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Disorders of the mammary gland are frequently diagnosed in bitches of all breeds and of all ages. They usually appear in the postnatal period, during lactation peak or during false pregnancy. They may also be related to different pathologies of the mammary gland, such as mammary neoplasia. It is frequently underestimated by clinicians or misdiagnosed. A reliable diagnosis is the key to success. Conventional diagnosis consists of a clinical diagnosis together with a standard blood test, while in some cases cytological examination of the mammary gland is performed. In some cases of mastitis, especially its subclinical presentation, those methods may prove unreliable. For this reason, determination of specific inflammatory biomarkers may enable clinicians to produce a precise diagnosis, while it is very useful in treatment monitoring. A wide variety of inflammatory biomarkers have been extensively studied both in human and veterinary medicine. In this article, we will describe the most commonly evaluated inflammatory biomarkers - acute phase proteins, which seem to be promising tools in the diagnostics of canine mastitis. We hope that this paper will provide clinicians with new ideas for precise diagnosis and more specific treatment of canine mastitis.
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Animal Science Papers and Reports vol. 36 (2018), no. 1, 33-44
Institute of Genetics and Animal Breeding, Jastrzębiec, Poland
New insights of canine mastitis ‒ a review
Ilona Kaszak1*, Anna Ruszczak1, Szymon Kanafa1,
Olga Witkowska Piłaszewicz2, Mariusz Sacharczuk3, Piotr Jurka1
1 Department of Small Animal Diseases with Clinic, Warsaw University of Life Sciences,
Nowoursynowska 166, 02-787 Warsaw, Poland
2 Department of Pathology and Veterinary Diagnostics, Warsaw University of Life Sciences,
Nowoursynowska 166, 02-787 Warsaw, Poland
3 Laboratory of Neurogenomics, Institute of Genetics and Animal Breeding,
Jastrzebiec, Postępu 36A, 05-552 Magdalenka, Poland
(Accepted January 25, 2018)
Disorders of the mammary gland are frequently diagnosed in bitches of all breeds and of all ages.
They usually appear in the postnatal period, during lactation peak or during false pregnancy. They
may also be related to dierent pathologies of the mammary gland, such as mammary neoplasia.
It is frequently underestimated by clinicians or misdiagnosed. A reliable diagnosis is the key to
success. Conventional diagnosis consists of a clinical diagnosis together with a standard blood test,
while in some cases cytological examination of the mammary gland is performed. In some cases
of mastitis, especially its subclinical presentation, those methods may prove unreliable. For this
reason, determination of specic inammatory biomarkers may enable clinicians to produce a
precise diagnosis, while it is very useful in treatment monitoring. A wide variety of inammatory
biomarkers have been extensively studied both in human and veterinary medicine. In this article,
we will describe the most commonly evaluated inammatory biomarkers - acute phase proteins,
which seem to be promising tools in the diagnostics of canine mastitis. We hope that this paper
will provide clinicians with new ideas for precise diagnosis and more specic treatment of canine
KEY WORDS: biomarkers / bitch / dog / inammation / mammary gland
*Correspoding author:
The mammary gland is a transformed skin gland. It is functionally connected with
the secretion of ovarian hormones secretions; therefore, ovarian pathologies may have
an inuence on the mammary glands. Bitches usually have 5 pairs of mammary glands
located symmetrically on both sides of the chest and abdomen, but abnormalities in
the position and number of glands may occur. The mammary gland is basically an
exocrine gland, which basic function is to produce milk to feed the ospring. It is
composed of epithelial cells, which form the lining of alveoli and ducts, surrounded
by myoepithelial cells. The stroma of the gland consists of blood and lymphatic
vessels, brous and fat tissue and nerve endings. The contraction of myoepithelial
cells produces milk secretion into the lumen of secretory ducts which drain in the
opening in the nipple. During the puberty, mammary gland development is related to
cyclic ovarian activity and hormonal changes, with the growth continued until sexual
maturity is reached [Marti et al. 2010, Momont et al. 2002].
Mastitis is a medical term, which refers to an inammation with or without an
infection of the mammary gland. Therefore, we can distinguish septic and aseptic
mastitis. It may involve one or more glands. Inammation of the mammary gland
is a common problem in bitches of all breeds at various ages. Despite that fact,
mastitis is frequently underestimated or incorrectly diagnosed. The pathogens are
usually bacteria, but some cases of fungal mastitis in endemic areas or in dogs with
immunodeciency were observed as well [Ditmyer et al. 2011, Murai et al. 2013].
It is more often observed in non-spayed bitches, as it frequently appears in
the postnatal period, during lactation peak or during false pregnancy. However, it
may also be related to dierent pathological states of the mammary gland, such as
galactostasis, mammary hyperplasia or mammary neoplasia. Sometimes, mastitis is
indistinguishable from a mammary tumor with present inammation. There are four
clinical presentations of mastitis: acute mastitis, gangrenous mastitis, chronic mastitis
and subclinical mastitis. Risk factors include: poor hygienic conditions, trauma and
systemic infections. The most common route of infection is the ascending route from
the nipple, while trauma and haematogenous route are less frequent. Trauma may
be produced by sucking puppies during lactation. In some cases, injuries involving
foreign bodies or insect bites may cause similar lesions. In extreme cases the bitch
may present no signs of the disease or may be already in a critical condition. The
mammary gland is usually changed, but in the case of a subclinical presentation it may
remain normal [Marti et al. 2010, Momont et al. 2002].
