engleski

UNILATERAL SEGMENTAL APLASIA OF THE UTERINE HORN WITH PYOMETRA

A 15-year-old intact female Pekingese was referred to the Clinic because of vaginal bleeding and polydipsia. The patient had a previous diagnosis of degenerative mitral valve disease ACVIM stage C, and was stable under standard therapy. An enlarged and painful abdomen was observed during examination. Haematology and biochemistry profile showed signs of inflammation, most probably due to infection, and increased BUN and creatinine levels. Abdominal ultrasound showed dilation of the uterus with anechoic area and right uterine horn filled with content. The patient was premedicated with midazolam (0.25 mg/kg IV) and methadone (0.15 mg/ kg IV). General anaesthesia was induced with propofol (3 mg/kg IV), followed by endotracheal intubation. The patient was connected to the anaesthetic machine with a rebreathing circuit and maintenance of the anaesthesia was provided by a combination of oxygen and isoflurane. Pain management was provided by the use of fentanyl boluses (2, 5 µg /kg IV). Patient monitoring included capnometry, non-invasive arterial blood pressure measurement, pulse oximetry, and ECG. Intraoperative findings were unilateral segmental aplasia of the left uterine horn and right horn filled with content and uterine body tumor. Ovariohisterectomy was performed with subsequent pathohistology. The pathohistology findings were: squamous metaplasia and cystic degeneration of the endometrial glands, uterine adenomyosis and squamous aplasia of the left uterine horn and left ovary. Postoperative care included pain management, antibiotic therapy, control of renal parameters and constant monitoring of breathing frequency with with attention to the occurrence of edema due to cardiac problems. The patient was discharged to home care two days after the procedure. In conclusion, this was a complex case of unilateral uterine horn aplasia, pyometra and uterine tumor complicated with a heart disease that in the end had positive outcome

unilateral segmental aplasia, pyometra

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