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Straticò P, Hattab J, Guerri G, Carluccio A, Bandera L, Celani G, Marruchella G, Varasano V, Petrizzi L. Behavioral Disorders in Mares with Ovarian Disorders, Outcome after Laparoscopic Ovariectomy: A Case Series. Vet Sci 2023; 10:483. [PMID: 37624270 PMCID: PMC10458155 DOI: 10.3390/vetsci10080483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 06/23/2023] [Accepted: 07/21/2023] [Indexed: 08/26/2023] Open
Abstract
Owner complaints of estrus-related behavior in mares are a common cause of referral for laparoscopic ovariectomy. Granulosa cell tumors are a common neoplastic condition affecting the equine ovary, causing behavioral changes at rest and reduced performance. The reported success rate of ovariectomy in treating behavioral disorders is 64-86%. The aim of this study was to retrospectively evaluate the long-term follow-up of laparoscopic ovariectomy in mares in our case series, focusing on the owner's perspective of the behavior of the mares after surgery. In addition, the histopathological features of the removed ovaries were investigated. The clinical records of mares that underwent laparoscopic ovariectomy between 2015 and 2022 were retrospectively reviewed. Owners complaining of poor behavior were interviewed about the main behavioral problem leading to referral and its eventual resolution after surgery. Eleven mares were included. The most common complaints were increased sensitivity on both flanks (10/11, 91%) and general riding problems (9/11, 82%). In 5/11 cases (45%), both ovaries were removed by laparoscopic ovariectomy. Histopathologic findings consistent with GCT/GTCT were found in five out of six examined ovaries (five granulosa theca cell tumors, GTCT). According to owner interviews, the scores assigned to each behavior improved significantly after surgery, regardless of histological findings. Although many factors can influence the behavior of horses, granulosa cell tumors (GCTs) proved to be a common cause and, as reported by the owners, ovariectomy resulted in improvement or complete resolution of the abnormal behavior.
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Affiliation(s)
| | | | - Giulia Guerri
- Department of Veterinary Medicine, University of Teramo, 64100 Teramo, Italy; (P.S.); (J.H.); (A.C.); (L.B.); (G.C.); (G.M.); (V.V.); (L.P.)
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Drozdzewska K, Gehlen H. Markers for internal neoplasia in the horse. Vet Med Sci 2022; 9:132-143. [PMID: 36495211 PMCID: PMC9857019 DOI: 10.1002/vms3.1042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
The diagnosis of internal neoplasia in horses is challenging. Increased production of hormones physiologic for adult animals (e.g., adrenocorticotropin, norepinephrine, and erythropoietin) or typical for the foetal phase (alpha-fetoprotein, anti-Müllerian hormone, and parathyroid-hormone-related protein) might aid in tumour diagnostics. Thymidine kinase-1 and alkaline phosphatase are examples of intracellular enzymes, whose activity in the blood may increase in some neoplasia cases. Furthermore, inappropriate production of abnormal monoclonal or autologous antibodies can accompany lymphoma and multiple myeloma. Many of those tumour markers lead to clinical or laboratory changes, called paraneoplastic syndromes, such as hypercalcaemia and erythrocytosis. The interpretation of the results of the tumour marker measurements in horses is complicated due to many factors affecting the markers' concentration or activity (e.g., young age, pregnancy, and inflammation) and other diseases triggering the same changes. Moreover, the presence of paraneoplastic syndromes is inconsistent, which leads to low sensitivity of those substances as tumour markers. In conclusion, screening for neoplasia in horses is not recommended. The measurement of tumour markers should be performed only in risk groups with suspicious clinical or laboratory findings, and the results should be interpreted with caution. It is advisable to add inflammatory markers to the tumour profile or repeat the measurements.
