Background: Multi-drug resistant bacterial strains with biofilm-forming ability are one of the significant reasons contributing to the failure of medical management and recurrence of canine pyometra. The predominant bacterial agent implicated in canine pyometra is Escherichia coli, the different strains of which can be grouped into distinct phylogroups with the same ecological niches, characteristics and tendency to cause disease. The identification of a phylogroup of an unknown strain can facilitate the&nbsp; control, prevention and treatment of infections. 
 
Methods:&nbsp;The isolates of E.coli obtained from 25 clinical cases of pyometra were identified based&nbsp; on the cultural, morphological&nbsp; and biochemical characteristics. The antibiogram of the isolates were done employing Kirby-Bauer disk diffusion method. Biofilm&nbsp; forming ability of theisolates were detected by tissue culture plate method and the presence of virulence genes among them were&nbsp; detected using a multiplex PCR. The phylogrouping of E. coli was done employing the novel quadruplex PCR method. 
 
Result: In the antibiogram, most isolates were found sensitive to Amoxycillin-clavulanate (90%), Gentamicin (80%),Tetracycline (50%) and Amikacin (50%), while 100% resistance were shown towards ceftazidime-clavulanate, enrofloxacin,ceftriaxone-tazobactam, ciprofloxacin and cefotaxime-clavulanate. Among the E. coli isolates, strong and moderate biofilm producers showed&nbsp; resistance to a wide range of antibiotics compared to non-biofilm producers. Around 80% of the isolates belonged to the&nbsp; phylogroup B2 and all of these had the presence of fimH, sfa, and csgA genes. Among the isolates belonged to the phylogroup B2,&nbsp; 87.5% of the isolates had pap gene while none of them possessed afa gene.

Phylogrouping, Virulence Profile and Antibiogram of&nbsp; Escherichia coli Strains Associated with Canine Pyometra

<div>Background: Pyometra is an infectious condition characterized by a pus-filled uterus, which basically developed due to hormonal, anatomical and physiological changes and the inside environment of the queen uterus help to grow the opportunistic pathogen. The aim of the present study was made to assess the haemato-biochemical changes of pyometra in infected queens.&nbsp; 
 
Methods: The study was carried out in 12 clinical cases of cat with a history of lethargy, depression, inappetence, polydipsia, occasional vomition and vaginal discharge, presented for treatment at Teaching Veterinary Clinical Complex, College of Veterinary Sciences and A.H., Central Agricultural University, Aizawl, Mizoram. The presumptive clinical diagnosis of pyometra was made based on history, clinical signs and imaging techniques. The involvement of the pathogen was further confirmed by microbial examination of the pus-filled uterus after the ovariohysterectomy.&nbsp; 
 
Result: The study revealed alterations in the total erythrocyte count, haemoglobin and packed cell volume in pyometra cases. The leucogram revealed leucocytosis, neutrophilia and lymphopenia. Biochemical analysis revealed hyperprotenemia, increased liver enzymes and BUN and creatinine. The major pathogens involved in pyometra infected queens are Escherichia coli, Staphylococcus, Streptococcus, Pseudomonas, Proteus and Pasteurella. The analysis of various parameters indicated that haemato-biochemical analysis may be good prognostic markers for feline pyometra.</div>

Clinico-pathological Alterations of Pyometra in Cat&nbsp;

<div>Background: Pyometra is a pathological state of the compromised uterus of grown-up to old, diestrum bitches. Pyometra is easy to identify but can be more challenging when there is no vaginal discharge. In the present study, an attempt was made to find out the pathogen involvement and clinico-haemato-biochemical alteration in bitches affected with Pyometra. \ 
 
Methods: Twelve bitches with a history of inappetence, polydipsia, dirty vaginal discharge, occasional vomition irrespective of breeds and age groups were clinically examined and diagnosed as pyometra. The presumptive clinical diagnosis was based on case history, clinical signs, vaginal cytology, abdominal ultrasonography or radiography, gross examination of a pus-filled uterus after the ovariohysterectomy. 
 
