Reproduction and Periparturient Care 0195-5616/86 $0.00 + .

20

Non-Neoplastic Disorders of the

Mammary Gland

Cheri A. johnson, D.V.M., M.S.*

MASTITIS

Mastitis, or bacterial infection of the mammae, occurs in one or more

lactating mammary glands of the postpartum bitch. Mastitis is uncommon
in queens and in pseudopregnant, lactating bitches. Usually, clinical signs
include firm, swollen, hot, and painful gland(s), but occasionally mastitis is
severe enough to cause abscessation or gangrene. Affected females may
develop systemic illness manifested by fever, depression, anorexia, and
neglect of the offspring. The most common bacteria isolated from dogs are
Escherichia coli, staphylococci, and 13-hemolytic streptococci.
Mastitis should be treated with systemic antibiotics. Antibiotic selection
is preferably based upon results of bacterial culture and sensitivity deter-
mination, but the antibiotic should also achieve high concentration in milk
and have no adverse effects on nursing young. Minimum inhibitory anti-
biotic concentrations in canine milk have not been determined; therefore,
most recommendations are extrapolated from studies in other species.
Antibiotics often used to treat canine mastitis are erythromycin, lincomycin,
clindamycin, ampicillin, cephalosporin, and chloramphenicol. Aminoglyco-
sides are poorly lipid-soluble and achieve only low concentrations in milk.
Although the effects of milk containing antibiotics on nursing pups
have not been widely studied, potential problems such as altered intestinal
flora or staining tooth enamel (tetracycline) must be considered. Whether
it is beneficial or desirable for pups to continue nursing remains to be
determined. Bitches with mastitis may be reluctant to nurse or unable to
provide adequate nutrition, especially if multiple glands are involved.
Hand-rearing pups could allow wider antibiotic choice, for potential effects
on the pups would not have to be considered. Whether or not the pups
are allowed to continue nursing, they should be closely monitored for

*Diplomate, American College of Ve terinary Internal Medicine (Specialty of Internal Medi-

cine); Assistant Professor, Department of Small Animal Clinical Sciences, and Head of
Inte rnal Medicine, Michigan State University College of Veterinary Medicine, East
Lansing, Michigan

Veterinary Clinics of North America: Small Animal Practice- Val. 16, No. 3, May 1986 539
540 CHERI A. JOHNSON

weight gain and signs of illness. Mastitic milk has been cited as a cause for
neonatal septicemia, but any connection between milk composition and
puppy morbidity or mortality has not been critically evaluated.
Antibiotic infusion (for example, 0.2 per cent nitrofurazone) into a teat
orifice through a lacrimal cannula may be helpful. Any abnormal secretions
should first be expressed completely. Warm compresses applied to the
affected glands seem to reduce swelling and discomfort. Abscesses should
be surgically drained and flushed with dilute antiseptic solutions (Beta-
dine*). Additional systemic supportive care such as fluid therapy is dictated
by the individual case.

GALACTOSTASIS

Accumulation and stasis of milk within the mammary glands can cause
an inflammatory reaction resulting in enlarged, warm, painful glands.
Galactostasis occurs most often during weaning but also during pseudo-
pregnancy or in association with mastitis.
Treatment is nonspecific. Warm compresses may be helpful in relieving
the swelling and discomfort. Massaging or expressing the glands should be
avoided to prevent any further prolactin and oxytocin release, which could
cause additional milk production and let-down. Low doses of diuretics or
glucocorticoids may be helpful but are usually unnecessary. Reduction of
the bitch's caloric intake to maintenance amounts will decrease milk
production and is useful in treatment as well as prevention of galactostasis.
Gradual weaning of pups by early introduction (by 3 weeks) of solid food
will also help prevent galactostasis.

AGALACTIA

Agalactia (lack of milk production) is a rare problem in bitches. The

cause is usually undetermined . Poor nutrition, particularly rations with
low-quality protein or inadequate calories, will result in decreased milk
production. There is no known therapy that will produce lactation. Although
oxytocin is helpful in promoting milk let-down, it will not affect milk
production. Puppies can be hand-fed, but the willing bitch can still provide
all other care.
Some nervous bitches are reluctant to nurse even though milk produc-
tion may be adequate. Reassurance by the owner (or cautious tranquiliza-
tion) will usually resolve the proble m. If not, the bitch should not be used
for breeding, for maternal instinct appears to have some genetic component.

GALACTORRHEA

Galactorrhea is inappropriate lactation not associated with pregnancy

and parturition. In bitches, galactorrhea is very common in pseudopreg-

*Purdue Fredrick Co., Norwalk, Connecticut.

