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C-reactive Protein in the Differentiation of Pyometra From Cystic Endometrial Hyperplasia/Mucometra in Dogs

From the Departments of Veterinary Clinical Sciences (Fransson, Ragle), Animal Science (Park), and Statistics (Evans), Washington State University, Pullman, Washington 99164-7060; the Department of Pathology (Karlstam), National Veterinary Institute, 750 07 Uppsala, Sweden; and the Department of Small Animal Clinical Sciences (Bergstrom, Lagerstedt), Swedish University of Agricultural Sciences, 750 07 Uppsala, Sweden.

Hematological parameters, plasma C-reactive protein (CRP), and tumor necrosis factor were analyzed in 64 dogs with a presumptive diagnosis of pyometra. Final diagnosis (i.e., pyometra or cystic endometrial hyperplasia [CEH]) was determined by histopathology. As a single test, the percentage of band neutrophils had the highest sensitivity in the prediction of pyometra (sensitivity, 94%). The combination of percentage of bands and CRP had the highest sensitivity (97.7%; specificity, 75%) in predicting the presence of pyometra. The most common clinical signs noted in the study were vaginal discharge, polyuria, polydipsia, lethargy, and gastrointestinal signs. A combination of three or more of these clinical signs was significantly associated with pyometra.

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