Associação da acupuntura e aglepristone no tratamento de hiperplasia mamária em gata / Association of acupuncture and aglepristone in treatment of mammary hyperplasia in cat

ABSTRACT

Backgroun d Feline mammary hyperplasia is a nonneoplastic condition characterized by a rapid hypertrophy and hyperplasia of stroma and ductal epithelium of mammary glands due to hormonal stimuli. This condition is frequently seen in young female cats and is associated with an increase in serum endogenous progesterone or application of exogenous progestogen used as contraceptive. The present study aimed to describe a case of feline mammary hyperplasia treated with the association of aglepristone and acupuncture. Case A female cat was attended at Hospital de Clínicas Veterinárias of Universidade Federal do Rio Grande do Sul presenting a history of increasing mammary volume after a single progestogen injection. The contraceptive administration was made by the patient owner due to signs of her first estrus and starting mammary development after this application four days ago. The patient had a generalized increase in breast, with solid consistence and high temperature. The ovariectomy was performed through the flank and, 24 days after surgery, had not been seen any mammary reduction, it was decided to aglepristone administration at 10 mg/kg subcutaneously, once a day, for three consecutive days. Acupuncture was performed once or twice a week, stimulating the acupuncture points Yintang, SP6, ST36, ST40, GV14, GV20, GV24, LIV2, LIV3, LIV13, LIV14, CV4, CV8, CV10, CV17, BL23 and LI4, that have, among other indications, analgesic, anti- inflammatory, soothing and immune stimulant actions. Tissue involution had began after antiprogestin applications and some acupuncture sessions. However, there was formation of an abscess in breast that prevents further tissue remission and was only detected after fistulation, delaying patient recovery. After abscess content drainage there was a significant mammary volume reduction and restoration of breast normal size occurred in seven days. Discussion: The patient had received one exogenous progestogen injection and was presenting generalized mammary in - crease, symmetrically and bilaterally, with solid consistence and high temperature, allowing the achievement of a diagnosis based on history and clinical signs. The patient was treated surgically by ovariectomy performed through the flank due to the oversized mammary glands, removing endogenous source of progesterone and preventing the recurrence of disease, as recommended by several authors. Aglepristone, that acts by blocking progesterone receptors, was administered at a dose of 10 mg/kg as recommended by manufacturer and aimed to accelerate mammary volume reduction. This antiprogestin has been indicated by literature when surgical treatment is not effective. During aglepristone action the patient was sub - mitted to acupuncture sessions with intention of accelerate mammary tissue regression and healing process and improve her immunity. Among several indications of acupuncture, it is reported the promotion of analgesia, immune modulation and activation of regenerative processes, which occur due to release of chemicals and neuropeptides as a result of nervous system stimulation. The association of aglepristone with acupuncture was effective in mammary hyperplasia treatment because, despite an abscess formation at the site, there was a rapid mammary involution after drainage of purulent content.(AU)