Bitch with massive mammary hyperplasia

Re: Bitch with massive mammary hyperplasia

Anthony Todd — Sat, 25 Apr 2015 00:01:35 GMT

[quote user="Anthony Todd"]Search "mammary hyperplasia in cats" on Google.[/quote]

WikiVet has a good section, and spaying seems to be the way to go, in cats anyway, so sounds like I was wrong again..

Re: Bitch with massive mammary hyperplasia

Anthony Todd — Fri, 24 Apr 2015 23:53:19 GMT

"Should have read the thread first!"

Yes I should!

[Hangs head]

Re: Bitch with massive mammary hyperplasia

Michael Woodhouse — Fri, 24 Apr 2015 22:53:59 GMT

I was with you when you suggested spay.

If this was prolactin driven then you'd expect response to the cabergoline.

I still think there is likely to be an aberrant oestradiol source - ovarian cyst or theca cell tumour. That fits so much better, particularly with the anaemia.

Re: Bitch with massive mammary hyperplasia

Martin Atkinson — Fri, 24 Apr 2015 19:00:54 GMT

[quote user="Anthony Todd"]Yeah well, had I known that..... How poor is "poor"?[/quote]Should have read the thread first!

Revised figures from Axiom HCT 26.8% <37, HGB 8.8g/dl <12, MCH 23.9pg >23, MCHC 32.8g/dl (31-34), slight aniocytosis, scanty polychromatocytes, reticulocytes 89x10^9/l.

Re: Bitch with massive mammary hyperplasia

Anthony Todd — Fri, 24 Apr 2015 17:31:55 GMT

Search "mammary hyperplasia in cats" on Google.

May have some relevance?

PS "breast enlargement" goes down a different track entirely

Re: Bitch with massive mammary hyperplasia

Anthony Todd — Fri, 24 Apr 2015 17:26:15 GMT

[quote user="Martin Atkinson"] if she hadn't had such a worrying, poorly regenerative anaemia. [/quote]

Yeah well, had I known that..... How poor is "poor"?

Re: Bitch with massive mammary hyperplasia

Martin Atkinson — Fri, 24 Apr 2015 17:21:47 GMT

[quote user="Anthony Todd"]

I know PMI [Policy of Masterly Inactivity, a la Gordon Knight] is totally out of favour and has been replaced by multiple tests and procedures but just sometimes it's the best thing to do, obviously monitoring the animal coincidentally.

I'll bet London to a Jar of Jam it's hormonally related and will subside if you do nothing.

Give her a fortnight; if no improvement think again.

[/quote]This would be a sound approach if she hadn't had such a worrying, poorly regenerative anaemia. Leave her a fortnight and she might just be pushing up roses without a blood transfusion!

Re: Bitch with massive mammary hyperplasia

Anthony Todd — Fri, 24 Apr 2015 17:19:36 GMT

PS, insults and joking aside this is the real value of vetsurgeon.org!

Somewhere in the world some vet has, or will, get this presented to them and, hopefully, this case will help, 'cos it ain't easy and it's sort of unique.

Ask the dinovets 'cos they've been seeing 'em for longer and PMI may or may not have been revealing.

It's the sort of presentation that you will remember!!

Re: Bitch with massive mammary hyperplasia

Anthony Todd — Fri, 24 Apr 2015 17:12:17 GMT

[quote user="Martin Atkinson"]ust seen a 5 year old Tibetan Terrier bitch with a massive mammary hyperplasia in all her mammary glands which was treated last week for the same. It was assumed to be a pseudopregnancy at is was 4-6 weeks post oestrus and pregnancy diagnosis was negative. She was given Galastop at the recommended dose for 6 days with no effect. There is no milk or discharge, glands are not painful or inflammed just very enlarged and hard, her temperature is sub-normal (100F), she is quiet but eating and drinking normally. Just doing haematology but results not available until tomorrow morning. [/quote]

Well, going on your history and the fact that the mammary glands are, I remember, outside the abdomen even I wouldn't dream of an ex-lap; spaying her may well end up with persistent abnormal glands to say nothing of the incisional problems you may have with the spay.

Might pay to get the previous history too ie has it happened before etc....

Do you really think you can rely on an ultrasound to give you enough information to confidently do something??

I'll bet London to a Jar of Jam it's hormonally related and will subside if you do nothing.

Give her a fortnight; if no improvement think again.

Re: Bitch with massive mammary hyperplasia

Luca Poddighe — Fri, 24 Apr 2015 17:12:14 GMT

I thought she might have come to you as a second opinion or such... sorry! Anyway cabergoline is luteolytic so it was a sensible approach.

Re: Bitch with massive mammary hyperplasia

Martin Atkinson — Fri, 24 Apr 2015 16:21:03 GMT

[quote user="Luca Poddighe"]

I have a question... when she was started with cabergoline did she have milk production? I understand that was done by somebody else but you should have the history.

[/quote]I'm a solo vet so it so only me who has seen the case. Sorry if it was not clear in the OP but the answer is no, there has never been any milk or obvious behavioural signs. She was brought in for a pregnancy diagnosis because the owners thought she had a lot of mammary development. It immediately struck me it as very odd but I thought that I might as well try some cabergoline first.

Re: Bitch with massive mammary hyperplasia

Luca Poddighe — Fri, 24 Apr 2015 15:32:39 GMT

I have a question... when she was started with cabergoline did she have milk production? I understand that was done by somebody else but you should have the history.

