Mastectomy in 25 small ruminants (2002-2019).

OBJECTIVE: To describe the outcome of small ruminants treated with unilateral and bilateral mastectomy by using three surgical techniques. STUDY DESIGN: Retrospective study. ANIMALS: Twenty-five small ruminants (24 goats and one sheep). METHODS: Medical records of animals that underwent mastectomy between November 1, 2002, and May 1, 2019, were reviewed. Follow-up information was obtained by telephone questionnaire with owners. Signalment, surgical data, intraoperative and postoperative complications, bacterial culture results, histopathologic diagnoses, short- and long-term outcomes, and other procedures performed were recorded. RESULT: Procedures consisted of six unilateral (with an elliptical incision) and 19 total (with inverted cloverleaf or elliptical skin incisions) mastectomies. All animals survived to hospital discharge. Intraoperative complications included contamination of the surgical site with mammary-gland fluid, hemorrhage, and difficulty dissecting skin from the mammary gland. Postoperative complications included seroma formation (7/25), surgical-site infection (5/25), and dehiscence of the skin incision (3/25). Mammary neoplasia was diagnosed in seven of 15 animals with histopathologic examination. No association was detected between surgical technique, diagnosis of neoplasia, and long-term outcome. Overall, client satisfaction was high. CONCLUSION: Mastectomy was effective at removing abnormally enlarged udders secondary to chronic mastitis, inappropriate lactation, idiopathic causes, or neoplasia and was associated with a low rate of complications in small ruminants. CLINICAL SIGNIFICANCE: Unilateral mastectomy with an elliptical skin incision or total mastectomy, preferably with inverted cloverleaf skin incision, may be indicated to remove diseased mammary tissue in small ruminants and can result in long-term survival with low morbidity and cosmetically pleasing results.

Correlação entre as escalas analógica visual, de Glasgow, Colorado e Melbourne na avaliação de dor pós-operatória em cadelas submetidas à mastectomia total unilateral / Correlation between visual analog scales, Glasgow, Colorado and Melbourne in the evaluation of postoperative pain in dogs undergoing total unilateral mastectomy

Objetivou-se correlacionar a necessidade de resgate analgésico pós-operatório por meio das escalas analógica visual (EVA), de Glasgow, Colorado e Melbourne, por meio de um avaliador experiente (AE) e outro não experiente (ANE), em cadelas submetidas à mastectomia unilateral total. Foram utilizadas 24 cadelas, hígidas, internadas 24 horas antes do procedimento cirúrgico, para avaliação do seu comportamento, com o auxílio das escalas descritas acima no momento basal (M0). Foram pré-medicadas com acepromazina e morfina (0,02 e 0,5mg/kg) e induzidas à anestesia geral com propofol (4mg/kg), mantidas em plano anestésico com CAM de isoflurano 1%. A manutenção analgésica transoperatória foi realizada com cetamina e fentanil (10µg/kg/min e 10µg/kg/h). As demais avaliações ocorreram em uma, duas, quatro, seis, oito, 12 e 24 horas de pós-operatório, sendo os resgates realizados com morfina (0,5mg/kg), pela via intramuscular, quando fosse observada uma pontuação maior ou igual a 50, seis, dois e nove pontos, respectivamente, para as escalas descritas, quando observada pelo AE e quando ao menos duas das escalas demonstrassem esses valores. Houve aumento dos escores de dor do M1 ao M12 para o AE e para o ANE para a EVA. Na análise de Colorado, maiores pontuações de dor ocorreram em relação ao M0 entre o M2 e o M8 para o AE e do M1 ao M12 para o ANE. Na análise de Glasgow, maiores escores foram detectados entre o M1 e o M12 para o AE e do M1 ao M24 para o ANE. E para a de Melbourne, maiores valores foram observados do M1 e do M24 para o AE e o ANE. A melhor correlação entre as escalas foi de 0,775 entre Glasgow e Colorado e entre os avaliadores de 0,925 para a Glasgow. Conclui-se que a escala de Glasgow apresentou-se mais sensível para detectar resgates analgésicos em cadelas submetidas à mastectomia total unilateral, que a inexperiência do avaliador não compromete a qualidade das avaliações de dor e sugere-se reduzir a pontuação da EVA e Melbourne para aumentar a sua capacidade em detectar resgates analgésicos pós-operatórios.(AU)

The objective was to relate the need for analgesic postoperative recovery through Visual Analogue Scale (VAS), Glasgow, Colorado and Melbourne, by an experienced assessor (AE) and other non-experienced ones (ANE), in bitches undergoing total unilateral mastectomy. Otherwise healthy bitches, a total of 24, were admitted 24 hours before the surgical procedure for assessment of behavior with the help of the above scales to determine the baseline (M0) moment. They were pre-medicated with morphine and acepromazine (0,02 and 0,5 mg/kg) and general anesthesia was induced with propofol (4 mg/kg) and maintained with isoflurane at 1% MAC. The analgesic during surgery was maintained with ketamine and fentanyl (10 µg/kg/min and 10 µg/kg/h). The other evaluations were performed at 1, 2, 4, 6, 8, 12 and 24 hours postoperatively, and redemptions made with intramuscular morphine (0,5 mg/kg) when a greater than or equal score of 50, 6, 2 and 9 points was observed respectively for the described ranges, as observed by the AE and when at least two scales demonstrated these values. There was an increase of M1 to M12 pain scores for AE and the ANE for VAS. In Colorado analyses, the highest painful scores occurred in relation to M0 between M2 and M8 to the AE and M1 to M12 for ANE. In Glasgow analyses, higher scores were detected between M1 to M12 for AE and M1 to M24 for ANE. And for the Melbourne highest values were observed in M1 and M24 for AE and ANE. The best correlation between the scales was 0,775 between Glasgow and Colorado and of the evaluators of 0,925 to Glasgow. The Glasgow scale was shown to be more sensitive to detect painkiller redemptions in dogs undergoing total unilateral mastectomy, the inexperience of the appraiser does not compromise the quality of painful reviews, and it is suggested to reduce the score VAS and Melbourne to increase it is ability to detect rescue postoperative analgesics.(AU)

Unilateral fibroepithelial hyperplasia of the mammary gland in a goat.

A 2.5-year-old female Nubian goat was admitted because of a mass involving the right mammary gland. Ultrasonography and cytologic examination of the mass revealed a benign or hyperplastic condition. A right mastectomy was performed. Results of histologic and immunohistochemical tests indicated mammary fibroepithelial hyperplasia (fibroadenomatous change), which is a condition usually found in cats. The mammary mass had not redeveloped in the goat after 1 year.