Civvie Question - False Pregnancy and other Hormonal Issues

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Gina & Yittle (GA)

Gina & Yittle (GA)

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Well, my beloved zaftig calico civvie Tailte has decided she wants to play another round of "stump the vet". She won the last round, but like I told her then I don't care if you play and win as long as you a. end up getting better and b. it doesn't cost a lot of money. Having said that, this time seems more serious then last times odd lumps on her neck that looked exactly like she had alien worms crawling under her skin (minus the motion - it was a fluid wavy pattern). We couldn't get anything out of them with a needle aspiration, or rather we got stuff which dissolved immediately on the slide when they put the liquid on it to view - the vet tech said it was there one moment gone the next with nothing to view on the slide. We put some topical itch cream on her for awhile and they vanished.

This time she's decided to up the ante and I had 2 vets with many years experience stumped today. I noticed a couple months ago that it looked like one of her nipples - the lower left (if holding her in your lap head towards me feet away) looked like it was a little enlarged. We'd just had her rear shaved to help with grooming because she's got fur thats on the long side of regular (vs long-haired) and being such a roly poly she can't reach everywhere. I thought at first I was seeing things or that she was grooming more now and just happened to be bathing that area more. Later on I found Vandal our semi-tame/semi-feral rescue sleeping with her so I wondered if perhaps he'd done a "Mommy" and was kneading her tummy and trying to nurse when we weren't looking. Over the next few months the nipple got more enlarged and really looked like it was inflated. I'd poke her belly and couldn't find any lumps, she didn't mind me handling it, and I didn't get any fluid out of it although I probably wasn't doing it right. I wanted to take her to the vet but we had a human health crisis going on with my mom having emergency open heart triple-bypass surgery and being diagnosed with cancer inside of less then 2 weeks. Once my mom's chemo started up and she recovered from the heart surgery a few weeks I was able to convince her to help me take the cat to the vet. Bluntly I needed somebody (my dad) to help me carry the carrier down the steps cause its heavy, she's heavy and I'm partially disabled and hubby was working nights now so he was never home when the vet was open.

So we took her in on Monday and they felt her all around and did find 2 small lumps, neither of them within 2 inches of a nipple which might be why I missed them. They said both of her bottom 2 nipples were enlarged, it just was that the left one was more so then the right so I hadn't noticed the right was too. We were all a bit surprised when they managed to get clear liquid squirting out of the right one when they palpitated her in that area. When they tried the left side (the larger one) they got a milky fluid out. The vet originally wanted to collect some fluid and send it off to be tested but the owner of the clinic said she didn't think that would provide as much info as we hoped and we'd be better off with a blood panel to start. So we had them do an extended panel (I think) with CBC and T4. They said results would be in Wednesday and we'd find out then what we needed to look into after that. They do not believe she has kitty breast cancer (in October, how ironic), and among other possible causes was false pregnancy or some sort of hormonal imbalance.

Tailte is 9 years old, we rescued her when she was about 2 1/2 years old. We neutered her then and she's remained an indoors only cat since then. All of the males in the house are neutered. She's fully vaccinated. We believe she had at least one litter of kittens during the time she was feral (about 6-9 months) and we believe that the kittens did not survive. She had enlarged nipples when we rescued her but no milk production. It was the end of December and she was positively skeletal. Its possible she managed to wean them shortly before then, but either way she was not nursing kittens at that time but had recently. We waited 1 heat cycle before we neutered her because we weren't sure if she was pregnant or not at the time, she wasn't.

Reading up on feline false pregnancy I don't see any examples where a neutered female can have this, although I saw one article that said something like if a tiny bit of tissue remained after surgery and certain things happened it could regrow enough to cause hormonal issues later. Most examples involved a sterile male mating with a female, which I suppose one of my 2 males who were over 2 when they got neutered could do, but honestly the only thing I've ever seen humped in my house is a pillow, and thats my neutered as a kitten male that does that.

