METRITIS

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Causative Agent(s)

Bacteria: Escherichia coli, Streptococcus spp, Staphylococcus spp, Proteus spp.

Other predisposing factors: Prolonged delivery, dystocia, retained fetuses and placenta.

Clinical Presentation and Epidemiology

Primary signs of metritis is purulent vulvar discharge. Other observable signs are fever, lethargy, anorexia, neglect of puppies. Metritis develops in post-partum period and occasionally after abortion or breeding. It can occur in both in dogs and cats across all breeds and age group.

Diagnostic Considerations:

Diagnosis is based on history of parturition (in the past one or two weeks), clinical signs, physical examination, complete hematology and chemistry blood profile, abdominal radiography, abdominal ultrasonography, vaginal cytology, microbial culture and sensitivity test of the vulvar discharge.

Management and Treatment

In view of the high level of resistance being recorded from most antibiotics, it is of utmost importance that MCS is done before start of antibiotic therapy in cases of Pyometra and Metritis.

First Line Antibiotics: (while waiting for the result of the MCS) (Amoxicillin clavulanate (10-30mg/kg PO, IM, IV q12hr), Ciprofloxacin (5-15mg/kg PO, IV q12h)

Ofloxacin (5-20mg/kg PO q12h) Cefixime 5-12.5mg/kg PO q12hr)

 

Second Line Antibiotics:

Ceftriaxone (20mg/kg IM, IV q12hr) Levofloxacin (20mg/kg PO, IV q24hr)

Imipenem (5-10mg/kg IM-Using IM preparation, IV-Slow IV q8hr in dogs; 5-10mg/kg IV q8hr in (20mg/kg IM, IV q12hr)

Erythromycin (10-22mg/kg PO q12hr in dogs; IV q8hr in cats) Meropenem (12-24mg/kg IV, SC q8hr)

 

Adjunct/supportive therapy Fluid/Ozonated fluid therapy

Infusion of Ozone directly into the uterus. Probiotic

Duration of use: 1- 2 weeks depending on the severity of infection.