Feline Pyometra (Uterine Infection) – Symptoms, Diagnosis, Treatment, Surgery and Aftercare

Feline pyometra is a life-threatening infection of the uterus where pus and fluid accumulate due to bacterial invasion and hormonal changes. It is most common in older, intact female cats after heat cycles, but it can occur at almost any age if the cat is not spayed. Without timely treatment, pyometra can lead to sepsis, organ failure, and death.

ovariohysterectomy (OVH – removal of ovaries and uterus)

Key Facts at a Glance

• Is pyometra fatal? Yes, if left untreated it is almost always fatal.

• What is the gold standard treatment? Emergency ovariohysterectomy (OVH – removal of ovaries and uterus) with IV fluids and antibiotics.

• Can antibiotics alone cure it? Only as a temporary measure in rare cases; surgery is the definitive solution.

• What is open vs closed pyometra? Open = pus drains from the vulva. Closed = no drainage; higher risk of uterine rupture and sepsis.

• How is it diagnosed? Ultrasound is the gold standard.

• Can spayed cats get pyometra? Not normally, but “stump pyometra” can occur if ovarian tissue remains after spay surgery.

Pyometra

Causes and Risk Factors

• Hormonal imbalance (progesterone): Post-estrus, the cervix closes, uterine tone decreases, and secretions accumulate, allowing bacterial growth.

• Cystic Endometrial Hyperplasia (CEH): Chronic hormonal stimulation thickens uterine lining, setting the stage for infection.

• Bacterial infection: Commonly E. coli, sometimes staphylococcus or streptococcus.

• Risk groups: Older cats, never bred, repeated heats, cats given progesterone-based “contraceptive injections,” or incomplete spays.

Closed Pyometra

Symptoms (Open vs Closed Pyometra)

General signs:

• Lethargy, anorexia, vomiting

• Excessive thirst and urination (toxin effect on kidneys)

• Abdominal enlargement, fever or hypothermia

Open pyometra:

• Foul-smelling pus/bloody discharge from vulva

• Increased licking of genital area

Closed pyometra:

• No visible discharge

• Distended abdomen, sudden collapse possible

• Much higher risk of rupture and peritonitis

Will a Cat Die from Feline Pyometra?

Yes. If untreated, cats can die within days from septic shock, renal failure, or uterine rupture. Pyometra is a medical emergency.

Diagnosis

1. History & physical exam: Female cat after heat cycle, with discharge or systemic illness.

2. Blood tests:

   • CBC: leukocytosis (early) or leukopenia (advanced sepsis).

   • Chemistry: elevated urea/creatinine (kidneys), ALT/AST (liver), electrolyte imbalances.

   • CRP/SAA often elevated.

3. Imaging:

   • Ultrasound (USG): Dilated uterine horns filled with fluid, thickened uterine wall.

   • X-ray: Enlarged tubular soft tissue structure, must differentiate from pregnancy.

4. Vaginal cytology and culture: Helps confirm bacterial infection and guide antibiotic choice.

Treatment Options

1) Surgical – Ovariohysterectomy (OVH) Gold Standard

• Indicated in almost all cases.

• Pre-op stabilization: IV fluids, broad-spectrum antibiotics, antiemetics.

• Anesthesia: safest option is inhalation anesthesia (isoflurane/sevoflurane) with monitoring (ECG, SpO₂, blood pressure, CO₂).

• Surgery: Removal of uterus and ovaries without rupturing the infected contents. Abdominal lavage performed if rupture suspected.

• Permanent cure, recurrence impossible.

2) Medical Management – Limited Use

• For breeding cats only, with open-cervix pyometra and mild systemic signs.

• Includes prostaglandins/aglepristone (in some countries) to induce uterine evacuation, plus antibiotics.

• High recurrence rate (>50%).

• Not recommended in closed pyometra or severely ill cats.

