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Mammary Disorders, Non-Neoplastic 619

incidence is 40%-50% after ovulation in cats Etiology and Pathophysiology influence an antibiotic’s ability to penetrate
with pseudocyesis. Mastitis: the mammary gland. For example, when milk
VetBooks.ir ASSOCIATED DISORDERS hygiene, traumatic nursing) or hematogenous milk. The pH can be determined using a Diseases and Disorders
pH > 7.0, cephalosporins concentrate in the
• Possible ascending bacterial infection (poor
spread of fungal infection (e.g., Blastomyces
Mastitis:
urine dipstick.
dermatitidis)
• Galactostasis after weaning or overt
pseudopregnancy • Incidence highest for stimulated mammary Advanced or Confirmatory Testing
• Benign mammary hyperplasia in queens glands; may be due to presence of abundant • Bacterial culture and susceptibility of
• May be associated with mammary neoplasia substrate (milk), open ducts, trauma from mammary secretions
Mammary hyperplasia: nursing, and increased trauma because glands • Serum and milk acute phase proteins
• Secondary mastitis and/or necrosis are enlarged (e.g., haptoglobin, C-reactive protein)
Mammary hyperplasia: can be used as an indicator of subclinical
Clinical Presentation • Hormonally-induced condition: hormones mastitis.
DISEASE FORMS/SUBTYPES include progesterone (endogenous or exog- • Ultrasonography of mammary tissue (loss of
• Mastitis: acute, fulminant, or chronic/nearly enous), growth hormone, and prolactin. distinct layering of the tissue is characteristic
subclinical of mastitis and inflamed regions have reduced
• Mammary hyperplasia: acute DIAGNOSIS echogenicity)
• Biopsy of mammary tissue (to rule out
HISTORY, CHIEF COMPLAINT Diagnostic Overview neoplasia and benign mammary hyperplasia)
• Mastitis History and physical exam are generally suffi-
○ Lactating bitch or queen: uncomfortable cient to formulate a diagnosis: enlarged, painful TREATMENT
dam may or may not want to nurse mammary glands (usually during lactation) in
offspring; neonates do not nurse (crying mastitis patients or rapidly enlarged, nonseptic Treatment Overview
puppies or kittens) mammary glands in cats with mammary • Goals of treatment of mastitis are returning
○ Rarely occurs after an overt false hyperplasia. the patient to normal mammary function
pregnancy/pseudocyesis (bitch) and preventing septicemia.
• Mammary hyperplasia: acute enlargement Differential Diagnosis • Goals for treatment of mammary hyperplasia
of mammary glands • Mammary adenocarcinoma (inflamed or are to prevent mastitis.
septic) usually in older females with no
PHYSICAL EXAM FINDINGS concurrent lactation (pp. 621 and 623) Acute General Treatment
Mastitis: • Galactostasis: dam not ill, nonseptic Mastitis:
• Mammary signs: firm, warm, swollen, • If mammary necrosis is present or milk is
often painful mammary gland (one or Initial Database too contaminated for puppies and kittens
more); it may be possible to express • CBC: unremarkable or leukocytosis +/− left (i.e., grossly purulent/malodorous milk or
purulent or discolored milk from gland; shift; leukopenia possible if acute sepsis (mas- neonates are hungry, showing diarrhea/
gland may abscess, become ischemic, and titis); within normal limits with mammary weight loss), offspring should be removed
rupture. hyperplasia and the necrotic tissue surgically drained
• Systemic signs: lethargy, dehydration, ± fever; • Cytologic exam of mammary secretions: in and debrided.
may progress to septic shock mastitis, many toxic neutrophils; in mammary
• Mammary hyperplasia: enlarged mammary hyperplasia, few to moderate epithelial cells
glands (all glands usually involved; can be • Milk pH: normal milk pH = 6.3; with
painful; can develop necrosis) mastitis, pH of mammary secretions can

MAMMARY DISORDERS, NON-NEOPLAS-
TIC Gross appearance of fibroepithelial hyperplasia
in a young cat. (From Lana SE, et al: Tumors of the
mammary gland. In Withrow & MacEwen’s Small
MAMMARY DISORDERS, NON-NEOPLASTIC Gangrenous mastitis in a Lagotto Romagnolo bitch. Affected animal clinical oncology (4th ed) St. Louis, 2007,
area has been outlined with a black marker. (Used with permission from Cathy Gartley, DVM, DVSc, DACT.) Saunders, pp 619-636.)

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