Angina

How to care for a cat after tumor removal. Mammary tumor in cats and dogs

Photo magazine Clinician's Brief

Journal of Feline Medicine and Surgery May 2013 15: 391-400,

Translation from English ..:veterinarian Vasiliev AB

Summary

Practical significance: Mammary tumors are one of the most common tumors in both cats and dogs, but the prevalence of malignant histological types in cats is much higher (the ratio of malignant to benign is at least 4:1).

Clinical problems: The more aggressive nature of mammary tumors in cats poses treatment challenges. The prognosis is influenced by the size of the tumor and, therefore, early detection and treatment of breast tumors is of paramount importance. Although primary tumors can be removed surgically, there are no studies showing that chemotherapy significantly increases survival time; therefore, metastatic spread remains an important clinical problem.

Patient group: Mammary tumors usually affect older female cats, mainly unspayed females. Siamese and Oriental breeds may be predisposed. Male cats can develop neoplasia, but this is rare.

Evidence base: This review summarizes the current literature regarding the etiology, pathology, clinical presentation, diagnosis, staging, treatment, and prognosis of feline mammary tumors.

Epidemiology

Mammary tumors are the third most common type affecting female cats, after lymphoma and skin tumors, accounting for 17% of all tumors. The published incidence is 25.4 per 100,000 female cats per year(1). Although precise statistics are not available, the incidence of mammary tumors in cats may vary globally, depending on the adoption of sterilization policies. Sterilization is performed less frequently in Scandinavia and some other parts of Europe than in the UK, for example.

Gender, age, breed

Mammary tumors occur in older female cats (average age 10-12 years) and usually in unspayed cats. Mammary tumors also occur in male cats (mean age 12.8 years) (7), but they are rare, accounting for 1–5% of mammary tumors. Siamese cats and other Oriental breeds may be at risk for developing mammary tumors at a younger age, but domestic shorthair cats, which are probably the most common cat breed, are also very often affected by these tumors.

Etiology

As in humans and dogs, hormonal fluctuations associated with repeated estrous cycles may influence the development of mammary tumors in cats. This is supported by a case-control study reporting that cats neutered before 1 year of age had a reduced risk of developing mammary tumors (9) and that non-neutered cats were 7 times more likely to have mammary tumors in the cat population compared to with a control group (10). However, cats neutered before 1 year of age also develop mammary tumors, so early neutering does not eliminate the risk of mammary tumors (8) and early studies report an increased incidence of mammary tumors , may perhaps reflect sterilization practices at the time more than a true increased risk (11).

Other evidence supporting a hormonal etiology is that estrogen and progesterone receptors are found in normal breast tissue and benign tumors, but are often absent in malignant tumors and metastases (12–17). In addition, exogenous administration of progesterone to prevent pregnancy or suppress aggression has been associated with the development of tumors (benign and malignant) in both male (18) and female cats (19). A possible dose-dependent effect may occur, with an increased risk of breast carcinoma if progesterone is given regularly rather than intermittently (10). There is no definitive evidence for a viral etiology of mammary tumors in cats, although this has been suggested in early reports. Obesity doesn't matter, but dogs do.

Clinical picture

Cats have 4 pairs of mammary glands (2 mammary and 2 abdominal) and although any tumor can be involved, some studies report a predisposition of the caudal glands to mammary tumors (11,20). Mammary tumors appear as solitary subcutaneous nodules or masses in within the mammary glands (Figures 1 and 2), which may be discrete and mobile or associated with underlying tissue and appear ulcerated (Figure 3). Some may look like cysts. In cats, it is difficult to distinguish benign from malignant nodules, so all should be treated as potentially malignant. Multiple tumor masses within multiple lobes are common (usually unilateral but occasionally bilateral) (Figure 4) and, according to one study, occur in 60% of cats (8). Sometimes the true extent of this disease cannot be assessed without removing the fur. Drained lymph nodes (inguinal or axillary) may also be visible or palpable enlarged.

Fig.1 Tumor mass in the thoracic lobe of the mammary gland in an 11-year-old unsterilized domestic shorthair cat

Figure 2 Tumor mass in the pectoral lobes and axillary lymph node of an eight-year-old unsterilized domestic shorthair cat.

