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Jennifer Roberts, DVM Marc R. Raffe, DVM, MS, DACVA, DACVECC Steven L. Marks, BVSc, MS, MRCVS, DACVIM STANDARDS of CARE: EMERGENCY AND CRITICAL CARE MEDICINE.
The cystic endometrial hyperplasia (CEH)/pyometra complex may present as either an acute or chronic disease that occurs as a result of chronic and repeated exposure of the endometrium to progesterone. The underlying uterine pathology is CEH, which predisposes the uterus to an ascending bacterial infection causing pyometra. Generally, the diagnosis of open-cervix pyometra is based on physical examination findings of enlarged uterine structures and the presence of a purulent vaginal discharge. Closed-cervix pyometra is more insidious, with early clinical signs of general malaise that may escalate to clinical signs compatible with a lifethreatening disease in later stages. Rapid recognition and intervention in fulminant cases of pyometra is important because these patients may be profoundly dehydrated and demonstrating signs of septicemia or shock secondary to systemic infection.