Suppression of estrus in cats with melatonin implants

A Pilot Study to Evaluate the Potential of Melatonin Implants to Control Cyclicity in the Bitch

In short-day breeders such as the sheep, melatonin stimulates oestrus activity; in contrast, a high serum concentration of melatonin inhibits oestrus in long-day breeders such as the cat. Therefore, implants with melatonin have been used to suppress or induce oestrus depending on the species. The aim of this pilot study was to evaluate if melatonin could be an alternative to control the reproductive cycle in the bitch. Nine beagle bitches were observed for three oestrus cycles. Five beagle bitches were treated with 18 mg melatonin implants on average 27 days before the next expected oestrus based on the previous interoestrus interval. Four bitches served as untreated controls. Blood samples for evaluation of serum melatonin were collected at the time of assignment to treatment or control group and 1-4 weeks thereafter. Clinical signs and vaginal smears were used to follow the cycle. Melatonin varied significantly with bitch (p < 0.05) but not with treatment. Treatment did not affect the interoestrus interval (p > 0.05). In conclusion, treatment with 18 mg melatonin implants approximately one month before expected oestrus is not likely to be a useful method to control cyclicity in the bitch. It is still not known if melatonin is involved in regulation of the oestrus cycle in the domestic dog.

Behavioral and cardiovascular effects of a single dose of gabapentin or melatonin in cats: a randomized, double-blind, placebo-controlled trial

OBJECTIVES

The aim of this study was to verify whether a single oral dose of gabapentin (100 mg) or melatonin (3 mg) given 60 mins before a cardiac evaluation would reduce anxiety without interfering with heart rate (HR), systemic blood pressure (SBP), electrocardiogram (ECG) and echocardiographic indexes.

METHODS

Seventy-five client-owned healthy cats underwent two sets of cardiac assessments 60 mins apart, randomly divided into gabapentin, melatonin and placebo groups. The interval between treatment and the second ECG and SBP measurement was 60 mins, and 70 mins for echocardiography. A compliance score (CS) classified the behavior, focusing on the ease of handling.

RESULTS

Most variables did not change between the examinations. The placebo group showed more significant changes (SBP, tricuspid annular plane systolic excursion, HR during echocardiography, aortic flow velocity, S' wave from lateral mitral annulus), but they were not considered to be hemodynamically relevant. Gabapentin and melatonin significantly increased the cats' compliance without interfering with cardiac assessment. Eight cats presented with mild sedation, seven after gabapentin and one after melatonin. No major side effects were observed.

CONCLUSIONS AND RELEVANCE

Gabapentin tranquilized the cats when it was given 60 mins prior to ECG and SBP measurement, and 70 mins prior to echocardiography, without interfering with systolic echocardiographic indexes. Melatonin also decreased the CS, but without sedation in most cases. The waiting period may have relaxed the cats in the placebo group, resulting in lower SBP measurements. However, this tranquility did not last as some echocardiographic changes signaled a sympathetic predominance.

Reversible Control of Reproduction In Queens: Mastering the use of reproductive drugs to manipulate cyclicity

BACKGROUND

The literature is full of papers reporting side effects of progestogens in cats; however, they are, in fact, safe drugs, as discussed in this article. Gonadotropin-releasing hormone (GnRH) agonists and melatonin are additionally a practical solution for controlling cyclicity in queens, but they also have some contraindications and need to be used carefully.

CLINICAL RELEVANCE

Mastering the use of reproductive drugs allows feline practitioners to handle many more clinical situations than can be solved using surgery. It is not necessary to be a specialist in reproduction to be able to halt cyclicity in a valuable breeding queen using hormones.

EQUIPMENT AND TECHNICAL SKILLS

A sound knowledge of appropriate dosages and criteria for patient selection for all reproductive drugs currently used in feline reproduction is the best guarantee of owner satisfaction and of ensuring the queen's health. Availability of a serum progesterone assay, either in-house or via an external laboratory, is also important, in order to confirm a queen is at an appropriate stage of the reproductive cycle for treatment.

