Metritis is a bacterial uterine infection that causes inflammation of the lining of the uterus. The infection can develop from a retained placenta or fetus after a difficult delivery or a large litter of puppies; the bacteria enters the uterus through the open cervix. It requires prompt veterinary treatment as it can lead to septic shock and death. Metritis can be a chronic condition causing infertility in breeding females. Having your dog spayed is the only way to prevent metritis.
Symptoms can be mild or severe from decreased appetite and lethargy to fever, dehydration, rapid heart rate and a foul-smelling, bloody vulvar discharge with pus. Other symptoms may include a swollen abdomen, dark red gums, depression, vomiting and diarrhea and reduced milk production. It may remain in your dog as a low-grade infection that can prevent conception at the next breeding season. Females who have had metritis may have difficulty in conceiving their next litter or may become infertile.
Metritis usually occurs within 7 days of giving birth but may be seen after miscarriage or medical abortion or nonsterile artificial insemination procedures as well as a difficult birth or lengthy delivery in which retained fetuses, placentas and other tissues provide bacteria with a medium in which to grow. The bacteria responsible for the infection are colifom bacteria, such as Escherichia coli. These bacteria will often spread into the blood. If left untreated, metritis can lead to septic shock and death.
An X-ray or uterine ultrasound may show fluid in the uterus, retained placenta or fetus, and in the case of uterine rupture, fluid within the abdominal cavity. To diagnose metritis, your vet will perform a complete chemical blood profile, an electrolyte panel, a urinalysis and a complete blood count. A sample of the vaginal discharge will be taken for microscopic examination to determine the type of bacteria present in the blood in order to prescribe the most appropriate antibiotic for treatment. Until the results are obtained, a broad-spectrum antibiotic will be prescribed. Blood tests may reveal abnormalities in liver and kidney functions, hypoglycemia and abnormal electrolytes.
This condition requires prompt veterinary treatment, which may require removal of uterine contents, antibiotics, intravenous fluid and electrolytes. Drugs that stimulate uterine contractions, such as prostaglandins, are used to help expel the contents of the uterus. If your dog is stable enough to undergo surgery, an ovariohysterectomy (spaying) is often performed. These dogs usually respond well. If your dog is of breeding quality, this may not be a desired route for treatment, but it may be the best option for a successful recovery. Spaying is the only way to prevent metritis.
Undiagnosed metritis may cause nursing puppies to die, a condition known as fading puppy syndrome. Infected puppies may develop symptoms, such as bloating and diarrhea, and require immediate medical treatment. If your dog is being treated for acute metritis, she will no longer be able to nurse her puppies. They will need to be raised as orphans and bottle fed because of the risk of transmission of the infection from the milk as well as the risk of the potentially harmful effects of the antibiotics to the developing puppies.