Reproductive Abnormalities in Queen Cats

Reproductive abnormalities in queen cats are ovarian dysgenesis, true hermaphroditism, ovarian cysts, remnant syndrome, etc.

Abnormalities of Ovary

Ovarian Dysgenesis

Ovarian dysgenesis refers to underdevelopment of the ovary, ovarian hypoplasia, or hermaphroditic and streak gonads, usually associated with an abnormal sex chromosome complement, such as XO monosomy or mosaicism.

True Hermaphroditism

True hermaphroditism is rare in cats and has not been reported in phenotypic females where both gonad histology and chromosome complement are known.

Reported in cats that are phenotypically male, where both gonad histology and chromosome compliment are known, suggesting that presence of testicular tissue in the embryo induces development of (male phenotype) secondary sexual characteristics, regardless of presence of ovarian tissue or karyotype.

Diagnosis of ovarian anomalies is based on history of primary anestrus (ovarian agenesis or dysgenesis) on careful gross evaluation of internal and external genital organs, on histologic examination of the ovary, and on karyotype of affected queens.

Ectopic Adrenocortical Paraovarian Nodules

Ectopic adrenal gland nodules occur in the broad ligament of the ovary, within 1 to 4 cm of the ovary, as single, unilateral nodules, as bilateral nodules, or as two nodules on a single side and range in size from 2 to 5 mm in diameter.

Ovarian Cysts

Follicular cysts that arise from mature or atretic follicles are common and affected queens may be asymptomatic or may exhibit prolonged estrus if cells lining the cyst secrete estrogen.

Prolonged estrus may be hard to distinguish from normal estrus, because the normal queen may cycle in and out of the follicular phase as frequently as every 4 to 7 days.

The Ovarian Remnant Syndrome

The ovarian remnant syndrome describes presence of ovarian tissue and signs of estrus in a female cat after OHE.

The causes of the ovarian remnant syndrome are:

• may be failure to remove all or a normal ovary at OHE
• presence of a partial or complete separation of a portion of normal ovary during development (the fragment may be located near the ovary or in the broad ligament) that is not detected at OHE.
• supernumerary ovary although rare may also be considered as the cause of estrus signs after bilateral OHE.
• Affected queens demonstrate normal signs of estrus, and may allow copulation, but do not become pregnant if bred.
• Diagnosis is based on confirmation of estrus, on detection of serum progesterone concentrations exceeding 2 ng/ml 2 to 3 weeks after induction of ovulation at estrus in a neutered cat.
• Treatment is exploratory laparotomy within 3 to 6 weeks of induction of ovulation at which time presence of corpora lutea in a “grape cluster” appearance on the surface of the ovarian remnant may make small remnants easier to identify.

Ovarian Neoplasia

The granulose cell tumor of sex cord-stromal origin is the most common primary ovarian tumor in the cat.

Presence of palpable mass in the cranial or mid abdomen. Abdominal and thoracic radiographs and abdominal ultrasonography are indicated in all cases to assess tumor size and location, and evidence, if any, of the presence of metastases. A vaginal cytology specimen should be examined for cornification as evidence of estrogen secretion in suspect queens. Measurements of serum estrogen, testosterone, and progesterone are of interest if functional tumors are suspected based on clinical signs of prolonged estrus, virilization, or pyometra. Evaluation of the hemogram and serum chemistry profile is indicated prior to exploratory surgery.

Adenoma or Cystadenoma, Adenocarcinoma, Dysgerminoma have also been reported in cats.

Abnormalities of Uterus and Oviduct

Hyperplasia of the Uterus and Uterine Tubes

Multiple, broad-based or pedunculated hyperplastic endometrial polyps have been reported in cats ranging in age from 4 to 15 years and protrude into the uterine lumen.

Hydrometra or Mucometra

Hydrometra and mucometra, the accumulation of non-inflammatory, clear to slightly cloudy, watery to viscid, sterile fluid in the uterine lumen, occurs occasionally in the cat.

