Postoperative complications and antibiotic use in dogs with pyometra: a retrospective review of 140 cases (2019)

summary of:
Postoperative complications and antibiotic use in dogs with pyometra: a retrospective review of 140 cases (2019)
Vet examine dog abdomen
Turkki, O.M., Sunesson, K.W., den Hertog, E. and Varjonen, K.
Published in:
March 2023
Type of access:

Open access

In our edition of: Jun 2023
In our categories of: small animals

our summary:

Turkki, O.M. et al. (2023) Postoperative complications and antibiotic use in dogs with pyometra: a retrospective review of 140 cases (2019). Acta Veterinaria Scandinavica, 65 (11)

The aim of this retrospective study was to investigate the prevalence of postoperative complications within 30 days following surgical treatment of pyometra in dogs and to assess the compliance of clinicians to the Swedish national antibiotic prescription guidelines.

The records of a small animal hospital in Sweden were reviewed for canine cases of pyometra that were surgically treated with open abdominal ovariohysterectomy during 2019.  Data collected included breed, age, bodyweight, general demeanour, co-morbidities, presence of peritonitis at the time surgery, postoperative complications including signs of surgical site infection (SSI), and type, timing and duration of antibiotic treatment given.

The dogs were categorised into two groups based on whether or not they received antibiotic treatment within 24 hours before or during surgery. Dogs that did not receive antibiotic treatment were allocated to Group A and those that had received antibiotic treatment were allocated to Group B. Adherence to the current Swedish antibiotic guidelines for pyometra cases treated with surgery, which recommend that antibiotics are only used in cases presenting with moderately to more severely depressed general demeanour prior to surgery, was assessed based on information in the clinical records. Cases with good or mildly depressed demeanour allocated to group A based on antibiotic treatment were considered to adhere to the guidelines, while cases allocated to Group B recorded as having a good or mildly depressed demeanour were considered not to adhere to the guidelines.

A total of 140 dogs were included in the final analysis, 90 in Group A and 50 in Group B. Postoperative complications were seen in 27 cases thirty days following surgery (Group A = 24, Group B = 3). Three dogs died or were euthanised during the immediate postoperative period.

The most prevalent complication was SSI followed by reaction to suture materials. SSI only developed in dogs that were not given antibiotics (Group A), suture reactions did not appear to be affected by antibiotic use and were the only complication experienced by dogs given antibiotics (Group B). Ampicillin/amoxicillin was used in 44/50 of the cases given antibiotics, including most cases showing signs of concurrent peritonitis.

Based on information in the clinical records clinicians adhered to the national antibiotic prescription guidelines on when antibiotics should be given in 90% of cases.

Limitations of the study include the retrospective nature and that the study population came from one Swedish small animal hospital and may not be generalisable to UK primary care practice.

Take Home

This study provides some evidence of the possible postoperative complications following pyometra surgery in dogs and highlights that the use of  antibiotics before or during surgery is not required in all cases. Further studies that will help identify cases that would benefit from antibiotic treatment are required.

The following may also be of interest:

inFOCUS: Responsible use of antibiotics in veterinary practice [RCVS Knowledge] [online] Available from:    [Accessed 18 June 2023]

BSAVA/SAMSoc (2018) PROTECT ME [BSAVA] [online] Available from: [online]  [Accessed 18 June 2023]

Swallow, A. (2016) In Bitches diagnosed with pyometra, is medical therapy using antibiosis alone as effective as combining ovariohysterectomy with antibiosis in reducing morbidity and mortality? Veterinary Evidence, 1 (1), no. 16.

Claiming CPD for reading inFOCUS articles

Reading and reflecting on articles can count towards your CPD, and we have a template to help you with the process.

Image copyright attribute: pressmaster

Join the discussion

We encourage discussion on all material highlighted in each edition of inFOCUS. Use the button below to join the conversation on Twitter and include your comment in the feed for this issue.

Twitter feed is not available at the moment.
0 replies

Leave a Reply

Want to join the discussion?
Feel free to contribute!

Leave a Reply

Your email address will not be published. Required fields are marked *


This site uses Akismet to reduce spam. Learn how your comment data is processed.