Page 1007 - Small Animal Internal Medicine, 6th Edition

CHAPTER 55 Clinical Conditions of the Bitch and Queen 979

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FIG 55.32
+ Ultrasonographic evaluation of mastitis (cursors).
(A) Cellulitis. (B) Abscessation, surgery is
indicated.

A B

sensitivities force the choice of a drug potentially toxic to
neonates. Warm compresses or whirlpool therapy of the
affected gland, with gentle stripping of milk, can potentially
avert abscessation and rupture of the gland. Serial ultraso-
nography can help identify abscessation (Fig. 55.32, A, 55.32,
B). Severe necrosis warrants debridement or mastectomy
when the dam is stabilized, as well as more aggressive wound
management. Antiprolactin therapy (cabergoline, 1.5-5 µg/
kg/day, divided bid) may be indicated in severe cases to
reduce lactation. There is no evidence that nursing from
affected glands is problematic for neonates; they tend to
avoid glands that are difficult to obtain milk from and are
already exposed to flora in the box. The affected gland should
be protected from trauma from nest box edges and neonatal
claws. Mastitis can recur in subsequent lactations regardless FIG 55.33
of preventive measures. Early detection and treatment is Feline mammary hyperplasia of 6 weeks’ duration in a
optimal, rather than prophylactic, antibiotics, which tend to 5-month-old queen. (Image courtesy Dr. Cheri Johnson.)
favor development of resistant organisms rather than pre-
venting mastitis.

Feline Mammary Fibroadenomatous therapy, as well as antiprolactin therapy (cabergoline
Hyperplasia 1.5-5 µg/kg PO q24h for 5-7 days), can be helpful. Mastec-
Feline mammary fibroadenomatous hyperplasia is a non- tomy can be indicated in severe cases. Progestin therapy
neoplastic progesterone-mediated condition usually found should be discontinued in neutered cats. More recently, the
in pregnant or pseudopregnant queens or in neutered male progesterone antagonist aglepristone (Alizine [Virbac]) has
or female cats given exogenous progestins, most commonly been used successfully to treat fibroadenomatous hyperpla-
methylprednisolone acetate (Depo-Medrol [Upjohn]). Pro- sia (10-15 mg/kg SC on days 1, 2, and 8) but is not yet avail-
gestins are most commonly used for behavioral or antiin- able in the United States.
flammatory therapy in cats. Cats present with mammary
enlargement involving one or more glands; the enlargement
is due to rapid proliferation of mammary duct epithelium DISORDERS OF THE REPRODUCTIVE
and stroma (Fig. 55.33). Hyperplastic mammary tissue may TRACT IN OVARIOHYSTERECTOMIZED
undergo spontaneous regression or progress to mastitis with BITCHES AND QUEENS
abscessation and gangrene. Mammary hyperplasia must be
distinguished from mammary neoplasia, by cytology or Despite the majority of client-owned pets in the United
biopsy. Ovariohysterectomy (if intact) prevents recurrence. States being neutered, veterinarians are commonly con-
NSAID (licensed for use in felines) and antimicrobial fronted with disorders of the (residual) genitourinary tract.