Toa Payoh Vets
Making veterinary surgery alive
to a veterinary student studying in Australia
using real case studies and pictures
Medical Problems of
Old Female Not-Spayed Dogs - pyometra and breast tumours
Kong Yuen, BVMS (Glasgow), MRCVS
27 November, 2010
Be Kind To Pets
CASE 1. RINGWORM AND
"Can you remember this dog?" the man in
his late 20s put the Maltese X with
fully formed cataracts in her eyes on
the consultation table.
"No," I said. "It is not easy to
identify Malteses or their crosses as
they look almost alike."
"In June, you extracted her right tooth
which you said was infected with pus,"
the man said as I referred to the
"Yes," I said. "This 15-year-old must be
the oldest dog in Singapore to suffer
from an oro-nasal fistula. How is she
"No more problem," the man showed me the
right side of the face. Hair had fully
grown and as I tried to open the dog's
mouth, she turned her head away. The
owner tried but was not successful as
that was what occurred in June. The
old dog remembered the pain and was
avoiding the pain by turning her head
"What's her problem today?" I asked.
"She is itchy and keeps rubbing her back
on the floor."
The dog's back was losing hair compared
to the fullness of hair on the face.
I put some of the back hairs under the
microscope. "There is ringworm in the
hairs," I asked the young man to view
"Does the dog lick her private parts?" I
asked. "See the vulval area. It is
swollen and is 10 times larger than
"I don't think so. She only licks her
thighs," he said.
"To you, it appears that the thighs are
itchy as well." I said. "She has some
infections, either in the womb as she is
not spayed or in the bladder. As she is
so old, I would not advise spaying as
she might die on the operating table. If
spaying had been done at a young age, we
could be sure that the dog would not be
suffering from infections of the womb or
have ovarian cysts or tumours."
Due to economic reasons, I did not
advocate blood test to check whether the
dog had pyometra infections.
The owner wanted to
clip the dog himself as he had bought a
clipper. "It is not that easy for you to
shave her completely bald," I said. "You
can't even open her mouth for me to
examine her teeth."
I had not forced
this old dog to open her mouth this time
as her main problem was the skin. It
would be prudent to check the mouth but
then she had her dental work and scaling
just 6 months ago and had no bad breath.
So, I spared her the agony.
What's the cause of the skin itchiness?
I put the infected hairs under the
microscope and showed the young man that
the hairs had fungal spores.
Although ringworm is a primary cause in
the back skin, this old female dog has a more
serious insidious health problem.
It is likely that this
15-year-old dog has open pyometra. She
keeps leaking out pus from her vagina.
She licks off the discharge to be clean.
So the irritated vulval lips become
swollen 10X over the past few days or
weeks. To the owner, she is just having
itchy thighs and back area.
I got the dog clipped bald from head to
toe by a professional groomer. She was bathed, and
treated with antibiotics and anti-fungal
medication. This is likely a case of
pyometra and/or ovarian disorder e.g. hyperestrogenism,
ovarian cysts, ovarian tumours. I hope
this old dog does not need anaesthesia
and surgery as I don't want to do it.
The more the vet operates on high-risk
cases, the higher the chances of getting
deaths on the operating table and it
does affect most vets and their staff
emotionally. It is extremely traumatic
for many veterinary staff.
TIPS: Spay your female dog when she is
young. If she lives to 15 years, she
will not be having pyometra.
every older female dog will get pyometra
or breast cancers. You just need to
check her daily and be observant. Blood
tests and annual vet examination will
prevent many sadness and inoperable
tumours if you can spare the time for
Her oro-nasal fistula case in June 2010 is recorded
The image of the oro-nasal fistula above
was taken in Jun 2010 with the
cooperation of the young man who takes
good care of his companion.
"Open your mouth for the vet," he said
to his companion. "No way," she clamped
her mouth shut. It is extremely painful
to have decayed teeth and here the vet
wanted her to open her mouth!
CASE 2. BREAST TUMOURS IN OLDER
"What are those bluish lumps?" the young
lady asked me. "I check my dog daily and
saw them last week." The soft lumps
under the skin were present between MG4
and MG5 on the left side. MG = Mammary
"They are breast tumours," I said. "The
lumps may be cancerous if they grow
"What to do?"
"Surgery to remove them while they are
small in size," I said. "If they are
cancerous, they will spread to the other
breasts or grow to big sizes like
As the lady was worried about
anaesthesia, she chose to have a
complete blood test done to check
whether her dog was healthy. "Whether
she is healthy or not," I said. "Your
dog needs surgery if the breast tumours
grow big and fast. It will be too late
if you wait another few weeks."
Early spay will usually not result in
breast tumours in the female dog in the
majority of cases.
KIND TO OLDER DOGS & CATS --- GET TUMOURS REMOVED
EARLY --- WHEN THEY ARE SMALLER. More case
make an appointment: e-mail
tel: +65 9668-6469, 6254-3326
Be Kind To Pets
All rights reserved. Revised: November 27, 2010
Toa Payoh Vets