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Emergency Spaying while in heat!?!?

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Emergency Spaying while in heat!?!?
  • I was wondering what you all thought on the this subject.  The reason I ask is because I know someone who's dog was in the middle of a heat and started to bleed heavily and clot so when they took her to the vet they did an emergency spay on her.  NOW, after the spay this dog developed AIHA/IMHA.  I can't help but wonder the circumstances behind the vet decision and if he/she made a right choice.  Is this type of bleeding normal?  The dog is 11 years old and is a Shih Tzu.  Is there or was there something else the vet could have done?

    I know very little on this subject and was just seeking opinions and thoughts.

    Thanks

  • 11 years old and unspayed?? The dog probably had Pyo (or heck even uterine or ovarian cancer!)...the alternative? Put the dog down most likely. Guess it's a judgement call. This one would be on the owner more than the vet IMO. That's irresponsible. Older girls need to be spayed BEFORE they develop issues.

  • I've gotta agree with Gina 100% here -- it sounds VERY like pyometra and that's probably what the "emergency" was about the spay.  The drugs for pyo are BIG heavy-hitting antibiotics and between the stress of the pyo, spay and the antibiotics (and what do you want to bet the vet vaccinated her before he'd do surgery??) -- that would have triggered IMHA.

    People with "little dogs" somehow get the impression that spaying/neutering is "dangerous" -- that's just plain a vet who's not very good. 

    The older a bitch is the higher the likelihood is of pyometra.  It's an infection that takes hold in the uterine folds (warm moist place?  mega lovely place for bacteria to grow anyway).  a female can get pyo any time she's intact, but the chances increase greatly the older she gets.  Like any ... ahem ... mature lady sags, bags and general stretching of the uterine tissue in particular, greatly increases the viability of the environment, and the older the dog the more easily they succumb. 

    Frankly, if she started bleeding mid-heat, she may have been carrying pyo since her prior heat -- they can get super debilitated over the course of the disease.  By 11 her heats were probably getting difficult to discern anyway --

    I'm not sure I've said all this specifically and technically correct (and Gina will know) but that poor little girl had the deck stacked against her from the get-go.  I'd ask the person if the vet also did vax, cos I'd betcha they did. 

  • So then is it treatable or would it be a losing battle?  I'm also wondering what the emergency spay was for.  Is this the best course of action?

  • Umm you ONLY treat a bitch in full pyo, with a course of meds (hormone/antibiotic cocktail, which is risky all by itself),  if you can then immediately BREED HER to stop it recurring. I don't even know if you CAN use the med route in a open pyo...I mean the uterus has a HOLE in it which is leaking purulent vile infected tomato soup fluid into the body...

    Understand...pyo is a LIFE THREATENING EMERGENCY...I am not sure why the treatment is under question? If the owner was not going to BREED an 11 year old bitch...what would be the point of doing anything other than a spay?

    The alternatives? put her down. Or treat (which I am not even sure is POSSIBLE with an open), hope for the best, then BREED an 11 year old, Toy breed bitch.

  • rwbeagles
    then BREED an 11 year old, Toy breed bitch

    Are you serious or just being sarcastic?

     

  • I am serious in assuming this option was NOT on the table for an 11 year old toy breed bitch that probably should have been spayed in a non emergency type situation...years beforehand.

    But, not my call. I do understand that part.

    The vet very likely saved her life.

  • Open Pyo....what exactly is this? 

    ANYHOW, I'm not exactly looking for "SHOULD OF'S" ..... more "what are my options and the best route to take NOW....other than putting her down.  What "should of" been done isn't going to help the case any.

    None of the numbers support pyometra...is this common I wonder?  All WBC were normal before the operation as well as BUN and creatinine. 

    AND...is it possible it could be something different or is this usually the case with an older unspayed female who bleeds heavily during heat.  I just find it odd a vet wouldn't be able to tell if this was related or not! 

  • rwbeagles

    I am serious in assuming this option was NOT on the table for an 11 year old toy breed bitch that probably should have been spayed in a non emergency type situation...years beforehand.

    But, not my call. I do understand that part.

    The vet very likely saved her life.

     

    I just want to add for lurkers, breeding your bitch prior Pyo WILL NOT prevent it.  It may help *IF* your bitch has already developed open Pyo.  If she doesn't, breeding your bitch will not act as a preventative, and will do nothing but add more puppies to the world. The only preventative is a Spay. I've known two reputable breeders whose bitches have developed Pyo while in whelp, needing an emergency spay losing entire litters of nearly full term pups. It's an awful and very scary thing.

