DISEASE SUMMARY PAGE

Uterine Infection in Lagomorphs

Summary Information
Diseases / List of Bacterial Diseases / Disease summary
Alternative Names
  • Endometritis
  • Metritis
  • Pyometra
Disease Agents Various bacteria, particularly Pasterella multocida, also Staphylococcus aureus, Chlamydophila spp., Escherichia coil, Listeria monocytogenes, Moraxella bovis, Brucella melitensis, Salmonella spp., Actinomyces pyogenes and Proteus. (B601.9.w9, B602.18.w18, J4.171.w9, J4.189.w14, J4.203.w3, J213.5.w1, J296.52.w J495.40.w1, J495.42.w1)

Infection of the uterus may occur:

  • Through mating
  • Through artificial insemination
  • Postpartum
  • Following pseudopregnancy
  • By haematogenous spread.

(B600.14.w14, B601.9.w9, B602.18.w18, J4.171.w9)

Note: "Predisposing factors, such as build up of ammonia fumes in the rabbit house, ambient temperature changes and drafts, reproduction, older age, existence of carriers, and poor sanitation contribute to the likelihood of development of clinical pasteurellosis." (J4.203.w3)

Infectious Agent(s)
Non-infectious Agent(s)
  • Exogenous oestrogens?
Physical Agent(s)
General Description
Clinical signs
  • General: anorexia, lethargy/depression, weight loss. (B601.9.w9, B602.18.w18, J213.5.w1)
  • Abdominal distension. (B601.9.w9, B602.18.w18, J4.203.w3, J213.5.w1, J495.40.w1)
  • Mucopurulent vaginal discharge. (B600.14.w14, B601.9.w9, J4.171.w9, J213.5.w1)
  • On physical examination, the uterus may be large and doughy. (B601.9.w9, B602.18.w18, J213.5.w1)
    • Take care during abdominal palpation since the wall of the uterus may be thin, friable and liable to rupture. (B602.18.w18, J213.5.w1))
  • Rectal temperature may be raised. (J4.171.w9, J213.5.w1)
    • Hypothermia may occur. (J213.5.w1)
  • Note: With mild endometritis, clinical signs may be subtle, and with chronic disease, there may be no clinical signs. (B602.18.w18)
Clinical pathology
  • Sometimes heterophilia and slight leucocytosis. (B601.9.w9, B602.18.w18)
  • May be leucocytosis with neutrophilia. (J213.5.w1)
  • Normocytic normochromic anaemia in a doe with chornic pyoendometritis and ovanian abscesses. (J4.203.w3)
  • Sometimes azotaemia, which may be due to dehydration or deposition of amyloid in the kidney. (B601.9.w9)
  • See: Clinical Pathology of Lagomorphs
Pathology
Gross pathology
  • "Gross locular dilatations of the uterine horns" containing thick creamy pus. Adhesions between the uterus and other viscera. (J8.23.w1)
  • In a doe with endometritis and uterine torsion, the uterus was distended, the serosal surface red to black and the uterus contained 700 mL of yellow viscous liquid. There were scattered bacterial colonies and a light infiltration of heterophils and mononuclear cells in the mucosa. Proteus sp. was cultured from the uterine lumen. (J495.40.w1)
  • In a doe with metritis and septicaemia due to Moraxella bovis: (J4.171.w9)
    • Uterus: necrotic purulent metritis: mucopurulent exudate filling the uterus, mucous contained necrotic and haemorrhagic areas, and deep in the uterine wall were numerous abscesses.
    • Liver: numerous small necrotic foci, and one 1.5 cm abscess.
    • Kidneys: severe congestion, perivascular lymphocyte accumulation in the cortex.
    • Lungs: congestion and oedema, with diffuse serofbrinous pneumonia. and two organised thrombi centred on bacterial colonies.
    • Spleen: congestion, lymphoid depletion.
    • Moraxella sp. isolated from vaginal exudate and Moraxella bovis from uterus, liver, lungs and spleen. (J4.171.w9)
  • In a doe with Pasteurella multocida pyoendometritis, pyosalpingitis and ovarian abscesses: (J4.203.w3)
    • Uterus: walls thickened, horns containing tan-coloured pasty material with a thin encapsulating layer of red-tan fibrous tissue, and body containing inspissated tan exudate. 
    • Ovaries: mottled white-brown, consisting of cystic cavities containing chalky white inspissated exudate.
  • In a doe with Pasteurella multocida pyometra: (J4.189.w14)
    • Uterus enlarged and distended, filled with white viscous material.
  • In a wild Lepus europaeus - Brown hare. (J1.10.w5)
    • Uterus: both horns grossly distended, taking up the posterior third of the abdominal cavity and displacing other organs cranially. Sacculations of the horns, 2 x 1.5 cm, contained thick gree-yellow pus with a "clotted cream" consistency. There were adhesions between the uterus and the rectal mesentry and the parietal peritoneum.
    • Liver: a few 0.5 - 1.0 mm grey-white necrotic foci, scattered.
    • Spleen: enlarged, sausage-shaped.
    • Lymph nodes: mesenteric lymph nodes slightly enlarged
    • Adrenals: markedly enlarged, combined weight 700 mg (normal 200 mg).

