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Difli Kedilerde Hormonal Kontrasepsiyon Amac›Yla

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Difli Kedilerde Hormonal Kontrasepsiyon Amac›Yla Tr.J.ofVeterinaryandAnimalSciences 23(1999)EkSay›3,455-459 @TÜB‹TAK DifliKedilerdeHormonalKontrasepsiyonAmac›ylaProligeston, MegestrolAsetatveGnRHKullan›m› MuratFINDIK,NilERÜNALMARAL,SelimASLAN AnkaraÜniversitesi,VeterinerFakültesi,Do¤umveJinekolojiAnabilimDal›,Ankara-TÜRK‹YE GeliflTarihi:16.06.1997 Özet: Buçal›flman›namac›,ikifarkl›progestagenintekbafl›naveyaGnRHilebirliktekullan›m›n›n,diflikedilerdekikontraseptifetkin- li¤iniaraflt›rmakt›.Çal›flma,çeflitli›rktanvesiklusunde¤iflikevrelerindekitoplam73kediüzerindeyap›lm›flt›r.Kediler,se ksüel aktivitenininteröstrüs(n=35)veöstrüs(n=38)evrelerindebulunanlarolmaküzere2anagrupalt›ndasa¤alt›lm›flt›r.‹nteröstr üs evresindebulunanbirincianagruptaki20kediye(Grup-1/A)30mg/kgproligeston(PRG)vedi¤er15kediye(Grup-1/B)ise25mg megestrolasetat(MA)(s.c.)uygulanm›flt›r.Östrüsevresindebulunanikincianagruptakikedilereönce50µg(i.m.)gonadotropi n sal›n›mhormonu(GnRH)uygulanm›fl,uygulamadan48-96saatsonra23kediye(Grup-2/A)30mg/kgPRGvedi¤er15kediyeise (Grup-2/B)25mgMA(s.c.)verilmifltir. Östrüssemptomlar›n›nortadankalkmas›Grup-1/Ada2.85±0.74gün,Grup-1/Bde2.93±1.35gün,Grup-2/Ada3.08±0.84gün veGrup-2/Bde2.86±0.64günolaraksaptanm›flt›r.HormonenjeksiyonundansonrasakinkalmasüreleriGrup-1/Ada8.00±2.20 ay,Grup-1/Bde3.33±1.01ay,Grup-2/Ada7.57±2.35ayveGrup-2/Bde4.90±2.65ayolarakbelirlenmifltir. Gruplararas›ndaöstrüssemptomlar›n›nortadankalkmas›bak›m›ndaneldeedilenortalamade¤erlerdeherhangibirfarkl›l›ksap- tanamam›flt›r(Grup-1/A:Grup-1/B=p<0.83;Grup-2/A:Grup-2/B=p<0.37).‹lac›nenjeksiyonundansonraenuzunsakinkalmasüresi s›ras›ylaortalama8.0ve7.57ayileGrup-1/A(PRG)veGrup-2/A(GnRH+PRG)’dagörülmüflvebusüredi¤ergruplardakisakin kalmasüresinegöreistatistikselyöndenönemlidüzeydefarkl›bulunmufltur(Grup-1/A:Grup-1/B=p<0.0001;Grup-2/A:Grup-2/B= p<0.0038).GnRHuygulamas›n›n,diflikedilerin%84.2’sindeöstrüsbelirtileriniilk3güniçindesonaerdirdi¤i,yaln›z%15.8’indebu belirtilerinazalmaklabirliktedevametti¤isaptanm›flt›r.Proligestonuygulanandiflikedilerdepyometravememetümörüoluflumu gözlenmemifl,MAuygulamas›n›takibenise2kedide(%6.6)pyometraolgusunarastlanm›flt›r. Diflikedilerdeöstrüslerinertelenmesiveyaovulasyonunuyar›lmas›amac›ylaproligestonveyaGnRH+proligestonuygulamalar›n›n uzunsürelivekomplikasyonsuzsakinkalmadönemisa¤lad›¤›belirlenmifltir. AnahtarSözcükler: Proligeston,Megestrolasetat,GnRH,DifliKedi,Kontrasepsiyon. Theuseofproligestone,megestrolacetateandGnRHonqueenswiththeaimofhormonal contraception Abstract:Theaimofthisstudywastoinvestigatetheefficacyoftheuseoftwodifferentprogestagenseithersinglyorinacom- binationwithGnRHonqueencontraception.Thestudywasperformedonatotalof73femalecatsofvariousbreedsatvarious stagesofcycles. Queensatinteroestrous(n=35)andoestrousperiods(n=38)ofsexualactivityweretreatedundertwomaingroups.Twentycats ofthefirstmaingroupatinteroestrousperiod(Group-1/A)wereadministered30mg/kg(sc)proligestone(PRG)andtheremain- ing15cats(Group-1/B)wereadministered25mg(sc)megestrolacetate(MA).Thecatsatoestrousperiodwerefirstgiven50µg