    I agree with Gina, though, the Vet probably saved her life.  She should have been spayed years earlier (though I'm sure you agree with us there :)  Pyo is a real problem as bitches age.  

    Here is some info on what Pyometra is.

    I'm sorry your friend went through this, and really not much to do at this point, but to treat the IMHA.  Good luck to her.  I believe there was a thread dedicated to it here somewhere.

     

  • Can one of you guys (and I'm not at all knowledgeable about this aspect of whelping) -- define for him what you are referring to as "open pyo" -- just to clarify terms?

    In cases *I* have known where pyo infection is found typically they spay THEN.  But I have a feeling what Gina is referring to as "open pyo" is when it has ruptured and gone systemic.  In that case you wouldn't want to make ANY cuts but you'd just treat with massive antibiotics.

    Also -- could someone else verify this for *me* -- it's my understanding that a mature (as in geriatric) bitch will have lessening bleeding as she ages -- that it becomes almost imperceptible in appearance. 

    They don't go thru menopause like a human woman and "stop" cycling. 

     Just wanting a little clarification here.  And I also know primary behind John's question is the IMHA issue (he has a dog with IMHA and he's actually one of the primary ones who keeps that 200 page thread going with his research -- so his questions are all going to serve as information for IMHA-dog owners.

    Just trying to keep the vocabulary on common ground here -- you get used to thinking one way when you're thinking about IMHA (and the things that trigger it) and pyo treatment and spay surgery are kinda at opposite ends of that spectrum.

    The bottom line understanding for ANY lurkers has to be that pyometra is a viscious nasty disease and one you need to protect your female from.  If you choose to leave her intact in her younger years that's one thing.  But I've seen dogs even under a year old develop pyometra.

    No, it's not super common -- but it's the responsibility of every human who HAS an intact bitch to understand the always-possible element of pyometra in an intact bitch and that such a possibility increases almost exponentially as they age past the prime breeding age. 

    A couple of years ago a casual friend of mine was relating to me that her under-a-year-old bitch had just gone thru her first heat and how "funny" it was to see the dog moping around and dragging a toy around and how "different" she was ... but that she was still spotting just a little (5 weeks after onset??) and I told her to get her dog to the vet NOW.

    She had never heard of pyometra -- she gave me a HARD TIME bout this because she was SURE little poochie was just SO cute and she'd promised the guy at the PET STORE that she'd bring her puppies in to see him some day *sigh*.

    It ticked me off because she thot the dog's morose behavior was funny -- but I put the fear of doG in her a little bit (imagine that - ME?  forceful??) and told her if it WAS pyo she could lose her precious bundle EASY.

    Yep -- it WAS pyo and little Poochie got spayed in a heartbeat (the vet didn't even tell her anything else was an option -- thankfully so -- good breeder material she is NOT)

    But intact bitches of any age can get pyometra.  But old gals really don't stand much chance. 

    John -- my best guess is that the surgery likely saved her life -- and it would be typical by anything *I* have ever seen done (and I've fostered MANY older bitches recently-spayed and one who HAD suspected pyo). 

    IMHA is just something pretty newly named -- even 10 years ago if a dog had slipped into IMHA after something like this, no one would have thought a thing of it -- simply because the treatment for Pyometra is SO difficult, the drugs are harsh, surgery at that age IS risky and if a dog became anemic afterward and died no one would have questioned it.

    IMHA isn't totally new -- it's just newly "recognized" - if that makes sense.  And as I said above -- likely it wasn't just the surgery and pyo treatment -- I bet she got vax and a bunch of other things so it's pretty impossible to even guess what triggered the IMHA.

    I'd even hazzard a guess that since tick disease and IMHA are often inextricably linked, that pyometra and IMHA could also be -- because it's an infection that goes septic so easily.  Did that make sense?

  • I would worry about either a tumor/ cancer of some sort or a lurking infection. Heavy bleeding and clotting is NOT normal for a dog in heat, and not healthy for an elderly dog.  Contary to most beliefs, veterinarians are generally not surgery happy and do not like spaying during a heat cycle at all. Much less during a heat cycle on an elderly toy breed. Most would, if they felt they had an option, suggest to wait until the cycle was over, and suggest spaying afterward. I would guess, then, that they were sufficiently worried for the health of this dog to do so.

