Madeline was just a little “off” and had some diarrhea for the past few days. Not a typical history for pyometria, but that is what she had.

Pyo means pus and metria means uterus and pyometria is what happens when the uterus thinks it is pregnant and fills up with fluid, but it is not pregnant and the fluid gets infected. Then the uterus is just like a several pound abscess that is going to rupture into the abdomen. Although there are hormonal treatments, immediate surgery is the best and often life saving treatment.

But let’s back up to when Madeline came in. The owner said that Madeline was going in and out a lot and she had noticed a lot of little piles of diarrhea.

But other than that, Madeline acted fine. Madeline only eats dog food, so that part was good. When questioned, Madeline’s mom said that Madeline did have some mucous in the stool. Okay, mucous only comes from the colon so obviously we have colitis. (Col = colon + itis = inflammation or infection, so inflammation or infection of the colon.) The most common cause of colitis is whipworms, even if they don’t show up on a fecal exam.

Lucky for Madeline, it did not stop here.

Madeline was a new patient to us, so I asked how old she was and when the last time she had been to the vet. The owner said that Madeline was eight years old and had never been to the vet.

Alarms bells are now going of in the back of my head. Dogs that are over age three have an increased risk of pyometria (and breast cancer).

Uterine problems can happen at any time, but endometritis happens during heat cycles and pyometria happens 2-8 weeks after a heat cycle. Pyometria is extremely common in the three to six-week period after heat.

In the case of advanced pyometria, the bacteria will leak through the walls of the uterus and be circulated in the blood stream. This in turn causes kidney damage which can be fatal. The increased bacteria will also cause an increase in the white blood cell count. This increase is profound. A normal WBC count will be 6-17 thousand. A pyometria will usually be over 30 thousand and I have seen over 100 thousand WBCs.

The blood work came back at 20,000 cells, not really high enough to be pyometria and Madeline did have colitis which could explain a 20,000 count. But there was something about this cute little yorkie. Maybe she was just a little too quiet or something.

I discussed with the owner that we could take radiographs or x-rays, but I really thought she needed surgery. I explained that if I was right that Madeline could die without surgery. If I was wrong, it was a somewhat expensive and risky way to do a spay. In short, I asked an owner who just met me to trust my gut instinct.

We started Madeline on IV fluids and antibiotics and at surgery found an early pyometria. Because of a few extra questions and time and just a little trust, Madeline is at home and doing well.

MJ Wixsom is a veterinarian at Guardian Animal Medical Center in Ashland, Ky.