AUDIENCE

This article is aimed principally (but not exclusively) at veterinarians working with cat breeders and whose clientele is increasingly interested in alternative methods of controlling reproduction in pet queens. Surgery is no longer the only choice, and practitioners who manage to keep abreast of new developments will be able to address clients' needs in a modern, professional way.

EVIDENCE BASE

This review draws on a vast body of scientific evidence-based literature. Previously, personal (and sometimes misinformed) opinions, such as the proposed dangerous side effects of progestogens, have been perpetuated in the scientific literature. The papers cited in this review have therefore been carefully scrutinised to distinguish reliable information based on controlled studies from non-evidence-based information.

Reproductive Management in Catteries: Optimising health and wellbeing through veterinarian-breeder collaboration

PRACTICAL RELEVANCE

Many veterinarians - even those engaged in small animal reproduction - are uncomfortable with taking care of cat breeders or being in charge of catteries. Likely reasons for this are that feline reproduction is largely under-represented in undergraduate and graduate reproduction teaching, as well as in postgraduate education and science, whereas cat breeders themselves are often well informed and actively share knowledge with other cat breeders via the internet and social media.

CLINICAL CHALLENGES

A variety of problems can exist within a cattery, and collaboration between veterinarian and breeder to solve these is ultimately beneficial for the breeder, for the veterinarian, and for the health and wellbeing of the individual cats and of the cattery as a whole.

AIM

This review presents a comprehensive overview of aspects of cattery management that might negatively impact reproduction, including sanitation, hygiene and infectious disease control. It also discusses monitoring of reproductive performance, breeding recommendations, and the diagnostic and therapeutic approach to some common and specific problems.

EQUIPMENT AND TECHNICAL SKILLS

Reproductive management in the cattery requires no specialised equipment, as such. What it does need is an open mind, in terms of seeing how things are done, an open ear, for listening to the breeder, and the veterinarian's clinical skills in palpation, auscultation and, where required, further examination of the animals. Keeping abreast of the latest information on infectious diseases, disinfection and genetics ensures proper advice is provided.

EVIDENCE BASE

Current knowledge of reproductive management in catteries is summarised in order to apply an evidence-based approach, whenever possible. Notwithstanding, much of the information remains empirical.

Effect of cat seminal plasma and purified llama ovulation-inducing factor (β-NGF) on ovarian function in queens

The present study aimed to determine the effect of cat seminal plasma and purified llama ovulation-inducing factor (β-NGF) on ovarian activity in queens. Queens (n = 6) were used for all the treatments in a crossover design with an interval time between treatments of three interestrus intervals. Forty-eight hours after the detection of an estrus vaginal cytology, queens were given cat seminal plasma (subcutaneous or intramuscular), purified llama ovulation-inducing factor (15 or 35 μg), hCG (75 UI), saline, or were mated with a male. A total of 192 estrous cycles were observed. Estrus length and serum estradiol concentration were 6 ± 1 days (range 2-10 d) and 38 pg/mL (range 10-75 pg/mL), respectively. Queens mated and given hCG showed higher serum progesterone concentration and longer interestrus interval (47 ± 5 d) than that of controls (10 ± 3 d). Sixty-seven percent of queens (4/6) treated with subcutaneous cat seminal plasma, and 17% of those treated with purified llama β-NGF showed high serum progesterone concentrations along with prolonged interestrus. However, intramuscular administration of cat seminal plasma produced interestrus intervals similar to controls (15 ± 5 d) and basal serum progesterone concentration (<0.50 ng/mL). This study demonstrates that the subcutaneous administration of cat seminal plasma induced ovulation in queens. Therefore, molecules present in cat seminal plasma, contribute to the induction of ovulation in queens. Identifying those molecules will improve the knowledge of queen's reproductive physiology. Also, it could offer a physiologic alternative to induce ovulation in queens when reproductive biotechnologies are used.

Disappearance of signs of heat and induction of ovulation in oestrous queens with gonadorelin: a clinical study

OBJECTIVES

The objective of this study was to assess the efficacy of a single intramuscular administration of gonadorelin to induce ovulation in queens in oestrus.