Needle aspiration of the lumps was put forth as an option but only if we do a sonogram to guide the needle because she's so pudgy. That would run around $400. Testing the fluid from the breast if the blood panel comes back with no firm answers has also been suggested and that would cost about $150. And lastly since the cat doesn't seem to be having any pain from this, wait and see has been suggested also. Yesterday cost us $230 between the exam and the blood panel. I also paid to have her anal glands expressed and her rear trimmed a bit to make cleaning her easier but thats not really part of the diagnosis process. Finances are a concern, but so is her health. How likely is false pregnancy as an option? Treatment for it seems to usually boil down to cuddle the cat a lot and wait for her to get over it. Are there any other tests I should be considering. Obviously I'll update when I've got test results back.
 
Re: Civvie Question - False Pregnancy and other Hormonal Iss

I think they said because the small lumps were several inches away from the mammary area, but within the path of the lymphatic system they didn't feel they indicated breast cancer. The head of the clinic also said the fatality rate on breast cancer was so high that treatment (particularly on my budget) would be largely limited to palative care and intellegent choices regarding when to let her pass over.

This cat has pretty much always been my love-bug. I remember her being really obnoixious during the one heat cycle we had her 7ish years ago after we rescued her and before we got her neutered. Surgery didn't change it all that much. She's the kind of cat that if you glance past her in a crowded room she starts singing and runs over to climb on you because surely you MUST want to pet her because you looked at her. And if you speak to her, even to tell her you weren't looking at her then she knows its true because you TALKED TO HER. She's what we call a self-petting model. All I have to do is put my hand up and she'll spend the next 30 minutes rubbing herself against my hand, no participation on my part is required. So honestly, when they tell me increased desire for affection is a symptom I'm left shrugging. She even taught herself that if you stop petting her she'll reach out a paw and pet you while whining, as if to show you what she wants.

I suppose its possible some little bit remained, and with all neutered male cats in this house it wouldn't really matter. If thats the case and one of them did try to mate with her we could have a bonafied false pregnancy due to mating of a sterile male with a fertile (ish) female.

Still waiting on the call back with the blood test results. Hoping they'll indicate which direction to look for answers.
 
Re: Civvie Question - False Pregnancy and other Hormonal Iss

Blood tests came back (panel plus cbc and t4) and the vet said they were "perfect". Not just normal, stunningly perfect. Her blood sugar is pristine (The cheering you hear in the background is Tailte knowing she won't have her beloved kibble taken away now).

So they put breast cancer back on the table as a possibility, they're calling it a bit of a zebra case (if you hear hoof beats...) My vet did consult with a endrocinologist regarding what to do and gave me the following options.

The current diagnostic path that they are suggesting, taking into account my lack of funds and trying to get the most information for dollars spent is to first try an LH level test to determine if there are hormones (specifically estrogen) in her blood at rates that are not normal for a neutered female. If the test indicates the presence of estrogen then the likely diagnosis is ovarian remnant syndrom with possible false pregnancy, or an adrenal gland tumor. At that point I could choose to either needle aspirate one of the very small lumps either with or without a sonogram to guide the needle, test the fluid in the breasts for abnormal cells, or jump straight to the sonogram which would probably show us whether we had the adrenal gland tumor or the remnant. I could also get the aspirate done when we did the sonogram if the results were mixed and they wanted extra info. While she does have a bit of dandruff, she doesn't have diabeties, or most of the other symptoms of an adrenal gland tumor (yet at any rate).

If the LH level test comes back normal then we're back to possible breast cancer again and the vet said we'd reevaluate at that point what I wanted to do in terms of further diagnostic tests (breast fluid sample, needle aspirate, sonogram and perhaps other things) or possibly simply wait awhile to see if the cat developed any new symptoms. With the outcomes being so poor on feline breast cancer I do know that I will not being putting her through major surgery in an attempt to treat that. I'm not even sure I want to do the surgery if its ovarian remnant syndrome. With her age and weight it may not offer enough reward to offset the risk. Hormone treatment is a possibility there but it can induce diabeties. I suppose not suprisingly I'm almost more willing to deal with that possibility, she's an easy to handle cat and now that I know the drill I feel comfortable with my ability to treat that properly with Lantus. Although she would have to give up her kibble, which would break her heart.

We hope to schedule the LH level test for sometime next week, my mom has chemo tomorrow so we can't get the cat to the vet any sooner then that. Anybody have suggestions for alternative options or things I should ask the vet before then?
 
