Acute metritis is a bacterial infection that spreads upward into the uterus during the birthing process or shortly after. Some cases are caused by a retained placenta or a mummified fetus. Others are caused by contamination of the birth canal during or after delivery. Unsanitary whelping quarters and failure to dispose of the placentas and change the bedding immediately after whelping predispose a bitch to bacterial infection.
Many cases of acute metritis can be prevented by a postpartum checkup 24 hours after delivery. The veterinarian will give the dam an injection of oxytocin to clear the uterus, if needed.
Signs of metritis appear two to seven days after whelping. A dam with acute metritis is lethargic, refuses to eat, has a fever of 103°F (39.4°C) to 105°F (40.5°C), is not attentive to her puppies, and may vomit and have diarrhea. There is a foul-smelling vaginal discharge, which should be distinguished from the normal greenish or bloody discharge common for the first few days. A normal discharge is not accompanied by high fever, excessive thirst, and other signs of toxicity, such as vomiting and diarrhea. Abdominal palpation and ultrasonography help determine whether there has been a retained fetus or placenta. Cultures are taken to determine the pathogens involved and their antibiotic sensitivities.
Be sure to take the dam’s rectal temperature daily after whelping and notify your veterinarian if she develops fever or any of the signs just described. Acute metritis is a life-threatening illness that can rapidly progress to toxemia and shock.
Treatment: Treatment involves administering intravenous fluids and antibiotics to support circulation and treat toxemia. Oxytocin or prostaglandin PGF2 (Lutalyse) is given to empty the uterus. Your veterinarian may insert a small catheter through the cervix and flush the uterus with sterile saline or Betadine solution. A severely ill dam may require life-saving surgery to remove the uterus and ovaries.
Most dams with acute metritis are too ill to nurse puppies. The puppies should be taken off the mother and raised by hand, as described in chapter 17. Bitches who recover from acute metritis may develop a persistent low-grade infection of the lining of the uterus (see Endometritis).