Figure 3 Ulcerated tumor mass of the second abdominal lobe in a 21-year-old neutered domestic shorthair cat

Figure 4. Bilateral masses in the mammary glands before (a) and after (b) hair removal

In the presence of aggressive inflammatory carcinoma with widespread lymphatic involvement, the breasts may be swollen, hot, and tender (4). This clinical presentation may be difficult to distinguish from fibroadenoma hyperplasia (fibroepithelial hypertrophy, feline mammary hypertrophy), although the latter more commonly affects young cats (21).

Differential diagnosis

A variety of non-neoplastic hyperplasias and dysplasias can occur in the mammary glands and, although much less common in cats than in dogs, they can all be mistaken for mammary tumors. These include glandular ductal hyperplasia, ductal ectasia (dilatation), cysts, and lobular hyperplasia, all of which may demonstrate focal fibrosis. Widespread bilateral breast enlargement and swelling may also occur with fibroadenomatous hyperplasia, a type of lobular hyperplasia that may appear after prolonged metestrus, false pregnancy or pregnancy, or the use of exogenous progesterone.

Diagnosis

If the tumor mass is palpable, confirmation that it is neoplasia requires tissue biopsy or fine needle aspiration to perform cytological examination. Because most mammary tumors in cats are malignant, fine needle aspiration is more reliable than in dogs and useful in confirming the diagnosis (Figure 5).

Figure 5. Cytologic examination of feline mammary carcinoma demonstrating a mass of polygonal neoplastic epithelial cells with anisocytosis and anisokaryosis, several multinucleated cells, and visible nucleoli, often several per nucleus.

Most mammary tumors in cats arise from the glandular epithelium and all are strictly adenomas or adenocarcinomas, although the latter are often classified as carcinomas. Benign tumors are uncommon, with fibroadenoma being the most common and simple adenoma or ductal papilloma being rare. The main histological type of mammary tumors in cats is simple adenocarcinoma, arising from the epithelium of the mammary ducts and alveoli (Figure 6). Complex or mixed tumors involving both ductal and myoepithelial cells are rare in cats compared to dogs, although they may be associated with a better prognosis (22,23). In cats, carcinomas may be tubulopapillary, solid, cribriform, or mucinous, although transitional cell carcinoma and mixed carcinosarcoma also occur (24).

Figure 6. Histological examination of simple adenocarcinoma of the mammary glands of cats. Sections show invasion of the primary tumor into the muscle (a), metastasis to the lungs (b) with tumor cells in the blood vessels and lung tissue.

Inflammatory mammary carcinoma, which has a particularly poor prognosis due to an additional inflammatory component that blocks the lymphatic system and impairs lymphatic drainage, causing the glands to become swollen and tender, was identified in three cats with an underlying high-grade, papillary mammary carcinoma (25).

Stages of the disease

If a breast tumor is suspected or confirmed, then studies should be performed to determine the local extent and degree of invasion into body tissue before surgical removal of the tumor. Because few breast masses are benign and general appearance is not a reliable basis for differentiating benign from malignant tumors, disease staging should be routine when breast masses are present. The WHO staging system is commonly used (Table 1) (26)

Measurement of the primary tumor is important because tumor size affects prognosis: tumors<3 см в диаметре ассоциированы с лучшим выживанием, чем опухоли >3 cm.

Table 1 TNM and clinical staging system for feline mammary tumors

Staging of a confirmed tumor should include palpation and aspiration of lymph nodes draining the tumor site, since more than a quarter of cats have regional metastases at the time of diagnosis (27). Involvement of multiple axillary lymph nodes is usually detected by lymphangiography (58-75% of cases), but involvement single lymph node is more common (84-94% of cats) (28). Although axillary and inguinal lymph nodes are the most commonly involved lymph nodes in feline mammary tumors (80% of cats), obstructive lymph nodes may also be involved (30% of cats) (27). To assess the spread of the tumor in the body, radiography in three projections (mainly performed under anesthesia in the inhalation phase) and ultrasound examination of the abdominal cavity are performed, since the most common regions of metastases are the lungs, medial iliac lymph nodes and abdominal organs (Figure 7). Pulmonary metastases usually show a miliary pattern on chest x-ray, but the pleural membranes may also be involved and in some cases metastatic lung disease may cause pleural effusion (Figure 8). More rarely, metastases can be detected in the bones.

Figure 7. An enlarged left medial iliac lymph node with surrounding hyperechoic fat identified on staging ultrasound in an eleven-year-old spayed Abyssinian cat with mammary carcinomas in the left caudal abdominal and right cranial thoracic lobes.

