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Kitty Pyometra With a Twist

Patient Information

6 Years
Female, Intact



“Kitty Pyometra With A Twist”: Dr. Brian Barnes shows his swagger in the clinical sonography & surgery Olympics representing Powell River, BC, Canada in this month’s SonoPath case of the month.

This is exemplary of diagnostic and surgical efficiency that proved successful for this British Columbian Siamese cat. Sick>Sonogram>Surgery>Survive to see the Olympics with a little telemedicine in the mix. It’s pretty simple really….“If its sick it needs a probe” – Lindquist.

Sonogram: Jazzy

History: This 6-year-old female in-tact Siamese cat presented for anorexia, severe anemia, and a history of multiple heat cycles. The physical exam revealed depression and dehydration. Further diagnostics were limited owing to the emergency presentation.

Clinical Differential Diagnosis

(Remo Lobetti PhD, DECVIM): Neoplasia, pyometra, chronic inflammatory disease, gastritis, pancreatitis, bowel torsion, abdominal or thoracic hemorrhage.

Image Interpretation

(Lindquist DMV, DABVP): The uterus was severely dilated with echogenic fluid with thickened, irregular and polypoid changes (Videos 1 & 2). This is consistent with chronic pyometra. The dilated uterus occupied most of the abdomen. The ovaries were not visualized. The sonographer must ensure that these dilated tubular structures are not intestine or severely dilated ureters that can also, in extreme circumstances, appear similarly during obstructive pathology in their respective organ systems. These dilated "tubes" connected caudally with the cervix and the uterine body was appropriately positioned between the bladder ventrally and the colon dorsally in the pelvic inlet in order to ensure that pyometra was the correct diagnosis.

Sonographic Differential Diagnosis

(Lindquist DMV, DABVP): Pyometra with concurrent peritonitis or hemorrhage


Immediate exploratory surgery was performed with a rapid ovariohysterectomy.


Torsion of the left horn was found with hemoabdomen owing to resultant hemorrhage (images 5 & 6). The patient recovered uneventfully.


Special thanks to Dr. Brian Barnes DVM of Westview Veterinary Hospital, Powell River, British Columbia, Canada for his excellent management of this case and rapid sonographic & surgical intervention.