Hydrometra or Mucometra caused by:

• lack of patency of vulva, vagina, cervix, or uterus resulting from congenital
• anomaly,
• neoplasia
• inflammation,
• scarring,
• accidental ligation.

Fluid volume in the uterine lumen may reach 500 ml, and distention of the uterine body and/or horns may be diffuse or segmental.

Management of Hydrometra or Mucometra is OHE.

Cystic Endometrial Hyperplasia or Pyometra Complex

Pyometra in cats is a uterine inflammatory disorder characterized by cystic endometrial hyperplasia (CEH).

Clinical signs include purulent vulvar discharge, anorexia, dehydration, lethargy, pyrexia,vomiting, polyuria or polydipsia, and weight loss. The uterus becomes palpably enlarged.

Diagnosis in the intact queen is based on:

• signalment,
• history of previous estrus and clinical signs,
• physical examination,
• hemogram,
• presence of a purulent vulvar discharge and /or enlarged uterus in the nonpregnant animal.
• Abdominal radiography or ultrasonography is indicated to define uterine size and shape for initial diagnosis, to rule out pregnancy (ultrasonography, after 21 days following estrus).

Recommended treatment for CEH/pyometra in the queen is OHE with concurrent fluid and antibiotic therapy.

In females with reproductive value and an open-cervix pyometra (diagnosed by the presence of a purulent vulvar discharge), uterine evacuation can be attempted with:

• PGF₂ alpha at a dose rate ranging from 0.05 to 0.5 mg/kg subcutaneously (SC) once or twice daily for 2 to 5 days until uterine size decreases to normal.
• Prostaglandin analogues should not be used in the cat, because safe and effective does have not been established.
• Within 1 to 60 minutes of drug injection, panting, restlessness, grooming, tenesmus, salivation, vomition, defecation, or diarrhoea.

Salpingitis

Inflammation of the feline uterine tube, salpingitis, usually is purulent, and occurs secondary to uterine inflammation.

Neoplasia of the Uterine Tubes

• Uterine tumors constitute 1 to 2 per cent of tumors of the female reproductive organs of the cat including mammary glands), or 0.2 to 0.4 per cent of all feline tumors and include uterine leiomyomas and leiomyosarcomas.
• Clincal signs of uterine adenocarcinomas depend on tumor size and pattern of metastatsis and include ascitis, anorexia, weight loss, purulent or hemorrhagic vulvar discharge, vomiting, constipation, dysuria, and presence of a palpable abdominal mass.
• Diagnosis is based on uterine palpation, abdominal and thoracic radiographs, surgical exploration, and histopathologic examination of tumor tissue.
• Ultrasonography has been used to detect uterine neoplasia in the diffusely enlarged uterus with pyometra.
• The recommended treatment for primary uterine neoplasia without metastasis is OHE.
• Tumors of the uterine tubes have not been reported in the queen.

Disorders of Vagina Vestible and Vulva

Anomalies of the vagina and vulva that have been described in the cat include:

• segmental aplasia of the cranial vaginal (mullerian duct system).
• presence of a common vulvovestibular-anal opening.
• rectovaginal fistula.

Neoplasia

The most common primary vaginal tumor type in the cat is the leiomyoma, which may measure up to 7x7x8 m.

Clinical signs of vaginal tumors include:

• bulging of the perineal region.
• prolapse of tumour tissue from the vulva.
• dysuria,
• pollakiuria,
• constipation.

Initial diagnosis is based on palpation and on retrograde vaginography and/or cystourethrography to characterise size and extent of the mass. Abdominal and thoracic radiography to look for tumor metastasis should be performed prior to surgical excision. Exfoliative cytology may be diagnostic and should be performed on accessible masses of the vagina and vestibule. Final diagnosis is based on histopathologic examination after core or excision biopsy.