Enlarged uterus on the lateral radiograph of the bitch
9-year-old entire bitch with polyuria, polydipsia and lethargy, 5 weeks after oestrus. Lateral abdominal radiograph; the author of the image has drawn white lines around a soft-tissue opacity:
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Which statement about the radiographic appearance of an enlarged uterus is correct?
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A. It is a tubular soft-tissue structure in the caudal and ventral abdomen that displaces the bowel cranially and dorsally
Correct. The distended uterus occupies the caudal and mid-ventral abdomen, folds on itself and displaces the small intestine cranially and dorsally. Soft-tissue loops without gas in that area in an entire bitch should make you think of the uterus.
B. A normal non-pregnant uterus is always visible on the lateral radiograph of an entire bitch
The normal non-pregnant uterus is thin and usually cannot be distinguished from the bowel loops; when it is seen as a tubular structure, it is enlarged.
C. Radiography distinguishes pyometra from a 30-day pregnancy by the opacity of the contents
Before the fetal skeleton mineralises (around days 42–45), a pregnant uterus and a fluid-filled one have the same opacity. Ultrasound is used to tell them apart.
D. The enlarged uterus displaces the colon ventrally and the bladder dorsally
The uterine body lies between the colon, dorsally, and the bladder, ventrally. If it displaces them, the colon moves dorsally and the bladder ventrally or caudally.
lightbulb Key takeaway
An unwell entire bitch with tubular soft-tissue structures in the caudal abdomen: think of pyometra and confirm it with ultrasound. A normal radiograph does not rule it out, because a mildly distended uterus may not be visible.
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Updated: October 31, 2026 · Educational content for veterinary professionals. It does not replace current clinical guidelines or the judgement of the attending veterinarian.