYou cannot really "practice" handling surgery :-) Fortunately, it largely depends on overall health. And anesthesia protocols are constantly improving and getting safer.
DeleteI absolutely know how Luna's people felt. Reese is thirteen and had surgery last year. I was beside myself. The risk versus reward assessment is a great idea. So glad Luna is looking better - I hope she makes a full recovery!
ReplyDeleteWithout surgery, Luna would not make it with an extremely high probability and she'd suffer greatly. The surgery in such case was the lesser of the evils.
DeleteI've never heard of this condition but not is that scary. I was a wreck when my 8 year old dog had to go under anesthesia for a dental cleaning! I can imagine how Luna's parents felt. I was surprised they didn't do a full hysterectomy for her, at 12 she can't be having more puppies - I would hope!
ReplyDeleteLove & biscuits,
Dogs Luv Us and We Luv Them
If you never had an intact female, you don't need to know about pyometra though SOMETIMES there can be "ghost" parts left and it could still develop when the spay surgery wasn't done with full success.
Delete