What is Metritis in Dogs?
Metritis is defined as inflammation and infection of the uterus. It occurs when bacteria enter the uterus after whelping or giving birth in dogs. The medical term for inflammation of the uterus is endometritis when it affects the lining (endometrium), and metritis when it affects the uterine wall (myometrium).
Metritis most commonly occurs within the first 2 weeks after a dog gives birth, as the uterus has not fully healed and closed off yet. During birth the cervix dilates allowing bacteria to enter. In addition, placental tissue left behind can become necrotic and allow bacteria to multiply (Merckvetmanual.com).
Common symptoms of metritis include fever, lethargy, loss of appetite, vomiting, diarrhea, enlarged abdomen, and foul-smelling vaginal discharge. The discharge may contain pus, tissue debris, and be green, brown, or red in color.
Metritis can be life-threatening if left untreated as the infection can spread to the blood stream. It requires urgent veterinary treatment with fluids, antibiotics, and sometimes oxytocin therapy. With prompt treatment, most dogs recover fully.
What Causes Metritis After Whelping?
Metritis after whelping is typically caused by a bacterial infection of the uterus. The most common bacteria involved are E. coli, Streptococcus, Staphylococcus, and Pseudomonas. These bacteria are opportunistic and can invade the uterus during birth, especially if there are retained placentas or uterine trauma.
Retained placentas are a major risk factor for metritis. If pieces of placenta are left attached to the uterine wall after birth, they provide an ideal medium for bacterial growth. As the placenta tissue decays, bacteria multiply rapidly.
Uterine trauma, such as lacerations or bruising during the birthing process, also allows bacteria to invade the damaged tissue and set up an infection. Difficult births or the use of obstetric instruments can cause trauma to the uterine lining.
Other factors like poor sanitation, poor nutrition, and concurrent illness can contribute to bacterial infection after whelping. Proper cleaning of the whelping area and providing excellent prenatal and postnatal care reduce the risks.
In summary, the main causes of metritis after whelping are bacterial infection, retained placentas, and uterine trauma during delivery, which allow opportunistic bacteria to invade the uterus.
Symptoms of Metritis
The most common symptoms of metritis in dogs after whelping include:
- Fever – Dogs with metritis often develop a fever over 103°F (39.4°C) as the body fights the uterine infection (Merck Veterinary Manual).
- Lethargy – Infected dogs tend to be very tired and lethargic, lacking energy or motivation to move around (WagWalking).
- Loss of appetite – Metritis frequently causes lack of appetite or refusal to eat as the dog feels unwell (PetCareRX).
- Vomiting – Nausea and vomiting are common as the body struggles to cope with the uterine infection (PetCareRX).
- Enlarged abdomen – The infected uterus may become enlarged and fluid-filled, causing a visibly distended abdomen (Merck Veterinary Manual).
Other symptoms may include bloody or foul-smelling vaginal discharge, dehydration, weakness, and maternal neglect of the puppies. Symptoms tend to appear 2-7 days after whelping once the infection has taken hold in the uterus (WagWalking).
Diagnosing Metritis
There are several methods a veterinarian will use to diagnose metritis in dogs:
Physical Exam
A veterinarian will first perform a thorough physical exam, looking for signs of illness such as fever, lethargy, dehydration, rapid heart rate, and foul-smelling vaginal discharge [1]. Gentle palpation of the abdomen may reveal an enlarged, fluid-filled uterus.
Blood Tests
A complete blood count (CBC) is usually recommended to check for elevated white blood cell count, which indicates infection. Blood chemistry tests help assess organ functions [2].
Ultrasound
An ultrasound allows visualization of the uterus to see any fluid accumulation, uterine wall thickening, or abnormal tissue that could indicate infection [1].
Bacterial Culture
A sample of vaginal discharge can be cultured to identify the specific bacteria causing the infection. This helps determine the most effective antibiotic treatment [3].
Treating Metritis
Metritis is treated based on the severity of the condition. Mild cases may be treated with antibiotics, while more severe infections often require intensive inpatient treatment. Some common treatment methods include:
Antibiotics: This is often the first line of treatment for metritis as it can help to eliminate the bacterial infection causing the inflammation and discharge. Vets typically prescribe broad-spectrum antibiotics like amoxicillin or doxycycline, and may adjust based on culture results. Antibiotics may be given orally or by injection. [1]
IV fluids: Dogs with severe metritis are often dehydrated and may need intravenous fluids to restore hydration and electrolyte balance. Fluids also help improve blood flow to the uterus.
Hormone therapy: Progesterone supplements may be given to encourage uterine contractions to expel infected material. Other hormones like oxytocin may also be used.
Ovariohysterectomy: If metritis is severe or recurrent, a vet may recommend surgically removing the uterus and ovaries. This eliminates the infection and prevents recurrence.
Other supportive care like anti-inflammatories, pain medication, and nutritional support may also be part of the treatment plan. Close monitoring is important, as metritis can rapidly deteriorate.
