Problems and Clinical Challenges: Feline Reproduction
Problems and Clinical Challenges: Feline Reproduction
doi:10.1016/j.jfms.2011.05.008
        CLINICAL REVIEW
                              FELINE REPRODUCTION
                              Problems and clinical challenges
Susan Little
          The most common location for ovarian remnants are the ovarian pedicles.
                Other common sites are the omentum and peritoneal walls.
                         Remnants may be unilateral or bilateral.
Surgical treatment
Once ORS is confirmed, the ovarian tissue
should be surgically removed. Queens with
ovarian remnants may be at increased risk of
mammary and ovarian neoplasia. Moreover,
many owners will not be tolerant of the estrous
behavior. Exploratory laparotomy is required
to remove the ovarian remnant. A thorough
search of the peritoneal cavity is necessary,
starting at the most common location for
remnants, the ovarian pedicles. Other common
sites for ovarian remnants are the omentum
and the peritoneal walls. Remnants may be
unilateral or bilateral. Surgery is most reward-
ing if performed when the cat is in diestrus or
has been induced to ovulate. The corpora lutea
are visible as yellow–orange structures against
the red background of ovarian tissue. Excised
tissue should be submitted for histopathology
to confirm ovarian tissue has been removed.
   In some cases, queens have undergone more
than one laparotomy in an attempt to resolve           a                                              b
ORS; failed attempts to locate ovarian rem-           FIG 2 (a) Mammary hyperplasia in a young late-gestation pregnant queen. A litter of kittens
nants are a common reason for referral to a           was born 12 days later. The queen was treated with cabergoline, broad-spectrum antibiotics
                                                      and analgesics. The kittens were hand-raised. (b) The same queen approximately 2 months
board-certified surgeon.                              later, after ovariohysterectomy. Courtesy of Dr Shelagh Morrison
    Spayed or intact?
  It may be difficult to determine if an adult queen with unknown shows a positive result when serum LH level is >1 ng/ml
  history has been previously spayed. Traditional methods to (Witness-LH; Synbiotics Corporation). The test was developed
  determine reproductive status include observing for signs of       for timing of canine ovulation and has been validated in the
  estrus and examining the ventral abdomen (or flank) for a          queen – test sensitivity and specificity for determination of
  surgical scar that may be due to                                                         reproductive status were determined to be
  ovariohysterectomy/ovariectomy. Surgical        Surgical scars will not be 100% and 92%, respectively.5 A single
  scars will not be evident on all cats – and,                                             negative test is highly likely to indicate a
  if a scar is found, there is no guarantee it         evident on all cats                 sexually intact queen. A single positive test
  is from surgical sterilization.                                                          suggests a spayed queen, although
                                                   – and, if a scar is found,
     Serum LH can be used to determine                                                     false-positives may occur if an episodic
  reproductive status. LH is released from        there is no guarantee it is LH surge is sampled or the queen is in
  the anterior pituitary gland in response to                                              estrus. The manufacturer recommends
  copulation. LH stimulates ovulation and        from surgical sterilization. that positive tests be confirmed with
  luteinisation of mature ovarian follicles. In                                            a second sample taken 2 h later.
  intact queens, serum LH is maintained at basal levels through Anecdotally, equivocal test results have been reported in some
  the negative feedback provided by ovarian estradiol secretion.     spayed cats. Some commercial laboratories offer LH testing to
  Following ovariohysterectomy/ovariectomy, this negative feed- veterinarians, but these assays may not have been validated
  back is lost and serum LH levels elevate persistently.             for the dog or cat, so investigation to determine validity
     A rapid, semi-quantitative colorimetric assay is available that is recommended.
 Pregnancy diagnosis
Clinical signs
Failure of a queen to come back into heat after breeding is one of
the most obvious signs of pregnancy, but pseudopregnancy will
produce the same effect. However, queens experiencing a pseudo-
pregnancy will usually return to heat within 50–60 days of the last
estrus. One of the first physical indications of pregnancy is ‘pinking’
                                                                           A pregnant
of the nipples, which occurs around days 15–18 after ovulation. This       queen at term.
change in the nipples, which become noticeably pinker and easier           Radiography
                                                                           is useful for
to see as they increase in size and the hair around them recedes           determining
somewhat, is most obvious in maiden queens. It can be recognised           the number of
                                                                           fetuses, simply
with experience in queens that have had several litters as well.           by counting
                                                                           the number of
Palpation                                                                  skulls present
Cryptorchidism
                                                                                         Cryptorchid configuration
The testes are normally descended into the                                               Most cryptorchids are unilateral (78–90%),
scrotum by birth or shortly afterwards. The                                              with left and right sides equally affected. In
testes may move freely up and down in the                                                one study where the location of the retained
inguinal canal prior to puberty, however.                                                  testis was recorded, 49% were inguinal,
Cryptorchidism is failure of one or both                                                       33% were abdominal and 14% were with-
testes to descend into the scrotum and                                                           in the inguinal ring.26 In the author’s
remain there by 7–8 months of age. It is                                                           practice, 87% of 72 cats had unilateral
uncertain if cryptorchidism is linked to                                                            cryptorchidism and the most
                                                                   Terminology
other congenital defects in cats.              Cryptorchidism is the most common congenital
                                                                                                     common configuration was the uni-
   The prevalence of cryptorchidism in defect of the feline urogenital system. The term lateral inguinal cryptorchid (51.6%
cats has been reported as 1.3–3.8%, ‘monorchid’ refers to total absence of one testis. of cases). Bilateral cryptorchids are
which is generally lower than the Monorchidism is very uncommon in cats. likely to have abdominally retained
prevalence in dogs.26–28 In one study Unilateral           testicular agenesis has been report-
                                                 ed, with the finding of a rudimentary spermat-
                                                                                                    testes. If one testis is in the scrotum, it
of over 100,000 feral cats admitted to            ic cord and no associated testis.         26     may   be difficult to determine if it is on
trap–neuter–return programs, 1.3% of                The term ‘anorchid’ refers to the total       the left or right side. Pushing the scro-
male cats were cryptorchid.29 In another               absence of both testes, and is an        tal testis dorsally and cranially toward
study of over 5000 free-roaming cats admitted              exceedingly rare event.           the inguinal canal can help determine its
to a trap–neuter–return program, 1.9% of the
males were cryptorchid.30 In the author’s prac-
tice, records of 4140 cats presented for castration
over a 10-year period were reviewed. Seventy-                 In the author’s practice, 72 of 4140 cats (1.7%)
two cats (1.7%) were identified as cryptorchid.
