Linda's Pyometra: My Nightmare Come To Life

If you’ve never heard of pyometra go ahead and log it away in the same brain pocket as leukemia, overdose, rattlesnake bites — it’s a death sentence without immediate medical attention. Hell, even sometimes with medical attention dogs don’t make it.

Pyometra is an infection of the uterus. It mostly appears in domestic dogs and cats, but it can occur in mammals of all types, domestic and wild. It is gross. Be prepared for gross, or feel free to skip this one. Nobody’s holding you here.  

We’ve got a lot to cover.

Neutering Domestic Dogs

The correct medical term for rendering an animal sterile is “gonadectomy.” Colloquially, we refer to “spaying females” and “neutering males.” For purposes of simplicity, we’ll just be using “neutered” to refer to gonadectomies in any sex.

Neutering has become a hot, hot topic in the US over the last few decades and both pro-neuter and anti-neuter folk have compelling reasons.

The Pros of Neutering

The initial push for pro-neutering was fueled by an attempt to reduce stray populations. This seems sensible. Certainly fewer fertile animals results in a lower population, right? Oddly enough, we don’t actually know. The few existing studies seem to show no correlation between neutering and population reduction in dogs, measured by shelter intakes and euthanasias. In cats? Yes, there is a reduction. In dogs? No. 

This feels bass-ackwards but upon further thought does actually make some sense. Dog breeding is increasingly viewed as an easy money-making side job. Hobby breeders are erupting by the hundreds in every nook and cranny of the goddamn country. Until we really, really crack down on this idea, neutering alone will never do enough to manage populations. 

The second most-cited reason for neutering is to reduce risks of gonad cancers. Which, in my opinion, is a bit of an odd claim. If we removed the dog’s legs there would be a reduced risk of leg cancer — so of course removing gonads reduces risks of gonad cancers. It is known that intact dogs have a higher risk for mammary, ovarian, and testicular cancers than neutered dogs. It’s complicated though, and varies depending on breed, age, and overall health of the dog. I’m definitely not qualified to make any specific claims here — this is something you should discuss with your vet specifically.

Other “benefits” include decreased aggression, reduced roaming, less marking, calmer demeanor. All of these are both substantiated and unsupported depending which study one refers to. 

And then, of course, pyometra. Neutering in females completely eliminates the risk for pyometra. No uterus, no uterine infection.

For all these reasons, spay and neuter became the gold standard for every shelter, every vet, every dog owner.

The Cons of Neutering

We also know that neutering, especially when done early, can cause all sorts of problems. Neutering can significantly increase the risk of Cruciate ligament tears, hip dysplasia, elbow dysplasia, and numerous cancers. Cancer risk (certain types) does increase, particularly osteosarcoma (OSA), hemangiosarcoma, lymphoma and mast cell tumours. A study on OSA in several breeds found a twofold increase in neutered dogs relative to intact dogs. Some studies state that intact cancers are deadlier than neutered cancers, but again, it depends on age, breed, and other factors. There is no singular answer. 

Neutered females experience urinary incontinence at a rate of somewhere around 20%. This is definitely directly related to the loss of hormones that help control bladder function. Neutering also decreases the metabolism of both male and female dogs. This is a major contributor to obesity and subsequent diseases. 

And, like all surgeries, neutering requires anesthesia to the patient. Depending on the health of the dog, sedation may not be safe. A vet should always run a blood panel and other necessary tests to check off all known risks regarding this topic. Then, of course, there are incisions that must heal. Such an injury is always at risk of infection, rupture, incorrect healing, and other traumas.

Here’s a better, smarter, explanation from someone who is actually qualified to speak about these things. https://www.youtube.com/watch?v=rVFrurpIn80 

Linda Specifically

I chose to keep Linda intact for longer than normal because of all the aforementioned risks. Linda is a working dog. We do obedience, rally, agility, dock diving, barn hunt, scent work. We do all the things and she helps me teach other dogs all of those things. We absolutely cannot afford 3 months of downtime for an exploded hip or tendon. There is effectively no risk of pregnancy, aggression, roaming, or marking due to our lifestyle. And as far as cancer, cancer risks increase for both intact and neutered dogs. It's nearly impossible to know which cancer is "worse."

The pros did not outweigh the cons for us.

I did know, however, of the risks of pyo (and if you hate vaginas or gross medical stuff, now's a great time to leave). Because of said risks, I checked her abdomen and vagina frequently, especially around heat cycles since the cervix is more opened up. Pyometra is most common after a heat cycle has ended, though it can happen at any time.

Pyometras come in two forms: open and closed. Open pyometras are infections where the cervix remains open. Closed pyometras are those where the cervix has fully closed after a heat cycle.

Both open and closed pyometras are life-threatening situations, but open pyometras are the "less serious" of the life threatening (is there even such a thing?). An open pyo allows somewhere for the infection to drain. It also increases the chance that the dog owner can actually see the infection leaking out. Closed pyos turn into pressure cookers. With a closed cervix, there's nowhere for the increasing infection to go. Left long enough the uterus will rupture and at that point euthanasia is the only humane option.

Pyometra is terrifying.

So, how did I catch it?

I caught Linda's pyo exceedingly early. It was still in the open phase and the infection was small enough that the surgery was just a normal spay. In the case of severe, closed pyos, surgery is a ticking time bomb and one wrong move can kill the dog. Even gently nicking the uterus can cause the infection to explode into the abdomen, which as we stated, is a death sentence. A dog's uterus is Y-shaped so locating and removing each of the arms can prove very dangerous and very deadly.

