Cystic endometrial hyperplasia (CEH) is a condition occurring in unspayed dogs. It's most common in older dogs who have been in heat but never mated. Some dogs never show symptoms or develop complications. Other dogs develop the more dangerous pyometra as a result of the uterine changes.
Understanding Cystic Endometrial Hyperplasia in Dogs
CEH occurs when the lining of the uterus thickens. A dog's ovaries produce both estrogen and progesterone. During the third stage of a dog's heat cycle, progesterone is released in high levels. If a dog doesn't mate, the lining of the uterus continues to thicken, spurred on by the progesterone and estrogen. Pockets in the lining can form creating the perfect zone for bacteria. Not every dog develops the bacterial issue, but if a dog does, pyometra is the likely outcome.
Dangers of Pyometra
As the lining thickens from cystic endrometrial hyperplasia, fluid builds up in the horns of the uterus causing them to swell. The uterus expands becoming uncomfortable. If the fluid exits the horns and enters the vagina, the dog will begin to groom herself excessively exposing bacteria to the vagina and cervix. If the bacteria makes it into the uterus, the infection can spread.
Pyometra takes two forms: open pyometra or closed pyometra. With open pyometra, the cervix remains open allowing liquid and pus to continually drain from the uterus. The drainage is easy to spot because it is thick and reddish-pink. It's easier to treat this form of pyometra.
In some cases, known as closed pyometra, the uterus closes up and fills with pus and fluid. You may notice your dog's abdomen swelling and she may seem lethargic and refuse meals. The kidneys can become strained trying to flush out the toxins from the bloodstream. Septic shock is a potential problem. Another issue with pyometra is that the expanding uterus can rupture filling the abdomen with bacteria and pus.
Treating Cystic Endometrial Hyperplasia
The best way to prevent CEH is to have your dog fixed. Without a uterus, it is extremely unlikely for the dog to develop Cystic Endometrial Hyperplasia or pyometra.
Most dogs have CEH without their pet owner ever knowing it. Symptoms are unlikely. Fever doesn't happen, if anything, the dog's temperature may be lower than normal. They only way to check for CEH is through a biopsy. If it is determined, a spay is generally recommended.
If this doesn't happen, you should closely monitor her for symptoms. The problem is many dogs show no signs until the CEH has developed into pyometra. If you notice your dog grooming her vaginal area excessively, contact your veterinarian immediately. The sooner the dog undergoes an ovariohysterectomy, the lower the risk of her developing septic shock.
For pet owners who are adamantly against an ovariohysterectomy as a treatment for cystic endometrial hyperplasia, antibiotics can help fight an infection. Prostaglandin will also be used to cause the uterus to contact and expel the pus and fluid. Prostaglandin should never be used if the dog has closed pyometra. Be aware that the uterus may rupture, even with open pyometra due to swelling of the uterus and strength of the contractions.