gonadotropinreleasinghormone(GnRH)(im).48-96hoursfollowingtheapplication23ofthesecats(Group-2/A)wereadminis- tered30mg/kg(sc)PRG,whiletheother15cats(Group-2/B)wereadministered25mg(sc)MA. Thedisappearanceofoestroussymptomswasestablishedtobe2.85±0.74daysinGroup-1/A,2.93±1.35daysinGroup1/B, 3.08±0.84daysinGroup-2/Aand2.86±0.64daysinGroup-2/B.Followinghormonalinjectiontheperiodsofremainingcalmwere establishedtobe8.00±2.20monthsinGroup-1/A,3.33±1.01monthsinGroup-1/B,7.57±2.35monthsinGroup-2/Aand 4.90±2.65monthsinGroup-2/B.Nodifferencehasbeenestablishedamongmeanvaluesfromthepointofviewofthedisappear- anceofoestroussymptomsamonggroups(Group-1/A:Group-1/B=p<0.83,Group-2/A:Group-2/B=p<0.37).Followingtheinjec- tionofhormonethelongestperiodofremainingcalmwasonaverageof8.0and7.57monthsinGroup-1/A(PRG)andGroup-2/A (GnRH+PRG)respectivelyandthisperiodwasfoundtobestatisticallysignificantwithrespecttoperiodsofremainingcalmin the othergroups(Group-1/A:Group-1/B=p<0.0001;Group-2/A:Group-2/B=p<0.0038). IthasbeenestablishedthattheGnRHapplicationterminatedtheoestroussymptomsin84.2%ofthefemalecatswithinthefirst 3 daysonly,thoughin15.8%ofcatsthesesymptomscontinueddecrease.Infemalecatsonwhom,PRGwasapplied,formationof pyometraandbreasttumourswasnotobservedwhilefollowingtheapplicationofMA,pyometraformationwasseenin2cats (6.6%). IthasbeendeterminedthatpostponementoftheoestrousandinductionofovulationwiththeuseofPRGorGnRH+PRGprovide longtermandcomplication-freeperiodsofremainingcalm. KeyWords: Proligestone,Megestrolacetate,GnRH,Queen,Contraception. 455 DifliKedilerdeHormonalKontrasepsiyonAmac›ylaProligeston,MegestrolAsetatveGnRHKullan›m› Girifl antigonadotropinveantiöstrogeniketkilidir.MAP,CAP Kedilermevsimselpoliöstrikhayvanlard›r.Ocak-fiubat veDMAayn›zamandadi¤erlerindendahaaktifmoleküler aylar›ndauzamayabafllayangün›fl›¤›süresisiklikaktivite yap›lar›sayesinde,bus›rayagörekuvvetliölçüde döneminibafllatmakta,sonbahardaazalan›fl›ketkisiylede antiandrojeniketkinli¤esahiptir(12,15). fizyolojikanöstrüsdöneminegeçiflflekillenmektedir. Megestrolasetat(MA)sentetikbir17 α-acetoxy-6α Sonbahar›nsonuvek›flaylar›yapay›fl›kuygulamalar›ile methylprogesteroneanalo¤udur.Bupotentantiovulatör seksüelyöndenaktifdönemlerhalinegelebilmekte,bu bilefli¤in,progestageniketkisiprogesterondan25kat durumeviçindebeslenenkedilerdebelirginleflmektedir fazlad›r.MA’n›nantiöstrogeniketkisiyan›nda (1).Akkayan(2),Ankaraileçevresindekikedileriny›l glukokortikoidbenzerietkisidebulunmaktad›r(16,17). boyuncaöstrüsgösterdikleriniancak,Temmuz-Kas›m PRGise14 α7α propylidenedioxyprogesteron aylar›aras›ndaöstrüsgösterenkedisay›s›n›nazald›¤›n› yap›s›ndaeflde¤erbirprogestinolup,düflükdüzeydeki bildirmektedir. progestageniketkisininyan›nda,antigonadotropve Pubertasyafl›4-12(ortalama10)ayolandiflikedide, antiöstrogeniketkilibirbilefliktir.De¤iflikyap›sal östrüsbelirtileriningörüldü¤üfollikülerdönemortalama formülündenötürüproligestonevcilkarnivorlarda 7.4günsürmektedir.Süreç,›rkaba¤l›olarak3-16gün tekrarl›olarakveyayg›nbiçimdekullan›lmaktad›r(18). aras›ndafarkl›l›klargösterebilir.