If you're feeling brave, you can find photos online of removed pyometras. They are distended, ready to rupture. And the surgery is scary as hell.

So anyway, Linda's pyo was open. I caught it early. I caught it because I am insanely bananas nuts obsessive. During her heat I would check her vagina and abdomen multiple times a day, every day. And during one of these checks, I noted a small amount of pus. And I'm talking small, like maybe a literal singular drop.

I told myself not to freak out, and promised to check her two times as often. The next 5 or 6 checks featured nothing. Then there was another drop of pus. "that's odd" I thought, and then I CAUGHT THE SMELL OF IT. It is so absolutely disgusting, the way that single drop of pus held the stench of rotting death I immediately knew. I packed her up and drove to urgent care minutes later.

At urgent care the vet remained doubtful that her symptoms were from pyo but I insisted. They ran the labs and, sure as shit, uterine infection. We scheduled her for surgery the following morning. And luckily, she made it.

I learned a lot, and this is what I'd share to anyone curious about life-threatening medical situations:

1: Know Your Dog

• Your Dog’s Genetics: What diseases are they prone to? What’s the health status of their parents and siblings? This is the absolute golden ticket of buying from an ethical breeder — having eyes on the ancestry. If your pup develops a major issue, tell your breeder. Information is gold. On a few occasions I’ve seen breeders remove a stud or bitch from their program because of health issues in the offspring, but they can’t make that decision without your contributions.

• Your Dog’s Baseline: Know how your dog moves when they are 100% healthy. How do they sit, lie down, stand, walk, and sprint? I’ve caught hip dysplasia just by obsessively noting these things.

• Be Your Dog’s Paparazzi: BE ANNOYING. TAKE PHOTOS, NOTES, VIDEOS. I take a photo with detailed notes every single * time my dog vomits. Almost always, these are rendered unimportant and they just get deleted. But on rare occasions, these photos and notes have contributed greatly to treatment. Take 10 seconds to snap a pic, it could make a massive difference.

2: Advocate 

Find a great vet, build a relationship, and stay loyal. But remember: YOU are the manager of your dog’s healthcare team.

The day I dragged Linda to the vet shouting PYO!, the vet was understandably skeptical. Linda had no fever, no behavior changes, no pain. There was just one symptom: tiny, infrequent drops of pus that I only caught because I was tracking her like a hawk in psychosis. And just for reference, this was her just one day before. There's no question she was acting and feeling perfectly fine.

But because I had my notes, the vet listened and agreed to test for both a UTI and pyo. If your vet isn't listening or refuses to test, don’t roll over. Advocate for your dog.

3: Change Plans

When you sign up for a dog, YOU SIGN UP FOR THE WHOLE THING. If they get sick, YOU are on duty. If they need crate rest, YOU are the prison warden.

This means you might miss out on parties, holidays, or vacations. This is what you signed up for.

I missed 5 out of 7 days of a family vacation for Linda’s pyo, and I’d do it again in a heartbeat. The only reason I went for the last two days was because she was healing perfectly, I was only a short drive away, and I have a trusted professional who follows instructions to the letter.

The Harsh Truth: DO NOT drop your freshly injured or sick dog off with a friend or sitter just so you can sip margaritas in Mexico. The dog is YOUR responsibility.

4. Accept Regression

Your only goal right now is physical recovery. Throw everything else straight in the trash.

Your dog's training will regress. Accept it. Do not force your dog to maintain training at the expense of their healing. I get it—training is hard work and you don't want to lose progress. But forcing a sit-stay or trying to sneak in a hike can obliterate recovery.

• Let the dog heal.

• Yes, they will be annoying as fuck after two days of crate rest. Deal with it.

• Only implement physical activities as the vet clears them.

If your dog busts their stitches or re-fractures a bone, your jail sentence doubles. Buckle down. Take a Xanax. Power through.

5. Financial Planning 

Linda’s procedure ran about $2,500. Her insurance covered about half (excluding some elective add-ons I chose).

The financial side of pet ownership truly sucks giant horse balls. I’m not going to sit here and lecture you to keep $10,000 in cash lying around for every dog. That’s just not realistic for most people. I also can’t blindly advertise pet insurance, because premiums can skyrocket to $400+ a month, which is insane.

Here is my personal strategy: The Financial Limit. I set a mental financial cap for each dog based on their age, health, and quality of life.

• Age: Spending $5,000 on a 13-year-old dog for a chronic issue that won't prolong their life just doesn’t make sense. Young dogs: It depends entirely on their potential for a full recovery, their future quality of life, and how it impacts the rest of the household.

• Working Dogs: It probably makes sense for top-performing bomb detection dog to receive more services than your neighbor’s couch potato.

• Finances: Take a serious look at your finances and make sure it won’t turn your life upside down. There are times when, of course, that makes sense. And there are times where it doesn’t. 

If a procedure falls within the limit and makes sense for that specific dog, it’s a green light. If it’s over, I stop, gather more information, and make a tough, rational decision.

During recovery, keep your eyes wide open. Take photos of the incision daily. Check for swelling, redness, or broken stitches. Lean hard into Rule #1 (Know Your Dog), and if anything feels funky, Rule #2 (Advocate).

You've got this!