I. Kaszak et al.
Causes of mastitis
The term lactation refers to the beginning of milk production and secretion. It
is strongly related to hormonal changes during pregnancy and parturition. Due to
a decrease of progesterone secretion at the end of pregnancy, the concentration of
prolactin increases. Prolactin together with other factors is responsible for the initiation
of lactation. There are several factors that either stimulate (e.g. oxytocin, serotonin,
oestrogens) or inhibit (e.g. dopamine, somatostatin, progestogens) prolactin release
[Concannon et al. 1989]. Mastitis during lactation develops as a consequence of
mammary gland trauma caused by sucking puppies or due to poor hygienic conditions.
Trauma and formed skin lesions facilitate bacteria penetrations into the mammary
tissue. Post-partum metritis through the haematogenous route may also cause mastitis.
Mastitis during lactation can be life – threatening both for the bitch and the puppies
[Schafer-Somi et al. 2003].
New insights of canine mastitis
Fig. 1. Acute mastitis during lactation in a 3 years old Yorkshire Terrier.
False pregnancy
False pregnancy, also called pseudopregnancy is a physiological state of a bitch.
It is connected with hormonal changes (progesterone concentration) after oestrus that
are similar both in pregnant and non-pregnant bitches. The clinical signs are present
usually in 6-8 weeks after oestrus and include mammary gland enlargement, beginning
of milk production, change in behaviour to typical of pregnancy and lactation such
as nesting behaviour, anorexia or agitation. Secretion from mammary glands may be
physiological but sometimes it may even be brown and mastitis may appear. Usually
treatment is necessary, especially in cases of severe lactation, galactostasis, complicated
additionally by infection and inammation [Marti et al. 2010, Momont et al. 2002].
Galactostasis is the overload of the mammary gland with milk that is seen before
the parturition or shortly afterwards. The enlargement of mammary gland is observed,
which leads to failure of milk let-down. Animals usually show pain and discomfort,
with the progression of the disease aseptic or sceptic mastitis may develop. It is
observed in highly lactating bitches, especially at very early weaning of puppies.
The treatment consists in limited feeding of the animal for several days (fasting may
be recommended during rst day), cold packs or compresses with baking soda are
recommended, use of diuretics and glucocorticoids may be necessary. A prolactin
antagonist should only be administered in cases of galactostasis due to false pregnancy
or when the ospring was weaned.
I. Kaszak et al.
Mammary gland tumors
Tumors of the mammary gland represent the most frequent cases of neoplasia in
female dogs. Around half of them are malignant neoplasia. They occur in bitches at an
older age, usually between 8 and 10 years old [Benavente et al. 2016, Sorenmo 2003].
It is more common in intact bitches. It is known that ovariohysterectomy before rst
oestrus greatly reduces the risk of mammary tumor [Beauvais et al. 2012]. Still,
the aetiology of canine mammary tumor is unknown. Some risk factors have been
identied, among which the most frequent are: hormonal, nutritional and genetic.
Tumors are usually discovered when macroscopic changes of the mammary gland
are visible. Inammation is very common, especially at a prolonged process of tumor
development is long. The treatment of choice is mastectomy with resection of local
lymph nodes, however, because of mastitis, in some cases antibiotics together with
anti-inammatory drugs have to be administered prior to the surgery.
Fig. 2. Galactostatis after weaning in a young female dog.
Fig. 3. Enormous mammary tumor with gangrenous mastitis.
Mammary gland hyperplasia
Mammary gland hyperplasia also called mammary hypertrophy or mammary
broadenomatosis is a non-neoplastic proliferative process. It is more typical in
queens than in bitches. It concerns young females, usually after the rst oestrus,
although it may also appear during pregnancy or false pregnancy. It is related to the
progesterone concentration [Martin et al. 2000, Momont et al. 2002]. It is thought that
the administration of progestogens plays an important role in its pathogenesis [Loretti
et al. 2009, Marti et al. 2010]. Mammary glands are usually rm and enlarged, it may
aect one, several or all glands. In severe cases, mastitis with ulcerative necrosis of
the skin may appear. Treatment should always be undertaken.
Clinical presentation of mastitis
Acute mastitis
In the case of acute mastitis mammary glands are usually hot and painful during
palpation, enlarged, swollen and erythematous [Marti et al. 2010]. If acute mastitis is
septic, clinical signs such as fever, apathy, depression, lethargy, anorexia and neglect
of puppies may appear. The puppies may present the toxic milk syndrome, which is
basically a bacterial infection of puppies due to maternal milk contaminated with
bacteria and their toxins. The secretion of the gland is brown, may contain small
amounts of pus and blood, its smell may be changed [Marti et al. 2010]. In cases of
acute mastitis urgent treatment is needed.
Gangrenous mastitis
Gangrenous mastitis is usually a consequence of untreated acute mastitis [Marti
et al. 2010]. It is characterised by pus production and abscess formation may appear.
Secondly, mammary glands may become ulcerated and necrosis may form. Altered
glands become darker, colder and have an unpleasant putrid odour. Signs of sepsis are
usually present at that time.
New insights of canine mastitis
Fig. 4. Severe gangrenous mastitis together with mammary gland neoplasia.