3) When Surgery Is Too Risky

• If the cat is too unstable for anesthesia (shock, severe heart disease, advanced age):

  • IV fluids + IV antibiotics + oxygen support

  • Temporary stabilization

  • Emergency surgery once stable

• Note: Antibiotics alone do not cure pyometra.

Postoperative Care and Risks

• Hospital care (24–48h): IV fluids, antibiotics, monitoring of temperature, urine output.

• Home care (10–14 days): Elizabeth collar, wound kept dry, restricted activity, medications as prescribed.

• Complications: Hemorrhage, wound infection, peritonitis, sepsis, kidney damage, rare “stump pyometra.”

Can Spayed Cats Get Pyometra?

Not if completely spayed. However, if ovarian tissue is left behind (ovarian remnant syndrome), stump pyometra can develop. Progesterone injections in spayed cats can also mimic hormonal cycles and predispose to infection.

Vaginal Infections vs Pyometra

• Vaginitis: discharge only, no systemic illness, normal ultrasound.

• Pyometra: systemic illness, distended fluid-filled uterus on ultrasound.

“Can Rahim Infection Be Cleaned with Antibiotics?”

No. Antibiotics may temporarily suppress bacteria, but the uterus remains filled with pus and toxins. Surgery is the only definitive cure.

Cost of Cat Pyometra Surgery (USA – USD)

Prices vary widely by clinic, city, cat’s condition, anesthesia/monitoring, and length of hospitalization. Ranges below are informational.

Condition / Case Severity	Surgery (OVH)	Typical Add-ons (examples)
Open-cervix pyometra, stable	$1,200 – $2,500	Exam/ER fee $75–250, CBC/chem/coag $100–300, abdominal ultrasound $250–600, IV catheter + fluids $100–300, antibiotics $50–150, pain meds $30–80, e-collar $10–25
Closed-cervix pyometra or moderate systemic illness	$2,500 – $4,500	+ Hospitalization 24 h $200–600/day, repeat labs $100–200, culture/antibiogram $100–200
Rupture/peritonitis or severe sepsis	$4,500 – $7,500+	ICU level care $600–1,800/day, broad-spectrum IV antibiotics $100–250, abdominal lavage, additional imaging $150–600
Laparoscopic approach (rare in pyometra)	+ $1,000 – $2,000	Availability varies by center

Notes• Female pyometra surgery is more complex than routine spay; costs reflect emergency care, sedation, monitoring, and possible ICU.• Medical-only management (antibiotics ± prostaglandins in select open cases) may lower immediate surgical cost but has high recurrence and often ends in surgery later.

FAQ

What are the treatments for pyometra in cats?Emergency OVH + fluids + antibiotics; medical therapy only in rare breeding cases.

How much does pyometra surgery cost?8,000–25,000+ TL depending on severity.

What happens after surgery?Elizabeth collar, wound care, limited activity, 10–14 days of recovery.

Why do cats get pyometra?Hormonal changes after heat cycles + bacterial infection.

What are the symptoms?Discharge (open form), lethargy, anorexia, PU/PD, abdominal swelling.

What is open pyometra?Cervix open, pus drains from vulva. Closed form has no discharge.

Is antibiotic treatment enough?No, only temporary in unstable patients; surgery is the cure.

What happens if left untreated?Sepsis, uterine rupture, death.

Do dogs get pyometra too?Yes, very commonly. Covered in a separate blog.

Prevention

• Spaying before first heat prevents pyometra.

• Avoid progesterone injections for heat suppression.

• Prompt veterinary evaluation for any post-heat illness.

References

• AVMA – Spay/Neuter & Reproductive Health

• AAHA – Pyometra Guidelines

• Royal Veterinary College (RVC, UK) – CEH-Pyometra in cats

• Cornell University College of Veterinary Medicine – Feline Pyometra Overview

• PetMD / Pet Health Network – Pyometra in Cats

• VetLife Veterinary Clinic, Mersin (Turkey) – Google Maps Location