METHODS

Twenty-seven queens presented in oestrus for elective ovariectomy were divided into a treatment (n = 19) and a placebo (n = 8) group. Treated queens received a 50 µg dose of gonadorelin, while placebo-treated queens were injected intramuscularly (IM) with an equal amount of saline solution. All treatments were performed between the second and fourth days of heat.

RESULTS

Two days later, signs of behavioural heat had disappeared in all gonadorelin-treated queens, while 5/8 placebo-treated queens were still in heat. Following ovariectomy, performed 4 days after drug administration, the ovaries of each queen were evaluated histologically and the number of corpora lutea were counted. Sixteen of 19 (84%) gonadorelin-treated queens had ovulated and developed five (range 2-9) corpora lutea, while 3/8 (37%) placebo-treated queens had ovulated and developed five (range 3-6) corpora lutea.

CONCLUSIONS AND RELEVANCE

This is the first study to document the efficacy of a 50 µg/cat gonadorelin dose to induce ovulation in oestrous queens when administered IM on days 2-4 following the onset of oestrus.

Melatonin Administration Accelerates Puberty Onset in Mice by Promoting FSH Synthesis

Although melatonin has been extensively studied in animal reproduction, the mechanism of melatonin in puberty remains elusive. This study was designed to explore the effect of intraperitoneal administration of melatonin on puberty onset in female mice. The injection of melatonin into postnatal days 10 mice at a dose of 15 mg/kg accelerated the puberty onset in mice. Mechanistically, there was no difference in physical growth and serum Leptin levels after melatonin administration. Meanwhile, the serum levels of reproductive hormones involved in hypothalamic-pituitary-ovarian axis, such as FSH and estrogen level in serum were increased. The mRNA levels of GnRH and GnRHr were not affected by melatonin, while the expressions of FSHβ in pituitary and Cyp19a1 in ovary were significantly up-regulated. In addition, melatonin still promoted FSH synthesis after ovariectomy. Furthermore, the enhanced activity of ERK1/2 signaling verified that the expression of FSHβ increased in pituitary. We confirmed that melatonin promoted the FSH synthesis in pituitary, thereby increased serum estrogen levels and ultimately accelerated puberty onset. However, these effects of melatonin may be pharmacological due to the high dose. This study would help us to understand the functions of melatonin in pubertal regulation comprehensively.

Contraceptive implants used by cat breeders in France: a study of 140 purebred cats

OBJECTIVES

Deslorelin 4.7 mg and melatonin 18 mg subcutaneous implants were studied in purebred male and female cats, via questionnaires sent to French cat breeders, to assess breed, age, duration of the contraceptive effect, fertility after use, changes in behaviour and side effects.

METHODS

Reproductive data were collected in 57 tom cats and 41 queens implanted with deslorelin 4.7 mg, and 42 queens implanted with melatonin 18 mg, for a total of 140 purebred cats, from 38 different catteries, representing 18 breeds.

RESULTS

Using deslorelin (Suprelorin 4.7 mg; Virbac), sexual behaviour in males was inhibited for a mean ± SD of 13.4 ± 3.2 (range 8-21) months in 37/57 cats. Of these, 24/37 mated successfully and produced litters at a mean of 15.5 ± 3.6 (range 9-20) months. Inhibition lasted 11 ± 1.1 (range 9-12; n = 6), 13.2 ± 2.4 (range 12-18; n = 6) and 15 ± 3.5 (range 9-18; n = 6) months in Norwegian Forest Cat, Singapura and Ragdoll males, respectively. In 26/41 females implanted with deslorelin 4.7 mg, oestrus was inhibited for a mean of 16.0 ± 5.7 (8-38) months; 12/26 went on to produce a litter. Of the side effects specific to females: two presented persistent oestrus, leading to the removal of the implant; two developed lactation; one had fibroadenomatosis; and one was sterilised owing to cystic endometrial hyperplasia. Using melatonin (Melovine 18 mg; Ceva), 33/42 females had oestrus inhibited for a mean of 86 ± 50 (range 21-277) days after implantation with a peak return to oestrus in March, and 12/33 had a subsequent litter. No side effects were reported.

