Which test do you prefer for feline ovarian remnants?

RE: Which test do you prefer for feline ovarian remnants?

Kate Richardson — Sat, 27 Apr 2024 10:13:19 GMT

As a related tangent to this, what would people recommend for a male neutered cat showing male sexual behaviour? I have just seen a 1y5m cat, neutered at 9weeks of age, started humping blankets and soft toys at about 12m of age, and has continued to do this intermittently, bites the toy as he would a female cat. No other male physical or behavioural characteristics. Unable to extrude his penis to examine it unfortunately, so have sent bloods to check basal testosterone. As far as I am aware normal castration procedure albeit they would have been tiny.

RE: Which test do you prefer for feline ovarian remnants?

David Mills — Sat, 27 Apr 2024 01:05:38 GMT

veterinaryevidence.org/.../356

RE: Which test do you prefer for feline ovarian remnants?

Clive Ansell — Mon, 15 Apr 2024 13:47:44 GMT

[quote userid="9440" url="~/f/clinical-questions/30919/which-test-do-you-prefer-for-feline-ovarian-remnants/244315#244315"]Perhaps I just didn’t find a remnant but I found the ovarian vessels either side with no visible ovaries and am now stumped . [/quote]

I was involved with a case, over 20 years ago, where a Labrador bitch came back into season 6 months post spay. At revision surgery, ovarian pedicles were clear, but a tiny, 1mm, piece of ovary was found at the cervical stump, presumably auto-transplanted from one of the clamps. Confirmed by histopathology.

RE: Which test do you prefer for feline ovarian remnants?

Clive Ansell — Mon, 15 Apr 2024 13:42:50 GMT

I've had a run of cats over the last 3 - 4 months, with part or sometimes whole retained ovaries, and all except one of the suspect cases we blood tested came back positive with an AMD hormone test. Some we took straight to surgery without testing and found ovarian remnants too

One exception, was a cat from a breeding colony that the breeder owner insisted showed signs of oestrus and MUST have had retained ovarian tissue. Tested negative for AMD hormone, and no findings at surgery. We are wondering whether the behaviour is connected to the other unneutered in season cats, either by direct contact or via pheromone?

RE: Which test do you prefer for feline ovarian remnants?

Helena Rymaszewska — Mon, 15 Apr 2024 10:32:56 GMT

Your cat 's owner has nt started using HRT has she ?

eg the rub in oestrogen gel or patches? as i believe there is anecdotal evidence of neutered dogs/cats showing oestrus signs after being in contact with HRT.

RE: Which test do you prefer for feline ovarian remnants?

Anthony Dennison — Mon, 15 Apr 2024 10:19:22 GMT

[quote userid="2675" url="~/f/clinical-questions/30919/which-test-do-you-prefer-for-feline-ovarian-remnants/244103#244103"]The lab we use recommended AMH in cat showing behaviour of oestrus[/quote]

We always use this - if it is negative client bears the cost, if it is positive it's FOC

[quote userid="3169" url="~/f/clinical-questions/30919/which-test-do-you-prefer-for-feline-ovarian-remnants/244112#244112"]If showing heat, its as cheap having a look than doing hormone testing - especially if you are doing it all FOC.[/quote]

True, but then you could avoid an unnecessary surgery with a blood test, so it's swings and roundabouts.

[quote userid="8663" url="~/f/clinical-questions/30919/which-test-do-you-prefer-for-feline-ovarian-remnants/244131#244131"]But it is demonstrably less traumatic to the patient (there's a paper on this with my name on it)[/quote]

There's a paper about spay technique with my name on it too - Vet Record in 2012 IIRC. It was describing the flank spay method of bitch spays done at a neutering clinic in Jaipur. I do remember with my research (and this was in the discussion), it didn't matter about the technique used, it was the surgeon's experience that was the deciding factor.

So in terms of this discussion, Alasdair will have similar outcomes of post-op measurements doing lap spays that David would have doing midline coeliotomy approach, and vice-versa the other way around.

