DIAGNOSTIC TREE h INTERNAL MEDICINE h PEER REVIEWED

Mammary Gland Enlargement in Male Dogs

Valeria M. Tanco, DVM, MSc, PhD, DACT
Charleston Veterinary Referral Center
Charleston, South Carolina

GYNECOMASTIA OBSERVED

Neutered Intact

INVESTIGATION INVESTIGATION
Obtain history & perform physical examination to Examine for other signs of feminization:
check for: h Alopecia (hyperpigmented, bilateral, nonpruritic)
h Polyuria/polydipsia h Pendulous prepuce
h Recurrent skin/urinary tract infections h Decreased penile size
h Alopecia (non-pruritic, bilateral, symmetrical) h Attraction to male dogs
h Panting h Female positioning for urination
h Temporal muscle atrophy h Potential cryptorchid
h Polyphagia h Abdominomegaly
h Abdominomegaly

History of exposure to exogenous hormones

h 

(eg, human estrogen cream/spray)†

INVESTIGATION
Perform testicular/diagnostic examination:
h CBC, serum chemistry profile, urinalysis
h Abdominal ultrasonography
INVESTIGATION
Perform diagnostic testing: h ACTH stimulation test/low-dose dexamethasone
h CBC, serum chemistry profile, urinalysis suppression test/urine cortisol:creatinine ratio
h Abdominal ultrasonography (home-caught urine sample)
h ACTH stimulation test/low-dose dexamethasone h Measure total T4, cTSH levels
h Palpation
suppression test/urine cortisol:creatinine ratio
h Ultrasound (testes, abdomen, inguinal area)*
(home-caught urine sample)
h Measure total T4, cTSH levels h Preputial cytology for functional testicular neoplasia

(intact, cryptorchid)
h Biopsy of mass/castration of testicle/histopathology
h FNA/cytology of testicles, inguinal lymph nodes

DIFFERENTIAL
Endocrinopathy
h Hyperadrenocorticism
h Hypothyroidism (less likely)
DIFFERENTIAL
Endocrinopathy
h Hyperadrenocorticism
h Hypothyroidism (less likely)

Normal Abnormal testicular cytology/biopsy

*Tumor type cannot be differentiated on ultrasound.
†
Patient contact with humans who use such preparations should
be explored, as it can be causative.
INVESTIGATION
Check for patient history of exposure to exogenous
hormones (eg, human estrogen cream/spray)†

cliniciansbrief.com January 2018

 INVESTIGATION INVESTIGATION
Mass is solitary, white to pale yellow, and firm Multiple tan, soft, small, round masses
+/- medullary aplasia
h  +/- medullary aplasia
h 

+/- prostatic perianal hyperplasia

h 

INVESTIGATION INVESTIGATION
Measure plasma hormone concentrations for: Measure plasma hormone concentrations for:
+/- elevated estradiol
h  +/- elevated estradiol
h 

Normal testosterone
h  Elevated testosterone
h 

INVESTIGATION INVESTIGATION
Check for clinical signs of feminization: Check for clinical signs of feminization:
Pendulous prepuce
h  Pendulous prepuce
h 

Gynecomastia
h  Gynecomastia
h 

Symmetrical alopecia
h  Symmetrical alopecia
h 

Hyperpigmentation
h  Hyperpigmentation
h 

Preputial keratinization
h  Preputial keratinization
h 

Attraction to male dogs

h  Attraction to male dogs
h 

DIAGNOSIS DIAGNOSIS
Sertoli cell tumor Leydig cell tumor

INVESTIGATION
Confirm via histopathology

TREATMENT
(Hemi) castration
h 

Blood or platelet transfusion as needed for anemia

h 

Pre-op CBC with platelet count to diagnose

h 

medullary aplasia

January 2018 cliniciansbrief.com