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Affiliation(s)
| | - Heidrun Gehlen
- Equine Clinic, Surgery and RadiologyFreie Universitaet BerlinBerlinGermany
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Goto A, Tagami M, Kato F, Suzuki T, Yamaga T, Murase H, Sato F, Tsogtgerel M, Niikura T, Moriyama T, Chiba A, Watanabe KI, Tsuzuki N, Nambo Y. Equine nonneoplastic abnormal ovary in a draft mare with high serum anti-Müllerian hormone: a case study. J Equine Sci 2022; 32:147-151. [PMID: 35023993 PMCID: PMC8731685 DOI: 10.1294/jes.32.147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 10/05/2021] [Indexed: 11/17/2022] Open
Abstract
We performed a standing hand-assisted laparoscopic ovariectomy in a draft mare that
presented with high serum anti-Müllerian hormone (AMH) level and had an enlarged single
cystic ovary. Histopathological examination revealed no tumor cell proliferation in the
ovary, but the presence of a large ovarian cyst was confirmed. In the diagnosis of
abnormal ovaries in mares, a comprehensive assessment should be performed, including the
monitoring of ovarian morphology and biomarkers over time, to determine the disease
prognosis and treatment plan. The case of this mare with a nonneoplastic abnormal ovary
and increased serum AMH level was rare. We suggest that standing hand-assisted
laparoscopic ovariectomy is useful for the removal of large ovaries in draft mares.
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Affiliation(s)
- Akira Goto
- Department of Veterinary Medicine, Obihiro University of Agriculture and Veterinary Medicine, Hokkaido 080-8555, Japan
| | - Masaaki Tagami
- Department of Veterinary Medicine, Obihiro University of Agriculture and Veterinary Medicine, Hokkaido 080-8555, Japan.,Shadai Horse Clinic, Hokkaido 059-1361, Japan
| | - Fumiki Kato
- Shadai Horse Clinic, Hokkaido 059-1361, Japan
| | | | | | - Harutaka Murase
- Equine Science Division, Hidaka Training and Research Center, Japan Racing Association, Hokkaido 057-0171, Japan
| | - Fumio Sato
- Clinical Veterinary Medicine Division, Equine Research Institute, Japan Racing Association, Tochigi 329-0412, Japan.,Department of Clinical Veterinary Science, United Graduate School of Veterinary Sciences, Gifu University, Gifu 501-1193, Japan
| | - Munkhtuul Tsogtgerel
- Department of Veterinary Medicine, Obihiro University of Agriculture and Veterinary Medicine, Hokkaido 080-8555, Japan.,Department of Clinical Veterinary Science, United Graduate School of Veterinary Sciences, Gifu University, Gifu 501-1193, Japan
| | - Tadamasa Niikura
- Doctoral Program in Veterinary Medicine, Graduate School of Animal Husbandry, Obihiro University of Agriculture and Veterinary Medicine, Hokkaido 080-8555, Japan
| | - Tomoe Moriyama
- Department of Veterinary Medicine, Obihiro University of Agriculture and Veterinary Medicine, Hokkaido 080-8555, Japan
| | - Akiko Chiba
- Department of Veterinary Medicine, Obihiro University of Agriculture and Veterinary Medicine, Hokkaido 080-8555, Japan
| | - Ken-Ichi Watanabe
- Department of Veterinary Medicine, Obihiro University of Agriculture and Veterinary Medicine, Hokkaido 080-8555, Japan
| | - Nao Tsuzuki
- Department of Veterinary Medicine, Obihiro University of Agriculture and Veterinary Medicine, Hokkaido 080-8555, Japan
| | - Yasuo Nambo
- Department of Veterinary Medicine, Obihiro University of Agriculture and Veterinary Medicine, Hokkaido 080-8555, Japan.,Department of Clinical Veterinary Science, United Graduate School of Veterinary Sciences, Gifu University, Gifu 501-1193, Japan.,Doctoral Program in Veterinary Medicine, Graduate School of Animal Husbandry, Obihiro University of Agriculture and Veterinary Medicine, Hokkaido 080-8555, Japan
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Tsogtgerel M, Tagami M, Watanabe K, Murase H, Hirosawa Y, Kobayashi Y, Nambo Y. Case report: The case of a 17 kg ovarian granulosa cell tumor in a Breton draft mare. J Equine Sci 2021; 32:67-72. [PMID: 34220274 PMCID: PMC8240524 DOI: 10.1294/jes.32.67] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 04/14/2021] [Indexed: 11/01/2022] Open
Abstract
Granulosa cell tumor (GCT) is a benign tumor which affects the mare's ovaries. In this report, a case of unilateral GCT in an ovary, which weighed 17.04 kg, of a 9-year-old Breton draft mare is described. A transrectal ultrasonography exam revealed a unilateral multi-cystic enlarged ovary. Laparoscopic ovariectomy was difficult due to enlargement of blood vessels in the ovarian broad ligament. The mare was necropsied, and the pathological changes in the GCT-affected ovary and unaffected ovary were evaluated. The ovarian mass in the GCT-affected ovary had a cribriform pattern and was positive for anti-Müllerian hormone (AMH) and its receptor (AMHR2). The contralateral ovary showed no follicular development and was negative for AMH. AMHR2 was positively expressed in stromal cells. The AMH concentration in plasma was 4,210 ng/ml. This is the first report showing the presence of AMH (2,210 ng/ml) in ascites fluid, and it also shows that laparoscopic ovariectomy might not be suitable for larger ovaries affected by a GCT. Ultrasonographic, endocrine, and histopathological analyses were helpful for making a definitive diagnosis of GCT in this mare.
