INFECTIONS OF THE UTERUS IN THE BITCH.

Bitches have a very high rate of infections of the uterus and should be desexed after they have finished being bred with. If left intact, there is a high risk of both uterine infections and mammary tumours. Either condition can kill a bitch, particularly an elderly bitch. Low grade uterine infections such as metritis can be very debilitating to older bitches and are often the preliminary indicator of future pyometritis. Cystic ovaries can produce excessive amounts of hormones which again predispose bitches to infections.

Infections

Infections of the uterus are not uncommon in the bitch. During a season the cervix is relaxed, permitting a greater flow both in and out of the uterus. The infections are generally mild and can be quite easily cleared up with a course of antibiotics. Many veterinarians consider these to be insignificant and are dubious as to the value of vaginal swabbing unless there is a history of problems previously (failure to hold pregnancy, early abortion etc).

However, discoloured discharges can be an indication of low grade metritis (inflammation of the uterus) and should be investigated. Bitches over four years of age, are more likely to have low grade inflammatory changes or infections than younger bitches. Bitches who start to have prolonged seasons and/or erratic seasons, these are often indicators of approaching problems.

Running more than two bitches together while in season can create problems not only because they are more likely to fight while in season, but also because they clean and lick one another, occasionally transferring infections. With valuable bitches, it is wise not to take them swimming, not to travel excessively, or allow them to mix with other bitches while in full season.

Unless the infection is severe or very resistant to antibiotics, a bitch is generally able to be mated as long as she has been on the antibiotics for at least 3-4 days. It doesn't matter if the bitch is still on antibiotics while being mated as they do not generally interfere with the bitch's fertility, nor should they affect the stud dog in any way.

If the bitch has a very nasty, dark discharge that it is not clearing up after 3-4 days of antibiotics, I suggest that the bitch is re-swabbed and probably not bred from, in that season. If on culture a bitch returns with a pseudomonas infection, I personally would not advise the bitch be mated that season.

Before accepting bitches, many stud dog owners require certificates to state that they have been swabbed and treated if there was an infection (more of an issue in older bitches or those that have poor reproductive histories).

Discharges during pregnancy

During pregnancy, a bitch will normally have a small amount of mucous discharge which is clear to cream, and is a very good indicator of pregnancy. There should never be any brown or greenish discharge. If there is ever any discharge of this nature, your bitch should be checked over immediately by your veterinarian. Generally the vet will put your bitch on antibiotics or re-swab her. Some care must be taken when giving your bitch antibiotics during pregnancy as some antibiotics such as tetracycline, can cause permanent damage to the unborn puppies by affecting their adult teeth. Other drugs, if used in the first third of pregnancy can possibly, though rarely, cause birth defects.

If a bitch had an infection prior to mating, but was treated with antibiotics successfully, there is no need to repeat the antibiotic treatment unless there is a nasty discharge during. pregnancy or the bitch has a previous history of problems. On the whole, if the bitch is going along well and is healthy, leave her alone and do not fill her with antibiotics unnecessarily. This is important especially in the last week of pregnancy, when if a bitch is on antibiotics (for no particularly good reason), and something goes wrong (e.g. the puppies' membranes start to break down), the antibiotics can mask the problem and allow the situation to get out of hand

Where discharges persist, the chance of abortion or metritis increases. There may be hormonal reasons for the discharges e.g. failure to hold pregnancy.

desexing will cure the problem, as metritis invariably develops into pyometra in subsequent seasons.

Bitches with metritis should as a precaution be placed on high doses of lactobacillis acidophilus or other gut stabilising compounds (eg. Protexin) as these compounds have the added advantage of assisting the bacterial flora of the uterus to stabilise. I usually suggest such bitches stay on these products until they are eventualiy retired. ie. desexed.Metritis

Mild cases of infection of the uterus are called metritis. Metritis can be in the form of a low grade and chronic infection of the uterus, causing infertility, irregular seasons, poor fertility or early abortions. Many of these bitches when opened up have very thin walled uterus, incapable of holding a pregnancy. Some may have fluid in the horns are well. Metritis can be the first sign of the uterus failing to cope (often as a result of irregular hormone levels coming from the ovaries), which may develop into pyometra at a later date. This condition needs antibiotics for the infection and drugs such as prostaglandins and/or Alizin * to assist with drainage.If the bitch is old and you have finished breeding from her,

Pyometra

This is a very serious condition and can cause a critical emergency. Pyometra is a severe bacterial inflammation of the uterus, which can develop rapidly into a very toxic condition. Toxaemia occurs through the absorption of toxins from increasing amounts of pus geing produced by the bacterial infection .:

It is usually seen in the older bitch, who is over 5-6 years of age and is within 2-4 weeks of having finished a season. It can occur in younger bitches but is less common.


