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The Case of the Very Sad Old Lady and her Beloved Dog
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Thu Mar 04 2010, 09:37PM

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Joined: Sun Feb 28 2010, 10:31PM
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The Case of the Very Sad Old Lady and her Beloved Dog

Mrs McKenzie came into the waiting room cradling her little Jack Russel terrier. Her family surrounded her, trying to comfort her. Her old, lined face was streaked with tears. I asked her what the problem was. With a quivering voice she said, "Doc, my little Cindy is so sick. She wouldn't eat for the last two days. She vomits any water she drinks and now she can hardly walk she's so weak!"

A middle-aged attractive woman, clinging to Mrs McKenzie's arm said, "We've decided to put Cindy to sleep. We're sure that she's on her last legs!"

I replied, smiling, "Before we make such a drastic decision, let's examine Cindy, shall we?"

I established that Cindy was about seven years old and had not been spayed. She'd been 'on heat' about a month previously. She drank a lot of water, but vomited it up soon afterwards. When I felt her somewhat swollen abdomen, she flinched and I thought I could feel a doughy sausage-like mass inside.

I told Mrs McKenzie "My dear, I think I know what's wrong with Cindy. She's probably suffering from a condition called pyometra. Her uterus has become filled with pus and it's poisoning her system. I don't think there's any reason to put Cindy to sleep. I just have to do a few more tests to confirm my diagnosis and then we'll do an emergency operation."

It's very difficult to change somebody's mind once they've agonised over a difficult decision and actually committed themselves to having their pet put to sleep. I argued long and hard and eventually the family agreed to let me try.

Further blood tests confirmed a probable massive infection in the body. I immediately started with intravenous antibiotic therapy and put Cindy on anti-shock therapy, which included putting her on an intravenous drip. After about an hour I decided that she was strong enough to have the operation.

When I cut into the abdomen I could see immediately that the uterus was grossly enlarged like a glistening monstrous sausage. I had to be very careful handling it. One tear and the abdomen would be awash with deadly pus. I enlarged the wound slightly and gently pulled on the uterus. Eventually the entire organ lay coiled on the surgical drapes covering Cindy's body. It was huge! The diameter was about 5cm and the whole organ covered the body and spilled over onto the operating table.

Suddenly the respiratory monitor's beeping stopped. This meant that Cindy had stopped breathing! Quickly I gave orders for the anaesthetic gas to be stopped and pure oxygen to be pumped into Cindy's lungs. Still the beeps of the respiratory monitor kept ominously silent. The heart monitor continued beeping reassuringly. I reached for the emergency drug tray and injected a respiratory stimulant directly into Cindy's vein. Within a few seconds she gave a large breath and we all gave a huge sigh of relief. I quickly scrubbed up again and changed to new sterile gloves to continue with the operation. The rest was routine. I removed the entire pus-filled uterus including the ovaries after clamping off the blood vessels supplying the diseased organ.

Cindy made an uneventful recovery and went home the next day.

Ten days later the entire McKenzie clan brought a happy, tail-wagging Cindy in for suture removal. Mrs McKenzie's eyes filled with tears as she gave me a hug. Teasingly I said, "Now now, No more crying. I want to see some happy faces!" She hugged me harder and the look on her face as she looked into my eyes, said it all.

Cases like this make my job really worth while.


Pyometra is a fairly common problem in older, entire (unspayed) bitches. This is one of the reasons why vets usually recommend that bitches should be spayed at an early age. Some years ago vets used to give injections or pills to stop females from coming into "season". This often caused pyometra. Fortunately this practice has now largely come into disrepute.

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