Hollinshead Fiona, Krekeler Natali
GlenBred, Matamata Veterinary Services, 26 Tainui Street, Matamata 3400, New Zealand
Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Werribee, VIC 3030, Australia.
J Feline Med Surg. 2016 Jan;18(1):21-33. doi: 10.1177/1098612X15623114.
Pyometra is a commonly occurring uterine disease in cats that often leads to loss of breeding potential and, in some cases, can be life threatening. An increased incidence of cystic endometrial hyperplasia (CEH) and pyometra is seen with age. Most queens present with uterine lesions after 5-7 years of age (average 7.6 years, range 1-20 years). Clinical signs most commonly occur within 4 weeks of the onset of oestrus in queens that are either mated, spontaneously ovulate or are induced to ovulate (mechanical stimulation or hormone induction). The disease is most often observed in dioestrus.
Queens with pyometra often go undiagnosed as there may be few or only very mild clinical signs and laboratory changes. For example, the classic sign of mucopurulent bloody vulvar discharge often goes unnoticed. Abdominal ultrasound is the best tool for diagnosis of pyometra and for monitoring response to therapy.
Classically, middle-aged/older nulliparous intact queens present with pyometra. However, so-called 'stump pyometra' can occur if ovarian tissue is left behind during ovariectomy or ovariohysterectomy (ovarian remnant syndrome). Queens treated with exogenous steroid hormones such as high doses of megestrol acetate or medroxyprogesterone acetate for oestrus prevention can also develop CEH and pyometra.
There has been little published to date on CEH, endometritis and pyometra in the queen and most of the currently available information has been extrapolated from studies carried out in the bitch. The queen and the bitch have very different reproductive physiology; thus, further research and investigation into the precise aetiopathogenesis of these disease processes of the uterus in the queen is warranted.
This review is aimed at clinicians working in small animal practice, especially those in countries where surgical sterilisation is not practised as commonly as in the United States, Canada or Australasia, and who will therefore see a greater proportion of intact queens.
子宫蓄脓是猫常见的子宫疾病，常导致繁殖能力丧失，在某些情况下还可能危及生命。随着年龄增长，囊性子宫内膜增生（CEH）和子宫蓄脓的发病率会升高。大多数母猫在5至7岁后出现子宫病变（平均7.6岁，范围为1至20岁）。临床症状最常出现在已交配、自发排卵或诱导排卵（机械刺激或激素诱导）的母猫发情开始后的4周内。该病最常在发情后期被观察到。
患有子宫蓄脓的母猫常未被诊断出来，因为可能只有很少或非常轻微的临床症状和实验室变化。例如，黏液脓性血性外阴分泌物这一典型症状常常未被注意到。腹部超声是诊断子宫蓄脓和监测治疗反应的最佳工具。
传统上，中年/老年未生育的未绝育母猫会出现子宫蓄脓。然而，如果在卵巢切除术或卵巢子宫切除术（卵巢残留综合征）中遗留卵巢组织，就可能发生所谓的“残端子宫蓄脓”。用外源性类固醇激素如高剂量醋酸甲地孕酮或醋酸甲羟孕酮预防发情的母猫也可能发生CEH和子宫蓄脓。
迄今为止，关于母猫CEH、子宫内膜炎和子宫蓄脓的文献报道很少，目前可用的大部分信息都是从对母犬的研究中推断出来的。母猫和母犬的生殖生理有很大不同；因此，有必要对母猫子宫这些疾病过程的确切病因发病机制进行进一步的研究和调查。
本综述针对从事小动物临床工作的兽医，特别是那些所在国家不像美国、加拿大或澳大拉西亚那样普遍实施手术绝育的国家的兽医，因此他们会见到更大比例的未绝育母猫。
