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Ovary sparing surgery after pyometra and progesterone sensitivity

LilF

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I talked to the Repro doctor yesterday in person visit, to go over all my options and concerns.He said he COULD remove the uterus but since she had pyo already it is a lot harder to not leave any tissue in there but he thought he could do it. (I go to a Repro hospital and pay more for their experience!) if I wanted an OSS. He said no benefit to leaving one ovary in. He also mentioned false pregnancy as another matter if she kept her hormones. He said to leave both ovaries in if I wanted the OSS. He also did say that he would leave the uterus in if I decided on the ovary removal because he said the uterus is progesterone sensitive and it would not be an issue without the ovaries. He said that Blossom got pyo because she is probably hormonally sensitive to the progesterone. He said pyo is first a hormonal disease. So the conditions were ripe for her infection and said she would probably get it again. if she remained intact. I would like her to keep her hormones but don't want problems hormonally yet to be manifested. I do not mind the heats etc.... but don't want any other health problems. I believe she may be 4 or even 5 years old. I hope there would not be too many changes in her personality. I told the doctor I liked her nesting and mothering tendencies. He said if she does it when she is not in heat then the spay would not affect that. I am concerned about her becoming more fearful or aggressive with a full spay like I saw with another dog I know. I like her personality now. The doctor said that with ovaries only left they can get ovarian cysts. So how common are those? Also what role would progesterone sensitivity play in any future problems either generally medically or with her ovaries? I really do want her to keep her hormones. Has anyone ever done an OSS after a pyo and had a dog who lived with few problems related to hormones since pyo is a hormonal problem. Like the doctor told me: once you take it out you can't put it back in.
 
they can get ovarian cysts. So how common are those?
Great question Lil! Older dogs can get these cysts up to 10% of the time. However, they rarely produce hormones or create a problem.

what role would progesterone sensitivity play in any future problems either generally medically or with her ovaries?
Sorry, I'm not sure what you're asking.

Has anyone ever done an OSS after a pyo
I have not had a patient who had OSS after pyo.
 
I was just reading that in Norway it is illegal to neuter a healthy dog and in Denmark the standard treatment for Pyometra is drugs. So I am rethinking this whole neutering decision. I do want her to keep her hormones and am grieving already her losing them. So how does the uterus keep from building up after the heat with progesterone and why don't dogs in Scandinavia have this problem after every heat if not bred? When I asked the doctor about keeping her intact I thought he was going to fall over on the floor. Is it a slam dunk to say she would get it again?? I cam so confused and running out the clock on this before it is to late. I am back and forth. Why can't I just wait till her next heat is over. I guess I could recognize it now unless it was a closed pyometra which might be harder.. I was ding dang pretty sure Dr. SAra said her dog had pyo and did an OSS same time. I thought I remember reading that and committed it to my memory.I don't know why the doctor did not seem to think that the risk for hemangio, cognitive impairment, joint disease, endocrine disease was important. I told him I did not want a dog who had to be pilled with thyroid twice a day because it just means breaking their fast at the beginning and end of the day, requiring food and that I did not want a dog with incontinence. These are specialists and I was stunned I knew more than he did. He did mention false pregnancy but who cares. I did tell him that her risk for mammary cancer is no less now getting neutered because she has already had 2 heats and the tissue was sensitized. I am now thinking I need to talk to the doctor again and maybe cancel the surgery until afer her next heat in December. Running out of time for the surgery before she starts her next estrus cycle.
 
Is it a slam dunk to say she would get it again??
Not IMHO. Especially if a trained vet homeopath is on your vet care team (and Dr. Judy is experienced with pyo and intact female dog stuff).
 
After I posted this I went to youtube and watched some videos. I saw one from Dogs Naturally where she does mention homeopathy which I was aware of. After Blossom's pyo Dr. Cooney sent me some Pulsatilla to give which I did but I still completed the antibiotic course. The lady from Dogs Naturally said that she used Yunnan Baiyou too which I remember asking about but I did not give her that. I have plenty of that from Gabby's Hemangiosarcoma 2 years ago... But I thought we want the uterus to drain rather than getting big and heavy. I am still confused on using the Yunnan. I can text Dr. Cooney to see if he has a protocol for pyo prevention. I was concerned about closed Pyo and I do know surgery on a sick dog is most risky -- the uterus is more friable and prone to rupture then causing sepsis. So I might be rolling the dice I think by keeping her intact. I also read on the UC Davis Vet School site that we have to worry about stump granuloma as well (in addition to stump pyometra). if leaving in the uterus which is what my surgeon wanted to do while removing the ovaries. Stump granuloma I never heard of but it reacts with the suture material. They should use absorbable suture material that disappears minimizing the residual uterine tissue left in the abdomen but they were going to leave IN Blossom's uterus so not sure there would be any stitches in that area if just removing the ovaries laproscopically. I wish I knew her real age. The shelter said between 2-4 but the DNA test said she had a close relative in NY here she hails from, that was 5. One thing I did hear in an interview was using DHEA to increase estrogen in dogs but I bet even most vets don't know about this option. I like it better than the incuran (synthetic estrogen) for dogs. When I asked about bioidentical hormones for dogs, the doctor said those studies haven't been done. In a perfect world I want physiological dose and bioidentical hormone replacement for my dog. Short of that her own hormones are best. Is she old enough where she has had her hormones long enough to get the longevity benefit? Also in the Dr. Karen Becker video from 10 years ago she did mention that dogs can have a sensitivity to Progesterone which is what my doctor said about Blossom, I guess that would mean more prone to getting Pyo--I think that was the context in the Becker video as to why some dogs get it and others don't. I asked Blossom what she wants me to do and I haven't gotten an answer yet.....
 
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