Page 1160 - Problem-Based Feline Medicine

1152 PART 14 QUEEN AND KITTEN WITH PROBLEMS

Treatment Cystic endometrial hyperplasia is associated with
infertility from implantation failure or early embry-
Mate the queen to see if breeding can ovulate the
onic death.
cysts.
The incidence of cystic endometrial hyperplasia
Try to induce follicular rupture with hCG (predomin-
increases with age. It can be seen as early as 5–6 years
antly LH); 250 IU IM daily for 2 days.
but is more likely from 10 years of age. It is more
Surgical removal of the cyst(s). Cysts can be ruptured common in nulliparous queens than in multiparous
mechanically, or if only one ovary is involved then queens.
remove the ovary if the cyst is large.
Clinical signs
Prognosis
The queen is apparently healthy, with normal estrus
Prognosis is good for future pregnancies if the cysts can cycles. Mating behavior is normal but no litter eventu-
be ruptured by one of the methods above. ates.

Prevention Diagnosis

Do not allow a young queen frequent estrus cycles Abdominal ultrasound may be able to visualize the
without mating. Breed queens frequently, long periods cysts in the uterine wall and is a non-invasive way of
of estrus without mating are conducive to the formation detecting the condition.
of cystic ovaries. The statement “Queens should be
Exploratory laparotomy and biopsy of the uterus pro-
pregnant, lactating or both” is often quoted as being the
vide a definitive diagnosis.
ideal for good reproductive health.
Differential diagnosis
CYSTIC ENDOMETRIAL HYPERPLASIA**
Other causes of normal mating but failure to produce a
Classical signs litter.
● Poor general health of the queen. A history and
● Normal estrus cycles and mating but
physical examination should detect any problems.
failure to produce a litter.
● Fertility and mating problems of the male cat. A his-
tory of recently siring litters and observations of
Pathogenesis normal mating are reassuring of fertility of the stud.
● Management practices should be checked to ensure
Cystic endometrial hyperplasia involves chronic
that they allow an adequate number of matings to
hyperplasia and cystic glandular development of the
produce ovulation.
endometrium.
● Reproductive tract abnormalities. Ultrasonography
In the dog, these changes have been produced by pro- may reveal neoplasia. An exploratory laparotomy will
longed exposure to progesterone. be necessary to detect developmental abnormalities,
and biopsy of the uterus to detect abnormal conditions
This mechanism may be possible in those cats that
such as cystic endometrial hyperplasia or neoplasia.
undergo serial spontaneous ovulations and hence pro-
Cystic endometrial hyperplasia is a relatively com-
longed exposure of the uterus to progesterone. However,
mon cause of the problem.
spontaneous ovulation is an uncommon occurrence in
cats.
Treatment
Usually intact non-pregnant females undergo waves of
follicular development and then atresia. Therefore, in Once the endometrium has undergone cystic change,
cats the changes in the endometrium are likely caused there does not seem to be a treatment that reverses the
by estrogens. changes.