RE: Which test do you prefer for feline ovarian remnants?

janine redman — Sun, 14 Apr 2024 18:17:23 GMT

So I have a client with a cat she says is “calling” and desperately trying to get outside to a Tom cat who has tried to mate with her . Progesterone level 2.85 , ex laparotomy and no obvious ovaries except a vascularised nodule in the remnants of the broad ligaments which I assumed was ovarian tissue . However it has come back as a lymphofollicular reactive tissue . Perhaps I just didn’t find a remnant but I found the ovarian vessels either side with no visible ovaries and am now stumped .
do I go back in ?
cat is eight and spayed a couple of years ago apparently

RE: Which test do you prefer for feline ovarian remnants?

Evelyn Barbour-Hill — Tue, 26 Mar 2024 14:11:48 GMT

How would you eat a slice of melon with chopsticks?

Roald Dahl, in "Going Solo", does describe learning to eat an orange with a knife and fork.

RE: Which test do you prefer for feline ovarian remnants?

Alasdair Hotston Moore — Tue, 26 Mar 2024 09:39:32 GMT

My opinion is that they are better. Your opinion seems to be equivocal (although you offer the surgery and have done for a few months). Both are valid viewpoints of course. I am aware of no studies that show lap spays are worse in any sense, and several suggesting they are better (pain, indicators of tissue trauma) so surely opinions should also take account of evidence?.

I’m sorry if you’ve had any fatalities. I haven’t. I had a couple of bleeders early on but not for a decade (that have needed any more than another quick zap). Never had a sudden death.

Im sure I dont do as many of either as you, although I spent two days a week for many years assisting students learning how to spay so I do have some experience of traditional surgery (and the challenges it presents) as well as lap spays

RE: Which test do you prefer for feline ovarian remnants?

David Mills — Mon, 25 Mar 2024 17:10:28 GMT

This opens up all sorts of issues for me. I have been doing lap spays for the last 6 months and normal spays for 16 years. Some observations.

Total GA time is much longer in lap spays because of the faffing around with the kit and the length of procedure. Whilst an assistant can help with some of this, they aren't always available in 1st opinion and some training is required. So most lap spays from induction to finishing are at least an hour, often longer. I can spay most bitches regardless of size in about 15-20 minutes, often quicker, through a 3-4cm hole, often smaller. For cats, including this case, I would expect it to be a 10 minute op max, probably less. As said, the total hole size would be similar. By the time the lap spay is set up I would normally expect to be almost finished a traditional spay.

Referral practitioners carrying out spays in any study comparing them with lap spays is a poor comparison - they aren't the best people to be spaying animals and will be both slower and less familiar with the technique, be more traumatic and therefore skew the results.

Traditional spays will form some adhesions as there is foreign material left behind. The significance of this is minimal. Human studies have no place here because women don't get spayed like dogs or cats. I would expect some fibrosis in this case which may preclude adequate visualisation around the kidney. This increases the risk of not finding the remnant, or spending a lot of time doing so, and may increase risk of thermal renal damage. In cases such as this cat, digital confirmation of ovarian tissue would be very helpful.

Lap spays are not without risks either. There are a small number that die under GA when the abdo is inflated. Haemorrhage is possible. Losing the ovary, or incompletely removing it are possible.

The opinion that lap spays are better is just that - opinion. For referral surgeons they probably are as quick, and associated with less trauma. But that isn't necessarily the case for the vast majority of vets.

RE: Which test do you prefer for feline ovarian remnants?

Alasdair Hotston Moore — Mon, 25 Mar 2024 14:47:33 GMT

Not sure what to make of that Alastair. Compliment or criticism? I'll accept either and smile.