Chronic mastitis
Little is known about chronic mastitis in dogs. It is typically a consequence of less
severe acute cases of mastitis or are related to mammary neoplasia. During clinical
examination, the gland might by slightly inamed or swollen and its consistency
during palpation may be heterogeneous. Chronic mastitis should be suspected in cases
of an increased rate of falls in new-borns and when the litter is not gaining weight
Subclinical mastitis
Subclinical mastitis is very dicult to diagnose, it is a challenge for clinicians
as no clinical signs are seen. Moreover, this form of mastitis occurs quite often
[Marti et al. 2010, Vasiu et al. 2015]. Sometimes the only presenting complaint is
slow progress of the ospring growth and their limited weight gain. Additionally,
puppies may also show signs of the toxic milk syndrome. It may develop and lead to
systemic inammation or sepsis. Therefore, subclinical mastitis cannot be neglected
and an early and precise diagnosis must be provided. The mammary gland remains
unchanged and the secretion may also be normal, so clinical diagnosis is usually
unhelpful. Diagnostic imaging may appear to be useful, but not always changes in
the mammary gland structure will be visible. Evaluation of specic inammatory
biomarkers in serum as well as in milk samples may represent the best non- invasive,
fast and very sensitive method of mastitis diagnosis [Vasiu et al. 2015]. In the next
section selected inammatory biomarkers used in the diagnosis of mastitis will be
If during a veterinary consultation we suspect mammary gland inammation,
rst of all we need to obtain relevant information from the owner. We need to ask:
how long the animal has been presenting this symptom, when was the parturition,
whether it was its rst parturition, how many puppies were born and/ or whether
it is the rst time the bitch presents a false pregnancy. To diagnose mastitis in a
bitch full clinical examination is required [Marti et al. 2010]. All mammary glands
should be evaluated, checking their symmetry, temperature, size, consistency and
skin colour. Secondly, a blood test together with sampling of secretion/ milk from the
abnormal mammary gland should be performed. In the case of secretion, we need to
evaluate its colour, consistency and smell. Cytological examination should always
be performed. In cases of chronic mastitis a microbiological culture of the secretion
together with drug susceptibility testing may be indicated. The most common isolated
pathogens are staphylococci, streptococci and E. coli [Murai et al. 2013, Seweryn
et al. 2009]. Apart from that, X-ray should always be considered, especially if the
I. Kaszak et al.
mammary gland neoplasia is suspected, in order to exclude metastases to the lungs.
Also, ultrasonography of the mammary gland appears to be a very useful diagnostic
method for mastitis as well as mammary tumor detection. It can precisely estimate
the degree of inammation as well as detect abnormalities inside the gland [Trasch
et al. 2007]. Fine needle biopsy is usually recommended if mammary neoplasia is
suspected, though the obtained results may not always be very precise. Last, but not
the least, determination of specic inammatory biomarkers in serum might prove to
be highly informative.
Selected inammatory biomarkers used in the diagnosis of mastitis
Inammatory biomarkers are usually proteins, which can be measured in blood or
other tissues (e.g. milk) and provide information on the presence of the inammation,
results of treatment or further prognosis for the patient. They are also detectable in
the serum and tissues of healthy dogs, but their levels are signicantly lower. During
local or systemic inammation processes, inammatory cells secrete proinammatory
mediators such as cytokines and chemokines, which are released into systemic
circulation. A wide range of compounds are classied as inammatory biomarkers,
among which acute phase proteins, T-lymphocytes, macrophages, interleukins,
receptor tyrosine kinases, as well as cyclooxygenases play a particularly important
role. In the case of canine mastitis only the determination of acute phase proteins
has been briey described [Vasiu et al. 2017]. The results of this research proved
that evaluation of inammatory biomarkers of inammation may be very useful in
the diagnosis of mastitis, especially its subclinical presentations, which remain a
challenge for the clinicians. Additionally, their assay in cases of clinical mastitis may
be useful in monitoring the treatment outcome.
Acute phase proteins
Acute phase proteins (APP) are serum proteins, which concentrations change as
a part of innate host defence systemic response to infection, inammation or trauma
[Ceron et al. 2005, Eckersall et al. 2010, Paltrinieri et al. 2007]. APP can be divided
into positive, moderate and negative APP, with the concentration of the former
increasing after inammation, the levels of moderate increasing slightly, whereas the
concentration of negative APP is reduced after inammation. The most commonly
evaluated positive APP are C-reactive protein (CRP) and serum amyloid A (SAA),
whereas, albumin is the main negative APP. An APP assay may be helpful in the
diagnostics of the inammation, in treatment monitoring of inammation as well as
in diagnostics of some neoplastic diseases [Ceron et al. 2005, Eckersall et al. 2010,
Planellas et al. 2009, Tecles et al. 2009]. APP production is rapid (being detectable
within several hours after the beginning of the inammatory process), intense, but
also unspecic for the disease. They can be induced by any inammatory stimulus
New insights of canine mastitis
or even by pathophysiological conditions (tumors, stress, pregnancy) [Eckersall
et al. 2010]. For these reasons, due to its low specicity its clinical importance is
limited. On the other hand, it gives us a clear sign, that the organism is suering from
some pathological process, which can possibly be life-threatening. Therefore, APP
may be very useful in the detection of particularly subclinical mastitis as well as for
monitoring patients during recovery.
C-reactive protein
C-reactive protein (CRP) is a very well-studied inammatory biomarker, it has
been described in cases of canine pyometra, systemic inammatory diseases and
mammary tumors etc. [Christensen et al. 2015, Dąbrowski et al. 2007, Dąbrowski
et al. 2015, Planellas et al. 2009, Tecles et al. 2009]. Its biggest advantage is that its
concentration increases rapidly after the onset of the tissue damage and decreases
with its recovery [Vasiu et al. 2017]. As it was mentioned before, CRP is a non-
specic acute phase protein and its concertation may be increased due to any disease.
However, an elevated CRP concentration in milk is evidence of mastitis. A recent
study conrmed that CRP concentrations in both serum and milk samples from bitches
presenting mastitis were higher than in healthy bitches [Vasiu et al. 2017]. A positive
correlation was observed between serum and milk CRP concentrations. Interestingly,
no dierences were noticed between subclinical and clinical presentations of mastitis.
The serum values in bitches suering from mastitis ranged from 0.3 to 162.3 µg/
ml, while in healthy bitches it was 2-8.6 µg/ml, thus in diseased bitches the CRP
concentration was as high as 20-fold higher in comparison to healthy bitches. Milk
CRP levels in bitches suering from mastitis ranged from 0.3 to 40.0 µg/ml, while in
healthy females it was 0.1-4.9 µg/ml, so in diseased bitches the concentration was
even 8 times higher then in healthy bitches. Still the range of recorded concentration
values was wide, moreover, other on-going pathologies were not excluded and nally
the number of patients was relatively low. Nevertheless, it seems to be a very good
biomarker for early mastitis diagnosis, especially in cases of subclinical mastitis,
which is dicult to diagnose clinically.