Figure 8 Left lateral (a) and dorsoventral (b) radiographs of the cat's chest cavity from Figure 7. These radiographs showed a general increase in radiodensity within the chest cavity with a pronounced collapse of the lung fields below the dorsal wall and a smoothing of the silhouette of the heart and diaphragm, which is characteristic of pleural effusion .

Advanced imaging techniques (including computed tomography) of the lungs provide a more accurate assessment of the presence of metastases and should be used if chest radiography raises questions.

Figure 9. X-ray in the left lateral projection of a 12-year-old unsterilized domestic shorthair cat with carcinoma of the second abdominal lobe of the mammary gland. A pair of faint, ill-defined soft tissue masses superimposed on the silhouette of the heart and raised suspicion for metastases in this view (arrows) but not in the right lateral view. CT scan of the chest confirmed the presence of a 2-3 mm hyperattenuated nodule in the right middle lobe of the lung and (b) and a 4.8 mm hyperattenuated nodule in the caudal left lobe of the lung (arrow).

Since most sick animals are aged, it is also necessary to perform general and biochemical blood tests and a urine test to identify concurrent diseases. Paraneoplastic conditions are rare in mammary tumors, and feline leukemia virus and feline immunodeficiency virus are not related to the etiology of the disease. However, if further treatment, including chemotherapy, is being considered, it is important to assess the status of viral infections, as immunosuppression caused by viruses may interfere with the effectiveness of treatment.

Surgical treatment

The main method of treating mammary tumors is still surgical removal. The extent of the operation is influenced by the lymphatic drainage pathways for mammary gland tumors (see table), since tumor cells quickly spread beyond the primary tumor and complete removal of the tumor must include all possible lymphatic drainage pathways.

Recommendations based on studies of lymphatic drainage pathways include unilateral or bilateral mastectomies, due to possible contact between individual lobes and between the right and left sides. Although radiographic imaging studies suggest that this is not necessary in every case, additional prognostic analyzes support the use of unilateral or bilateral mastectomy because the apparent surgical volume corresponds to a significant difference in local recurrence/disease-free interval (DFI) (33) and survival time (34).

For bilateral mastectomy, a two-week interval between operations is recommended, although simultaneous bilateral mastectomy can also be performed (Figure 10). Fixation of the tumor to the skin or abdominal fascia is an indication for en bloc removal of these structures (35).

Figure 10. Bilateral mastectomy in a cat with mammary carcinoma.

Removal of lymph nodes The inguinal lymph node has a close connection to the caudal lobe of the mammary gland and is therefore removed along with the lobe as part of the gland block being removed. An axillary lymph node should be removed if it is enlarged or if there is tumor extension identified by biopsy or FNA, but there is no evidence that prophylactic removal prolongs survival.

Simultaneous ovariohysterectomy. There is no evidence that ovariohysterectomy at the time of mastectomy has any benefit on survival or tumor recurrence (8), or the development of new tumors or carcinoma progression (10). It may, however, reduce the need for progestin therapy, which may be beneficial.

Lymphatic drainage

Since tumor cells spread rapidly from the primary site, complete removal of all known drainage routes must be performed.

Lymphatic drainage has been studied by dye injection and postmortem examination (29,30) and radiological

intravital methods in healthy cats (28), the latter being more accurate because dynamic blood pressure influences the direction of natural lymphatic flow. The data from most studies agree that the first and second (thoracic) lobes drain cranially into the axillary lymph nodes; although pathological studies have shown that the second lobe may drain caudally into the axillary lymph node, this is not visualized using radiographic techniques. The third (abdominal) lobe drains both cranially into the axillary and caudally into the inguinal lymph nodes, and the fourth lobe drains caudally into the inguinal lymph node. Direct drainage from the third and fourth abdominal lobes to the medial iliac lymph node was reported in one cat, however, direct drainage from the first, second, third lobes to the retrosternal lymph node was not confirmed in this cat.

Although connectivity between the lobes of the mammary gland and between the right and left sides has previously been suggested, intravital studies have not confirmed this in healthy cats (28). Drainage may vary between normal and tumor-bearing lobes, making it difficult to determine precise drainage routes (31) and probably making it desirable to use indirect lymphography in each patient to help determine the type of drainage and examine sentinel lymph nodes (32). Potentially, this may encourage more conservative resections.

