Surgical Management of Spontaneous Uterine Rupture and Septic Peritonitis Secondary to Pyometra in a Saarloos Wolfdog with a Concurrent Malignant Mammary Tumor

Background: Uterine rupture secondary to pyometra is a rare, catastrophic complication leading to septic peritonitis and a grave prognosis. This condition is often concurrent with other pathologies in older, intact female dogs. Methods: An ۸-year-old, intact female Saarloos Wolfdog was presented in lateral recumbency following a ۴-۵ day history of anorexia and lethargy. Despite the owner observing clinical signs, there was a delay in presentation to the hospital. The diagnostic protocol included physical examination, complete blood count (CBC), serum biochemistry, and abdominal ultrasonography. After initial stabilization for septic shock, an emergency exploratory laparotomy was performed. The procedure involved an ovariohysterectomy, peritoneal lavage, and excision of a concurrent caudal abdominal mammary mass. Results: Physical examination revealed pale mucous membranes and malodorous, serosanguinous vaginal discharge. The patient was normothermic (۳۸.۴°C). The CBC revealed a total white blood cell count within the reference range (۱۴.۲۰ x ۱۰³/µL), characterized by a significant regenerative left shift (۱۲.۰۰% bands), toxic changes, and severe thrombocytopenia (۹۷ x ۱۰³/µL). Biochemistry showed severe azotemia (Urea: ۲۱۱.۰۰ mg/dL) and marked hepatic enzyme elevation (ALP: ۲۲۳۴.۰۰ U/L). Ultrasonography confirmed pyometra and echogenic peritoneal effusion. Surgery revealed a full-thickness uterine rupture and generalized purulent peritonitis. Histopathology of the excised mammary mass confirmed a Complex Carcinoma, Grade II. The patient survived the procedure and was discharged. Conclusion: This case highlights the critical nature of uterine rupture in bitches with pyometra, which often present with signs of septic shock and carry a poor prognosis. Despite the severity of the clinicopathological derangements and the concurrent malignant diagnosis, a positive outcome is possible with aggressive and immediate surgical and medical intervention.

کلیدواژه ها:

Pyometra ، Uterine Rupture ، Septic Peritonitis ، Saarloos Wolfdog ، Complex Carcinoma