Serum amyloid A
Serum amyloid A is another very important positive APP, assayed in many
systemic diseases in dogs [Christensen et al. 2014, Dąbrowski et al. 2007, Jiptean
et al. 2014]. Some studies indicated that SAA may be a more sensitive maker of
systemic inammation than CRP, as its concentration may be increased, while CRP
concentration would remain normal [Christensen et al. 2014, Jiptean et al. 2014].
Also, the recorded concentration ranges in patients presenting the disease turned out to
be narrower in the case of SAA in comparison to CRP [Jiptean et al. 2014], which was
in contrast to the data from a previous study [Christensen et al. 2014]. Therefore, it
I. Kaszak et al.
seems to be a more sensitive and more precise inammatory biomarker. Nevertheless,
a simultaneous assay of both SAA and CRP is usually recommended. Still, to the best
of the authors’ knowledge no studies have been conducted on the determination of
SAA in the case of canine mastitis.
Cyclooxygenases (COX) are inammatory biomarkers of inammation basically
assayed in neoplastic diseases [Benavente et al. 2016, Carvahlo et al. 2016]. The
cyclooxygenese enzyme catalyses the prostaglandin biosynthesis from arachnoid
acid. There are two isoforms: Cox-1 and Cox-2, but they have dierent biological
functions. Cox-1 is expressed in normal tissues and is responsible for the control of
renal function, reproduction and cytoprotection of stomach, among other things. Cox-
2 is undetectable in normal tissues, as it is expressed in tissue due to inammatory
reactions, growth factor, tumor promoters or oncogenes. Many studies conrmed that
prostaglandins play an important role in tumor’s development. COX-2 expression
was found to be increased in cases of malignant mammary tumors [Benavente et al.
2016, Carvahlo et al. 2016]. Determination of COX-2 in the cases of mastitis may be
interesting, especially in order to distinguish between mastitis and mammary tumors.
However, no such studies have been conducted to date.
All the above-mentioned presentations of mastitis require treatment: rstly,
stabilisation of patients by uid administration targeted at correcting metabolic
disturbances. This is followed by therapy involving broad-spectrum antibiotics,
selected based on drug susceptibility testing, while milk pH should also be considered.
If the milk pH is lower than serum pH (<7,3), trimethoprim/ sulfathiazine 15-30 mg/
kg orally BID during 21 days), erythromycin (10 mg/kg orally TID during 21 days),
lincomycin (15 mg/kg orally TID during 21 days) should be used. When pH is >7.4,
ampicillin (20 mg/kg intramuscularly TID during 21 days) or cephalexin (30 mg/kg
orally BID during 21 days) are administered [Jiptean et al. 2014]. Some antibiotics
may reach therapeutic concentrations in milk regardless its pH, but they are usually
not recommended due to their negative eect on the puppies’ growth. In the case of
acute mastitis, the selected antibiotic is not that important as the integrity of the milk/
serum barrier has already been broken [Marti et al. 2010].
Moreover, additional therapy consisting in manual emptying of abnormal
mammary glands to avoid the accumulation of secretion is very important. Keeping
the area clean by washing and disinfecting is also necessary. Application of warm
compresses at least twice a day may help to reduce the inammation of the gland.
In some cases, local application of antibacterial and anti-inammatory tubes used in
cows for intramammary treatment of mastitis (e.g. Tetra Delta, Zoetis) may be helpful.
New insights of canine mastitis
Whether to separate puppies from their mother or not remain disputable. In
cases of severe mastitis with the presence of abscesses and gangrenous inammation
it is strongly advised against to continue nursing of puppies, as ingestion of toxic
or antibiotic-containing milk may produce health problems among the ospring.
The owner needs to hand-raise the neonates. In the case of slight mastitis, natural
feeding can be maintained, but it is necessary to remember that during mastitis milk
composition will deteriorate and weight gains among the puppies will be lower.
It is recommended to perform a surgical drainage in cases of gangrenous
inammation; sometimes drains have to be left in the tissue for several days. In some
very severe cases mastectomy is the method of choice.
If sepsis has not been developed, mastitis can be treated without any complications.
Mastitis is usually resolved with appropriate antibiotic therapy, although it takes some
time. The function of the mammary gland remains unaected, unless it was seriously
damaged due to abscesses or necrosis. Bitches may suer from mastitis during every
lactation and every false pregnancy, probably because the mammary gland anatomy
facilitates introduction of pathogens through the nipples. This phenomenon must be
mentioned to the owner and pros and cons of bitch castration should be discussed.
Disorders of the mammary gland are frequent health problems in bitches of
various ages. Among them mastitis is relatively common, especially in lactating
bitches or in false pregnancy. When left untreated it can be life-threatening, so proper
diagnosis and specic treatment are of great importance. Standard diagnostic methods,
involving clinical examination, blood tests and cytological examination of mammary
gland secretion may be insucient, especially in the case of subclinical mastitis. In
order to provide a rapid and more precise diagnosis inammatory biomarkers need to
be assayed. Acute phase proteins (CRP or SAA) detected in serum and milk samples
seem to be the most accurate inammatory biomarkers to diagnose canine mastitis, as
their concentrations are signicantly higher in bitches suering from mastitis than in
healthy bitches. However, more studies need to be conducted to evaluate dierences
in concentrations between dierent mastitis presentations (clinical vs. subclinical).