Chemotherapy

There is some evidence showing that chemotherapy may be effective in in vitro breast cell lines (36⇓–38) and that in vivo treatment of unresectable disease with doxorubicin and cyclophosphamide can reduce tumor size in 50% of cases and possibly prolong survival (Table 2 ) (38-40). The benefit of using chemotherapy as an adjunct to surgical removal of mammary tumors in cats, however, is not yet clear (Table 3).

Table 2. Effect of chemotherapy (doxorubicin) on breast carcinomas

Table 3 Effect of chemotherapy (doxorubicin) as an adjunct to surgical removal of breast tumors.

DFI - time interval without illness

Doxorubicin1 1 mg/kg IV every 3 weeks

Doxorubicin 2 dose not given

Cyclophosphamide dose not given

Doxorubicin 3 1 mg/kg IV every 3 weeks (one case was given IV vincristine 0.7 mg/m2 and 13 cases were given cyclophosphamide 250 mg/m2 IV 1 week after doxorubicin)

A large multicentric study of 67 cats supplemented with doxorubicin reported a median survival time of 448 days (41). Although this study did not have a control group, this survival time was longer than historical controls and was similar to that obtained in another study of 23 cats without a control group (460 days) when combining supplemental doxorubicin with the COX-2 inhibitor meloxicam (42).

A more recent study of 73 cats, which included a control group of 36 cats undergoing surgical excision alone, reported increased survival time and DFI for cats receiving postoperative doxorubucin and cyclophosphamide (1406 vs 848 days [survival time] and 676 vs 372 days)34 ); however, the difference was not statistically significant.

It is possible that with larger numbers and greater statistical power, the true benefit of aggressive chemotherapy may become apparent. Alternatively, various approaches to antiangiogenic metronomic (low-dose) chemotherapy may be effective, although low-dose chemotherapy using vincristine, cyclophosphamide, and methotrexate does not prevent relapse or metastasis, in one report (8).

Other treatments

Although immunomodulators such as Bacillus Calmette-Guerin (BCG) (43), Corynebacterium parvum (44), liposome-encapsulated muramyl tripeptid ephosphatidylethanolamine (L-MTP-PE) (45) and oral levamisole (46) have been used by injection in tumor (BCG) or in addition to surgical removal of mammary tumors in cats, has not been shown to have a beneficial effect on survival time or change the rate of recurrence. There are no reports on the use of antiestrogens in cats, probably because most feline mammary malignancies do not have estrogen receptors and the expected benefit is therefore likely to be minimal.

Small molecule inhibitors that act on receptor tyrosine kinases (receptor tyrosine kinase inhibitors or RTKIs) are effective in treating some types of veterinary tumors, especially those that have impaired TK activity (47). Imatinib and masitinib are well tolerated in cats (48–51), but there is no information available on their effectiveness against feline mammary tumors.

Forecast

The prognosis is poor for most cats with mammary tumors, with death usually caused by local recurrence or metastasis. The average time between tumor detection and death is 10–12 months (20.35); however, as already mentioned, the prognosis of breast tumors is influenced by several factors. (Table 4)

Table 4. Prognostic factors for feline mammary tumors

Factor	Details
Tumor size	Diameter ˂ 3 cm – median survival 21-24 months Diameter ˃ 3 cm – median survival 4-12 months
Clinical stage	Stage I - median survival 20 months Stage II – median survival 12.5 months Stage III—median survival 9 months Stage IV – median survival 1 month
Operative field area	Radical surgery (unilateral mastectomy) reduces recurrence rates compared with conservative mastectomy

In cats, this is, unfortunately, a common phenomenon. This disease takes the lives of four-legged pets who are unable to resist the disease. There are different treatment methods, but none of them gives a 100% result.

Tumors

Diseases associated with neoplasms are a real scourge of the modern world. Thousands of people and animals die from them every year. Medicine in this area does not stand still, and recently the treatment of cancer has become increasingly successful.

However, a medicine has not yet been obtained that would help absolutely everyone. In veterinary medicine, the situation is no better, especially when it comes to treating cats. The main means of stopping tumor growth is chemotherapy, but there is no guarantee that this goal will be achieved. A tumor of the mammary glands in cats will cause a lot of trouble for both the animal and the owner.

Mammary glands

The mammary glands in animals are designed to feed newborn kittens. They are located in pairs on the chest and stomach of the cat, their total number is normally eight. Their work begins before childbirth (swelling) and during false pregnancy (hormonal processes).