The causes of pyometra are varied. Older bitches often have poor hormonal control over their seasons and their cervixes no longer function properly. The cervixes are loose during, and do not close off tightly after, a season. This means that bacteria can more readily establish infections than in a fitter, healthier bitch.

The symptoms of pyometra are easy to recognise. The bitch will have had a season which has fmished within the last 2-4 weeks, she will be off her food, drinking excessive amounts of water, vomiting and be very depressed. There may possibly be a discoloured discharge, depending on whether the cervix is opened or closed. Some bitches present to the veterinarian as having had a prolonged season with bleeding for up to 4-6 weeks. The blood picture (count) is also very characteristic. There is a very high white cell count in response to the severity of the infection and immediate treatment is necessary.

An open pyometra occurs where the purulent material from within the uterus is able to discharge through the cervix and so relieve both the pressure and the toxic build up. These bitches have a thick discoloured pus discharge from the vulva, which is often rather foul smelling.

A closed pyometra is a very dangerous condition for the bitch as the cervix is closed, causing an increasing build up of purulent toxic material, which if not corrected fairly quickly, can cause death. These bitches have little or no discharge. Closed pyometras are often presented as medical emergencies.

Antibiotics and drugs to relax the cervix and to promote better drainage are used immediately upon diagnosis. Surgery is often necessary on the 'closed' cases in order to save the life of the bitch, as the toxic effect from the bacterial build up within the uterus, can kill the bitch within 1-3 days. Many of these very toxic bitches are operated on immediately they are diagnosed, waiting can kill them.

Ovarian Imbalances

Occasionally, these occur where the bitch may have conceived but either aborts at around 5-6 weeks or has mummified puppies at term. Mummified puppies are dried out and look shrivelled. They appear as a brown/greenish mess but do not smell or cause problems to adjacent puppies in the uterus. This is due to insufficient hormone levels to hold the pregnancy, possibly secondary to ovarian cysts. These problems tend to be recurring ones and injections of progesterone, usually given from 3-8 weeks of pregnancy, are needed to hold the pregnancy safely.   

'Open' cases can quite often be treated with drugs to assist in expelling the infected material from the uterus. However, despite this, the bitch may often have to be desexed within a short time if the condition does not clear up completely. Also, once pyometra has occurred, the likelihood of it recurring is very high. Younger bitches have a far greater chance of recovering and can often be bred from in the subsequent season.

 Prostaglandins and Alizin* offer good hope for non-surgical intervention, particularly in the younger bitches, but the above conditions in the older bitch still apply, and desexing is often the preferred option once initial symptoms are under control. Milder drugs that may be used to assist drainage include Millophyline and Buscopan , both of which act as smooth muscle relaxants.

Cystic Ovaries

A large number of older bitches suffer from cystic ovaries. Cysts on the ovaries can produce hormones which in turn upset the normal hormone levels and cycles. Ovarian cysts can produce excessive amounts of either oestrogen, progesterone, or no hormones at all.

Irregular season lengths can occur as the result of productive cysts on the ovaries. The seasons may be as close together as 2-3 months apart, or very infrequent e.g. every 12-18 months.

There can also be seasons of abnormal length, sometimes lasting 5-6 weeks. The bitch may also be in season for one week, then out for a short time, and then back on again for several weeks.

Oestrogen and progesterone producing cysts cause prolonged seasons with failure to ovulate and/or can cause prolonged anoestrus (failure to cycle). These type nf cysts can produce cystic endometrial hypoplasia and may be one of the predisposing causes of metritis. Persistent corpora lutea also produce progesterone.

Treatment of these problems vary as to the cause and the desired outcomes. Not all problems are treatable. Older bitches with pyometra are often found to have large numbers of cysts on both ovaries when they are operated on to be desexed.

Ovarian Imbalances

Occasionally, these occur where the bitch may have conceived but either aborts at around 5-6 weeks or has mummified puppies at term. Mummified puppies are dried out and look shrivelled. They appear as a brown/greenish mess but do not smell or cause problems to adjacent puppies in the uterus. This is due to insufficient hormone levels to hold the pregnancy, possibly secondary to ovarian cysts. These problems tend to be recurring ones and injections of progesterone, usually given from 3-8 weeks of pregnancy, are needed to hold the pregnancy safely.

