Page 1241 - Cote clinical veterinary advisor dogs and cats 4th

620 Mammary Disorders, Non-Neoplastic

• Antiprolactin therapy may be administered ○ Androgens: testosterone enanthate or remove herself from the neonates (e.g., top
to stop lactation (cabergoline 5 mcg/kg PO testosterone cypionate 2 mg/kg IM once. of crate, raised platform).
VetBooks.ir • Systemic antibiotic treatment of the dam Chronic Treatment for a portion of their caloric intake,
NOTE: not approved for use in cats in the
q 24h; response usually seen within 3-4 days;
○ Pups/kittens will start eating solid food
> 80% response by day 7).
United States.
decreasing the amount of time they are
is required. General guidelines are initially
based on Gram stain and milk pH and on Mastectomy for intractable disease nursing on the dam. This also benefits the
dam by greatly reducing her metabolic
whether neonates are still nursing. Subse- requirements.
quently, culture and susceptibility (C/S) Nutrition/Diet • Older offspring with teeth nurse more aggres-
results are used for definitive treatment. To reduce galactostasis in dams if nursing sively and can cause bite and nail trauma to
The therapeutic goal is to achieve significant offspring are removed, food intake should be the mammary gland, greatly increasing the
antibiotic concentrations in the mammary reduced by 50%. Do not reduce food intake if risk of inflammation and infection.
tissue. neonates continue to nurse from lactating dams. • Frequently, chronic subclinical mastitis has
○ If neonates are still nursing, empirical been suspected when neonates fail to thrive.
options for gram-positive infections include Behavior/Exercise However, subclinical mastitis has not been
amoxicillin-clavulanic acid 12.75 mg/kg Limit activity that may induce mammary reported in dogs and cats.
PO q 12h or first-generation cephalo- trauma (e.g., neonates biting or scratching
sporins (e.g., cefadroxil 22 mg/kg PO q mammary glands). This may include weaning Prevention
8h); options for gram-negative infections puppies and kittens. • Mastitis
include cefoxitin 30 mg/kg IV q 6h or ○ Adequate husbandry, particularly clean
chloramphenicol 40 mg/kg PO q 8h. Drug Interactions bedding for mother and offspring
○ Antimicrobial choice can be adjusted as Antiprolactinics stop lactation. Some antibiot- ○ Keep mammary glands clean, monitor
appropriate after C/S becomes available, ics are contraindicated for lactating bitches. glands for trauma from offspring’s nails
while avoiding the use of aminoglycosides, Aglepristone is abortifacient in dogs and cats. or teeth.
sulfa drugs, tetracyclines, metronidazole, ○ Clipping offspring’s toenails
and floroquinolones (relative contraindica- Possible Complications • Mammary hyperplasia: limit the clinical use
tion) if neonates are still nursing. Systemic antibiotic therapy in lactating dams of exogenous progestogens.
○ If the dam is no longer nursing neonates, may interfere with normal bacterial colonization
empiric recommendations can include any of gastrointestinal flora in nursing neonates, Technician Tips
of the drugs used for nursing mothers or resulting in diarrhea. • Monitor neonates closely and record body
quinolones (e.g., enrofloxacin 5 mg/kg PO weight twice daily. If neonates are hungry but
q 12h for dogs or pradofloxacin 7.5 mg/ Recommended Monitoring spit the nipple out or they are not gaining
kg PO q 24h for cats) for gram-negative • Temperature, respiration, and heart rate weight, they should receive nutritional
aerobes; metronidazole 15 mg/kg PO q • Physical signs of septicemia supplementation. If neonates are nursing,
12h or clindamycin 5-11 mg/kg PO q 12h • Offspring that are nursing: weigh daily any ruptured gland should be covered. This
for anaerobes; tetracyclines (e.g., doxycy- (neonates, twice daily) to determine adequate protects the painful gland and prevents the
cline 5 mg/kg PO q 12h), erythromycin, milk intake. Neonates should gain ≈10% of neonates from exposure to bacteria.
or quinolones for Mycoplasma. their body weight each day. • Cabbage leaf wraps on affected glands are
• Warm-packing and ongoing nursing: unless reported to accelerate resolution.
the gland is necrotic, continued nursing by PROGNOSIS & OUTCOME
the offspring and warm-packing the affected Client Education
glands will prevent galactostasis and promote Prognosis is generally good unless sepsis occurs. Primarily husbandry issues of proper hygiene
drainage. and weaning instructions
Mammary hyperplasia: usually self-limited in PEARLS & CONSIDERATIONS
2-3 weeks: SUGGESTED READING
• Progesterone withdrawal: if sexually intact, Comments Lopate C: Reproductive physiology of canine
ovariectomy or ovariohysterectomy is recom- • Abscessed mammary glands that do not pregnancy and parturition and conditions of
mended to prevent recurrence. rupture and drain within 12 hours should the periparturient period. In Lopate C, editor:
• Pain control be surgically drained and debrided to Management of pregnant and neonatal dogs, cats,
• Medical therapy prevent endotoxemia in the dam and toxic and exotic pets, Ames, IA, 2012, Wiley-Blackwell,
○ Progesterone receptor blocker: aglepristone milk that puts the offspring at risk for pp 25-42.
15 mg/kg SQ q 24h × 2 days. NOTE: not infection. AUTHOR: Michael Peterson, DVM, MS
approved for use in cats in the United • Ultrasound exam revealing decreased vascular EDITOR: Michelle A. Kutzler, DVM, PhD, DACT
States; will abort pregnant cats; or flow to inflamed tissues indicates possible
○ Prolactin inhibitor: bromocriptine mesyl- onset of gangrene.
1
ate 0.25 mg/CAT PO q 24h × 5-7 days. • Pups/kittens 4 2 to 5 weeks old should be
NOTE: not approved for use in cats in the allowed access to dam’s food, and the bitch
United States; will abort pregnant cats; or or queen should have an area where she can

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