Abstract
BACKGROUND: Reproductive tract disorders are increasingly recognized in aging captive cheetahs (Acinonyx jubatus), a species listed as vulnerable by the International Union for Conservation of Nature. Pyometra is commonly reported in felids under human care; however, open ovariohysterectomy has traditionally been used for surgical treatment. CASE DESCRIPTION: We describe the first documented case of laparoscopic-assisted ovariohysterectomy for pyometra in a cheetah, with the incidental histopathological identification of endometriosis-a condition rarely reported in non-primate species and never before in wild felids. A captive female cheetah aged 9 years presented with progressive weight loss, inappetence, and mild polydipsia. Hematology revealed mild neutrophilia and azotemia. Abdominal ultrasonography revealed an enlarged, fluid-filled uterine horn suggestive of closed pyometra. Stabilization was achieved using sedation-assisted fluid therapy and antibiotic treatment. Laparoscopic-assisted ovariohysterectomy was performed using a three-port approach and a ring wound retractor for organ exteriorization. The procedure was completed uneventfully in 60 minutes. The postoperative recovery was rapid, with minimal complications.Gross and microscopic examination confirmed pyometra with suppurative endometritis. Additionally, we observed multifocal foci of ectopic endometrial glands within the mesometrium and mesosalpinx, consistent with endometriosis-marking the first report of this lesion in a cheetah. This case highlights the technical feasibility, safety, and postoperative advantages of laparoscopy for managing pyometra in large exotic felids. The use of a wound retraction system enabled atraumatic exteriorization of a moderately dilated uterine horn (diameter ~4 cm), a factor that typically limits laparoscopic intervention. Furthermore, the incidental finding of endometriosis expands the spectrum of known reproductive pathology in this species and prompts further investigation into its prevalence and pathogenesis in non-primate mammals. CONCLUSION: This report supports the application of minimally invasive techniques in wildlife medicine and contributes novel insights into the reproductive pathology of cheetahs, reinforcing the value of integrative surgical and histopathological approaches in the healthcare of exotic species.