CONCLUSIONS AND RELEVANCE

This study is the first to collect a large amount of field data, in 140 purebred male and female cats where a deslorelin 4.7 mg or a melatonin 18 mg implant was used. These field results may allow for more accurate clinical advice and open up new avenues of research.

Effect of melatonin on the reproductive cycle in female cats: a review of clinical experiences and previous studies

Practical relevance Cat breeders aim to suppress the sexual cycle for a defined period. This is a challenge as most preparations available for this intention are orally administered progestins; however, these drugs may have side effects, especially when used over a long period of time. Long-acting gonadotropin-releasing hormone agonist implants have been used successfully to suppress the oestrous cycle in cats for a longer period. After removal of the implant, the duration of action was shortened; however, the re-occurrence of normal cyclicity cannot be foreseen. The search for alternatives is therefore ongoing. Clinical challenges Another possibility for oestrus control is orally administered melatonin preparations; however, previous studies have shown that the effect was not satisfactory. After subcutaneous application of a melatonin implant developed for induction of oestrus in sheep (Melovine; Ceva Santé Animale), duration of oestrus suppression was shown to differ highly in individuals and in some cases no effect was observed. Nevertheless, it is used for short-term oestrus suppression in female cats. Aims This article provides an overview of recent studies and clinical experiences of the use of melatonin as a contraceptive in cats. It explains the function of melatonin in cats, discusses previous studies, provides clinical experience with Melovine (27 cases) and elucidates advantages and disadvantages. Evidence base Information provided in this article is drawn from the published literature and the author's own clinical experience.

Pyometra in the queen: To spay or not to spay?

PRACTICAL RELEVANCE

Pyometra is a commonly occurring uterine disease in cats that often leads to loss of breeding potential and, in some cases, can be life threatening. An increased incidence of cystic endometrial hyperplasia (CEH) and pyometra is seen with age. Most queens present with uterine lesions after 5-7 years of age (average 7.6 years, range 1-20 years). Clinical signs most commonly occur within 4 weeks of the onset of oestrus in queens that are either mated, spontaneously ovulate or are induced to ovulate (mechanical stimulation or hormone induction). The disease is most often observed in dioestrus.

CLINICAL CHALLENGES

Queens with pyometra often go undiagnosed as there may be few or only very mild clinical signs and laboratory changes. For example, the classic sign of mucopurulent bloody vulvar discharge often goes unnoticed. Abdominal ultrasound is the best tool for diagnosis of pyometra and for monitoring response to therapy.

PATIENT GROUP

Classically, middle-aged/older nulliparous intact queens present with pyometra. However, so-called 'stump pyometra' can occur if ovarian tissue is left behind during ovariectomy or ovariohysterectomy (ovarian remnant syndrome). Queens treated with exogenous steroid hormones such as high doses of megestrol acetate or medroxyprogesterone acetate for oestrus prevention can also develop CEH and pyometra.

EVIDENCE BASE

There has been little published to date on CEH, endometritis and pyometra in the queen and most of the currently available information has been extrapolated from studies carried out in the bitch. The queen and the bitch have very different reproductive physiology; thus, further research and investigation into the precise aetiopathogenesis of these disease processes of the uterus in the queen is warranted.

AUDIENCE

This review is aimed at clinicians working in small animal practice, especially those in countries where surgical sterilisation is not practised as commonly as in the United States, Canada or Australasia, and who will therefore see a greater proportion of intact queens.

Alternative methods for feline fertility control: Use of melatonin to suppress reproduction

PRACTICAL RELEVANCE

Reversible contraceptives are highly desired by purebred cat breeders for managing estrous cycles and by scientists managing assisted reproduction programs. A variety of alternative medicine approaches have been explored as methods to control feline fertility.

SCOPE

In the field of veterinary homeopathy, wild carrot seed and papaya have been used for centuries. Both appear to be safe, but their efficacy as feline contraceptives remains anecdotal. In contrast, the use of melatonin in cats has been investigated in a number of studies, findings from which are reviewed in this article.

