Analys av prostaglandin F2α -metabolit i blodet : indikativt för pyometra hos tik?

Abstract: Pyometra (chronic purulent uterine inflammation) is a common disease in middle-aged and older intact bitches. The disease most frequently occurs in metoestrus and previous research studies have shown that both hormones and bacteria are involved in the development of the disease. Analysis of the blood levels of prostaglandin metabolite 15-keto-13,14-dihydro-PGF2α (PG-metabolite) has previously been shown to be clinically useful in the differentiation of canine uterine diseases such as pyometra and mucometra. The PG-metabolite concentration has also been correlated to severity in pyometra as determined by hospitalisation length. The purpose of the present study was to investigate if blood levels of PG-metabolite can differentiate uterine diseases such as pyometra from other diseases in female dogs. If so, a cage-side test for PG-metabolite analysis could be clinically useful and aid in diagnosis if it becomes available in the future. The present study included 212 bitches, whereof 55 were diagnosed with pyometra, 133 were diagnosed with other diseases and 24 were healthy control dogs. The dogs in the patient group were admitted to the University Animal Hospital, Swedish University of Agricultural Sciences, Uppsala, Sweden, where they were examined and treated for a wide variety of diseases. From all the 212 dogs, a blood sample (lithium-heparinised collecting tubes) was collected at admission, and plasma was subsequently freeze-stored until analysis of PG-metabolite levels was performed. The obtained PG-metabolite concentrations were compared between groups of dogs suffering from different diseases, including pyometra, and also with the control group. In most of the bitches with pyometra, the PG-metabolite levels were moderately to highly increased (mean level 3089 pmol/l). The total white blood cell count (WBC) was more often increased in cases with pyometra compared with cases with other diseases. Of the bitches with pyometra 17 out of 34 had increased WBC, in comparison to 4 out of 40 bitches diagnosed with other diseases. Highly increased PG-metabolite levels were also detected in other diseases such as neoplasia, acute mastitis and metabolic diseases of the musculature (30 294 pmol/l, 4573 pmol/l and 21 166 pmol/l respectively). The highest PG-metabolite levels (7871 to >40 000 pmol/l) were detected in ten bitches with dystocia. In conclusion, a single test for PG-metabolite does not differentiate pyometra from other diseases. Analysis of PG-metabolite levels might, however, still be clinically useful for detection of an ongoing inflammatory response, and as such also diagnostically useful when combined with other examinations and laboratory analyses. Further studies including more patients in each disease-group and extended laboratory parameters, would be necessary to determine the diagnostic and prognostic abilities of PG-metabolite analysis in other diseases than pyometra.