Re: Civvie Question - False Pregnancy and other Hormonal Iss

With breast cancer, the lumps can run like a string along the lymph system. I had a cat who had a tiny bit of ovarian tissue that was missed when she was spayed - the next year she went into sort of a half-heat - some signs of heat but not others. I took her to a different vet who ended up doing exploratory surgery and found a cyst on the uterine stump, removed it, and the biopsy showed it was ovarian tissue.

She was always kind of lumpy after that, and when she was about 11 I think I noticed there were some pronounced lumps. Turned out to be mammary cancer - I never did diagnostic tests (I was in 99.99% denial, convinced it was just her general lumpiness, and I was broke to boot). At some point though it became really clear it was cancer - when you can feel the lumps like a string of pearls or peas running along from like the nipple up into the armpit, or along their side, that's pretty much it.

The good news was she lived for a year from when I realized there were definite lumps, and they were pretty advanced by the time I noticed them so who knows how long they had been developing. She lived a lot longer than I think what the literature says for breast cancer, so hopefully if it is that in your kitties case, it won't necessarily be as quick as they say.

There are other things too though that can cause lumps, and your description sounds enough different than what I saw, that hopefully it is not that at all!!!
 
Re: Civvie Question - False Pregnancy and other Hormonal Iss

The Vet I saw had 25ish years experience, the head of the clinic also did, and I assume the endrocrinologist had a fair number also. And what I'm hearing from them is - its odd. Its not presenting like normal breast cancer, its a possibility but its just not quite normal for that. The were leaning towards false pregnancy even though its rarer. She was just out of heat when we had her neutered and about 2 1/2 years old (rescues you know...). We did take her to a good vet and it wasn't an assemblyline rescue neuter job, but even good vets can miss a bit. Or there are the times when a bit of ovarian tissue is somewhere it shouldn't be etc. I just remember her being really obnoxiously affectionate when she was in heat, and frankly that never stopping. Don't get me wrong, I love her - but this cat has never let it enter her head that there is anybody in the universe that doesn't want to love her and thats after she was quite obviously beaten at some point in her feral life. To this day and I've had her for years and years now she ducks when I try to pet her even as she's trying desperately to grab my hand and make contact with me. She just can't see your hand reaching for her head or she cowers and shuts her eyes but the moment you pet her she's ecstatic. Or if you don't pet her and remove your hand she goes nuts trying to get you to pet her.

It just occured to me that this summer she was having some cleanliness issues in the rear area which I attributed to her being a longish haired, zaftig cat who couldn't bathe that section. We had her tush shaved and her anal glands expressed and gave her a good bath (she needed it, badly). I suppose its possible that I completely mis-read that and it was actually her going into heat. At the time the vet who looked at her knew she was neutered and since either her nipples were not swollen then or we hadn't noticed yet - nobody asked the vet if it was anything but urine/fecal matter. But we'd clean up her behind with wet cloths and it was a dark brownish color that might have been a little reddish. It certainly wasn't blood colored and the vet didn't notice anything obviously wrong in the vaginal area. But hindsight being 20/20, we didn't look. She's had problems before with needing her anal glands expressed and it seemed like every other time really. I'll have to mention that to the vet taking care of her. We had her groomed at my mom's vet (my old vet) since it was a lot cheaper and it was just a simple task. But when I realized something was wrong we took her to my vet (Yittle's vet).

All of the lumps are about 2-3 inches away from her lower 2 nipples. One's more towards the bladder and the other much smaller one is higher up on her tummy. I could barely feel the smaller one at all. We had her checked out about 2 or 3 years ago for lumps cause I thought she seemed lumpy and they decided the lumps were all just fat pads at the time (nothing solid). This time around the one did feel more solid then squish.

It looks like we'll get the LH test next week sometime, which should hopefully tell us what side of the fence we're on. In the mean time she's her usual, incredibly demanding, affectionate to the point of driving you crazy self. She doesn't even dislike vets, she kisses them all and sings them songs and cuddles them even after they've expressed her anal glands. My siamese gets downright hateful after they do it to her (lol). Can't say I blame her either.
 