Identication of dierences between clinical and subclinical presentations may
promote a more adequate treatment. Other inammatory biomarkers such as
cyclooxygenases or interleukins seems to be promising both in diagnosis of mastitis
and dierentiation between mastitis and mammary tumours. However, before it is
clinically feasible, further studies on these biomarkers have to be carried out to obtain
more specic data.
I. Kaszak et al.
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... Walaupun begitu, mastitis sering diremehkan atau kesalahan diagnosa. Patogen penyebab mastitis biasanya bakteri, tetapi beberapa kasus disebabkan oleh jamur pada area endemik atau pada anjing dengan immunodefisiensi (Kaszak et al., 2018). ...
... Kadangkadang, mastitis tidak dapat dibedakan dari tumor mammae dengan peradangan yang ada. Terdapat empat presentasi klinis dari mastitis : mastitis akut, mastitis gangren, mastitis kronis dan mastitis subklinis (Kaszak et al., 2018). ...
... Hal ini biasanya merupakan konsekuensi dari kasus mastitis akut yang tidak terlalu parah atau berkaitan dengan neoplasia mammae. Selama pemeriksaan klinis, kelenjar mammae akan terlihat sedikit meradang atau bengkak dan memiliki konsistensi yang heterogen selama palpasi (Kaszak et al., 2018). Kasus ini ditemukan terdapat banyaknya peradangan limfosit dan infiltrasi makrofag di sekitar duktus kelenjar mammae (Gambar. ...
Anjing ras poodle berusia 9 tahun bernama Lezy datang bersama pemiliknya memiliki keluhan adanya benjolan di kelenjar mammae yang berkembang selama 3 tahun. Pemeriksaan fisik mulai dari inspeksi dan palpasi menemukan ukuran benjolan dengan diameter ±3,5 cm tanpa adanya cairan yang keluar dari area benjolan, hal ini membuat keputusan diagnosa sementara oleh dokter hewan yaitu tumor mammae. Terapi yang harus dilakukan adalah terapi operatif mastektomi. Teknik operasi ini dilakukan dengan prinsip pengambilan massa seperti tumor dari area kelenjar mammae. Sebelum dilakukan operasi, pasien menjalani pemeriksaan hematologi dan kimia darah, dan hasilnya menunjukkan kondisi normal. Massa seperti tumor yang telah diambil kemudian dijadikan sampel histopatologi, dan menunjukkan banyaknya peradangan kronis yang ditandai adanya sel-sel mononuklear seperti limfosit dan juga makrofag. Namun, biomarker sel tumor sama sekali tidak ditemukan. Sehingga, dari pemeriksaan histopatologi menentukan diagnosa mastitis kronis non supuratif pada pasien ini. Terapi pasca operasi menghasilkan luka operasi yang bagus setelah hari ke 12.
... counted and examined for surface integrity alongside the areola area (Englar, 2019;Kaszak et al., 2018) since non-patent or inverted nipples can predispose bitches to galactostasis (Davidson, 2016). ...
... Veterinary staff, breeders or owners, should express milk from each gland to evaluate, if the bitch is producing milk and assess its consistency, colour and smell (Englar, 2019;Kaszak et al., 2018). ...
... Inflamed mammary glands should be covered to prevent tissue excoriation by puppy nails (Davidson, 2008;Root Kustritz, 2010;Traas, 2008;Wiebe & Howard, 2009). Shaving the hair from around the teats, and trimming the puppies nails is also helpful (Grundy, 2018 To avoid side effects, one should start at a low dose and increasing slowly, or by dividing the dose by two, BID (Bassu, 2017;Davidson, 2017;Grundy, 2018;Kaszak et al., 2018 (Grundy, 2018;Martí, 2009;Root Kustritz, 2010). ...
Mastitis is a common reproductive disorder in bitches, reaching a prevalence of 0.71%. Mastitis has a wide range of forms, from asymptomatic to severe gangrenous mastitis that can lead to septic shock and death of the bitch and nurslings. However, most of the time it is overlooked, undiagnosed or mistreated. The present systematic review was performed to revise and summarize the existing knowledge related to this disorder, including diagnosis, treatment and prevention.
... Another non-infectious risk factor which could appear in newborns is toxic milk syndrome (TMS), caused by the milk being contaminated with bacterial toxins [132]. The most common cause of TMS is acute mastitis or metritis present in dams [132]. ...
... Another non-infectious risk factor which could appear in newborns is toxic milk syndrome (TMS), caused by the milk being contaminated with bacterial toxins [132]. The most common cause of TMS is acute mastitis or metritis present in dams [132]. Toxic milk syndrome usually affects puppies from birth to two weeks of age. ...
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The perinatal period has a critical impact on viability of the newborns. The variety of factors that can potentially affect the health of a litter during pregnancy, birth, and the first weeks of life requires proper attention from both the breeder and the veterinarian. The health status of puppies can be influenced by various maternal factors, including breed characteristics, anatomy, quality of nutrition, delivery assistance, neonatal care, and environmental or infectious agents encountered during pregnancy. Regular examinations and pregnancy monitoring are key tools for early detection of signals that can indicate disorders even before clinical signs occur. Early detection significantly increases the chances of puppies’ survival and proper development. The purpose of the review was to summarize and discuss the complex interactions between all elements that, throughout pregnancy and the first days of life, have a tangible impact on the subsequent fate of the offspring. Many of these components continue to pose challenges in veterinary neonatology; thus, publications presenting the current state of knowledge in this field are in demand.
... APPs has also been evaluated in mammary diseases which represent a frequent health problems of bitches [23]. APPs from serum and milk specimens may be used as accurate inflammatory biomarkers, since their concentrations are significantly higher in bitches suffering from mastitis than in healthy ones [23]. ...