Diseases of the mammary glands are reported in adult cats, regardless of whether they have given birth or not. The most common ailments are: mastitis, cancer and mastopathy. In some cases, veterinarians remove the affected glands.

It is difficult for a non-professional to distinguish between them, especially in the early stages. With mastitis, inflammation of the mammary gland occurs. Occurs in cats with excess milk (early weaning of kittens) or false pregnancy. The gland increases in size, redness and increased temperature are observed. There may be discharge of different colors and composition from the nipple.

Mastopathy is swelling of the mammary glands, which can be normal or pathological. In the latter case, gray liquid accumulates inside and the skin turns blue.

In order not to confuse these diseases, look at what a mammary gland tumor looks like in a cat (there is a photo in the article).

Types of neoplasms

More than 85 cases of neoplasms out of 100 are malignant. In the latter, there is a noticeable tendency towards growth and the appearance of metastases in the shortest possible time. And it all starts, as a rule, with a small lump, just like in humans.

What types of mammary tumors are there in cats? It can be malignant and benign. In the latter case, there is no cause for concern, because such neoplasms are characterized by slow growth, clear localization and lack of tendency towards necrotic processes.

Cancerous tumors often appear in several places at the same time. Interestingly, in a kitten up to 6 months of age, it reduces the likelihood of tumors appearing almost to zero and completely eliminates the malignant type. But the owners of animals kept for breeding will not be satisfied with this path. In addition, in the future the cat will need hormonal medications to avoid metabolic problems.

Stages of development of breast tumors

Each one goes through several stages of its growth:

The tumor is less than 10 mm in size, metastases are not detected.
The tumor reaches 30 mm, but there are no metastases.
The tumor is over 50 mm in diameter, ulcers may appear, and metastases are diagnosed in the lymph nodes.
Metastases are found in the lungs, liver and other organs and tissues.

Causes of neoplasms

What causes mammary tumors to appear in cats? Veterinarians and other specialists do not have a consensus on this matter. However, there are a large number of versions.

For example, living in large cities with high levels of environmental pollution has an adverse effect on the health of the animal. The same factors include monotony of diet, low quality food, and sometimes completely spoiled food. Predisposition to pathology at the genetic level cannot be ignored. By the way, this is why new owners are advised to take a closer look at the pet’s pedigree before purchasing it.

Symptoms of cancer

As a rule, the symptoms of a mammary tumor in cats are quite simple. These include:

the appearance of small seals in the nipple area;
inflammatory processes developing in this place over time;
necrosis of tissue around the nipples.

Pets actively lick the affected area with their rough tongue, which only worsens the situation because it provokes the appearance of ulcers. At the same time, the mammary glands emit a nasty smell of rotting tissue. As a result, the animal feels worse every day: strength and weight are lost, and existing chronic diseases pass into the acute phase.

Diagnosis of the disease

You can find out whether a cat has a malignant or mammary gland using a biopsy. It should be carried out very carefully to avoid mechanical damage. In addition, during the formation of serious ruptures, metastases may appear - harbingers of the imminent death of the animal.

Timely diagnosis allows you to determine the onset of the disease and immediately begin chemotherapy to save your pet. As a rule, a biopsy of lymph nodes located close to the site of the lesion is performed, because it is in them that metastases of neoplasms settle. Ultrasound and X-ray examination can determine their presence in the lungs and other abdominal organs.

A tumor of the mammary glands in cats requires blood tests: general and biochemical. They are necessary to determine the severity of the disease and the most appropriate type of chemotherapy for a particular pet.

Treatment

If a mammary tumor is detected in a cat, treatment should begin immediately. In most cases, surgery can save the pet, but its feasibility is questionable. An old animal that has lost a lot of strength may simply not survive this. In this case, you should limit yourself to conservative treatment. Drugs appear regularly that cope better with neoplasms. This gives hope for a favorable outcome in the fight against the disease.

However, if possible, it is worth giving preference to surgical intervention, because it allows you to remove the entire affected area with metastases (the latter is not always the case). This method is indispensable when the peripheral ones are affected. If they are not cut out, the cancer will soon spread throughout the body.

Removal of a mammary gland tumor in a cat is carried out together with the entire organ, since only occasionally it is possible to localize its location (if the tumor is benign).

The situation becomes more complicated when a bilateral mastectomy is necessary, since it is extremely difficult for cats to tolerate. Chemotherapy sessions are not canceled in order to completely stop the development of the tumor. It is required to show your pet to a veterinarian every day to monitor the general condition of the body and prevent its rapid deterioration.

