Friday, February 13, 2015

The second 13-year-old Golden Retriever with open pyometra

I had 2 Golden Retrievers with open pyometra recently. Both were very thin and in poor health, but the second dog was panting a lot for the duration of more than 15 minutes of consultation.

"She's frightened at the vet," the man said. "That is why she panted a lot."

"It is unusual for a dog to have such a fast respiratory rate, as if she had sprinted ," I said. "Such panting is a sign of very poor health.  Her heart is failing. There is also the blackish-red vaginal discharge. She has open pyometra and should be operated the next day, after one day of IV drip and antibiotics."

"She is too old for anaesthesia," the man did not want any surgery and I prescribed some antibiotics for the dog. "Feed her 6 times per day to let her regain her weight."

But the dog shut her mouth tightly and it was extremely difficult to hand feed her. The vaginal discharge came out every day for the next 7 days and the owner texted me. "The solution is to remove the bleeding womb," I texted back. "But she is unfit for anaesthesia and would likely die on the op table."

The dog was not panting so fast but she would not want to eat. Her vaginal discharge came out thick and dark red, soiling the floor. The owner decided to get her operated. I told them that the chances of survival are slim as she had heart disease causing the continuous panting. She also would not want to eat.

The dog kept passing vaginal blood. The couple decided on the operation. The dog was inpatient for 2 nights and given SC and IV drip for 2 days. "Her pulse was not palpable," I told the owner. "That means she has very low blood pressure and should not be operated. Her gums are purplish and so there was some difficulty in getting oxygenated blood into the gums. Are you sure you wanted the operation?" He gave his informed consent by texting me.

The dog was operated using just isoflurane gas. The uterus had a big sac around 20 cm x 10 cm of darkish red blood. This reservoir released the dark red blood every day out of the vagina.

The surgery was done by Dr Daniel who had warned that the dog was unfit for anaesthesia. "The owner had given his informed consent," I said.  I texted the owner that she had been operated but was panting a lot after surgery and sent him an image of the uterus with the cysts and the sac of dark red blood. Around one hour later, the dog panted much fasted and suddenly the dog passed away. There was heart failure. I informed the owner.

The parents and two daughters aged 10 years and 4 years came promptly. The 10-year-old felt the loss badly but the 4-year-old still could not understand that death was a permanent loss. "This dog is very old," I said to the 10-year-old. "Around 91 years in human age. She had lived a long life much loved by all in the family. Most Golden Retrievers don't live up to such an old age.. Many men alos die before they reach 70 years, not 91 years."  

"Would it make any difference if she was operated on the first consultation?" the man asked me. "I don't know," I said. "She was already having heavy panting then."

"I doubt it would make any difference if my dog was operated earlier on the first consultation," he replied. "But the solution to this heavy vaginal bleeding and reluctance to eat was surgery and I told my wife." 

If the dog survived the surgery, like the other 13-year-old Golden Retriever, she would live longer although she would need heart disease medication..  

In conclusion, this dog was likely to live longer if she had been spayed at one year of age. There would be no pyometra leading to dirty continuous vaginal discharge. There was also a swelling of the left posterior two mammary glands, possibly a sign of breast tumours. Early spaying might have prevented such tumours from developing.

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