NON-NEOPLASTIC DISORDERS OF THE MAMMARY GLAND 541
nancy. Behavioral signs such as nest-building, adoption of inanimate (or
animate) objects, restlessness, and irritability are common and usually more
troublesome than the galactorrhea. The hormone prolactin is responsible
for milk production and, probably in concert with other hormones, for
maternal behavior.
Prolactin release is controlled by many biochemical and physical events
such as suckling. Progesterone withdrawal stimulates prolactin release. For
this reason, pseudopregnancy occurs at the end of diestrus as luteal
progesterone production declines, or following oophorectomy during dies-
trus or after withdrawal of exogenous progestins.
Thyrotropin-releasing hormone (TRH) also stimulates prolactin release
in some species, including dogs . Some bitches with prolonged galactorrhea
were found to be hypothyroid. 2 When these bitches were treated with
appropriate thyroid hormones, the galactorrhea resolved. This suggests that
hypothyroidism resulted in elevated TRH, which in turn caused excess
prolactin with resultant galactorrhea. Prolactin was not measured in these
bitches.
Signs of false pregnancy, including galactorrhea, are usually self-
limiting within several weeks. Tranquilization may be considered for bitches
with significant behavioral signs; however, phenothiazines increase prolactin
secretion in people. The steroids testosterone, estrogen, and progesterone
have all been used to treat false pregnancy. When treatment is necessary,
androgens are preferable to estrogen or progesterone. The following are
reported effective doses: mibolerone (Cheque Drop*), 0.016 mg per kg
given orally for 5 consecutive days (signs should resolve in 72 hours), and
testosterone, 1 to 2 mg per kg given intramuscularly once (repeat in 1 week
if necessary). Progestins such as megastrol acetate (Ovabant) are inappro-
priate because the signs may recur when the progestin is discontinued.
Estrogens should not be used because the risk of bone marrow suppression
is greater than any potential benefit to the bitch. The adverse side effects
(vomiting, neurologic signs) of the prolactin antagonist bromocriptine pre-
clude its use.
If galactorrhea is prolonged, hypothyroidism should be considered.
Although pseudopregnancy may recur with subsequent estrous cycles,
there is no association with increased incidence of pyometra or other
reproductive abnormalities. Ovariohysterectomy during anestrus will pre-
vent recurrence.

MAMMARY HYPERTROPHY

Feline mammary hype rtrophy is characterized by rapid, abnormal

mammary gland growth. Seventy per cent of cases have been reported in
queens under 2 years of age. Mammary hypertrophy has also been reported
in pregnant fe males and in neutered males and females receiving exogenous
progestins. Circumstantial evidence suggests a causal relationship between

*Upjohn Company, Kalamazoo, Michigan.

tSchering Laboratories, Kenilworth, New Jersey.
542 CHERI A. jOHNSON

progesterone and feline mammary hypertrophy. Various terms have been

applied to the condition including mammary hypertrophy, fibroepithelial
hyperplasia, fibroadenomatous change, fibroadenomatosis, and fibroade-
noma.
Feline mammary hypertrophy is a benign condition. The major differ-
ential diagnosis is mammary adenocarcioma, which is also characterized by
rapid, abnormal growth. Because many feline mammary neoplasms are
highly malignant, prompt differentiation between the two conditions by
histopathologic examination is warranted. Removing the source of proges-
terone with or without mastectomy will resolve feline mammary hypertro-
phy. Although spontaneous remission may occur, ovariohysterectomy
should be performed in queens and exogenous progestin treatment should
be discontinued in any cat in which mammary hypertrophy is a problem.

REFERENCES
l. Brown, J. M. : Efficacy and dosage titration study of mibolerone for treatme nt of pseudo-
pregnancy in the bitch. J. Am. Vet. Med. Assoc. , 184:1467- 1468, 1984.
2. Chastain, C. B., and Schmidt, B.: Galactorrhea associated with hypothyroidism in intact
bitches. J. Am. Anim. Hosp. Assoc., 16:851-854, 1980.
3. Frantz, A. G.: Prolactin. N. Engl. J. Med., 298:201-207, 1978.
4. Hayden, D. W. , Johnston, S. D. , and Kiang, D. T. , et al. : Feline mammary hyperpla-
sia/fibroadenoma complex: Clinical and hormonal aspects. Am. J. Vet. Res, 42:1699-
1702, 1981.
5. Johnston, S. D.: Pseudopregnancy. In Current Veterinary Therapy VI. Philadelphia, W.
B. Saunders Co., 1977, p. 1240.
6. Ogilvie, G. K.: Feline mammary neoplasia. Compend. Con tin. Ed., 5:384-392, 1983.
7. Wheeler, S. L., Magne, M. L., and Kaufman, J., e t al. : Post-partum disorders in the
bitch. Compend. Contin. Ed., 6:493-500, 1984.

Department of Small Animal Clinicai Sciences

College of Veterinary Medicine
Michigan State University
East Lansing, Michigan 48824