uteritis with cats

What we in general call uteritis is an inflammation of the endometrium. Due to sex hormones the mucous membrane, which covers the inside of the uterus, degenerates. Numerous little vesicles arise in the mucous membrane and also an accumulation of mucus in the uterus takes place. The cat doesn’t show any disease symptoms yet. Due to bacteriums which get through the uterus, the accumulated mucus can infect. The bacteriums in the uterus secrete a poison which amongst others causes that the kidneys cannot hold liquid anymore. Much extra urine is secreted and the cat drinks a lot of water. Sometimes you notice that the cat vomits now and then and in general becomes seriously ill. The temperature might increase a lot. But mostly the course is much quieter.

There is pus now in the uterus. This pus comes out through the vagina. It might have a yellow-chocolate color. A problem is that cats are used to be clean and therefore will lick the pus themselves before the owner observes it.

Uteritis can also occur shortly after delivery. The cause is that mostly one or more (parts of) the afterbirth haven’t been expulsed. Also, a dead kitten might have been left behind in the uterus. Furthermore, an ordinary bacterial inflammation can be the case, which arose around birth.
In case of an uteritis after a delivery the cat will become seriously ill 1-3 days upon delivery. The belly is hard; dirty vaginal pus might come out. The mother doesn’t produce enough milk anymore, so that the weight of the kittens doesn’t increase anymore. Usually, this kind of uteritis can be treated better. In this case the treatment consists of giving antibiotics and possibly flushing the uterus with an antibiotic.
Next to the uteritis with the pus coming out of the vagina, the cervix might also be closed so that the pus stays in the uterus. These cats usually become ill very fast. They lose weight, are very listless and very depressed. Vomiting and diarrhoea can also occur. X-rays show that the uterus has been enlarged.
Besides you can, just like with an “open” uteritis, diagnose by means of blood tests that it concerns an inflammation. It is obvious that a medical treatment is necessary in case of uteritis. Without treatment the uterus might tear due to which bacteriums end up in the stomach, which might be mortal for the cat. The most occurring treatment in case of uteritis is to perform surgery and remove the uterus. In the initial stage of the inflammation this almost concerns a routine surgery. If the inflammation has been present for a longer time, the surgery will get more complicated. Usually an antibiotic cure is prescribed after the surgery. 
But if it concerns a breeding cat, removing the uterus is of course a drastic surgery. An alternative is the medicament treatment with a Prostaglandin. This is a group of medicines which reduce the progesterone in the blood, relax the cervix and stimulate the contraction of the uterus so that the bacteriums and the pus will be removed from the uterus. This treatment has, in case of an uteritis with an open cervix, a pass rate of 75-90%. But a risk of 50-75% on a new uteritis remains. Besides, the treatment has some side effects and we don’t recommend it for cats which are already seriously ill. A veterinarian must observe the cat well during the treatment with Prostaglandin. (Temporarily) side effects might arise like vomiting, diarrhoa, restlessness and intensive licking. This treatment must be combined with an antibiotic cure. If the treatment if successful, the cat should be covered at the first heat.  It is good to deliberate with the veterinarian if antibiotics (for example Amoxicillin) can be given duri

In the first 4 weeks of the pregnancy. Another treatment method is flushing the uterus with an antibiotic. The most used method is to spray the antibiotics through the vagina in the uterus and flush it in this way. A problem is that a cat’s uterus has an elongated horn shape. The antibiotic therefore doesn’t always reach the end of the uterus. The uterus must be removed afterwards in such a case.
As far as I know, another method has been followed once in the Netherlands. This is a method which is more often used with horses. The uterus is also flushed with an antibiotic in this method, but from the far end of the uterus horn. Under an aneasthetic the veterinarian fastens a tube at the end of each of the two uterus horns through which a fluid antibiotic is sprayed during 3 days in a row. This antibiotic will come out of the vagina after some time. After the third treatment the tubes are removed. Of course, the cat must wear a cap around his head in order to prevent that he touches the tubes. In above mentioned situation the cat was covered after the second heat upon treatment and got 7 healthy kittens. The problems have never returned.
It is good to realize that some medicines which contain progesterone (amongst others some cat pills) stimulate an uteritis. Progesterone causes an increase in size and thickness of the uterus septum and the glands. Besides, progesterone hinders the natural (local) resistance for inflammations and it reduces the contractions of the uterus. An ideal situation for bacterium growth arises.
In short, if your cat is listless, drinks a lot and/or vomits or if you notice pus coming out of the vagina, it is very important to see the veterinarian. Deliberate with him/her concerning the best treatment; there are more possibilities than just removing the uterus.