Pyometra, one of the most common gynecologic diseases in dogs, is a diestrus disease caused by bacterial agents in the uterus and characterized by a systemic inflammatory response syndrome (SIRS) in approximately 60 % of cases. As a result of overstimulation of progesterone, pathologies in the uterus and interaction with bacteria are observed. Escherichia coli, Streptococcus spp., Staphylococcus aureus, Proteus spp. and Pseudomonas spp. are the most commonly isolated [1,2]. Gram-negative bacteria, such as E. coli, cause severe disruption of leukocytes and uncontrolled production of inflammatory mediators with the lipopolysaccharides they secrete. Lipopolysaccharides are a component of the outer membrane of Gram-negative bacteria that act as endotoxins. These endotoxins trigger the recruitment and activation of cellular components such as macrophages, neutrophils, natural killer cells, and dendritic cells and also release a broad spectrum of extracellular mediators, such as cytokines, chemokines, and antimicrobial peptides. These mediators cause irreversible damage to the internal organs of the animal [3]. Due to endotoxemia, which is common in uterine infection and has fatal consequences, systemic inflammatory response syndrome (SIRS), sepsis, disseminated intravascular coagulation, and infection spreading to different organs, such as the myocardium or the eye, can cause severe dysfunction and a multiple organ dysfunction syndrome can be observed. Approximately 60 % of female dogs with pyometra develop sepsis [2]. Cases of pyometra with endotoxemia require urgent intervention due to the increased mortality rate [2,4].

SIRS is a set of events frequently observed in both veterinary and human medicine in which the body responds hematologically and immunologically to infectious or noninfectious causes [5,6]. SIRS is also observed after infection, burns, trauma, ischemia, toxins, anaphylaxis and some diseases [[7], [8], [9]].

The most common cause of SIRS is sepsis [10]. Sepsis is a condition mediated by endogenous mediators in which all organs and systems are affected, and it creates a more serious clinical picture than SIRS. As a result of inadequate response of the body to sepsis, severe sepsis, septic shock, disseminated intravascular coagulation, multiple organ dysfunction and death are observed in the following periods. Early diagnosis and treatment of SIRS and sepsis significantly reduce the mortality rate [11]. Although SIRS and sepsis are different concepts, they are inseparable in diagnosis and treatment. Early diagnosis of sepsis is important; early prediction of patients with poor prognosis is essential for urgent and correct intervention. According to current data, there is no gold standard diagnostic test for the diagnosis of sepsis.

Therefore, the use of scoring systems to predict patients' progression to sepsis is of increasing value [12]. The use of scoring systems in human medicine has been investigated for many years [13]. Finding an ideal scoring system that accurately predicts possible recurrences, risk of death, and length of hospital stay is important in selecting treatment options [6,14]. SIRS and quick sequential organ failure assessment (qSOFA) are two adjunctive scoring tools that are widely used in and outside the ICU setting worldwide [12,15]. qSOFA was developed because the SOFA score could not be used quickly in clinical practice. qSOFA criteria consist of measuring the respiratory rate per minute, mental status change, and systolic blood pressure. This scoring system is easy to evaluate, with 1 point given to each criterion and a maximum of 3 points in total. In a study conducted on dogs with pyometra, the qSOFA score was associated with mortality and hospital stay, and it was suggested that the qSOFA score could be used in risk determination in dogs with pyometra. The few studies in the veterinary literature on qSOFA and SIRS systems are mainly on general diseases [16,17] and prognosis [16,18,20].

In diseases such as pyometra with multiple organ damage and endotoxemia, fast, easily applicable and highly sensitive scoring systems should be developed in order not to miss sepsis, reduce delays in treatment and ensure successful treatment. In studies conducted in the field of veterinary medicine, more than one scoring system has been evaluated in different septic or nonseptic conditions. As a result of the studies, there are differences of opinion, and more studies are needed [16,17,19,20].

This study aims to evaluate the feasibility of using qSOFA and SIRS scoring systems at the bedside in dogs diagnosed with pyometra rapidly and independently of laboratory parameters. It aims to compare the findings obtained in dogs with pyometra with those of healthy animals and evaluate the effectiveness of the scoring systems in the diagnosis of dogs with pyometra at risk of sepsis. The results of the study aimed to determine which scoring system is fast, accurate and can be used repeatedly at the bedside and to investigate whether the scores used together or separately provide information about the diagnosis and to ensure the usability of the scores in clinical routine based on the data obtained.