Endometritis in dogs – current knowledge and future considerations

Abstract

Canine endometritis, as an entity separate from cystic endometrial hyperplasia, is 7 a poorly understood process, yet may be responsible for infertility. Inflammatory 8 infiltrates of the endometrium in the absence of proliferative changes are the hallmark of 9 this disease. The ascension of bacteria from the vagina through the cervix is theorized 10 to lead to a chronic, low-grade endometritis, which does not produce overt clinical 11 disease, such as that seen with pyometra. Escherichia coli is the organism most 12 commonly implicated in pyometra, and is likely the most common organism involved 13 with endometritis. Various uropathogenic virulence factors (UVFs) have been identified 14 from uterine isolates, many of which share common UVFs from isolates producing 15 urinary tract disease in dogs and humans. Of these, P fimbria is thought to be crucial for 16 initial bacterial adherence to the luminal epithelium. Reduction in Mucin-1 expression 17 and immunolocalization in endometrial epithelial cells in early diestrus may be involved 18 with producing a permissive state for bacterial adhesion, allowing colonization. Samples 19 that may aid in the diagnosis of endometritis include vaginal or uterine cultures, uterine 20 biopsy, and possibly endometrial cytology and ultrasonography. Treatment of 21 endometritis is focused on elimination of infection through the use of antimicrobial 22 agents, and physical clearance of the uterus through the use of prostaglandins, 23 dopamine agonists, and progesterone-receptor antagonists.