    (J1.10.w5)

  • In wild Lepus europaeus - Brown hares in Australia: (J1.40.w10)
    • Uterus: yellowish opaque fluid with darker flecks of more solid material. Unpleasant odour noted. (J1.40.w10)
Histopathology:
  • In a doe with Pasteurella multocida pyoendometritis, pyosalpingitis and ovarian abscesses: (J4.203.w3)
    • Ovaries: normal tissue replaced by fibrous connective tissue surrounding abscesses. 
    • Uterus: subacute suppurative endometritis and subacute suppurative salpingitis
    • Renal: multifocal subacute pyelonephritis (mild)
    • Cardiac: Pericardial effusion (mild)
    • Liver: Extramedullary haematopoiesis.
    • Gram-negative rods in the ovarian abscess exudate.
    • Culture: Pasteurella multocida isolated from ovarian exudate. (J4.203.w3)
  • In a doe with Pasteurella multocida pyometra: (J4.189.w14)
    • Uterus: subacute necrotizing metritis; transmural inflammation with diffuse serosal inflammation.
    • Kidneys: in the glomeruli and to a less extent the renal interstitium, multifocal eosinophilic amorphous deposits, identified as amyloid by staining with Congo red and by apple-green birefringence under UV light. (J4.189.w14)
    • Culture: Pasteurella multocida isolated from uterine samples. (J4.189.w14)
  • In wild Lepus europaeus - Brown hares in Australia: (J1.40.w10)
    • Uterus: "reduced number of dilated glands with significant lymphoplasmacytic and polymorphonuclear leukocytic infiltration.". (J1.40.w10)
Further Information

Nor particularly common; in a survey of rabbits with uterine disorders, pyometra was seen in one of 47 rabbits. (J27.64.w4)

Susceptibility
  • Usually in breeding does but can also develop in nulliparous does. (B602.18.w18, J213.5.w1)
Transmission
  • Usually by mating, but also haematogenous spread. (J213.5.w1)
Diagnosis
  • History: 
    • Fetal resorptions, abortion or stillbirths (with mild endometritis). (B602.18.w18, J213.5.w1)
    • Infection may be more common following abortion than following resorption. (J213.5.w1)
    • Recent parturition or pseudopregnancy, failure of breeding. (B602.18.w18, J4.203.w3)
    • Note: this disease can develop in nulliparous does. (B602.18.w18)
  • Physical examination findings, with a doughy enlarged uterus. (B602.18.w18, J213.5.w1)
  • Radiography/ultrasonography to confirm an enlarged, fluid-filled uterus and rule out other causes of uterine enlargement (polyps, masses, cystic alterations). (B601.9.w9, B602.18.w18, J8.23.w1, J213.5.w1)
  • Haematology: leucocytosis with neutrophilia. (J213.5.w1)
  • Vaginal discharge cytological assessment and Gram stain. (B601.9.w9, B602.18.w18)
  • Exploratory laparotomy is needed for definitive diagnosis. (B601.9.w9, J213.5.w1)
  • Note: with Pasteurella multocida infection there may also be ovarian abscesses. (B602.18.w18)
Treatment
  • Supportive care initially to stabilise the rabbit (fluid therapy, analgesia, appropriate treatment to avoid development of gastrointestinal stasis). (B601.9.w9)
  • Antibiotic therapy, initially broad-spectrum, then according to culture and sensitivity testing (culture from the uterine wall). (B601.9.w9, B602.18.w18, J213.5.w1)
    • Start antibiotic therapy before surgery. (J213.5.w1)
  • Ovariohysterectomy is the treatment of choice. (B600.14.w14, B601.9.w9, B602.18.w18, J213.5.w1)
  • Note: In a mild case of endometritis in a breeding doe, medical management (prolonged antibiotic therapy) plus fluid therapy as required may be tried. However, because rabbit pus is tenacious and caseous, full drainage of the uterus and resolution of the infection may not occur. (B601.9.w9, B602.18.w18)
  • Euthanasia may be required in severe cases. (J4.189.w14)
Prevention
  • Screen does and bucks for Pasteurella multocida before using for breeding. (J213.5.w1)
Associated Techniques
Host taxa groups /species
Disease Author Debra Bourne MA VetMB PhD MRCVS (V.w5)
Referees Aidan Raftery MVB CertZooMed CBiol MIBiol MRCVS (V.w122)

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