Re: Bitch with massive mammary hyperplasia

Martin Atkinson — Fri, 24 Apr 2015 15:30:18 GMT

[quote user="Anthony Todd"]There's no way any dinovet would spay with these sort of signs. [/quote]I thought that would flush you out of the woodwork!

The dinovet reference was more that dinos are more likely to just go with the exp lap and be damned than faff around with fancy imaging and blood tests like mod-vets do while the animal just gets progressively worse and you have to do the op anyway!

However this is not a typical pseudopregnancy by any means and, like others, if it was I would not be even contemplating spaying.

Is your supposition that it will return to normal in 3 months based on anything other than a guess or have you seen something like this in the past and can give that invaluable information confidently?

Re: Bitch with massive mammary hyperplasia

Anthony Todd — Fri, 24 Apr 2015 14:56:59 GMT

[quote user="Martin Atkinson"]So I surpressed the dinovet urges and aborted the spay[/quote]

There's no way any dinovet would spay with these sort of signs.

Having been through the drama of persistent FPs, anything to do with overactive mammary glands is a red flag for a spay, as far as I was concerned.

My guess is that the glands will return to normal overtime, say three months, despite, all the tests and exams and then I'd spay her for sure.

I think dinovets had, and have, a more wait-and-see attitude in conditions which are related to a reproductive cycle.

Re: Bitch with massive mammary hyperplasia

Kate Richardson — Fri, 24 Apr 2015 13:57:05 GMT

- interesting

Re: Bitch with massive mammary hyperplasia

Martin Atkinson — Fri, 24 Apr 2015 13:15:10 GMT

[quote user="Kate Richardson"]I would talk to them first.[/quote]Hi Kate, I took your advice and spoke to a nice American lady at CEVA who had a word with her senior colleague. They were as stumped as we are but did recommend not jumping in at the deep-end. So I surpressed the dinovet urges and aborted the spay especially as her anaemia is slight better or at least no worse depending on who's PCV result you trust and the glands felt a little softer. I am now going to refer for ultrasound and monitor things. Also did a slide agglutination test which was negative and have sent a sample for SPE.

Re: Bitch with massive mammary hyperplasia

Kate Richardson — Fri, 24 Apr 2015 09:38:34 GMT

Yes I saw your post. I would still talk to them though as they are sooooo helpful with things like this. As all glands are affected then it does sound hormonal, and it may be that speying IS the answer, but I would talk to them first.

Re: Bitch with massive mammary hyperplasia

Martin Atkinson — Fri, 24 Apr 2015 09:01:47 GMT

I did see your other thread Kate which is why I asked you to comment on this one. The difference is that their is no milk. There is no mastitis - no pain, no inflammation, normal WBC count, normal/low temperature, dog well, all glands affected equally. It looks just like a cat with fibro-adenomatous hyperplasia.

Re: Bitch with massive mammary hyperplasia

Kate Richardson — Thu, 23 Apr 2015 21:36:15 GMT

Speak to the galastop manufacturers and virbac- both really helpful with repro/hormonal questions. Galastop guys ?ceva were great with our post Spey pseudo pregnancy problems (see other thread). I wouldn't rush in to Spey until you've spoken to them as the timing may be crucial with regards to switching off negative feedback systems. Alternatively is it poss a mastitis? Have you tried antibiotics/anti-inflammatories at all?

Re: Bitch with massive mammary hyperplasia

Kate Richardson — Thu, 23 Apr 2015 21:36:15 GMT

Re: Bitch with massive mammary hyperplasia

Martin Atkinson — Thu, 23 Apr 2015 14:17:19 GMT

[quote user="Richard Carter"]

anaemia fits with oestrogen toxicity so probably does have functional ovarian cyst?

Just to be looking for the weird, what is the albumin/ globulin ratio like (thinking of lymphoma/ lymphocytic type reaction in lymphatics)

[/quote]I was thinking more the anaemia was iatrogenic due to the cabergoline but admittedly it is a bit profound for 6 days of that: HCT 30.9% <37, HGB 8.7g/dl <12, MCHC 28.2. Haven't done any biochem/proteins/electrolytes didn't think it was relevant at this stage and EDTA sample has gone to Axiom for haematology to confirm/check if regenerative or not.

Re: Bitch with massive mammary hyperplasia

Richard Carter — Thu, 23 Apr 2015 13:46:56 GMT

anaemia fits with oestrogen toxicity so probably does have functional ovarian cyst?

Just to be looking for the weird, what is the albumin/ globulin ratio like (thinking of lymphoma/ lymphocytic type reaction in lymphatics)

Re: Bitch with massive mammary hyperplasia

Elivet — Thu, 23 Apr 2015 13:11:23 GMT

Interesting! Please keep us posted on the progress.

Re: Bitch with massive mammary hyperplasia

Mark Hedberg — Thu, 23 Apr 2015 13:04:13 GMT

There are quite a few used and refurbished ultrasounds available online; also consider ex-human ones. This is off ebay!

Veterinary Ultrasound Scanner with 7.5Mhz Rectal Probe, CONTEC CMS600P2 vet

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Re: Bitch with massive mammary hyperplasia

Martin Atkinson — Thu, 23 Apr 2015 11:47:27 GMT

Don't have ultrasound, old one broke and can't justify new one as near retirement/dinovet age. So will probably discuss with owner and just spay but I'll give them an option of referral. Also anaemic (awaiting full lab results) so worried further hormonal therapy may make this worse.