Page 1169 - Problem-Based Feline Medicine

56 – THE CAT WITH VAGINAL DISCHARGE 1161

tions, which are an excellent medium for bacterial In cats, susceptibility to overgrowth of bacteria
growth. causing pyometra is increased when the uterus is under
both progesterone (diestrus) and estrogen (estrous)
influence. This situation occurs after coital stimula-
tion causing ovulation and formation of corpora lutea,
WHERE?
or after spontaneous ovulation, which can occur in cats.
Uterus, vagina and vulva.
Increased uterine secretion during diestrus is an
excellent medium for bacterial overgrowth.

Stump pyometra can occur if the uterine body is not
WHAT?
totally removed at ovariohysterectomy, but this is very
Most cats with a vaginal discharge have bacterial rare.
infection of the uterus.
It is a possibility with long-term use of progestogen
products because of their potential to produce CEH.
● If remnant ovarian tissue is left, allowing ovarian
DISEASES CAUSING VAGINAL cycles, then CEH can develop.
DISCHARGE ● The caudal position of the site allows easy coloni-
zation by ascending infection from the vagina.
CHRONIC CYSTIC ENDOMETRIAL
HYPERPLASIA/PYOMETRA COMPLEX***
Clinical signs
Classical signs
Copious vaginal discharge (serosanguineous to
● Low-grade inappetence and lethargy. mucopurulent) is most common.
● Vaginal discharge, or distended uterus palpable.
Closed-cervix pyometra with no discharge is less com-
● Fever.
mon; these cats often have significant uterine disten-
● Polyuria, polydypsia.
tion, which may cause abdominal enlargement.
Low-grade inappetence that may be present for weeks
or months.
Pathogenesis
Weight loss.
Chronic cystic endometrial hyperplasia/pyometra
complex presents with vaginal discharge, and cats may Depression, listlessness, ± dehydration.
have polyuria and polydypsia as a presenting sign.
Usually not pyrexic.
Pyrexia is rare.
Unkempt appearance.
Chronic cystic endometrial hyperplasia/pyometra
complex occurs in intact cats of any age, regardless of Polyuria, polydypsia.
whether they have previously had kittens.
Cystic endometrial hyperplasia (CEH) is thought to Diagnosis
occur from an exaggerated and abnormal response to
chronic and repeated progesterone stimulation. Clinical signs (vaginal discharge, listlessness) plus
● Use of progestagen products to prevent estrus has distended uterus on radiograph (can only be dis-
resulted in CEH. tinguished from pregnant uterus after 47 days when cal-
cification of fetal skeleton is visible).
CEH predisposes the uterus to develop infection.
● E. coli is the most common bacterium causing the Ultrasonography readily distinguishes between
infection, although numerous other bacteria have pregnancy and pyometra 21 days after the last breeding
been isolated. date.