If treatment was decided to be carried out conservatively, then daily visits to the doctor become mandatory. The cat will be tested regularly (almost every day) to monitor the effects of toxic and dangerous substances used in chemotherapy on the four-legged pet's body.

Under no circumstances should you self-medicate. Applying heat (such as heated salt) only makes the situation worse. As a result, the neoplasm begins to develop more intensively, and the malignant one will metastasize. The presence of inflammatory processes and necrosis is also a contraindication for the use of heat compresses.

In the most difficult situations, the animal is left in a veterinary clinic under the supervision of specialists. The cat is given anesthetics and other important substances.

Post-operative care

One of the important factors that has a direct impact on the result of the treatment is the organization of conditions for the sick animal. If an operation is detected, it will help get rid of it. But after surgery, the pet needs complete rest and feeding only what the veterinarian allows.

Ask him what preparation to use to treat the postoperative suture. Strictly follow your doctor's recommendations regarding the timing and dosage of taking medications. A special blanket is put on the cat, which will tighten and protect the seam. If a wound is opened, contact your veterinarian immediately.

The specialist will conduct examinations and take tests every week to monitor the condition of the animal’s body. This way he will be able to timely diagnose a relapse (if it happens). Even if a cat’s mammary tumor is removed, no one can say how long the animal will live.

Prevention

As already mentioned, before she reaches 6 months of age, it greatly reduces the likelihood of getting cancer. After cutting out the tumor, you cannot refuse to remove the ovaries. This will prevent relapse and prolong the life of your pet.

Always pay attention to any swelling that may be noticed when caring for your animal. Ignoring them can lead to very serious consequences. A festering and burst tumor should not be touched or picked at, as these actions contribute to the appearance of metastases. You cannot simply observe the tumor, hoping that “everything will heal on its own,” because during this time it will grow so much that surgical intervention will no longer be advisable. All that remains is to watch as the pet rots alive.

The sooner the disease is found, and the sooner the veterinarian performs the operation, the higher the chance of a complete cure.

For non-breeding pet owners, it is recommended that cats be spayed. But you need to decide on this as early as possible, then the risk of cancer will decrease almost to zero.

Cats have almost all the same diseases as people. Unfortunately, oncology is no exception. The operation is quite a difficult test for a small animal. After surgery to remove a mammary tumor, your beloved cat needs special care and attention. In many ways, the success and duration of the rehabilitation period will depend on the creation of the right conditions.

Creating favorable conditions for the cat

Unfortunately, almost no one is immune from the occurrence of tumors - neither people nor cats. One of the most common types of malignant neoplasms in cats is mammary tumor. Almost all animals suffer from this disease, and pets, dogs and cats, are no exception. The only possible treatment in this case is surgical removal of the breast tumor.

As a rule, during surgery, not only the tumor itself is removed, but also the affected mammary gland, a neighboring gland (sometimes the entire ridge of glands), surrounding tissues and blood vessels. The operation to remove them is quite traumatic for the animal. Therefore, it is important to create the most comfortable conditions for your pet so that recovery occurs successfully.

How to create the most comfortable and favorable conditions for a cat during the postoperative period:

When transporting an animal from the clinic to home, it must be lying on its side. It is advisable that the head be located slightly below the level of the entire body.
The head should not tilt to the side or fall on the chest.
The chest should be free from any compression.
The animal is unable to blink independently after surgery. Therefore, every 4-5 minutes you need to gently rotate your eyelids, opening and closing your eyes slightly. You can also use eye drops, but this should only be done after consulting your doctor.
The cat's heat exchange is disrupted after surgery. Therefore, on the first day it is necessary to provide her with external heating - place a heating pad or a bottle of hot water (not boiling water) next to her. You can also place the animal near the radiator. Make sure the temperature is not too high.
Do not place your cat in high places. He cannot walk, but will try to crawl in a semi-conscious state. It is better to make a soft and warm place for the animal on the floor, also providing a fence.

It should also be remembered that during the first day (and probably several days) the animal will not be able to relieve itself in its usual place. Therefore, you need to provide a set of removable diapers, under the bottom of which you need to lay a special hospital oilcloth.

During the first day, it is advisable to spend maximum time next to the cat. This is necessary both to monitor changes in her condition and to ensure her safety and proper care. Coming out of anesthesia, the cat cannot control its body and will try to crawl, walk, run and jump. During this, the animal can receive quite serious injuries, which will only aggravate the health condition and will not contribute to rapid rehabilitation after surgery.