Regarding the points at hand here:

the advantage of laparoscopy isn't just the size of the approach David Mills. There is less retraction and better visualisation of certain structures (and the ovarian pedicles are an excellent example). I wouldn't routinely do lap OHE in cats myself, it's an expensive faff. But it is demonstrably less traumatic to the patient (there's a paper on this with my name on it)

Time wise? if lap spays (as an example) are taking 4 X as long as open spays, something is very wrong. Surgery time can be similar (setting up time adds some but is reduced with a good nurse team and practice)

Adhesions needn't be a bar to either open or lap sx, but if there is lots, that's a reflection on the original technique (and in people adhesions are less after laparoscopy than open sx, as an aside)

Cost? Well, for ovarian remnant the charge to the client is hard to know from here. If the complication arises in the same clinic as the original surgery, then it's usually not charged. And if it's managed elsewhere, often VDS will pay to keep everyone happy. How much is charged for the laparoscopy is in the hands of the managers of the clinic.

As Alastair says, it is an elegant solution. And actually a practical and better one than another guddle round inside. But in the end, it's up to the clinician on the floor as to which to suggest to the client.

RE: Which test do you prefer for feline ovarian remnants?

Alastair Welch — Mon, 25 Mar 2024 13:05:06 GMT

What a nice example of the dichotomy within our profession. On one hand we have experienced 'coal-face' VS advocating a low tech solution to this issue, and one that even 24 years since I opened a cat's abdomen I would feel pretty comfortable doing. One the other hand we have an internationally recognised specialist (although not Specialist) offering what seems a very elegant albeit technically demanding option. In terms of cost there is probably an order of magnitude difference between them. I'm pretty sure that in human medicine a laparoscopic approach would be seen as the 'better' option but whether that is true in a cat is perhaps less clear.

RE: Which test do you prefer for feline ovarian remnants?

David Mills — Sun, 24 Mar 2024 23:15:45 GMT

Alasdair Hotston Moore In a cat?

A 2 port laproscopy wound would ordinarily be bigger summarily than a midline incision, take 4x ga time and if there's any fibrosis good luck.

Genuinely bemused/interested

RE: Which test do you prefer for feline ovarian remnants?

Clive Ansell — Sun, 24 Mar 2024 11:31:02 GMT

Thanks all for your thoughts.

We are getting a run of these, had 4 so far in the last month and others booked in I believe. Differing opinion between colleagues as to whether blood tests should be run first. What is the accuracy of the blood tests?

The 4 I have operated on so far, I have found the whole or partial ovary very easily, so tend to think just book for surgery.

RE: Which test do you prefer for feline ovarian remnants?

Alasdair Hotston Moore — Sat, 23 Mar 2024 22:00:32 GMT

My go to is laparoscopy. The blood tests are all uncertain I’m afraid

RE: Which test do you prefer for feline ovarian remnants?

David Mills — Fri, 22 Mar 2024 22:47:45 GMT

[quote userid="3169" url="~/f/clinical-questions/30919/which-test-do-you-prefer-for-feline-ovarian-remnants/244112#244112"]showing heat, its as cheap having a look than doing hormone testing - especially if you are doing it all FOC.[/quote]

This. When it's on heat, open midline and it's usually pulsing at you.

RE: Which test do you prefer for feline ovarian remnants?

Michael Woodhouse — Thu, 21 Mar 2024 22:55:47 GMT

[quote userid="5012" url="~/f/clinical-questions/30919/which-test-do-you-prefer-for-feline-ovarian-remnants"]HCG (Receptal)[/quote]

Receptal is buserelin a synthetic GnRH. HCG works on LH receptors and has a much more specific action (like PMSG). PMSG also hard to get but can be imported.

Having dealt with 1 cat with an ovarian remnant (not spayed by me), open it up and have a look. If in season, it will be screaming at you.

If showing heat, its as cheap having a look than doing hormone testing - especially if you are doing it all FOC.

RE: Which test do you prefer for feline ovarian remnants?

Richard Carter — Thu, 21 Mar 2024 10:09:39 GMT

The lab we use recommended AMH in cat showing behaviour of oestrus (it was negative so perhaps she just liked tomcats dragging her around by the neck or the test not as good as suggested)