17. junij 2008
(23:12)
Avtor: Nika Gregorčič
Kategorija: 1. Psi
Piometra je gnojno vnetje maternice. Lahko gre za odprto ali zaprto obliko bolezni. Pri odprti obliki bolezni se vsebina skozi nožnico izceja iz matenice, pri zaprti obliki bolezni pa vsebina ostaja v maternici za zaprtim materničnim vratom - cerviksom.
Infekcija je lahko tako močna, da je ogroženo življenje živali. V tem primeru mora psica na nujno operacijo, saj obstaja možnost pogina zaradi sepse - t.j. okužbe krvi z bakterijami. Ta je bolj verjetna pri zaprti obliki piometre, ker se vsebina iz maternice ne more izločati. Piometra je nevarna tudi zato, ker lahko privede do poškodbe in odpovedi ledvic, ki jo povzroči dehidracija ali glomerularna bolezen kot posledica bakterijske infekcije ali endotoksinov.
Ker je piometra infekcija maternice, spadajo v rizično skupino vse nesterilizirane psice. Običajno se pojavi v roku 8 tednov po zadnji gonitvi zaradi povišanih vrednosti progesterona. Pogosteje se pojavlja pri psicah, ki niso imele legla ali so imele zelo malo legel.
Klinični znaki
Najpogostejši klinični znaki so: izcedek iz vulve, neješčnost, slabše razpoloženje, pitje vode v povečanih količinah in povečano uriniranje, bruhanje in driska.
V ambulanti sem že doživela, da smo bolezen odkrili ob rutinskem pregledu, ki ga opravimo pred vsakim obveznim cepljenjem proti steklini. Nekatere psičke z odprto obliko piometre namreč nimajo zelo izraženih kliničnih znakov. Pri drugih pa lastniki opazijo, da je v zadnjem času psica nekoliko bolj otožna, manj jé in več pije ter izloča več seča. Izcedek iz nožnice je prozorno-krvave do belo-zelene barve in ima lahko tudi nenavaden oz. neprijeten vonj.
Postavitev diagnoze
Psičko, pri kateri obstaja sum na piometro, najprej fizično pregledamo. Na osnovi zgodovine (starost živali, ali je psička sterilizirana ali ne, ali je že imela mladiče in kolikokrat jih je imela, kdaj se je nazadnje gonila), kliničnih znakov in fizičnega pregleda potrdimo ali ovržemo sum na obolenje. Običajno so potrebne tudi dodatne preiskave, in sicer:
- hematološka preiskava krvi: pokaže prisotnost vnetja;
- biokemijska preiskava krvi: z njo ugotavljamo, ali so prizadete ledvice;
- ultrazvočni ali rentgenski pregled trebušne votline: omogoča “vpogled” v maternico in s tem odkrivanje morebitne vsebine v njej.
Zdravljenje
Obolelim psicam najprej predpišemo antibiotik, da preprečimo sepso in zmanjšamo število prisotnih bakterij, ki proizvajajo toksine. Nato se dogovorimo za operacijo, pri kateri odstranimo maternico in jajčnike. Pri pravočasnem ukrepanju piometro preživi približno 90% psic.
Operacija
Operacija s katero odstranimo maternico in jajčnike poteka v splošni anesteziji. Poseg zahteva precejšnjo pozornost, saj obstaja nevarnost, da bi prišlo do pretrganja maternice. Pri piometri je namreč le-ta močno povečana in napolnjena s serozno ali gnojno vsebino.
Zgornji sliki prikazujeta operacijo zaprte oblike piometre. Na levi se vidi operacijska rana, na desni pa maternica, ki smo jo med operacijo odstranili. Maternica je bila zaradi vsebine močno povečana. Maternica pri zdravi psici, ki ni breja ali se ne goni, je namreč debela približno tako kot navaden svinčnik.
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Vsebina strani je last Nike Gregorčič (avtor) in je avtorsko zaščitena po Zakonu o avtorskih in sorodnih pravicah (ZASP - UL RS 21/95). Preberi pravila uporabe.
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17. junij 2008 ob 23:20
[...] psička ni sterilizirana, bi lahko šlo za piometro. V tem primeru veliko pije in lula, lahko ima močno rdečo sluznico v ustih (ni pa nujno), lahko [...]
17. junij 2008 ob 23:21
[...] da je bolezensko spremenjena. Do tega pride pri tumorjih, kadar dobi psica gnojno vnetje maternice (piometra), včasih pa tudi pri starejših psicah (maternica je tedaj lahko spremenjena zaradi brejosti ali [...]
24. julij 2008 ob 19:04
Hudo zgleda tole, upam da so psico rešili.
11. marec 2009 ob 23:03
Tudi pri naši psički so ugotovili piometro. Pred dvema mesecema je dobila (ker je 11 dan ušla) preventivno injekcijo proti brejosti (četrti dan od dneva, ko je ušla). Takrat me je veterinar vprašal, če bo psička v prihodnosti imela mladiče. Odgovorila sem DA! Svetoval mi je, naj pridem do 4 dne od dneva pobega. Sedaj pravijo (veterinarji!), da je lahko posledica te injekcije piometra. Takrat me nihče ni opozoril na morebitne posledice. Vsem veterinarjem svetujem, da v prihodnje to naredijo. Psička je namreč rodovniška. Stara pa še ni 2 leti. Zdravimo jo z antibiotiki.
11. marec 2009 ob 23:42
@Simona: Piometra se zelo pogosto pojavi kot posledica hormonske injekcije. Prav to je razlog, da tega postopka ne izvajam in ga odsvetujem. Upam da bo s psičko vse ok!
12. marec 2009 ob 7:16
Kaj predlagate za naprej? Slikanje kolkov, vzrejni pregled?
12. marec 2009 ob 11:32
Ja. Najbolje, da se o vseh podrobnostih in časovnicah pozanimate pri Kinološki zvezi ali klubu pasme kateri vaša psička pripada.