Pyometra is one of the common emergencies in small animal practice, often requiring immediate (surgical) intervention. On the other hand, cystic endometrial hyperplasia is an important differential diagnosis, but the differentiation of both can be a problem. A group from Sweden tried a very popular parameter in human medicine, C-reactive protein, to differentiate both problems.
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Hematological parameters, plasma C-reactive protein (CRP), and tumor necrosis factor were analyzed in 64 dogs with a presumptive diagnosis of pyometra.
Final diagnosis (i.e., pyometra or cystic endometrial hyperplasia [CEH]) was determined by histopathology.
As a single test, the percentage of band neutrophils had the highest sensitivity in the prediction of pyometra (sensitivity, 94%). The combination of percentage of bands and CRP had the highest sensitivity (97.7%; specificity, 75%) in predicting the presence of pyometra. The most common clinical signs noted in the study were vaginal discharge, polyuria, polydipsia, lethargy, and gastrointestinal signs.
A combination of three or more of these clinical signs was significantly associated with pyometra.
Source: Boel A. Fransson, Erika Karlstam, Annika Bergstrom, Anne-Sofie Lagerstedt, Jean S. Park, Marc A. Evans and Claude A. Ragle (2004): C-reactive Protein in the Differentiation of Pyometra From Cystic Endometrial Hyperplasia/Mucometra in Dogs. In: Journal of the American Animal Hospital Association 40:391-399 (2004)
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