False Pregnancy

This can occur without any obvious cysts on the ovaries. The reason for this can be persistent 'corpora lutea', where cells lining the cavities of the ruptured follicles produce high levels of progesterone, which cause the body to think it is pregnant. This is a common occurrence in the bitch. Occasionally, the follicles developed during a season do not all rupture, again causing a similar picture.

The false pregnancy usually lasts 5-6 weeks, with some thickening of the abdomen, swelling of the milk glands and behavioural changes similar to pregnant bitches. Rarely, a bitch may even go so far as to nest, go into labour and possibly pass a small amount of clear fluid. These bitches can be maidens on their first seasons (particularly in certain breeds ego Dobermanns), and most will go on to have normal seasons and normal fertilities. Signs will disappear without treatment .and it can be harmful to future seasons to treat these with hormones unless there are very good reasons for interfering.

Bitches that constantly have false pregnancies may have a poor fertility as it is almost easier for these  

bitches to go into false pregnancy than into the correct pattern for pregnancy. Treatment of these bitches with anti-prolactin drugs for 6 weeks prior to the next season usually corrects this problem.

Mammary Tumors

Bitches over six years of age that are not desexed, have a reasonably high chance of developing mammary tumours. Older bitches can develop mammary tumours whether they have been bred from or not. Many mammary tumours are 'malignant' and rapidly develop and spread.

Mammary tumours are most commonly noticed during or following a season when a natural enlargement of the mammary tissue occurs. At this time, the owners notice that instead of settling down again to normal size, the tissue is enlarged, hardened, hot and swollen. The first thing most owners think of is that the bitch must have mastitis or an abscess, where the affected tissue tends to be thickened but softer in the centre. With mammary tumours the tissue is hardened and irregular and there may be areas of discharge and ulceration. Despite the drainage, the size of the lump will not diminish.

Treatment is usually surgical, particularly if the tumour is having a chronic debilitating effect. Usually, the veterinary surgeon will suggest that the bitch should be desexed at the same time in an effort to reduce the chance of new tumours developing. If the bitch is not desexed, then the problem will inevitably recur. Veterinarians generally x-ray the chest of the bitch when presented for surgery, to see if the tumours have metastasised (spread) to the chest and lungs.

On examination, if the lumps are not very numerous and they have not spread elsewhere, the bitch is desexed and the lumps removed. A sample is often sent away to determine whether the tumour is benign or malignant. If it is benign then breathe a sigh of relief. If the tumour is malignant and it has apparently been caught early enough, the bitch should have the chest x-rayed again 3-6 months later to make sure there have been no metastases in the lungs.

When the bitch is very elderly and there are large numbers of tumours of varying sizes, or when they have spread to the lungs, the owner is usually told that surgery will not be of assistance. In those cases the only thing to do is to keep the bitch comfortable for as long as she is coping with the condition. When she shows signs of obvious discomfort, she will have to be put down .'

Not all lumps are cancers. This is particularly so in younger bitches following a bout of mastitis. I have known of owners panicking and having vast amounts of mammary tissue removed from the bitch only to find out on biopsy that the tissue is normal, either chronic reactive tissue (old abscess) or involuting mammary tissue that has developed a pocket or cyst of milk tissue. Mammary tumours are rarely seen in bitches under five years of age.

Decreasing Fertility

The best breeding years a bitch has are between 18months to 6 years of age. When the bitch is over six years of age, there will be a gradual decline in her fertility and fewer puppies in each litter. The decrease is usually gradual with one or two fewer puppies in each successive pregnancy. The other aspect of the decreasing fertility is lower hormonal levels that are being produced by the ovaries. This can lead to failure to hold to term, or you may see the occasional mummified puppy.

There is also a decreasing viability of puppies due to the older bitch whelping more slowly

When to stop breeding your bitch.

Bitches vary widely in their ability to continue breeding as they get older. Generally, most bitches have finished their breeding career well before their health declines. The larger and giant breeds generally stop sooner that the small breeds. Most breeders will get their older bitches de-sexed at around 6-8 years of age.

Unfortunately however, some breeders do not have their older bitches de-sexed and consequently, end up with problems several years later. Bitches as a rule have a very high chance of developing both mammary tumors and/or pyometra as they age to the extent that rarely any bitch that has been left entire not develop pyometra over time!


Very slowly, attitudes are changing and veterinarians are de-sexing some older bitches before problems develop. This way, the grand old ladies will enjoy their old age in health and comfort, even if they do get a shade tubbier. They have generally more than earned it. After they have had their final litter, bitches should be de-sexed before the following season.

Courtesy of Samoyed Club of Victoria