Result: Vaginal examination revealed brown chocolate malodorous vaginal discharge with discolouration of the perivulval tissue. Abdominal ultrasound showed hyperplasia with echogenic material in the uterine wall along with distended uterine horns containing a large volume of cellular contents. Radiographic imaging revealed cranio-dorsal displacement of the small intestine and a twisted uniform tubular opacity with a distended uterus. The vaginal cytology revealed a large number of degenerated neutrophils, intermediate and parabasal cells. Escherichia coli were the major pathogen isolated from the pyometra uteri of bitches. The surface of the endometrium was columnar ciliated epithelium, with hyperplasia of subepithelial tissue and thick muscularis. The haemato-biochemical evaluation in pyometra infected bitches revealed decreased haemoglobin (Hb), packed cell volume (PCV), total erythrocytic count (TEC) and lymphocyte count indicating the microcytic hypochromic type of anaemia. Leucocytosis with a predominant absolute neutrophilia and lymphocytosis were consistently found in canine pyometra. There was a significantly elevated profile of blood urea nitrogen, creatinine, transaminases and alkaline phosphatase as well as total proteins observed in pyometric female dogs as compared to healthy ones which may have diagnostic and prognostic importance, which also indicated damage of vital organ caused by bacterial endotoxins. The haemato-biochemical indices correlating with imaging techniques, vaginal cytology and histopathological examination can serve as good prognostic markers in bitches with pyometra.</div>

Clinico-haemato-biochemical and Pathological Alteration of Pyometra in Canines

<div>Background: Pyometra is the most common genital affections observed in bitches around the globe in-spite of advancement of disease diagnosis and treatment. Paucity of available literature regarding pyometra in canines in Odisha prompted to undertake an in-depth analysis on determinants linked to epidemiology, haemato-biochemical, clinicopathological and diagnostic imaging in pyometra bitches. 
 
Methods: During the period 2019-20, a total of 148 bitches were screened for canine pyometra in and around Bhubaneswar, Odisha on the basis of clinical signs, haematology and diagnostic imaging. Uterus was collected after ovario-hysterectomy and processed for histopathology through routine haematoxylin and eosin staining. 
 
Result: The overall incidence of pyometra was 15.54% with 4% mortality rate. Present study recorded a significant higher occurrence of pyometra in older bitches (&gt;7 year, 78.26%), smaller breeds like Spitz (47.82%), nulliparous bitches (60.86%) and dogs in dioestrus stage (82.60%). Haematological examinations revealed anaemia with marked leucocytosis and neutrophilia. There was significant increase in AST, ALT, ALP and BUN concentrations in affected bitches. Enlarged uterus with hypo echoic tubular structures containing mostly echogenic fluids were constant findings through ultrasonography. Flabby uterine horns with thick and corrugated endometrial wall containing profuse mucopurulent exudates were seen during necropsy. Chronic inflammatory response leading to intense haemorrhages and hyperaemia were constant microscopic changes. The most common isolated pathogen in canine pyometra was Escherechia coli (67.5%).</div>

​Pathomorphological, Haemato-biochemical and Diagnostic Imaging Studies in Canine Pyometra

<div>Background: Pyometra or cystic endometrial hyperplasia complex in dogs is a hormonally mediated bacterial disease wherein middle-aged bitches are most affected. The current study was carried out in pyometra-affected bitches to determine the alterations in hormonal, histopathological and haemato-biochemical profiles after 14 days of ovariohysterectomy.&nbsp; 
 
Methods: Blood samples were collected both from control (n=15) and affected bitches (n=15) showing signs of open cervix pyometra preoperatively and postoperatively on the day of surgery, on the 7th and 14th day after ovariohysterectomy. Blood samples were subjected to the estimation of endocrinological and hematobiochemical parameters. The ovary, oviduct and uterus were collected for gross and histological observations. 
 
Result: The pre-operative serum progesterone (ng/ml) recorded in bitches affected with pyometra were 9-fold higher than controls (9.77&plusmn;2.64 vs 0.61&plusmn;0.66) (P&lt;0.01). There was a non-significant difference in the pre-operative (414.63&plusmn;62.88) and post-operative (390.6&plusmn;54.20) estrogen concentration and the results indicated a presence of an extragonadal source of estrogen. The enormous endometrial lumen of these cysts contained eosinophilic hazy granular material and tissue debris along with massive infiltration of inflammatory cells, predominantly neutrophils. The findings of the study revealed that progesterone is the major contributory factor and extragonadal sources of estrogen may be present along with hyperplastic changes in the uterine and glandular epithelium in pyometra-affected bitches.</div>

Detailed Pathophysiological Investigation of Canine Pyometra and the Curative Role of Ovariohysterectomy

