8. Old female unspayed dogs "on heat" bleeding

From: ...@singnet.com.sg>
Subject: Question re Dog Licking Herself More Often
To: drsing@toapayohvets.com
Date: Tuesday, June 24, 2008, 6:31 AM

Hi Dr. Sing,

It has been a while since we last corresponded.

Can I please get your advice as my dog Coco has been licking her private parts
more often recently? There's no discharge on the floor, and she's
eating per normal and active as usual. Normal urine and poo too. However when I
check inside her vulva, I see a clear discharge. It isn't much and
doesn't ooze or drip out of her body too.

Her vulva is not swollen or red; it is just normal in colour with one or 2
faint tinges of pink. When I check, her vulva feels soft to the touch, but the
part right after that, i.e. the area between the vulva and the anus, feels
firm/hard to the touch. Is that normal?

Is
there anything I should worry about? FYI, Coco is 9 years old and unspayed.

Could her licking be related to the possibility of her coming into heat soon?

My dog's last heat was in Feb 8 through 25. The one before that was in Sept
23 through Oct 11. It was 5 months or 20 weeks between last year's heat and
the most recent one in Feb. Do you think my dog is going on heat again soon?

When does a female dog start licking herself before her season? 2 weeks before
or?

Please advise. Thanks very much!

Best regards,
Name given


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Re: Question re Dog Licking Herself More Often - PYOMETRA
Tuesday, June 24, 2008 9:20 PM
From: "David Sing"
To:
...@singnet.com.sg
Cc:
drsing_98@yahoo.com


Most likely on-line diagnosis (which is not recommended or advised) is that your dog is suffering from open pyometra. In this condition, the womb of the old dog has been infected by bacteria. Large amounts of pus are produced inside the uterine tubes.

Toxins from the bacteria get into the bloodstream to damage the kidneys and other organs. In time to come, the dog cannot cope with the licking away of the copious flow of vaginal discharge. The dog gets septicaemia and starts vomiting more and more often.

The only treatment of pyometra is surgery to remove the womb and ovaries (spay). Pyometra can be an emergency in many cases as many Singapore owners delay treatment thinking that the unspayed female dog is just having heat.

I just had a 12-year-old Golden Retriever with "heat" 2 months ago. (I presumed the dog licked her vaginal discharge so the owner did not see any more discharge). 2 weeks ago, sticky yellow vaginal discharge attracted flies which would not be swatted away. She vomited 2 days before surgery. Would not eat.

Depending on its health status, some dogs die before, during or after surgery. As many Singapore pet owners consider spay as "cruelty" but are uneducated as to what is pyometra, they often seek surgical treatment very late and the vet sometimes gets blamed for the death of the dog during or after surgery.

In your case, you have no choice but to see your vet and get a professional examination and opinion. It seems that your unspayed dog has been infected for some weeks. Female dogs spayed when they are young will not get pyometra for obvious reasons - they don't have the womb. There are pros and cons of spaying.





SUNDAY JUNE 29, 2008

CASE: 9-year-old Lhasa Apso. Not spayed.
Presenting sign: Vaginal discharge.

History: Licking vulva for past few days.
Previous heat around 5 months ago.

Examination. No thick copious vaginal discharge at consultation. Dog could have cleaned herself.
Fever: No. Active and eating. Urine said to be clear although there may be cystitis from a recent urine analysis.Bladder wall not palpable nor is bladder full.

Palpation: Acute pain in bladder/uterine horn area.

Diagnosis: Pyometra (open) and possible cystitis (bladder infection). It is possible that the dog had been licking off the pus. Usually pyometra starts 4-8 weeks after the previous heat. The owner noted that the vulval-rectal skin area is thickened. This is due to continuous irritation by licking for some weeks.

1) On which day after surgery can we stop worrying about whether she jumps, stretches or runs, for fear that her stitches come apart? When can we rest assured that we can leave her to move around as normal?

10 DAYS WILL BE THE BEST. Most dogs move around with no problems (90%) on day 2 in my experience.


Since I will arrive in the evening to collect my dog, only after you have left for the day, would you be kind enough to give me a call on my mobile to let me know how she is after the surgery?

OK. Must ask my people to phone you and do this as a routine. Most times we don't phone when there is no bad news. NO NEWS IS GOOD NEWS?

Will there be any pain killers for her after the surgery?
YES


2) Wound.

Will there be visible stitches on both the nipple and abdomen areas? You mentioned in your blog that these will dissolve on their own, but when do they go away, so that we can't see them anymore?

STITCHES DISSOLVE IN 21-35 DAYS. YOU CAN REMOVE THEM OR WE REMOVE THEM AT DAY 14.

How long do you think the incision for removing her womb will be?
ESTIMATED FOR LHASA APSO LENGTH OF INCISON TO BE 4 CM. IN YOUR CASE, IF THE INFECTION HAD GONE AND THE WOMB IS BACK TO ALMOST NORMAL SIZE, I CAN HOOK IT UP. INCISION WILL BE LIKE THE USUAL SPAY INCISION. AROUND 1-1.5CM.

IT IS POSSIBLE THAT I CAN HOOK THE WOMB OUT IF IT REVERTS TO NORMAL SIZE AFTER ANTIBIOTICS. IN SUCH SITUATIONS, THE BEST TIME TO SPAY HER IS 1 MONTH LATER.

IF YOU CAN BE OBSERVANT, WAIT 1 MONTH AS THIS IS AN OPEN PYOMETRA CASE PROBABLY. THEN I WILL JUST SPAY HER AS AN ORDINARY SPAY. SKIN INCISION WILL BE 1.0 TO 1.5 CM IN THIS SITUATION. YOU NEED TO DECIDE YOURSELF.

IN CLOSED PYOMETRA (pus stuck inside the womb as the cervix is closed tight, pus accumulates), NOT ADVISABLE TO WAIT.


On which day after surgery can we bathe her without worrying about her wound/stitches?

FROM DAY 2 AS THERE IS A PLASTER COVERING INCISION.

3) Breast Lump

Will you be sending the minute breast lump to the lab to see whether it's benign or malignant? If you don't, since the additional cost may not be worth it, would you be able to tell from your professional perspective and experience your best opinion on the nature of the lump, just by looking at it?

CAN'T TELL WHETHER IT IS MALIGNANT OR BENIGHT, FROM LOOKING ESP. WHEN IT IS SUCH A SMALL TUMOUR OF LESS THAN 0.5 CM. DIAMETER. ONLY HISTOPATHOLOGY BY THE AVA LAB WILL CONFIRM.

4) E-Collar

On which day after surgery can we remove the E-collar? Do we need to keep it on her even at night when she sleeps? How many days must she wear it?

USUALLY NO NEED E-COLLAR IF GIVEN PAIN KILLERS. HOWEVER, KEEP IT ON FOR 2 DAYS. IF PLASTER IS NOT LICKED AWAY, AS SOME FEMALE DOGS DON'T BOTHER, THEN NO NEED E-COLLAR. THIS LICKING IS UNPREDICTABLE AS NO 2 DOGS BEHAVE THE SAME AFTER SURGERY.

YOU HAVE GOOD QUESTIONS FROM THE OWNER'S POINT OF VIEW. WILL NEED TO GO OFFLINE TO GET TO WORK. MANY QUESTIONS ABOUT SURGERY ARE BEST ANSWERED BY WRITING THAN BY PHONE. I will need to include the answers in my case study so that others in your situation may benefit.

IT'S 8.30 AM. NEED TO GO TO WORK. BYE.