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A healthy female Labrador Retriever was referred to the Reproduction Unit for a gynecological examination and for monitoring the cycle in view of the mating. The bitch underwent natural mating and the pregnancy diagnosis was performed on the 35th day after mating. The ultrasound examination revealed a mono gestational pregnancy and the presence of a parenclyymatous structure with very scarse liquid component consistent with the remaining of an empty gestational sac. At the end of the pregnancy a caesarean section was needed. The puppy was alive and apparently healthy. After ovariohysterectomy different nodular structures were observed on the endometrium of both uterine horns. A histopathological examination diagnosed a Pseudoplacentational Endometrial Hyperplasia (PEH) a not so common pathological finding often misdiagnosed as a common gstic endometrial hyperplasia.

La piometra e l’ascesso prostatico sono, rispettivamente nella cagna e nel cane maschio, patologie spesso gravi e potenzialmente mortali che colpiscono l’apparato genitale. Esse determinano comunemente un coinvolgimento sistemico legato alla diffusione di microrganismi o loro tossine dal focolaio d’infezione primaria; ne consegue uno stato di sepsi che, non di rado, progredisce in sepsi grave, disfunzione multiorganica (MODS), shock e in ultimo determina morte. Per garantire una corretta gestione di queste patologie, considerate emergenze medico-chirurgiche, e della sepsi ad esse associata, acquista crescente importanza l’individuazione di marker che agevolino l’esecuzione di una rapida e corretta diagnosi, consentano di stabilire la gravità del quadro clinico e permettano in certa misura di anticipare la prognosi del paziente. Scopo del presente lavoro è stato quello di valutare il significato prognostico di alcuni indicatori clinici e clinicopatologici in una popolazione di cani affetti da piometra o prostatite/ascesso prostatico, considerati inoltre un modello di sepsi spontanea. Le variabili correlate più significativamente con la prognosi includevano quelle associate al danno d’organo, ad alterazione dell’emostasi e a squilibri emodinamici, confermando che MODS e shock giocano un ruolo centrale nell’aumentare la mortalità tra i pazienti settici. I livelli ematici di Cratinina, Urea, Fosforo, Potassio, Cloro, Bilirubina, AST e Lattato e il valore di aPTT sono stati significativamente associati con l’outcome dei pazienti esaminati. Inoltre, un punteggio APPLEfast>25/50 è stato correlato ad aumento del rischio di morte all’interno della popolazione di studio. Questo lavoro ha inoltre rivelato l’interesse diagnostico di un parametro ematologico di decente definizione, il Delta Neutrophil Index (DNI), in relazione alla sepsi nel cane. Sebbene non direttamente associato con la prognosi, il DNI si è dimostrato un buon indicatore della gravità del quadro clinico, mostrando elevate sensibilità e specificità nel prevedere la presenza di shock settico (Se=100% and Sp=91,3% con DNI > 16,6%, P, Pyometra and prostatitis with prostatic abscessation are potentially life-threatening diseases affecting the reproductive tract of the female and male dog, respectively. Both these conditions are commonly associated with systemic illness caused by the diffusion of microorganisms and their toxins from the sites of primary infection into the bloodstream; this leads to sepsis which not rarely develops into severe sepsis, multiple organ dysfunction (MODS), septic shock and, finally, death. For these reasons the above mentioned diseases are accepted as medical and/or surgical emergencies and managed accordingly; in this view, the identification of markers which can be potentially useful to achieve a prompt and correct diagnosis, to assess the disease severity and to predict the patient outcome, acquires increasing importance. The aim of the present study was to evaluate the prognostic significance of some clinical and clinicopathological markers in a population of dogs affected by pyometra or prostatitis/prostatic abscess, also regarded as a model of natural-occurring sepsis. The variables which were more significantly related to prognosis included those associated with organ dysfunction, impairment of haemostasis and haemodynamic disorders, proving that MODS and shock play a central role in increasing mortality among septic patients; blood levels of Creatinine, Urea, Phosphate, Potassium, Chloride, Bilirubin, AST and Lactate and the value of aPTT were significantly associated with the patients’ outcome in our research. Moreover, an APPLEfastscore > 25/50 showed significance in predicting mortality in the study population. This work also revealed the diagnostic importance of a recently defined haematologic parameter, Delta Neutrophil Index (DNI), in canine sepsis. Although not directly associated with prognosis, it proved to be a good marker of disease severity, showing high sensitivity and specificity in predicting the presence of septic shock (Se=100% and Sp=91,3% for DNI > 16,6%, P

Blood lactate concentration is known to be a good prognostic indicator associated with the severity of illness and the patient's outcome both in human and veterinary medicine. It also plays a significant role in the assessment of the newborn, being a good indicator of fetal hypoxia and the ideal predictor of morbidity at term in babies. In veterinary neonatal medicine, hyperlactatemia is considered a valid prognostic marker in critically ill foals; moreover, blood lactate measurement has been proposed for the evaluation of newborn viability and the assessment of fetal distress during delivery in dogs. Unfortunately, only a few studies have been published concerning the canine species. The present work examines 67 brachycephalic newborn dogs and their mothers, with the aim to evaluate the time-dependent changes of blood lactate and glucose concentration during the first 24 h after vaginal or caesarean delivery both in puppies and bitches. To our knowledge, this is the first published study examining the time-dependent changes of these parameters in the bitch after parturition. Within the studied population of puppies, non-surviving was significantly associated with a higher lactatemia and a lower APGAR score. Blood lactate was high at birth then progressively decreased during the first 24 h of life and a lack of normalization of blood lactate levels within this time interval was suggestive for a poor prognosis for the newborn dogs; moreover, the decrease appeared to be slower after vaginal delivery. Lactatemia also showed a positive correlation with glycemia at birth. Concerning the bitches examined, blood lactate was found to be significantly higher after vaginal delivery than after caesarean section; the normalization occurred within 24 h after parturition. Blood glucose level was significantly higher at 2 h from delivery both in the group of bitches submitted to caesarean section and in those undergoing natural whelping but no statistical correlation was found between maternal glycemia and lactatemia. The results of the present study highlighted that the monitoring of lactatemia during the first 24 h of life, in association with the assessment of the APGAR score at birth, can be an useful prognostic tool helping to identify the most severely distressed puppies and to provide them an adequate support.