     I would hazard a guess that the outcome would have been worse than the current problem if surgery had not been done.

    And  yes, surgery is the best suggestion for an older dog with pyo.

  •  The only other thing they could have done was take the dog to a reproductive specialist for a second opinion, unless of course the dog would have died if the surgery wasn't done right then. Was this dog actually diagnosed with pyo or if not, what was the diagnosis? Pyo generally occurs after the seaosn, not during. Did the vet find any abnormal during the spay such as tumors? The vet likely did what most vets would have done in the situation.

      Pyo can be treated without spaying but spaying is the only option most general practice vets will offer. I have known of elderly dogs who developed pyo and had to be on antibiotics after every season. These dogs could not be spayed due to other health issues that made surgery unsafe for them - the treatment was not ideal but for these couple dogs, it worked. I also know people who have had bitches treated for pyo and did not have the pyo reoccur. This is a pretty good article about Pyo, traditional treatments and a newer treatment option: http://www.workingdogs.com/doc0100.htm

     As for keeping a bitch intact throughout their life, that is the owner's choice and there is a risk to everything.

  • I think we may be talking different terms here. I have always, always, heard of "open pyometra" as pyometra in which the pus and infection is able to flow freely from the body via the vulva - I have never heard of open pyo as being a hole in the uterus anywhere else (as in systemic). Closed pyometra is when the pus and infection cannot escape and builds up pressure and more severe illness.

    Open pyometra is by far the safer and more preferable of the two, and open pyometra is more easily treatable than closed. An emergency spay is often the best route to go with either, though, although sometimes vets will wait to do the spay with an open pyo until it has been treated to minimize risk of the infection getting into the rest of the abdominal cavity.

    I've been there and lived with a dog who ended up developing pyometra and needed an emergency spay. It's a messy situation for sure, and not so much fun to go through.

     Few resources:
    http://www.uoguelph.ca/~smulley/pyometra.html
    http://www.marvistavet.com/html/body_pyometra.html

  • Kim_MacMillan
    Open pyometra is by far the safer and more preferable of the two, and open pyometra is more easily treatable than closed. An emergency spay is often the best route to go with either, though, although sometimes vets will wait to do the spay with an open pyo until it has been treated to minimize risk of the infection getting into the rest of the abdominal cavity.

     

    That's what I've understood open Pyometra to be, also.  I've also understood breeding a bitch will only work if it's open.  Closed Pyo is extremely dangerous and while it has a lot of symptoms a lot of people mistake them for other things. 

    Most of my breeder friends spay their bitches when they are done breeding them, not just to prevent accidental litters but to prevent Pyo.  It is terribly scary.

    It's a tough situation and i'm thinkin' of the poor little girl!!

  • Sera_J

    Kim_MacMillan
    Open pyometra is by far the safer and more preferable of the two, and open pyometra is more easily treatable than closed. An emergency spay is often the best route to go with either, though, although sometimes vets will wait to do the spay with an open pyo until it has been treated to minimize risk of the infection getting into the rest of the abdominal cavity.

     

    That's what I've understood open Pyometra to be, also.  I've also understood breeding a bitch will only work if it's open.  Closed Pyo is extremely dangerous and while it has a lot of symptoms a lot of people mistake them for other things. 

    You are correct on what open vs. closed pyo is. However, if you read the link I posted above you will see that it is possible to treat a bitch with closed pyo and have her maintain normal reproductive health afterwards.

    "There are two types of pyometra, depending on whether the cervix, which is the opening to the uterus, is open or closed. Open pyometra occurs during or just after the heat cycle when the cervix is still open. Since the cervix is open, the pus, along with the blood-tinged or clear-colored vaginal fluid, exits through the vulva. Owners usually see or smell the foul vaginal discharge. These dogs just don’t feel well. Signs include lethargy, a mild fever, and increased thirst, some vomit. Closed pyometra occurs one to three months after the heat cycle, when the dog’s cervix is closed. Pus cannot drain out of the body, so it stays in the uterus. Some of the bacteria from the uterus reenter the bloodstream. This can lead to a blood infection, which is called septicemia, and can quickly be fatal. Signs are those of a very sick “Toxic” dog and include a high fever, weakness, a lack of appetite and vomiting."  http://www.carolonpets.com/blog/dogs/possible-reproductive-problems-in-dogs/