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Uterine Adenocarcinoma - Rabbit (view source)
Revision as of 18:35, 26 July 2012
, 18:35, 26 July 2012no edit summary
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==Introduction==
==Introduction==
This is the '''most common neoplasm in rabbits''', with an incidence of up to '''60% in intact females over 3 years old'''.
This is the '''most common neoplasm in rabbits''', with an incidence of up to '''60% in intact females over 3 years old'''.
The tumour arises from the '''endometrial glandular epithelium'''. It may be preceeded by endometriosis, endometritis, endometrial hyperplasia or endometrial venous aneurysms. These tumours frequently '''bleed''' and the haemorrhage can be life-threatening.
The tumour arises from the '''endometrial glandular epithelium'''. It may be preceded by endometriosis, endometritis, endometrial hyperplasia or endometrial venous aneurysms. These tumours frequently '''bleed''' and the haemorrhage can be life-threatening.
The tumours '''metastasise''' locally by extension into the myometrium and peritoneum, but also to distant locations such as the lungs, brain, bone and liver.
The tumours '''metastasise''' locally by extension into the myometrium and peritoneum, but also to distant locations such as the lungs, brain, bone and liver.
==Clinical Signs==
==Clinical Signs==
Does are usually presented for '''haematuria''' by the owner. It isn't true haematuria, but blood is released from the uterus during micturition. Blood clots are sometimes seen.
Does are usually presented for '''[[haematuria]]''' by the owner. It isn't true haematuria, but blood is released from the uterus during micturition. Blood clots are sometimes seen.
There may also be a '''serosanguinous vaginal discharge'''.
There may also be a '''serosanguinous vaginal discharge'''.
'''Cystic mastitis or neoplasia''' may involve one of more mammary glands.
'''Cystic mastitis or neoplasia''' may involve one of more mammary glands.
If does are presented late in the disease with metastasis, they may show signs of '''lethary, dyspnoea and pale mucous membranes'''.
If does are presented late in the disease with metastasis, they may show signs of '''lethargy, dyspnoea and pale mucous membranes'''.
The tumour may not be '''palpable''' until late in the disease process, but may feel as firm midcaudal masses palpable between the bladder and colon.
The tumour may not be '''palpable''' until late in the disease process, but may feel as firm midcaudal masses between the bladder and colon.
==Diagnosis==
==Diagnosis==
'''Haematology and biochemistry''' will determine the overall health status of the animal, and may reveal a variably regenerative anaemia. There may be increased liver enzymes with metastasis.
'''Haematology and biochemistry''' will determine the overall health status of the animal, and may reveal a variably regenerative [[anaemia]]. There may be increased liver enzymes with metastasis.
'''Abdominal radiography''' may reveal an abdominal mass, dorsal to the bladder
'''Abdominal radiography''' may reveal an abdominal mass, dorsal to the bladder.
'''Thoracic radiography''' may reveal evidence of metastases.
'''Thoracic radiography''' may reveal evidence of metastases.
Mammary masses can be examined with '''cytology'''.
Mammary masses can be examined with '''cytology'''.
'''Histopathology''' is required for a definitive diagnosis, and will reveal a well-differentiated adenocarcinoma
'''Histopathology''' is required for a definitive diagnosis, and will reveal a well-differentiated adenocarcinoma.
'''Gross inspection of the uterus''' shows: cauliflower-like or papillary projections into the uterine lumen. The tumours may be multicentric involving both horns, and may have a haemorrhagic or necrotic centre.
'''Gross inspection of the uterus''' shows: cauliflower-like or papillary projections into the uterine lumen. The tumours may be multicentric involving both horns, and may have a haemorrhagic or necrotic centre.
==Differential Diagnoses==
==Differential Diagnoses==
Endometrial venous aneurisms
:Endometrial venous aneurisms
:Pregnancy
Pregnancy
:Endometrial hyperplasia, hydrometra or mucometra
:Pyometra
Endometrial hyperplasia, hydrometra or mucometra
:Other uterine tumours
:Other mid-caudal abdominal masses
Pyometra
Other uterine tumours
Other mid-caudal abdominal masses
==Treatment==
==Treatment==
'''Ovariohysterectomy''' is the treatment of choice, and is curative if metastasis has not occurred.
'''Ovariohysterectomy''' is the treatment of choice, and is curative if metastasis has not occurred.
Even if metastasis is not grossly visible at the time of surgery, checks should be performed at '''6-monthly intervals''' and a the prognosis is still guarded.
Even if metastasis is not grossly visible at the time of surgery, checks should be performed at '''6-monthly intervals''' and the prognosis is still guarded.
'''Good nursing care''' is paramount in ensuring rabbits do not develop ileus and other gastro-intestinal problems post-operatively.
'''Good nursing care''' is paramount in ensuring rabbits do not develop [[Non-Obstructive Ileus – Rabbit|ileus]] and other gastro-intestinal problems post-operatively.
A '''blood transfusion''' may be necessary if the rabbit is severely anaemic or there is significant haemorrhage during surgery.
A '''blood transfusion''' may be necessary if the rabbit is severely anaemic or there is significant haemorrhage during surgery.
Merck and co (2008) '''The Merck Veterinary Manual''' ''Merial''
Merck and co (2008) '''The Merck Veterinary Manual''' ''Merial''
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[[Category:Neoplasia]]
[[Category:Rabbit Urogenital Disorders]]
[[Category:Expert Review - Exotics]]