Recovery and Prognosis
With prompt veterinary treatment, most dogs recover fully from metritis. The prognosis is generally good if treatment begins before the infection becomes severe or systemic. According to the Merck Veterinary Manual, over 90% of dogs recover after appropriate treatment.
However, there can be complications if the infection is not caught and treated early. These include:
- Sepsis – If the infection spreads to the bloodstream, it can cause life-threatening sepsis.
- Peritonitis – The infection may spread from the uterus to the abdominal cavity, causing inflammation of the peritoneum (peritonitis).
- Infertility – Severe, chronic metritis can cause scarring in the uterus and affect future fertility.
With quick veterinary care, most dogs will make a full recovery. However, metritis can be life-threatening if left untreated, so prompt treatment is essential.
Preventing Metritis
Proper whelping hygiene is crucial for preventing metritis in mother dogs after giving birth. The whelping area should be kept clean, dry, and free of feces to avoid introducing bacteria. The mother’s rear and vulva should be gently cleaned with a warm, damp cloth after each puppy to remove bodily fluids and debris.
It’s also important to monitor mother dogs closely in the days following birth. Appetite, energy levels, and vaginal discharge provide clues about metritis risk. Abnormal discharge that’s foul-smelling, greenish, or bloody could indicate infection. Loss of appetite, lethargy, and fever are other signs of concern. Monitoring helps detect problems early before they become severe.
Preventing retained placentas or dead fetuses is another key to avoiding metritis. Make sure all puppies and placentas are accounted for and no tissue remains inside the uterus. Count puppies as they are born and examine placentas for completeness. An ultrasound scan can check for any retained material if you suspect some remains. Promptly removing any retained tissue reduces the risk of infection.
If you plan to breed a dog again, allow proper recovery time between litters. Breeding too soon doesn’t give the uterus enough time to return to normal, increasing the chances of metritis. Most vets recommend waiting 12-18 months between breeding cycles. Following responsible breeding practices helps keep mother dogs healthy.
Caring for Dogs with Metritis
Caring for a dog with metritis requires providing supportive care and monitoring the dog closely during recovery. Some important aspects of caring for a dog with metritis include:
Rest – It is crucial for dogs with metritis to get plenty of rest during recovery. Their activity should be restricted to allow the uterus time to heal and prevent further irritation or damage. Dogs should be confined and prevented from running, jumping, or playing.
Monitoring – Close monitoring of the dog’s temperature, appetite, energy levels, and other symptoms should continue during care. If the fever persists or other concerning signs develop, veterinary treatment may need to be re-evaluated.
Warm environment – Providing a warm, comfortable environment aids healing. Place thick, cozy bedding in a draft-free area of the home. Maintaining a slightly warmer ambient temperature can also be beneficial.
Nutritional support – Good nutrition promotes healing and recovery. Feed a high-quality commercial dog food and provide fresh water at all times. Adding nutritional gel supplements or warming the food to increase palatability may encourage eating.
With attentive at-home care and monitoring, many dogs recover fully from metritis under the supervision of a veterinarian. However, prompt medical attention is still required if the dog’s condition deteriorates.
Impact on Future Breeding
Dogs who recover from metritis after whelping can usually breed again after they have fully recovered. However, there are some risks to be aware of.
Most dogs are able to get pregnant and deliver puppies normally after recovering from metritis. As long as the infection is cleared up through treatment, the uterus should return to normal function. However, some scar tissue may remain in the uterine lining, which could potentially cause issues with future pregnancies. Additionally, dogs who have had metritis are at higher risk of developing pyometra later in life.
It’s recommended to wait at least one heat cycle after recovering from metritis before breeding again. This allows time for the uterus to heal fully. Before breeding, a vet should examine the uterus to ensure there is no lingering inflammation or infection. Some vets may recommend pre-breeding antibiotics as a preventative measure.
In severe cases of metritis, scarring of the uterus may prevent future pregnancies. But as long as the infection is caught and treated promptly, most dogs go on to have normal breeding lives after recovering from metritis.
Overall, metritis usually does not permanently impact breeding capability if treated properly. However, a vet should monitor breeding dogs who have had metritis to ensure the uterus is healthy before future pregnancies.
When to See a Vet
It’s important to monitor your dog closely after whelping and seek veterinary care if any concerning signs develop. Contact your vet right away if you notice any of the following:
- Foul-smelling or abnormal vaginal discharge
- Lethargy, lack of appetite, or other signs of illness
- Fever over 103°F (39.4°C)
- Excessive panting or breathing difficulties
- Signs of pain or discomfort
- Lack of interest in the puppies
Your vet will likely want to examine your dog within 24 hours after whelping to ensure the birthing process went smoothly. Routine vet checks after giving birth are crucial to catch postpartum complications like metritis early. Don’t hesitate to call your vet with any concerns between scheduled visits too.
Prompt veterinary treatment is essential for dogs with metritis to prevent a life-threatening infection from developing. At the first signs of illness, take your dog to the vet for an exam, diagnostic testing, and appropriate treatment. With rapid care, most dogs recover fully from metritis.