... APPs has also been evaluated in mammary diseases which represent a frequent health problems of bitches [23]. APPs from serum and milk specimens may be used as accurate inflammatory biomarkers, since their concentrations are significantly higher in bitches suffering from mastitis than in healthy ones [23]. This is particularly important in the case of initial or subclinical mastitis, as standard diagnostic procedures, such as clinical exami-nations, blood tests, and cytological examinations of mammary gland secretion, may fail to diagnose a condition that, if misdiagnosed or left untreated, can become life-threatening. ...
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The investigation of acute phase proteins in veterinary medicine has opened the doors towards the identification and use of new markers for a timely assessment of health status in both companion and food-producing animals. The aim of this paper is to review the literature available on the use of serum amyloid A (SAA), an acute phase protein, for the diagnosis and monitoring of reproductive disorders in animals. This review critically appraises the usefulness of such marker in clinical practice and summarizes the current state of knowledge. Recent advances in the diagnosis and monitoring of reproductive diseases are presented, highlighting where SAA evaluation may enhance early diagnostic tools for dogs, cats, cattle, and equines.
... However, criteria allowing the differentiation between inflammation and neoplasia by ultrasonographic examination are not provided by current literature. Inflammation is very common in mammary neoplasia, especially during the prolonged process of tumour, and also, in clinical practice, mastitis may be indistinguishable from a mammary tumour with present inflammation [39], as has been reported in human medicine [40]. ...
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The study of the structure and function of the animals’ mammary glands is of key importance, as it reveals pathological processes at their onset, thus contributing to their immediate treatment. The most frequently studied mammary diseases are mastitis in cows and ewes and mammary tumours in dogs and cats. Various imaging techniques such as computed tomography, positron emission tomography, magnetic resonance imaging, and ultrasonographic techniques (Doppler, contrast-enchanced, three-dimensional and elastography) are available and can be applied in research or clinical practice in order to evaluate possible abnormalities in mammary glands, as well as to assist in the differential diagnosis. In this review, the above imaging technologies are described, and the perspectives of each method are highlighted. It is inferred that ultrasonographic modalities are the most frequently used imaging techniques for the diagnosis of clinical or subclinical mastitis and treatment guidance on a farm. In companion animals, a combination of imaging techniques should be applied for a more accurate diagnosis of mammary tumours. In any case, the confirmation of the diagnosis is provided by laboratory techniques.
... This is a problem of all dog breeds at various ages. Other than the post natal lactation period mastitis can also be related to the diff erent conditions li ke galactostasis, pseudopregnancy, mammary hyperplasia or mammary neoplasia (Kaszak et al., 2018). The four clinical forms of canine mastitis are acute, subclinical, chronic and gangrenous forms. ...
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A three year old female beagle dog, whelped 7 days back, was presented to the University Veterinary Hospital, Kokkalai with a complaint of reduced food intake and death of puppies. An oedematous right caudal mammary gland which was hot to touch and have sticky milk secretions. Milk sample was collected and examined for culture and sensitivity examination. The mammary gland underwent gangrenous changes and sloughing off happened for the tissue. The animal was treated with antibiotics and fluid therapy. The wound was managed with local applications and wet to dry dressing. After three week of post therapy a scar formed on recovered area and animal showed an uneventful recovery.
... In the population evaluated in the present study, it was not a common practice to have the mammary glands clipped or scrubbed unless there was a medical indication such as preparation for surgery. In regards to a hematogenous spread of bacteria, there are suggestions that there is an association between metritis and mastitis (Kaszak et al., 2018;Momont and Barber, 2003). In the present study, 6 of 22 bitches (27.3 %) that had metritis also had mastitis compared to the mastitis incidence of 13.1 % for bitches with no metritis and the two diagnoses were made on an average of 3.8 days apart. ...
Canine mastitis and metritis can cause severe illness but the incidence and risk factors have not been well-studied. Goals in the present study were: 1) report the incidence of mastitis and metritis in a large population, and 2) identify potential risk factors that predispose females to those diseases. A retrospective cohort study was conducted using data from two guide dog colonies that was collected for 17 and 10 years, respectively, for the two colonies. A total of 3,076 whelpings occurred during the respective study periods and data were analyzed. Clinical mastitis was diagnosed in 13.2% of whelpings (408 cases) with the average day of diagnosis being 16.7 postpartum. Risk factors for mastitis identified were colony, litter size where bitches that had large litter size of ≥9 pups (16.2%) were 60% more likely to develop mastitis compared with bitches that had litters of <9 pups (11.3%). Bitches with congestion of the mammary gland were 4.8 times more likely to develop mastitis compared with bitches without mammary congestion. Case incidence of metritis was small (0.7% of whelpings) and occurred on average at day-5 postpartum (range 1 to 16). There were no significant risk factors identified, and this may be due to the small number of metritis cases (22 cases) in the present study. Interpretations regarding metritis, therefore, should be made with caution. The results from this study provide parameters for breeders and veterinarians to identify bitches that may require close monitoring for mastitis and metritis.
... Acute phase proteins (CRP or SAA) in serum and milk samples seem to be the most accurate inflammatory biomarkers to diagnose canine mastitis, as their concentrations are significantly higher in bitches suffering from mastitis than in healthy bitches. Other inflammatory biomarkers like cyclooxygenases or interleukins seem to be promising both in diagnosis of mastitis and differentiation between mastitis and mammary tumours [18]. ...