RATIONALE

Cats are seasonally polyestrous (they cycle several times during their breeding season) and are described as long-day breeders because endogenous melatonin negatively regulates estrous cyclicity. Exogenous melatonin administered parenterally also suppresses ovarian activity in cats, and long-term oral or subcutaneous melatonin administration is safe.

CHALLENGES

The therapeutic use of melatonin is limited by its short biological half-life (15-20 mins), its poor oral bioavailability and its central effects in reducing wakefulness. Research is required to determine whether higher doses, longer-release formulations, repeated administration or combination implants might overcome these limitations.

Potential safety issues in the use of the hormone melatonin in paediatrics

Melatonin is a hormone produced by the pineal gland during the night in response to light/dark information received by the retina and its integration by the suprachiasmatic nucleus. When administered to selected populations of adults, in particular those displaying delayed sleep phase disorder, melatonin may advance the time of sleep onset. It is, however, being increasingly prescribed for children with sleep disorders despite the fact that (i) it is not registered for use in children anywhere in the world; (ii) it has not undergone the formal safety testing expected for a new drug, especially long-term safety in children; (iii) it is known to have profound effects on the reproductive systems of rodents, sheep and primates, as well as effects on the cardiovascular, immune and metabolic systems; and (iv) there is the potential for important interactions with drugs sometimes prescribed for children. In this review, I discuss properties of melatonin outside its ability to alter sleep timing that have been widely ignored but which raise questions about the safety of its use in infants and adolescents.

Cloprostenol treatment of feline open-cervix pyometra

Treatment with cloprostenol, a prostaglandin synthetic analogue, was evaluated in five queens with open-cervix pyometra. Cloprostenol was administered (5 μg/kg body weight SC) on 3 consecutive days and amoxicillin (20 mg/kg body weight IM) on 7 consecutive days. Transient post-injection reactions caused by cloprostenol administration included diarrhea, vomiting and vocalizations. Reactions began as quickly as 10 mins after cloprostenol administration and lasted as long as 30 mins. All queens improved clinically after cloprostenol treatment and remained healthy until the end of the study, 1 year after treatment. All queens resumed normal estrous cycles without further treatment and two (40%) delivered a normal litter. In conclusion, use of cloprostenol is an acceptable treatment for open-cervix pyometra in queens.

Reproduction control in cats: new developments in non-surgical methods

PRACTICAL RELEVANCE

Reproduction control is an area of feline medicine that is assuming increasing importance in companion animal practice. Signs of oestrus such as increased vocalisation, rolling on the ground and a very short interoestrous interval may negatively influence the relationship between cat and owner, and prompt the owner to seek a method of reproduction control. In breeding catteries, control of reproduction may be needed as part of a planned breeding programme.

CLINICAL CHALLENGES

Surgical contraception is not always the owner's wish - especially when a cat may be intended for future breeding. Besides, ethical principles and animal welfare legislation in an increasing number of countries are imposing restrictions on this 'classical approach' to reproduction control. Progestins are routinely used as non-surgical alternatives in cases where fertility is to be preserved, but the associated risks of uterine disease, mammary tumours, fibroadenomatosis or diabetes mellitus have to be taken into account - especially in predisposed animals. Modern, effective pharmacological alternatives are available for managing oestrous suppression and unwanted pregnancy. Detailed knowledge of the physiology of the oestrous cycle in the cat is necessary to ensure that the appropriate treatment is chosen for the individual animal and its owner.

AUDIENCE

This article presents an update for small animal practitioners on these alternative methods; specifically, the use of slow-release GnRH agonists or melatonin implants for hormonal contraception, and the antiprogestin aglepristone for pregnancy termination.

EVIDENCE BASE

Several studies have documented the mode of action and risk of side effects of the traditional alternative to surgical castration - treatment with progestins. Evidence underpinning the safety and efficacy of GnRH agonists and melatonin implants for suppression of fertility in queens and toms is reviewed.