College of Veterinary Medicine, Midwestern University, Glendale, AZ, USA.
Department of Primary Care, Animal Health Institute, College of Veterinary Medicine, Midwestern University, Glendale, AZ, USA.
Top Companion Anim Med. 2022 Sep-Oct;50:100695. doi: 10.1016/j.tcam.2022.100695. Epub 2022 Jul 30.
Current management practices of pyometra in the private practice setting are not well documented. The goal of this study was to understand pyometra management in the private practice setting, and the current relationship private practices have with high quality, high volume, spay-neuter (HQHVSN) clinics regarding referral for pyometra surgery. An anonymous electronic survey was piloted and distributed using SurveyMonkey via email, social media, and the Independent Veterinary Practitioners Association targeting veterinarians who see companion animals. A total of 153 responses were received from June to July 2021, with respondents distributed throughout the United States. Practices performed a median of 10 spay and neuters per week, with the median spay cost being $350 (IQR 250-500) for dogs and $250 (IQR 180-350) for cats. The median cost of a pyometra surgery was $1000 (IQR 700-1500) for dogs and $750 (IQR 450-1000) for cats. All practices treated pyometra at least sometimes, despite the disruption (major 19%, moderate 47%, mild 29%, none 5%) to their day. All pyometra presentations were accepted for treatment at least sometimes: BAR/QAR (98%), depressed or non-ambulatory (88%), and obtunded or lateral (62%) with mean estimated survival of 96%, 74%, and 31%, respectively. The majority (56%) of clients were reported to sometimes have trouble paying for all recommended services, while it was less often reported that clients often (31%) or rarely (13%) had trouble. Private practices willing to refer only did so always 20% of the time and sometimes 36% of the time. Private practices will do what they can to treat most pyometras that present at their practice within a timely manner before referring elsewhere. There is currently inconsistent utilization of HQHVSN clinics as a potential referral resource due to location or appointment availability.
目前，私人诊所中子宫蓄脓的管理实践并没有得到很好的记录。本研究的目的是了解私人诊所中子宫蓄脓的管理情况，以及私人诊所与高质量、大容量绝育（HQHVSN）诊所目前在子宫蓄脓手术转诊方面的关系。我们使用 SurveyMonkey 通过电子邮件、社交媒体和独立兽医从业者协会，对从事伴侣动物诊疗的兽医进行了一项匿名电子调查。该调查于 2021 年 6 月至 7 月进行，共收到 153 份回复，回复者分布在美国各地。各诊所每周进行中位数为 10 例的绝育手术，公犬绝育的中位数费用为 350 美元（IQR 250-500），母猫绝育的中位数费用为 250 美元（IQR 180-350）。公犬子宫蓄脓手术的中位数费用为 1000 美元（IQR 700-1500），母猫子宫蓄脓手术的中位数费用为 750 美元（IQR 450-1000）。尽管会对日常工作造成（重大 19%，中度 47%，轻度 29%，无 5%）干扰，但所有诊所都会至少有时治疗子宫蓄脓。所有子宫蓄脓病例均至少有时被接受治疗：BAR/QAR（98%）、精神沉郁或不能运动（88%）和意识障碍或侧卧（62%），其估计生存率分别为 96%、74%和 31%。报告称，约有 56%的客户有时难以支付所有推荐的服务费用，而客户经常（31%）或很少（13%）有困难的情况则较少。愿意转诊的私人诊所总是转诊的比例为 20%，有时转诊的比例为 36%。私人诊所会尽其所能，在及时转诊到其他地方之前，治疗大多数在其诊所就诊的子宫蓄脓病例。由于地理位置或预约可用性，HQHVSN 诊所目前尚未被充分用作潜在转诊资源。