Long-acting gonadotropin-releasing hormone (GnRH) analogs, which are approved for male dogs and ferrets, have been used off-label to suppress estrus in bitches predisposed to the side effects of spaying. Health data from the past 12 years were evaluated from bitches without progestogen pretreatment that received deslorelin acetate (DA) to suppress estrus for the first time before the age of 4.5 years. The study population included 32 client-owned bitches repeatedly treated with either 4.7 mg or 9.4 mg DA implants for a period of 5.3 ± 3.4 years (range 0.5–11.3 years). Follow-up information concerning immediate side effects of DA occurring within five months after the first DA treatment (n = 23) as well as long-term side effects of sustained gonadal suppression occurring after five months up to three years (n = 2), three years up to five years (n = 2) or more than five years (n = 8) were assessed through a questionnaire. Treatment was considered successful if no major side effects requiring medical treatment occurred, which applied to 26 out of 32 (81 %) bitches. In the six remaining bitches, the following major side effects led to treatment discontinuation: persistent urinary incontinence (n = 1), reoccurring induced heat (n = 1), uterine disease (n = 3) and/or ovarian tumor (n = 3). The bitches recovered completely after surgical spaying and/or DA implant removal. Minor side effects that did not require therapy or affect animal welfare included body weight changes (n = 18), subtle behavioral changes (n = 13), induced heat (n = 12), coat changes (n = 11), pseudocyesis (n = 6), transient urinary incontinence (n = 4), and/or temporary thickening of the uterine wall with little anechogenic content (n = 2). To examine a possible causal relationship between adverse side effects and DA treatment, further studies should compare the frequency of pathologies between groups of GnRH-treated, intact and spayed bitches of similar breeds and ages. Nevertheless, DA application before the age of 4.5 years may be a means of postponing surgical spaying for several years in breeds at high risk for developing urinary incontinence. Before DA is used in bitches, owners should be fully informed regarding possible side effects.
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Mammary tumors are the most common neoplasm in the female dog, with a median age of appearance between 9 and 11 years. They may appear as single or multiple nodules, and posterior mammary glands are more frequently affected than anterior glands. Both benign and malignant tumors may occur in the dog, and according to histological criteria, approximately 50% of the tumors are malignant. Mammary gland tumors tend to be heterogeneous in their pathological characteristics and clinical behavior. Different hormones and growth factors play a key role in the development of this neoplasm, however, the mechanism by which they influence tumor growth and their possible prognostic value are still under study. Besides, new therapeutic options for each particular tumor type are being developed. The aim of this article is to review pathological, prognostic and therapeutic aspects of canine mammary neoplasms.
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Infiltrating cells of the immune system are widely accepted to be generic constituents of tumor microenvironment. It has been well established that the development of mammary cancer, both in humans and dogs, is associated with alterations in numbers and functions of immune cells at the sites of tumor progression. These tumor infiltrating immune cells seems to exhibit exclusive phenotypic and functional characteristics and mammary cancer cells can take advantage of signaling molecules released by them. Cancer related inflammation has an important role in mammary carcinogenesis, contributing to the acquisition of core hallmark capabilities that allow cancer cells to survive, proliferate, and disseminate. Indeed, recent studies in human breast cancer and in canine mammary tumors have identified a growing list of signaling molecules released by inflammatory cells that serve as effectors of their tumor-promoting actions. These include the COX-2, the tumor growth factor EGF, the angiogenic growth factor VEGF, other proangiogenic factors and a large variety of chemokines and cytokines that amplify the inflammatory state. This review describes the intertwined signaling pathways shared by Tlymphocytic/macrophage infiltrates and important tissue biomarkers in both human and dog mammary carcinogenesis.
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C-reactive protein (CRP) is a major acute phase protein showing increasing serum concentrations in dogs with systemic inflammation following e.g., surgery, trauma, infections, or neoplasia. CRP is a useful diagnostic marker of systemic inflammation in dogs and automated assays have been validated for reliable measurements for routine diagnostic purposes. In the present study available evidence for the use of CRP as a marker of surgery related systemic inflammation in dogs was reviewed and assessed. Two main themes were in focus: (1) canine CRP as a potential marker of postsurgical infectious complications and (2) canine CRP as a marker of the degree of surgical trauma. As outlined in the review several studies suggest that CRP is a useful marker for both purposes. However, the evidence level is limited and studies in the field are all affected by considerable risks of bias. Thus, further studies are needed in order to confirm the assumptions from previous studies and increase the level of evidence for CRP as a useful marker for detecting inflammation after surgery in dogs.
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Background: Sepsis is a serious and potentially life-threatening condition and early diagnosis and appropriate treatment is crucial for survival. Pyometra is one of the most common diseases in intact female dogs. The disease often leads to sepsis (systemic inflammatory response syndrome, SIRS, caused by infection). Diagnostic markers for detecting sepsis are gaining increasing interest in veterinary medicine. Acute phase proteins (APPs) such as C-reactive protein (CRP) are useful for detecting systemic inflammation in dogs. Serum amyloid A (SAA) is another major APP in dogs that is not yet as widely used. Albumin is regarded as a negative APP and has earlier been evaluated for prediction of prognosis in septic dogs. The aim of the present study was to determine SAA, CRP and albumin concentrations in dogs with sepsis and pyometra and to evaluate whether these inflammatory markers are associated with length of postoperative hospitalization. Results: Thirty-one surgically treated bitches with pyometra were included, whereof 23 septic (SIRS-positive) and eight non-septic (SIRS-negative). Albumin concentrations were analyzed by routine automated methods. SAA and CRP analyses were performed with previously validated commercially available assays (ELISA and immunoturbidimetric).Mean (± SE) serum concentrations of SAA were significantly higher in septic (130.8 ± 8.0 mg/L) compared to non-septic bitches (88.5 ± 12.5 mg/L). Using a cut-off value for SAA of 109.07 mg/L (n = 31 bitches), the sensitivity and specificity for detecting sepsis was 74% and 50%, respectively. Serum albumin concentrations were not significantly different in septic compared to non-septic bitches (mean ± SE, 25 ± 1 g/L and 26 ± 1 g/L, respectively). CRP concentrations were also not significantly different in septic (mean ± SE 225.6 ± 16.0 mg/L) compared to non-septic bitches (mean ± SE, 176.0 ± 27.1 mg/L). None of these inflammatory markers were associated with the outcome as measured by length of hospitalization. Conclusions: SAA concentrations were increased in dogs with sepsis induced by pyometra and may be useful as an adjunctive diagnostic marker for sepsis. To evaluate the full potential of SAA as a marker for sepsis also in other diseases, further studies are warranted.
