Uterine blood flow evaluation in bitches suffering from cystic endometrial hyperplasia (CEH) and CEH-pyometra complex

Abstract

Doppler ultrasound is a useful diagnosis tool to evaluate uterine blood flow in different canine reproductive states. The aim of this study was to describe and compare uterine blood flow in bitches suffering from cystic endometrial hyperplasia (CEH) and CEH-pyometra complex. Ninety diestrous bitches were clinically, hematologically and ultrasonographically classified into 4 groups: 1) Clinical signs, leukocitocis, CEH and uterine luminal contents (CEH-P, n=31); 2) Asymptomatic bitches with CEH and uterine contents (CEH-C, n=15); 3) Asymptomatic bitches with CEH without uterine contents (CEH, n=16); and 4) Normal diestrus bitches (ND, n=28). The widest cross-sectional diameter (D) and uterine wall thickness (W) of uterine horns were measured using two-dimensional ultrasound. Peak systolic velocity (PSV) and end diastolic velocity (EDV) of uterine arteries were measured by Doppler ultrasound in all the bitches. Peak systolic velocity and EDV were higher in CEH-P than in CEH-C, CEH and ND (P < 0.01); although both parameters did not show differences among the latter three groups (P > 0.1). Conversely, RI showed lower values in CEH-P than in the other three groups (P < 0.01), being ND higher (P < 0.01) than both CEH-C and CEH which did not differ between themselves (P > 0.1). When all the bitches were considered, correlation between RI and D was r=-0.69 (P < 0.01) and between RI and W was r=-0.02 (P > 0.1). It is concluded that the uterine artery blood flow velocity of bitches suffering from pyometra was higher, not only from normal bitches, but also from females with endometrial hyperplasia. Furthermore, endometrial hyperplasia, accompanied or not by luminal contents, had a higher blood flow velocity than normal uterus. Hemodynamic parameters appear as useful markers to differentiate uterine pathological conditions.