                                                               presented for castration over a 10-year period
Of the cats presented for castration, 10.5% were
of a pedigree breed, with a total of 22 breeds                 were cryptorchid. Of these, the most common
represented. Among the pedigree cats, 6.2%
were identified as cryptorchid. The highest                         configuration was the unilateral inguinal
incidence was in the Ragdoll breed (>18%).                                            cryptorchid (51.6%).
    Poor libido
  Poor libido in the breeding tom cat is a common complaint and       It is preferable to bring the queen to the tom, as many toms will
  may be associated with a variety of factors. Successful breeding not breed successfully when outside their own territory. In pedi-
  tom cats must be physically, socially and sexually mature. Ideally, gree catteries, tom cats may be housed separately in cages or
  a young inexperienced tom should be paired with a calm, mature enclosures because of urine marking behavior and to control
  and experienced queen. In some late-maturing breeds, libido reproduction. Tom cats often dislike changes to their territory,
  cannot be assessed properly until 2–3 years of age.                 even changes in odor such as when scented cleaners are used.
     Poor libido is often caused by management problems or The enclosure for a breeding tom cat must provide enough
  underlying medical conditions. Investigation requires a thorough space to allow for normal exercise. Cats value vertical space, so
  physical examination, a medical history and collection of a provision of areas to climb, or shelving, is very important. It also
  minimum database (complete blood count, serum chemistry, provides a way for the tom to retreat from the post-coital reac-
  urinalysis and feline leukemia virus and feline                                         tion of the queen to avoid being swatted.
  immunodeficiency virus testing). Non-                   The tom cat’s                   Inadequate housing may inhibit the breeding
  reproductive disease, such as dental disease                                            behavior of normal tom cats.
  or degenerative joint disease, may influence        environment is very                    Measurement of baseline testosterone in
  willingness or ability to mate. Chronic illness,                                        tom cats with poor libido is not informative;
                                                           important . . .
  such as upper respiratory tract infection or                                            provocative testing must be used (see
  diarrhea, may lead to poor body condition and       Inadequate housing discussion on diagnosis of cryptorchidism).
  diminished libido.                                                                      Administration of supplemental testosterone
     Information should also be obtained on the          may inhibit the                  in an attempt to correct poor libido is inappro-
  cat’s housing, diet (including nutritional sup-     breeding behaviour priate. Exogenous testosterone may suppress
  plements) and medications (both prescription                                            release of GnRH and LH, thereby interrupting
  and non-prescription). The tom cat’s environ-       of normal tom cats. testosterone synthesis by the interstitial cells
  ment is very important for breeding success.                                            of the testes.
      It is not appropriate simply to ligate the                                            damage to the ureters.26 Abdominal testes are
                                                                                            often located near the bladder (Fig 6), but can
  vas deferens and testicular vessels in the hope                                           be present in the internal inguinal ring or in
                                                                                            the inguinal canal. The best procedure is to
a retained testis will atrophy. The blood supply can                                        find the vas deferens and follow it caudally to
   re-establish and the testis remain functional.                                           the testis. Applying gentle traction to the vas
                                                                                            deferens may facilitate location of the testis by
                                                                                            detecting its movement. While it can be frus-
                                                                                            trating trying to locate the retained testis in
simple incision. In other cases, a caudal mid-                                              some cases, it is not appropriate simply to
line incision and dissection deep to the                                                    ligate the vas deferens and testicular vessels in
inguinal fat pad is required. The external                                                  the hope the testis will atrophy. It is possible
inguinal ring should be examined but care                                                   for the blood supply to re-establish and the
should be taken not to damage structures in                                                 testis to remain functional.
the femoral triangle. For abdominally retained
testes, laparotomy via a midline approach
is required, although laparoscopic-assisted
cryptorchidectomy         has     also    been
described.33–35 Advantages of a laparoscopic
technique over laparotomy include minimal
invasiveness, reduced tissue trauma and,
potentially, reduced postoperative pain and
fewer complications. The principal disadvan-
tage is the need for specialized equipment,
with the associated costs and expertise
required. Initially, the laparoscopic approach
may take longer to perform than a traditional
laparotomy until the practitioner gains experi-
ence with the technique.
  Surgical techniques for removal of abdomi-
nal testes have been described elsewhere.31                 FIG 6 The retained testis
Use of a spay hook to retrieve the vas deferens             in cats with abdominal
                                                            cryptorchidism is often found
is not recommended because of the risk of                   near the bladder
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