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The diagnostic performance of canine serum amyloid A (SAA) was compared with that of C-reactive protein (CRP) in the detection of systemic inflammation in dogs. Sera from 500 dogs were retrospectively included in the study. C-reactive protein and SAA were measured using validated automated assays. The overlap performance, clinical decision limits, overall diagnostic performance, correlations, and agreement in the clinical classification between these 2 diagnostic markers were compared. Significantly higher concentrations of both proteins were detected in dogs with systemic inflammation (SAA range: 48.75 to > 2700 mg/L; CRP range: 0.4 to 907.4 mg/L) compared to dogs without systemic inflammation (SAA range: 1.06 to 56.4 mg/L; CRP range: 0.07 to 24.7 mg/L). Both proteins were shown to be sensitive and specific markers of systemic inflammation in dogs. Significant correlations and excellent diagnostic agreement were observed between the 2 markers. However, SAA showed a wider range of concentrations and a significantly superior overall diagnostic performance compared with CRP.
Presence of mastitis in lactating bitches can become life threatening for both the bitch and pups. The aim of the present study was to evaluate a possible utility of C-reactive protein (CRP) in both milk and serum for canine mastitis diagnosis. Our study showed that milk CRP levels ranged between 0.1 to 4.9 µg/mL and from 0.3 to 40.0 µg/mL in healthy and diseased bitches (P<0.01), respectively, while serum CRP levels ranged between 2.0 and 8.6 µg/mL and between 0.3 and 162.3 µg/mL in healthy and diseased bitches (P<0.01), respectively. Milk and serum CRP levels were higher in both clinical and subclinical mastitis when compared with healthy controls (p<0.05 in all cases). However, no significant differences were recorded in CRP concentrations between clinical and subclinical cases. Based on these results, it could be concluded that serum and milk CRP could be useful in order to diagnose canine mastitis.
Pyometra is one of the most common diseases of the reproductive system in bitches. The inflammatory processes occurring in the uterus result in changes in concentrations of numerous serum biomarkers, which are used for monitoring the postoperative period. The aim of the present report was to study the evolution of serum levels of insulin-like growth factor-1 (IGF-1) and C-reactive protein (CRP) in bitches suffered from pyometra and after ovariohysterectomy in comparison with the control group of healthy dogs submitted to the surgery. Our results indicate that the serum level of IGF-1 is decreased (101.6 ng/mL [73.8-177.8 ng/mL]), whereas CRP is increased (114.6 μg/mL [95.3-131.6 μg/mL]) during severe inflammation. When inflammation caused by pyometra and surgery is resolved, the level of IGF-1 is increased (186.0 ng/mL [94.6-344.3 ng/mL], P < 0.05) and CRP decreased (23.3 μg/mL [9.9-77.0 μg/mL], P < 0.01), suggesting that these markers could be useful for assessment of the postoperative period in bitches. Copyright © 2014 Elsevier Inc. All rights reserved.
A 2-year, 7-month-old female Chihuahua was admitted for a mammary mass measuring one cm in diameter. The dog had a history of demodicosis for 4 months and showed signs of pseudopregnancy at the time of the visit. Cytologic examination of an aspirate of the mass revealed a large number of macrophages containing nonstaining bacterial rods, which were acid-fast in a Ziehl-Neelsen stain, suggesting mycobacterial infection. Histologic examination of the mass revealed a pyogranulomatous mastitis characterized by an infiltration with macrophages containing acid-fast bacteria. Mycobacterium kansasii was subsequently cultured and identified by PCR. Surgical excision of the mass resulted in the growth of other dermal masses, but antimycobacterial treatment with rifampin and clarithromycin resolved these masses within 1 month. Three months after discontinuation of the treatment, similar organisms were found in aspirates of the enlarged bilateral inguinal lymph nodes by cytologic examination. Despite antimycobacterial treatment for another 4 months, there was no improvement and demodicosis also recurred. The dog eventually died of lymphoma 5 months after the relapse of mycobacterial infection. Although M kansasii is considered an important pathogen for pulmonary and cutaneous disease in people, there is only one report in a dog with an infection in a pleural effusion. As both adult-onset demodicosis in dogs as well as mycobacterial infection in people have been associated with T-lymphocyte deficiency, the M kansasii infection in this dog may have been associated with a condition of immune compromise.
A commonly-stated advantage of neutering bitches is a significant reduction in the risk of mammary tumours, however the evidence for this has not previously been assessed by systematic review. The objectives of this study were to estimate the magnitude and strength of evidence for any effect of neutering, or age of neutering, on the risk of mammary tumours in bitches. A systematic review was conducted based on Cochrane guidelines. Peer-reviewed analytic journal articles in English were eligible and were assessed for risk of bias by two reviewers independently. Of 11,149 search results, 13 reports in English-language peer-reviewed journals addressed the association between neutering/age at neutering and mammary tumours. Nine were judged to have a high risk of bias. The remaining four were classified as having a moderate risk of bias. One study found an association between neutering and a reduced risk of mammary tumours. Two studies found no evidence of an association. One reported "some protective effect" of neutering on the risk of mammary tumours, but no numbers were presented. Due to the limited evidence available and the risk of bias in the published results, the evidence that neutering reduces the risk of mammary neoplasia, and the evidence that age at neutering has an effect, are judged to be weak and are not a sound basis for firm recommendations.