<div style="text-align:justify">Background: Canine pyometra (chronic purulent endometritis) is one of the most important uterine disorder of bitches seeks medical treatment. The hormonal therapies are not much popular among the veterinarians thus needs to exploit some hormonal protocols for this condition. Therefore, the experiment was carried out to study the therapeutic response of antiprogestin and prostaglandin in canine pyometra.&nbsp; 
 
Methods: The experiment was carried out in total 21 bitches affected with pyometra were selected and divided randomly into 3 groups. Animals of control group (TC) were treated with non-hormonal supportive treatment for 7 days. Animals of T1 were received non-hormonal supportive treatment for 7 days similar to TC along with mifepristone @ 3 mg/kg orally BID on day 1, 2 and 8 and Dinoprost in @ 50-200 mcg/kg S/C day 3 to 7. Animals of T2 were treated similar to TC plus mifepristone @ 3 mg/kg orally BID on day 1, 2 and 8 and Misoprostol @ 3 mcg/kg intravaginally twice daily on day 3 to 7. 
 
Result:&nbsp;Therapeutic responses was recorded better in T1 group (100%), followed by T2 (71.43%) and TC (42.86%). The mean TLC values after completion of treatment (day 8) were significantly decreased in T1 and T2. The neutrophil count in different groups T1, T2 and TC was reduced significantly. There was significant decrease in mean concentration of BUN and creatinine on day 8 after treatment in T1 and T2 groups. The mean ALT values decreased significantly in T1 group. However, ALP values decreased significantly in T1 and T2 groups. The mean serum progesterone declined significantly in both the hormone treated groups (T1 and T2). The study can be concluded that therapeutic response of mifepristone with dinoprost tromethamine was found most effective for the treatment of canine pyometra than mifepristone with misoprostol protocol.</div>

Therapeutic Response of Mifepristone with Dinoprost and Misoprostol for Management of Canine Pyometra

Background: Canine pyometra, is a pathological condition that results in the accumulation of purulent exudate in the uterus due to hormonal imbalance in female dogs. This is the most prevalent hormonally mediated reproductive disorder and life threatening disease of intact female dogs. The objective of the present study was to assess the physiological, haematological and biochemical changes and isolate the pathogenic microorganism present in the uterus of pyometra bitches. 
 
Methods: This study was carried out in ten bitches with a history of lethargy, depression, in appetence, polydipsia, occasional vomiting and vaginal discharge presented for treatment at the Veterinary Poly Clinic, Coimbatore, Tamil Nadu. The disease was diagnosed by history, clinical signs, physical examination, imaging techniques haematology and biochemical study. The involvement of the pathogenic organism was confirmed by microbial examination of the pus-filled uterus after the ovariohysterectomy. 
 
Result: The result showed that physiological parameters rectal temperature, heart rate and respiration rate were increased in pyometra affected dog than healthy one. The haematological parameters of red blood cell count, haemoglobin and packed cell volume were decreased in pyometra affected dogs than healthy dogs. Leukocytosis, neutrophilia, lymphocytosis, monocytosis and eosinophilia condition also observed in pyometra affected dogs. Biochemically, increased Blood urea nitrogen (BUN) creatinine and hyperprotenimia were observed in pyometra dogs. Increased activity of hepatic enzyme Alanine transaminase (ALT), Aspartate aminotransferase (AST) and Alkaline phosphatase (ALP) were also observed in pyometra dogs. The major pathogenic microorganisms involved in pyometra are Escherichia coli (40.25%), Staphylococcus (20.46%), Streptococcus (20.32%), Pseudomonas (6.41%), Proteus (6.32%) and Pasteurella (6.24%). Thus the dogs with pyometra show significant changes in physiological, haematological, biochemical parameters and growth of pathogenic microorganism in uterine fluid were the important indications of pyometra affected dogs.

Microbiological and Haemato-biochemical Studies in Canine Pyometra

<div>Background: Canine pyometra is a common reproductive disorder of sexually intact bitches characterized by accumulation of pus in the uterine lumen and it is always associated with vagaries of clinical and pathological manifestations of multisystemic origin. 
 