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Affiliation(s)
- Munkhtuul Tsogtgerel
- United Graduate School of Veterinary Sciences, Gifu University, Gifu 501-1193, Japan.,Department of Veterinary Medicine, Obihiro University of Agriculture and Veterinary Medicine, Hokkaido 080-8555, Japan
| | - Masaaki Tagami
- Department of Veterinary Medicine, Obihiro University of Agriculture and Veterinary Medicine, Hokkaido 080-8555, Japan.,Shadai Horse Clinic, Shadai Corp., Ltd., Hokkaido 059-1432, Japan
| | - Kenichi Watanabe
- Department of Veterinary Medicine, Obihiro University of Agriculture and Veterinary Medicine, Hokkaido 080-8555, Japan
| | - Harutaka Murase
- Equine Science Division, Hidaka Training and Research Center, Japan Racing Association, Hokkaido 057-0171, Japan
| | - Yuko Hirosawa
- Animal Health Division, National Livestock Breeding Center Tokachi Station, Hokkaido 080-0572, Japan
| | - Yoshiyasu Kobayashi
- Department of Veterinary Medicine, Obihiro University of Agriculture and Veterinary Medicine, Hokkaido 080-8555, Japan
| | - Yasuo Nambo
- United Graduate School of Veterinary Sciences, Gifu University, Gifu 501-1193, Japan.,Department of Veterinary Medicine, Obihiro University of Agriculture and Veterinary Medicine, Hokkaido 080-8555, Japan
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Crabtree JR. A review of oestrus suppression techniques in mares. EQUINE VET EDUC 2020. [DOI: 10.1111/eve.13405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Behrendt D, Burger D, Gremmes S, Szunyog K, Röthemeier S, Sieme H. Active immunisation against GnRH as treatment for unilateral granulosa theca cell tumour in mares. Equine Vet J 2020; 53:740-745. [PMID: 32924167 DOI: 10.1111/evj.13352] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 08/24/2020] [Accepted: 08/29/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Stallion-like or aggressive behaviour in mares affected by unilateral granulosa theca cell tumour (GTCT) is well-known, but use of a GnRH-vaccine as an alternative to surgical removal of the neoplastic ovary has not been investigated. OBJECTIVES To determine the effect of immunisation against GnRH on ovarian size, testosterone concentration, Anti-Müllerian hormone (AMH) concentration, and owner-reported behaviour in four mares affected by unilateral GTCT. STUDY DESIGN Retrospective case report. METHODS A presumptive diagnosis of GTCT was made in four mares based on clinical signs, behavioural changes, transrectal palpation, and ultrasonography. All mares were vaccinated twice with the GnRH-vaccine Improvac® on day 0 and on day 13-33. Further booster vaccinations were administered if aggressive behaviour recurred between days 15 and 498. Before and parallel to the vaccinations, serum levels of oestradiol, progesterone (P4), testosterone, and AMH were evaluated and transrectal ultrasonography was performed. RESULTS In all horses, analysis of serum levels of oestradiol, progesterone, testosterone, and AMH confirmed the clinical diagnosis of GTCT. Serum levels of testosterone dropped to baseline levels following the first two of three vaccination in all mares. In addition, AMH serum values decreased shortly after the second vaccination in three of four mares, and in one of the four mares returned to baseline levels. No further GTCT linked behaviour was reported by the owners and the affected ovaries diminished in size in all four cases. MAIN LIMITATIONS This report is a case series with a limited number of animals, no controls and no standardised immunisation protocol. CONCLUSIONS Repeated vaccinations with the GnRH-vaccine Improvac® mitigated owner-reported behavioural abnormalities and stopped tumour growth in four mares affected by unilateral GTCT over the entire observation period which extends to 7 years in one mare.
