Case Study

Stump garnuloma open pyometra in a 15 month old FS Shih Tzu

A 15-month-old SF Shih Tzu dog was presented for evaluation of frequent urination and painful abdomen a few days after having an ovariohysterectomy. On physical examination the patient was depressed and had a painful caudal abdomen at the site of incision.

DX

Stump granuloma/pyometra

Sonographic Differential Diagnosis

Stump granuloma/pyometra with localized peritonitis and adhesions. Immediate exploratory surgery is recommended with resection of the uterine stump down to the level of the cervix. Appropriate culture of the uterine tissue is recommended as well.

Image Interpretation

The uterine stump in this patient was thickened and irregular with hyperechoic inflammatory pattern with adhesion. This measured 1.6 cm. The uterine stump appeared to be potentially adhered to the dorsal aspect of the urinary bladder. A minor amount of free fluid was noted between the adhesion, inflamed fat pattern and stump granuloma. No fluid was present in the lumen to call this pyometra but open stump pyometra possible.