Successful Treatment of Pyometra Concomitant with Diabetes Mellitus in a Bitch

Pyometra, a diestrus period disorder with a long term of progesterone exposure to endometrium, is a common disease of nulliparous female dogs. Closed-cervix pyometra is an emergency medical condition that requires rapid intervention. The possibility of treatment is further limited when associated with a chronic disease such as diabetes. This case describes a closed cervix pyometra in a 4-year-old bitch with comorbid diabetes mellitus and long-term contraceptive therapy. Closed-cervix pyometra was diagnosed and confirmed by ultrasound examination typical of pyometra, vaginal smear indicating diestrus and serum progesterone level (52 ng/mL). Serum fructosamine level was 475 µmol/L, interpreting diabetes mellitus. Treatment included ovariohysterectomy and normoglycemia was achieved with glargine insulin. Although, reproductive hormones and diestrus are associated with Type II diabetes mellitus in bitches, there are no reports limited to our search, on pyometra concomitant with diabetes mellitus except Elkhounds. Since the situation has a vital clinical importance, this report aims to emphasize the insidious diabetes mellitus development potential and treatment in canine pyometra which is usually misdiagnosed or unconsidered in clinical practice.

Dişi Bir Köpekte Piyometra ve Eşlik Eden Diyabetes Mellitus Olgusunun Başarılı Tedavisi

Piyometra hiç doğum yapmamış dişi köpeklerde sıklıkla görülen, endometriumun uzun süreli progesterona maruz kalması sonucunda şekillenen bir dioestrus dönemi hastalığıdır. Kapalı serviks piyometra ise prognozu zayıf, mortalite oranı yüksek hızlı müdahale gerektiren acil bir tıbbi durumdur. Diyabet gibi kronik bir hastalık ile ilişkili olduğunda tedavi olasılığı daha da sınırlıdır. Progesteron kaynaklı insülin direncinden dolayı köpeklerde diabetes mellitusun eşlik ettiği piyometra vakalarına rastlanması olası bir durumdur. Bu olgu, uzun süre kontraseptif uygulanmış 4 yaşlı bir köpekte diyabetes mellitus eşlik eden kapalı serviks piyometrayı tanımlamaktadır. Tanı, kapalı serviks piyometra için tipik ultrason görüntüsü, diöstrusu işaret eden vajinal smear bulgusu ve yüksek (52 ng/mL) serum progesteron seviyesi ile doğrulandı. Eşlik eden diabetes mellitus durumu, yüksek serum fruktozamin seviyesi (475 µmol/L) ile teşhis edildi. Tedavi amacıyla ovaryohisterektomi operasyonu ve normoglisemi sağlamak için glarjin insulin uygulaması gerçekleştirildi. Bu rapor, klinik pratikte köpeklerde piyometra olgularında genellikle eksik tanıya neden olan ve dikkate alınmayan, sinsi diyabetes mellitus gelişim potansiyelini vurgulamayı amaçlamaktadır.

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