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Affiliation(s)
| | - Dominik Burger
- Swiss Institute of Equine Medicine ISME, University of Berne, Agroscope, Avenches, Switzerland
| | | | | | | | - Harald Sieme
- Unit for Reproductive Medicine - Clinic for Horses, University of Veterinary Medicine, Hannover, Germany
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Renaudin CD, Kelleman AA, Keel K, McCracken JL, Ball BA, Ferris RA, McCue PM, Dujovne G, Conley AJ. Equine granulosa cell tumours among other ovarian conditions: Diagnostic challenges. Equine Vet J 2020; 53:60-70. [PMID: 32391939 DOI: 10.1111/evj.13279] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 03/19/2020] [Accepted: 05/02/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND Granulosa cell tumours (GCT) are the most common ovarian tumours in mares. While the classical presentation may not represent diagnostic challenges, diagnosis is not easy in the early stages. OBJECTIVES Illustrate the variability in the presentation and serum biomarkers associated with ovarian abnormalities in the mare. STUDY DESIGN Retrospective case series. METHODS Nonclassical cases of GCTs and other ovarian conditions were identified and behaviour, GCT endocrine results, palpation and ultrasonographic findings are described and the diagnostic value of each is discussed. RESULTS Mares in this case series with GCTs had been presenting clinical signs ranging from no behavioural changes to behaviours including aggression, stallion-like and inability to work under saddle. Hormonal profiles of endocrinologically functional GCTs can be erratic and unpredictable. The clinical form and ultrasonographic appearance may also vary with time from an initially enlarged/anovulatory follicular structure that later develops a multicystic 'honeycomb' appearance. Mares with GCTs can also present with persistent anovulatory follicles or apparent luteal tissue that are unresponsive to treatment. If both ovaries are of relatively normal size and symmetry, but hormonal biomarkers are markedly increased (AMH >10 ng/mL, inhibin B and/or testosterone >100 pg/mL; 0.37 nmol/L), it is likely that a functional GCT is present. Still, it can be a challenge to decide which ovary to remove. Post-surgical endocrine testing can be helpful, especially if histopathology is not performed or a GCT is not found. MAIN LIMITATIONS Cases limited to 14. CONCLUSIONS Granulosa cell tumours present with a wide variety of clinical signs that do not fit what is commonly described as 'classic'. Only if AMH, testosterone and inhibin B concentrations are markedly increased, and there is an abnormally enlarged ovary, the diagnosis of a GCT is more confident. In the presence of normal size ovaries, normal hormonal biomarkers and abnormal behaviour, it is more likely that the ovaries are not involved.
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Affiliation(s)
- Catherine D Renaudin
- Department of Population Health and Reproduction, School of Veterinary Medicine, University of California at Davis, Davis, CA, USA
| | - Audrey A Kelleman
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - Kevin Keel
- Department of Pathology, Microbiology and Immunology, School of Veterinary Medicine, University of California at Davis, Davis, CA, USA
| | | | - Barry A Ball
- Maxwell H. Gluck Equine Research Center, Department of Veterinary Science, University of Kentucky, Lexington, KY, USA
| | - Ryan A Ferris
- Department of Clinical Sciences, Colorado State University, Fort Collins, CO, USA
| | - Patrick M McCue
- Department of Clinical Sciences, Colorado State University, Fort Collins, CO, USA
| | - Ghislaine Dujovne
- Department of Population Health and Reproduction, School of Veterinary Medicine, University of California at Davis, Davis, CA, USA
| | - Alan J Conley
- Department of Population Health and Reproduction, School of Veterinary Medicine, University of California at Davis, Davis, CA, USA
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Munkhtuul T, Murase H, Ball BA, Habukawa K, Sato F, Watanabe K, Nambo Y. Immunolocalization of anti-Müllerian Hormone and Its Receptor in Granulosa Cell Tumors in Mares. J Equine Vet Sci 2019. [DOI: 10.1016/j.jevs.2018.12.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Munkhtuul T, Murase H, Ball B, Habukawa K, Sato F, Watanabe K, Nambo Y. Localization of AMH and AMHRII in Granulosa Cell Tumor of Thoroughbred Mares. J Equine Vet Sci 2018. [DOI: 10.1016/j.jevs.2018.05.151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Wright S. Highlights of recent clinically relevant papers. EQUINE VET EDUC 2018. [DOI: 10.1111/eve.12889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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