Pet monitoring

After removal of a tumor in cats, the animal must be monitored very closely for several days in order to be able to notice deterioration and seek medical help in time.

Possible signs of deterioration:

fainting;
difficulty and heavy breathing;
a significant decrease in temperature on the pads of the paws;
paleness of gums and lips;
lack of physical activity during the day after surgery;
lack of control over the limbs 2 days after surgery;
vomiting and belching that occur regularly;
the presence of blood in the stool;
convulsions;
bleeding;
swelling of the tissues of the mouth, pharynx, muzzle;
allergic manifestations.

In order for the treatment to be as successful as possible, it is important to undergo a detailed examination, diagnosis and choose the most appropriate treatment regimen. But this is not enough for the cat to be healthy. After you have fought a breast tumor and overcome the disease, it is important to successfully go through the recovery period after surgery, and this depends on many factors. One of them, and perhaps the most important, is the creation of favorable conditions that will contribute to the recovery of the pet.

Even after a successful recovery of a pet, owners should remember the need for regular examinations several times a year. Cases of relapse in breast cancer account for about 60% of all clinical cases.

VETERINARIAN CONSULTATION REQUIRED. INFORMATION FOR INFORMATION ONLY. Administration

A large percentage of patients in our oncology department are cats and dogs with mammary gland tumors (MGT). The leading oncologist of the Biocontrol clinic, Candidate of Biological Sciences Alexander Alexandrovich Shimshirt, answered the most frequently asked questions by owners about this disease.

— What is a breast tumor? Who is she dating?
— A tumor of the mammary gland is a fairly common pathology; in terms of frequency of occurrence in cats and dogs, it ranks 3-4 among all pathological diseases.

— At what age does mammary gland tumor most often occur in dogs and cats?
— For dogs, this age is about 7-8 years. Breast cancer in cats most often occurs after 10 years of age, however, there are cases of the disease at a younger age.

— How often do tumors in the mammary gland turn out to be malignant?
— It is believed that 90% of tumors in the mammary gland in cats are of a malignant nature. Most often these are carcinomas with deliberately aggressive behavior.

For dogs, the statistics are slightly better: up to 60% of them have malignant processes and 40% are benign.

Unfavorable factors that indicate the aggressive behavior of the tumor and the need for prompt intervention are:

rapid tumor growth;
signs of inflammation;
the appearance of ulcers;
if this formation begins to bother the animal.

— Is a neoplasm on the mammary gland always a tumor or cancer?
— When examining and palpating an animal, it is impossible to say whether it is a lipoma or a tumor of the mammary gland. Any neoplasm that owners find in their animal in the mammary gland area (taking into account the age of the animal) requires contacting a doctor, preferably in a specialized clinic. Only a doctor, having examined the animal and carried out the necessary diagnostics, will be able to determine to what extent this neoplasm is malignant, its stage and how soon it is necessary to take action. It is possible that examination and differential diagnosis will show something different.

In principle, any formation in the mammary gland in an animal in adulthood and old age deserves close attention.

— Are there any predispositions or factors that contribute to the development of AML?
— If we talk about dogs, then here we can include in the risk group for those animals that often have false pregnancies. They would have O greater predisposition to changes in the mammary gland, because false pregnancy and lactation lead to the development of mastopathy, which can subsequently transform into tumor processes.

In cats, such a pattern was not observed, however, hormone receptors were found in the tissue of both cats and dogs. We can state that, of course, there is a certain connection, especially in cats, between giving the animal drugs that suppress estrus, and a subsequent increase in the risk of developing AMF.

— Owners quite often ask for surgery on their pets if there is a tumor on the mammary gland. Is this an effective solution?
— Much depends on the stage of the disease, because if these are the initial stages, then the treatment methods are predominantly surgical and the prognosis for such treatment is favorable.

— Can the tumor be operated on by any veterinary surgeon, or by someone who deals specifically with this problem?
— Surgical treatment of breast cancer is the main method of treatment. In principle, in the early stages it significantly prolongs life and, in some cases, helps get rid of the tumor process. The main task is to ensure that the surgical intervention is performed correctly. To do this, you need to contact a specialist who can expertly advise you regarding the stage of the tumor process.

