Ovarian remnant syndrome and uterine stump pyometra in three queensJournal of Feline Medicine and Surgery


M. A. Demirel, D. B. Acar
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Journal of Feline Medicine and Surgery http://jfm.sagepub.com/content/14/12/913

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DOI: 10.1177/1098612X12451373 2012 14: 913 originally published online 15 June 2012Journal of Feline Medicine and Surgery

Murside Ayse Demirel and Duygu Baki Acar

Ovarian remnant syndrome and uterine stump pyometra in three queens technique does not amount to an endorsement of its value or quality, or the claims made by its manufacturer. those of the authors and the inclusion in this publication of material relating to a particular product, method or of animals and interpretation of published materials lies with the veterinary practitioner. The opinions expressed are from actions or decisions based on information contained in this publication; ultimate responsibility for the treatment arisingcountry. The authors, editors, owners and publishers do not accept any responsibility for any loss or damage advertising material, it is the responsibility of the reader to check that the product is authorised for use in their own bear this in mind and be aware of the prescribing laws pertaining to their own country. Likewise, in relation to

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DOI: 10.1177/1098612X12451373 jfms.com


Spaying is performed to avoid over-population of unwanted queens and to eliminate unwanted behaviours associated with oestrus. Spaying is also recommended to reduce the risk of pathological conditions of the reproductive organs.1 Thus, spaying is the most common conservative and medical procedure in queens.2

However, some complications may develop after ovariohysterectomy (OHE), such as ovarian remnant syndrome (ORS). This syndrome may develop because of the failure to totally remove both ovaries (most commonly the right ovary) at OHE, or the presence of a partial or complete separation of a portion of normal ovary (the fragment may be located near the ovary or in the broad ligament) that is not detected at OHE.2–4 In some cases, uterine stump pyometra may occur because of ovarian remnants3 and this situation may be fatal in affected queens. Worldwide, fatal complications occur as a result of surgical errors in routine OHE. In this article, we report and discuss the importance of ORS and also stump pyometra associated with ORS in queens.

Case 1

A 28-month-old spayed queen presented with a history of reduced appetite, lethargy and purulent vaginal discharge. OHE had been performed via a left flank approach about 18 months earlier. Reappearance of oestrous behaviours was noted 4 months before presentation. Vaginal cytology revealed abundant neutrophils and purulent debris consistent with stump pyometra, and cornified superficial cells consistent with the presence of oestrogen from remnant ovarian tissue (Figure 1a). Ultrasonographic examination revealed a ruptured stump pyometra on the basis of the presence of an echogenic (scattered in the form of snow flakes) structure, measuring 11.5 × 6.8 cm, and a small amount of free fluid in the abdominal cavity.

Increased body temperature, increased heart and respiratory rate, and significant deviations of laboratory findings were found on physical and clinical examination (Table 1).

Intravenous (IV) fluid (0.9 % NaCl and balanced electrolyte solution) administration and amoxicillin–clavulanic acid (Synulox 8.75 mg/kg/day, IM; Pfizer) therapy were started before surgery to improve the general condition of the queen. Surgery was performed to remove the

Ovarian remnant syndrome and uterine stump pyometra in three queens

Murside Ayse Demirel1 and Duygu Baki Acar2


Ovarian remnant syndrome (ORS) is the presence of functional ovarian tissue with signs of oestrus as a complication after ovariohysterectomy (OHE) or ovariectomy. Stump pyometra is another complication that can be observed after

OHE. However, there are few reports about ORS and stump pyometra in queens. In this report, three queens with recurrent oestrous behaviours after OHE are described. In two queens, ORS with stump pyometra was diagnosed and in one queen ORS alone was diagnosed by physical examination, medical history, vaginal cytology and ultrasonography. Remnant ovarian and uterine tissues were removed by laparotomy. Two queens recovered without any complications; however, one queen died 2 days after surgery. This study reveals that ORS and stump pyometra can result in severe disease and can be fatal.

Accepted: 17 May 2012 1 Laboratory Animals Breeding and Experimental Researches

Center, University of Gazi, Ankara, Turkey 2 Department of Obstetrics and Gynaecology, Faculty of

Veterinary Medicine, Afyon Kocatepe University, Afyonkarahisar,


Corresponding author:

Murside Ayse Demirel DVM, PhD, Laboratory Animals Breeding and Experimental Researches Center, University of Gazi, 06330,

Ankara, Turkey

Email: aysedemirel@gazi.edu.tr 451373 JFM141210.1177/1098612X12451373Demirel and AcarJournal of Feline Medicine and Surgery 2012