Management of a Uterine Leiomyoma in a Western Lowland Gorilla (Gorilla gorilla gorilla)
American Association of Zoo Veterinarians Conference 2008
Natalie D. Mylniczenko1, MS, DVM; Susan S. Murrey2, MD, FACOG; Steven Smith3, MD; Luke W. Sewall3, MD; Francis Facchini3 MD
1Chicago Zoological Society/Brookfield Zoo, Brookfield, IL, USA; 2West Suburban Women’s Health, Adventist Hinsdale Hospital, Willowbrook, IL, USA; 3Adventist La Grange Memorial Hospital, La Grange, IL, USA

Abstract

A 46-year-old female western lowland gorilla (Gorilla gorilla gorilla) presented for metrorrhagia. Vaginal and rectal ultrasonographic examination of the reproductive tract under anesthesia revealed a uterine mass consistent with a leiomyoma (fibroid). Hormonal therapy was initiated to reduce the mass but was unsuccessful. Over the next several months, vaginal bleeding continued and appeared to increase in volume and frequency with a resulting non-regenerative anemia. Uterine hydrothermal ablation was performed in an effort to alleviate some of this animal’s clinical signs.3 The procedure was executed successfully in this gorilla with an excellent recovery, cessation of vaginal bleeding and a resolution of the anemia; however, vaginal bleeding recurred within 1 month. Uterine fibroid embolization (UFE) was subsequently performed and the animal had no complications from the procedure.4 Immediately following the procedure, vaginal bleeding stopped. At a 4-month recheck, the uterine mass had a significant reduction in size and the animal continued to be amenorrheic. Uterine tumors have been described in great apes and have been associated with serious disease.1,2,5 UFE appears to be a minimally invasive technique that can potentially halt ongoing menorrhea and can be an effective alternative to treating uterine leiomyomas without surgical intervention.

Acknowledgments

Special thanks to the Brookfield Zoo’s great ape staff, Dr. Michael Zinnaman, MD (Loyola University of Chicago, Maywood, IL), the technical staff at Adventist Health Systems (La Grange, IL), Jennifer Langan DVM DACZM, Tom Meehan, DVM, Mark Warneke and Kimberly Schmidt, DVM. Very special thanks to Boston Scientific (Chris Barron and Matthew Wyatt Fischer) and the General Electric Company (Sam D’Amico, Heiner Fuchs, Javier Guizar, Katie Bohling) for their generous collaborations in providing equipment, supplies and technical expertise.

Literature Cited

1.  Burns, R. 2006. Hemodialysis of a western lowland gorilla (Gorilla gorilla gorilla) with fatal septicemia and pyelonephritis secondary to urine stasis and uterine leiomyosarcoma. Proc. Am. Assoc. Zoo Vet.: 154–5.

2.  Gamble, K.C., M.C.K. North, K. Backues, S.R. Ross. 2004. Pathologic review of the chimpanzee. Proc. Am. Assoc. Zoo Vet.: 561–6.

3.  Hefni, M.A, T. El-Toukhy, C. Nagy, S. Mahadevan, A.E. Davies. 2002. Hydrothermal ablation: assessment of a new simple method for treatment of uncontrolled menorrhagia. Gynaecol. Endo. 11:111–7.

4.  McLucas, B, L. Adler, R. Pereella. 2001. Uterine fibroid embolization: nonsurgical treatment for symptomatic fibroids. Am. Coll. Surg. 192(1):955–105.

5.  Young, L.A., N.P. Lung, R. Isaza, D. Heard. 1994. Anemia in a chimpanzee (Pan troglodytes) associated with lead toxicity and uterine leiomyoma. Proc. Am. Assoc. Zoo Vet.: 250.

 

Speaker Information
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Natalie D. Mylniczenko, MS, DVM
Chicago Zoological Society/Brookfield Zoo
Brookfield, IL, USA


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