The extent of surgical intervention directly depends on the location, stage and type of tumor. For cats, for example, there are certain rules that involve removing the entire mammary ridge along with regional lymph nodes. For dogs, there is such a feature that if the tumor is in the third milk bag, and the animal has five mammary glands on each side, then the surgeon will remove the entire ridge. If the dog has a tumor in the fourth or fifth milk pouch, the third, fourth and fifth pouches are removed, along with the regional lymph nodes. If the first or second mammary gland is affected, the first three bags and the lymph node are removed.

— Does the tumor recur?
- Yes, this is quite real. That is why after surgery you need to see a doctor regularly, every 3 months.

— How is the stage of AML determined?
— Like most tumor processes, staging of breast cancer is based on:

the state of the primary focus;
the condition of the tumor itself;
the presence of altered lymph nodes;
presence of distant metastases.

It is believed that the criterion for the unfavorable behavior of a tumor is the size of the tumor: for cats it is 3 centimeters or more, for dogs of medium breeds it is 5-7 centimeters or more.

— What diagnostic stages does an animal go through when it is examined and the stage of AMF is established?
- This is an examination by a specialist doctor, blood tests, chest x-ray, ultrasound of the abdominal cavity. Sometimes a CT scan is required.

— If an animal is not in the early stages of AMF, then there is no hope?
— Breast cancer, both for animals and humans, is an aggressive neoplasm that is well treated in the initial stages. When the stage reaches the third or fourth, the prognosis and quality of life of the animal become significantly worse. Therefore, I believe that first of all, a correct diagnosis must be made in order to know the stage of tumor development, to be able to predict some points that will improve the animal’s quality of life and, perhaps, even cure it.

— At what age is it no longer worth removing a tumor?
— This is an extremely individual question, since everything is decided by the doctor after a full examination and analysis of the specific situation.

— Maybe if a breast tumor appears, it would be more correct to remove all the mammary glands and then the cancer will not return?
— The question is very controversial. Bilateral mastectomy is an extremely traumatic, dangerous and unjustified operation.

— How often are animals diagnosed with AMF sent for chemotherapy or radiation therapy?
— It all depends on the stage of the disease. If the third and fourth stages, then the question arises about additional treatment methods that can slow down the metastatic spread of the process. Unfortunately, at these stages of the disease, the prognosis is cautious: in cats, the average life expectancy at this stage can be up to 1.5 years, in dogs this figure is slightly longer.

— Is specific care indicated for animals diagnosed with AMF and undergoing chemotherapy?
— Chemotherapy is carried out under the supervision of a specialist. It is necessary to regularly monitor the animal's dynamics and take blood tests. Maintenance treatment for such a patient is necessarily prescribed, and no specific diet or special care is required.

– Is it true that mammary gland tumors occur not only in females, but also in males?
- Yes, that's true. However, they are much less common in males than in females. Of the total number of patients with breast cancer, only 2% are males. In terms of treatment tactics, division into stages and prognosis, the approach to treatment is the same as in cases with females: surgical intervention in the initial stages of the disease, and not in the early stages - a combination of surgical treatment with chemotherapy.

– What are the causes of the formation of mammary gland tumors in males?
– In females, the main predisposing factor to the development of mammary gland tumors is hormonal influence. This mainly happens in the first two years of the animal’s life, during the first two to four heats. Excess body weight is also a predisposing factor, since adipose tissue at a young age is a source of proestrogens (precursors of sex hormones), which can also affect the functioning of the mammary gland.

It's more complicated with males. There are no clear statistics, the number of such clinical cases is extremely small, so it is very difficult to say that they definitely have some kind of hormonal basis. Opinions on this matter vary. Some doctors recommend castrating the animal, some, on the contrary, are against it, because if we are talking about cats, then they are most often already castrated by the time mammary tumors develop. It is impossible to unequivocally answer the question why males also have mammary gland tumors.

– Is it possible to prevent breast cancer?
– Regarding females, it has already been unequivocally proven that in both cats and dogs, the main predisposing factor to the formation of mammary gland tumors is hormonal effects. It follows from this that mammary gland tumors in females are a preventable disease. Prevention - sterilization of the animal during the first two years of life, preferably within the first two heats. In countries where there is medical insurance for animals, long-term statistical studies were conducted by insurance companies, which showed the incidence of mammary tumors in sterilized females during the first two years of life and the incidence in non-sterilized animals. So far, a clear relationship has been identified between sterilization in the first two years of life and tumor incidence. It is believed that sterilization in the first years of life prevents the development of breast cancer by 80%.