Section: Veterinary Care In-depth
Diagnosis In-depth
A complete history and physical exam are crucial. A thorough history is always important in establishing a list of possible diagnoses. A physical exam may reveal an enlarged uterus, or vaginal discharge that had gone unnoticed previously. Additional tests may include:
Complete blood count. A CBC evaluates the red and white blood cells as well as the platelets. The results may be normal in a pet with a uterine tumor, but an elevated white blood cell count may be seen with both tumors and infections of the uterus.
A biochemical profile evaluates blood sugar, blood proteins and electrolytes, as well as providing information about liver and kidney function. This is useful to get an overall idea of systemic health and may guide further diagnostic testing.
Urine analysis. Evaluation of the urine is part of a complete laboratory assessment and gives a better indication of kidney function than the biochemical profile alone.
Abdominal x-rays or abdominal ultrasound exam. Imaging studies of the abdomen will allow visualization of the uterus. A normal uterus is hard to see on x-rays, so a prominent uterus is often a sign of uterine pathology. An abdominal ultrasound is useful to differentiate a fluid filled uterus from a uterine tumor.
Chest radiographs. X-rays of the chest are a good idea to look for evidence of spread of cancer to the lungs. Although most uterine tumors are benign, the malignant types are aggressive tumors and may quickly spread to other organs, including the lungs. It is important to know if there is evidence of metastatic disease (spread of cancer from the primary site) prior to treating the pet.
Mass biopsy. Biopsy of a uterine tumor involves obtaining tissue for microscopic analysis. This enables the veterinarian to determine if the tumor is benign or malignant. The best way to obtain a tissue sample for biopsy is generally to remove the entire uterus and the ovaries.
Therapy In-depth
Surgery is the treatment of choice for animals with uterine tumors. It is not clear how hormones may influence growth of uterine tumors, so it is advisable to remove not only the uterus, but the ovaries as well. Surgery therefore serves not only as a diagnostic modality, but as a therapeutic one as well.
If the tumor is benign, surgery should be curative.
If the tumor is malignant, chemotherapy may be recommended in addition to surgery. The purpose of chemotherapy is to prevent spread of malignant cells to other organs. Unfortunately, the efficacy of chemotherapy for malignant uterine tumors is not well known.
In cases of pyometra in addition to the presence of a tumor, antibiotics are indicated to treat the infection.