Re: Civvie Question - False Pregnancy and other Hormonal Iss

Good am to Tailte's momma,

I have been reading this post and it brings up questions to me about my civvie Slappy girl. She is 15 and has a small lump on her lower right side, just found 3 wks ago. 6+ yrs ago, she had a lump in the middle of her tummy, and licked/cleaned it for several months until it finally started leaking. Took her to the vet, he removed and it was not cancer.

I brought the new lump to the vets attention and she immediatley wanted to remove, stating that it was probably breast cancer. She also suggested an xray to see if there was any signs of cancer in the lung area?? She never suggested aspirating or a LH test. Of course, due to my finances right now, this has not been done.

I wanted to know what the LH test is? could you explain or lead me to where I could find out some information?

I would like to have the option to needle aspirate or do this LH test you are referring to??

For several yrs now, she will find her special furry ball (her 'baby') and carry it around the house meowing at the top of her lungs. She is one that never meows??? That is why I call it her baby? I just thought it was because she never got to have kitties of her own before I had her fixed and that she was getting older.....funny girl.

Any help would be great. I want to present options to my vet....
 
Re: Civvie Question - False Pregnancy and other Hormonal Iss

The LH test is pretty useless when it comes to diagnosing cancer from what I understand. It tests hormone levels which in a cat thats been neutered for 7+ years should be pretty much non-existant. The purpose of it in Tailte's case is to see if she's producing female hormones at levels that are not normal for a neutered female. If she is, then its very likely that she's got either ovarian remnant syndrom (where a bit of the ovaries gets left behind or regrows after neutering) and may be experiencing a false pregnancy. That would explain her weight gain, swelling of the breast tissue and discharge from her nipples. Another option if the hormones are present is an adrenal gland tumor. In her case it doesn't entirely rule out breast cancer but it forces us to look a other options first. I don't this test would be of any use to you in your current situation.

A needle aspiration test could be done in your case, but you have to understand the limitations of the test. They basically take a large needle and remove a sample of the area from your cat without having to sedate them (they can numb the area first). Usually they pull 2 samples from different spots and then look for abnormal cells in the sample. In Tailte's case because she's a very large pudgy cat they'd need to use an ultrasound to make sure they were putting the needle inside the lump itself and not in the fat around it. This makes the test run into the $350-500 range vs the more typical around $100-$200. The trouble with the test is that while it can give you a positive result for cancer, it can't really give you a negative. If malignant cells are found, you have your answer. But if you don't find malignant cells it could just mean they missed the lump, or they pulled a section of the lump that didn't have any. It can be used to positively diagnose other things like an pocket of infection (they'd get pus) or so forth. Its a bit like knocking on somebody's door. If they open the door they're obviously home but if they don't open the door all you know is they didn't open the door. They might not be home, or they could be somewhere in the house where they didn't hear you knock, or they could be ignoring you.

An x-ray would be a viable option in your case since its not invasive to the cat and generally speaking tumors show up pretty good on x-rays. In my opinion (and I'm by no means an expert so others with more experience may disagree) it would give you better information then a needle aspiration sample would and be minimally invasive to your cat. You can of course try the needle aspiration, and I've certainly had them done on my cats before - typically cats who were not good surgery candidates. I'd use it again in certain circumstances - for instance if Tailte gets an ultrasound and they find tumors then I might use one to see if they can determine if they're definately malignant or possibly benign. But just remember that it can only tell you what it found in a very small spot, not whats going on in the entire lump.

I hope you find out whats going on with your cat and that its treatable, and she's with you for a long time to come.

Ps - as for the meowing, most researchers believe that its the Mama cat that teaches a cat to Meow - and its something they only do to humans. At the moment I've got 8 cats, 3 of the 4 females either did have kittens or probably had kittens before they were rescued and neutered. The one that doesn't meow is the one who absolutely had kittens and I know for sure because I tried to rescue them too. Her kittens did meow, she doesn't. The 4 males, 2 meow, 2 don't. The 2 that don't had feral mothers who didn't teach them too. Of the 8, the non-meowing female that had kittens likes to carry around stuffed animals and one of the meowing males who was rescued as a kitten and neutered before he could mate does too. My mom has a cat who does the same thing with her pet "birdie", but only her birdie - never anything else. Mine will do it with multiple toys. The male in particular used to like to bring 3-4 toys to bed with him at night before he went to sleep.
 
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