Symptoms of pyometra include reduced or loss of appetite, decreased water intake, leading to dehydration, vomiting, bloated appearance with a distended stomach, and visible discharge from the vulva.

Ovariohysterectomy is the surgical removal of a dog's uterus and ovaries, and it's the most effective way to treat pyometra. This surgery removes the infected uterus, preventing the risk of toxins entering the bloodstream and ensuring the condition won't return. Most dogs recover quickly and completely from this procedure, especially if the disease hasn't caused complications.

Risks: although generally safe, the surgery does carry some risks, such as potential rupture of the uterus or bleeding from the blood vessels in the uterus and ovaries. The procedure is performed under general anaesthesia. While anaesthesia is usually safe for healthy dogs, it becomes riskier if the dog is severely ill from advanced pyometra. In such cases, careful anaesthetic management is crucial.

Benefits: for most dogs, surgery is the best option, offering a quick and complete recovery with no risk of the disease returning. However, it's important to note that this procedure will make it impossible for the dog to breed in the future. In cases where surgery or anaesthesia poses too high a risk, medical treatment might be a better option.

Medical management is an alternative for dogs where preserving reproductive function is important or where surgery is too risky. The preferred medical treatment is Aglepristone (Alizin), which is more effective and safer than older treatments like prostaglandins and dopamine agonists. However, it's important to note that Alizin is not licensed for treating pyometra and must be prescribed by a vet under specific conditions.

Aglepristone blocks progesterone, a hormone involved in pyometra, helping the uterus to expel its contents and resolve the infection. Treatment typically involves a series of subcutaneous injections. Most dogs recover well, with studies showing success rates between 60-100%. However, unlike surgery, this treatment isn't permanent. Some dogs may experience another episode of pyometra. In a long-term Swedish study, 48% of treated dogs had another episode, with 27% of those occurring within the first year.

Due to the possibility of recurrence, surgery remains the preferred treatment for most dogs unless contra-indicated.