AniCura Small Animal Hospital Bagarmossen, Ljusnevägen 17, 12848, Bagarmossen, Sweden.
Hertog Veterinary Research Support, Achterweteringseweg 30, 3738 MA, Maartensdijk, the Netherlands.
Acta Vet Scand. 2023 Mar 6;65(1):11. doi: 10.1186/s13028-023-00670-5.
Pyometra is commonly seen in intact bitches and is usually treated by ovariohysterectomy. Few studies have reported the frequency of postoperative complications, particularly beyond the immediate postoperative period. Swedish national antibiotic prescription guideline provides suggestions about which antibiotics should be used and when in individuals undergoing surgery. Studies on how well clinicians adhere to these guidelines, and on the outcome for these patients, have not been evaluated for cases of canine pyometra. This retrospective study conducted at a private Swedish companion animal hospital assessed complications that developed within 30 days of pyometra surgery, and whether clinicians followed the current national guidelines in regard to antibiotic use. We also assessed whether antibiotic use affected the rate of postoperative complications seen in this cohort of dogs, where antibiotics were predominantly used in cases presenting with a more severely depressed general demeanour.
The final analysis included 140 cases, 27 of which developed complications. In total, 50 dogs were treated with antibiotics before or during surgery and in 90 cases, antibiotics were either not given at all or treatment was initiated postoperatively (9/90) due to a perceived risk of infection developing. Superficial surgical site infection was the most common complication, followed by an adverse reaction to the suture material. Three dogs died or were euthanised during the immediate postoperative period. Clinicians adhered to national antibiotic prescription guidelines on when antibiotics should be given in 90% of cases. SSI only developed in dogs that were not given pre- or intra-operative antibiotics, while suture reactions did not appear to be affected by antibiotic use. Ampicillin/ amoxicillin was used in 44/50 cases given antibiotics before or during surgery, including most cases showing signs of concurrent peritonitis.
Serious complications following the surgical treatment of pyometra were uncommon. Excellent adherence to national prescription guidelines was observed (90% of cases). SSI was relatively common and only seen in dogs that were not given antibiotics before or during surgery (10/90). Ampicillin/ amoxicillin was an effective first choice antimicrobial in cases requiring antibiotic treatment. Further studies are needed to identify cases benefiting from antibiotic treatment, as well as the duration of treatment needed to reduce the infection rate while also avoiding unnecessary preventive treatment.
子宫蓄脓在未绝育的母犬中较为常见，通常通过卵巢子宫切除术进行治疗。很少有研究报告术后并发症的频率，特别是在术后即刻之后。瑞典国家抗生素处方指南提供了关于在接受手术的个体中应使用哪些抗生素以及何时使用的建议。关于临床医生遵守这些指南的情况以及这些患者的结果的研究尚未针对犬子宫蓄脓病例进行评估。这项在一家瑞典私人伴侣动物医院进行的回顾性研究评估了子宫蓄脓手术后 30 天内出现的并发症，以及临床医生在使用抗生素方面是否遵循当前的国家指南。我们还评估了抗生素的使用是否会影响本队列中狗的术后并发症发生率，其中抗生素主要用于表现出更严重的一般行为抑郁的病例。
最终分析包括 140 例病例，其中 27 例出现并发症。总共 50 只狗在手术前或手术期间接受了抗生素治疗，而在 90 例病例中，由于认为有感染发展的风险，根本没有给予抗生素治疗或术后开始治疗（9/90）。浅表手术部位感染是最常见的并发症，其次是缝线材料的不良反应。有 3 只狗在术后即刻期间死亡或安乐死。临床医生在 90%的病例中遵守了何时应给予抗生素的国家抗生素处方指南。仅在未给予术前或术中抗生素的狗中才出现 SSI，而缝线反应似乎不受抗生素使用的影响。在手术前或手术期间给予抗生素的 50 只狗中，使用了氨苄西林/阿莫西林 44/50 例，包括大多数并发腹膜炎的病例。
子宫蓄脓手术后出现严重并发症并不常见。观察到对国家处方指南的高度遵守（90%的病例）。SSI 较为常见，仅见于未给予术前或术中抗生素的狗（90/90）。氨苄西林/阿莫西林是需要抗生素治疗的病例的有效首选抗菌药物。需要进一步的研究来确定受益于抗生素治疗的病例，以及需要治疗的持续时间，以降低感染率，同时避免不必要的预防性治疗。
