A retrospective evaluation of clinical, diagnostic and treatment aspects of 154 feline pyometra cases presented at the University Veterinary Hospital, Universiti Putra Malaysia

Pyometra is a life-threating uterine infection that affects intact female cats. They are often underdiagnosed due to having non-specific clinical signs. This retrospective study aimed to evaluate the clinical characteristics, diagnostic approaches, treatment outcomes, and prognostic factors of feline pyometra cases presented to University Veterinary Hospital, Universiti Putra Malaysia from January 2008 to December 2024. A total of 154 medical records were analysed for patient signalment, history, clinical signs, diagnostic methods, treatments, complications, duration of hospitalisation, and post-treatment survival outcomes based on medical records and post-discharge follow-up via telephone communication. The mean age of affected cats was 39.2 months, where 75% of the cases were reported in cats four years or younger in this cohort. The most common clinical sign was vaginal discharge (83.1%) with a significant association between dehydration and mentation status (p < 0.001). Diagnostic imaging such as radiography and ultrasonography were used to confirm pyometra. Systemic Inflammatory Response Syndrome was identified in 60/97 patients (61.9%). Leukocytosis (64.6%) and increased urea (22.2%) were the common haematological and serum biochemical findings. Amoxicillin-clavulanic acid (66.8%) and metronidazole (67.5%) were the most used antibiotics. Peritonitis was the most common complication, occurring in 66 cases (42.9%). Shorter duration of hospitalisation (≤ 3 days) was significantly associated with mentation status (p = 0.016), serum concentration (p = 0.036), albumin concentration (p = 0.020), and heart rate (p = 0.030). SIRS status was significantly associated with leukocyte count (p < 0.001), lymphocyte count (p < 0.001), leukemoid reaction (p = 0.001), and globulin concentration (p = 0.011). Kaplan–Meier analysis demonstrated significant differences in survival distribution between hospitalisation duration groups, although binomial logistic regression showed that duration of hospitalisation and timing of surgical intervention were not significant predictors of survival outcome. These findings highlight the need to enhance education among pet owners and optimal veterinary care to improve treatment outcomes in feline pyometra cases.

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