Methods: The present study involved twenty three bitches of 8- 13 years of age with pyometra. Diagnosis of pyometra was performed based on the anamnesis, ultrasound examination, hematoglocial and biochemical changes. As an alternate to conventional prostaglandin protocol, Tab. Methylergometrine 0.125 mg/dog (Methergine, Novartis) BID and Tab. Cabergoline @ 10 &micro;g/kg body weight (Cabgolin, Sun Pharma) SID and Tab. Amoxicillin- Clavulinic acid @ 10 mg/kg body weight (Augmentin, Glaxo Smithkline) BID was advised for two weeks. In addition to that supportive fluid therapy and Inj. Pantoprazole @ 1 mg/kg body weight was also administered prior to initiation of treatment protocol. There was a significant clinical recovery in terms of physiological, hematological and biochemical parameters. Ultrasound examination on Day 0, 7, 9 and Day 14 of treatment revealed reduction in the diameter of uterine sacculations. All the bitches recovered after 10 to 15 days with complete evacuation of pus, with no recurrence. 
 
Result: Our investigation revealed that this alternative protocol along with antibiotics and supportive fluid therapy can be a better alternative to young dogs to preserve the reproductive capability and also in geriatric dogs which are unfit for traditional ovariohysterectomy.</div>

Therapeutic Management of Pyometra with Methylergometrine and Cabergoline in Bitches - An Alternative Approach

The aim of this study was to investigate the occurrence of pyometra in bitches and isolation of bacteria involved and determination of their antimicrobial susceptibility. For this purpose from March 2013 to February 2015, 230 bitches of different breeds and ages have been examined. Diagnosis was based on anamnesis, clinical signs, hematology, radiography and ultrasound. The isolation and identification of bacteria in pyometra was carried out &nbsp;using ISO-methods and the antimicrobial susceptibility of bacterial isolates using &nbsp;the disk diffusion method. Canine pyometra was found more in bitches between 9-12 years old 10 cases (52.63%), and the most common dog affected breeds were small female dogs breed. The most common isolated pathogens from canine pyometra were; Escherichia coli (63.1%), Streptococcus pyogenes., (15.8%), Staphylococcus intermedius., (10.5%) and, Pseudomonas aeruginosa., (5.3%). Regarding AMR (antimicrobial resistance) Penicilin G and Ampicillin showed a very high resistance, indicating for acquired resistance due to improper und uncontrolled use.

Occurrence and antimicrobial susceptibility of&nbsp;bacterial agents of canine pyometra

<div style="text-align:justify">Background: Antibiotic resistance is one of the major problems encountered in the therapy of canine pyometra. The ability of bacteria to form biofilm is implicated as one of the factors responsible for this. Escherichia coli and Staphylococcus aureus are the predominant bacteria associated with pyometra in canines and are known for their biofilm formation. Keeping in this view, a preliminary study was conducted to detect the biofilm forming strains of E. coli and S. aureus, if any, associated with canine pyometra. 
 
Methods: A total of 25 samples were collected, which included uterine discharges from cases of closed pyometra and anterior vaginal swabs from open pyometra. The isolates of E. coli and S. aureus were identified based on the cultural, morphological and biochemical characteristics. These isolates were subjected to antibiotic sensitivity test employing disc diffusion method. For biofilm detection, the isolates were screened by Congo red agar method, tube method and tissue culture plate method. 
 
Result: From 25 samples, two Streptococcus spp., thirteen&nbsp;Staphylococcus spp., seven E.coli, five Klebsiella spp. and two Pseudomonas spp. were isolated. All the isolates were found to be multi-drug resistant on antibiogram. The tissue culture plate and Congo red agar method was found more sensitive to detect the biofilm formation by S. aureus and E.coli isolates, respectively. The biofilm forming strains showed higher degree of antibiotic resistance in comparison with non-formers, indicating it as one of the major reasons for failure of antibiotic therapy in canine pyometra.</div>

Phylogrouping, Virulence Profile and Antibiogram of Escherichia coli Strains Associated with Canine Pyometra

Clinico-pathological Alterations of Pyometra in Cat

Clinico-haemato-biochemical and Pathological Alteration of Pyometra in Canines

Pathomorphological, Haemato-biochemical and Diagnostic Imaging Studies in Canine Pyometra

Detailed Pathophysiological Investigation of Canine Pyometra and the Curative Role of Ovariohysterectomy

Therapeutic Response of Mifepristone with Dinoprost and Misoprostol for Management of Canine Pyometra

Microbiological and Haemato-biochemical Studies in Canine Pyometra

Therapeutic Management of Pyometra with Methylergometrine and Cabergoline in Bitches - An Alternative Approach

Occurrence and antimicrobial susceptibility of bacterial agents of canine pyometra

Detection of Biofilm Formation by Escherichia coli and Staphylococcus aureus Associated with Canine Pyometra