Çiftleflmebusüreyi Birdekapeptidolando¤alGnRHmolekülünün k›saltmaktad›r(3-5).Yerdeyuvarlanma,bafl›npatilerle kimyasalyap›s›ndakide¤iflimler,potentGnRH ovulmas›,arkaayaklar›ylaçi¤nemehareketleriyapma, agonistlerininsentezineolanaktan›m›flt›r.Bunlardan de¤ifliktondasüreklimiyavlamadöneminbelirgin Buserelin(D-serine6pozisyondaveethylamide10 davran›flbiçimiolarakbildirilmektedir(1,6,7). pozisyonda)Gonadorelin’den50kezdahaetkilidir(19). Kedilerdeovulasyon,çiftleflme,serviksuterive Sunulançal›flman›namac›,siklikaktiviteninöstrüsve vaginan›nmekanikuyar›m›,vulvaves›rtbölgesine interöstrüsevrelerindekidiflikedilerde,ikifarkl› uygulananmasajlarveGnRHveyagonadotropinlerin progestagenintekbafl›naveyaGnRHilebirlikte kullan›m›ilesa¤lanabilir.Ovulasyon,çiftleflmeden25-32 kullan›m›n›n,östrüsüertelemeveovulasyonuuyarma saatsonrasonraflekillenmektedir.LHsal›n›m›n›ndüzeyi üzerindekietkinli¤iniaraflt›rmakt›r. vesüresi,kopulasyonunsay›s›veolufltu¤uzamandilimiyle ilgilidir(5,8). MateryalveMetot Ovulasyonoluflmazsakediler2-10günsüreyleöstrüs gösterirler.Folliküllerbusüreninsonundaatreziye Buçal›flma1993-1996y›llar›aras›ndaA.Ü.Veteriner u¤rarlar,progesteronsal›n›m›olmad›¤›ndan FakültesiDo¤umveJinekolojiAnabilimDal›Klini¤i’ne, endometriyumtransformasyonugerçekleflmez.Sekiz-9 ovulasyonunuyar›lmas›veöstrüsünertelenmesiamac›yla günlükk›sadinlenmedönemindensonra(interöstrüs) getirilençeflitli›rktan,ortalamayafllar›13.24±9.62ay yenibirfolliküldöneminegirilir.Anovulatorikbirsiklusun olan73diflikediüzerindeyap›lm›flt›r. süresiortalama16gündür(9-11). Çal›flmadakullan›lankedilerseksüelaktivitenin Evcilkarnivorlardaüremenindenetlenmesindeyayg›n interöstrüs(n=35)veöstrüs(n=38)evrelerinde yöntemlerdenbiriöstrüssiklusununkesintiye bulunanlarolmaküzere2anagrupalt›ndaeleal›nm›flt›r. u¤rat›lmas›d›r(12,13).Buamaçdo¤rultusundas›kça Östrüsveinteröstrüsevreleri,hayvansahibindenal›nan tercihedilenyöntemlerdenbiriolanmedikal anamnezveevrelereözgüdavran›fllar›nklinik kontrasepsiyonda,do¤al(progesteronvetestosteron)ve de¤erlendirmesido¤rultusundasaptanm›flt›r.‹nteröstrüs sentetiksteroidler(Medroxyprogesteronacetate=MAP, evresindekikedilerden20’sine(Grup-1/A)30mg/kg Megestrolacetate=MA,Chlormadinoneacetate=CAP, proligeston((PRG)vedi¤er15’ineise(Grup-1/B)25mg Melengestrolacetate=MGA,Delmadinoneacetate=DMA, megestrolasetat**(MA)(s.c.)uygulanm›flt›r.Östrüs Proligestone=PRG,Norethysteroneacetate=NAvb.) evresindekikedilereönce50µgGnRH***(i.m.)enjekte kullan›lmaktad›r(14). edilmiflvebuuygulamadan48-96saatsonrabunlardan Tümprogestinlerinyüksekdüzeydesentralve 23’üne(Grup-2/A)30mg/kgPRG,di¤er15’ineise periferalprogestageniketkilerivard›r.Tamam› (Grup-2/B)25mgMA(s.c.)enjekteedilmifltir. * Proligestone:Delvosteron®,100mg/ml,proligestone,20ml,Mycofarm. ** Megestrolacetate:Niagestin®,25mg/ml,megestrolacetate,10ml,Novo. *** GnRH:Receptal®,0,0042mg/ml,buserelinacetate,10ml,Topkim. 456 M.FINDIK,N.ERÜNALMARAL,S.ASLAN Çal›flmabulgular›kedilerinuygulamasonras›ndaikiay azalmaklabirliktedevametti¤isaptanm›flt›r.Bukedilerde aralarlakontrolleriyap›laraktoplanm›flt›r.Uygulama sakinleflme,dahasonrakiPRGveyaMAuygulamas› sonras›etkiningörülmesüresivebirsonrakiöstrüse sonras›ndagözlenmifltir.Progesteronuygulamalar›ndan kadargeçensüre(sakinkalmasüresi)hergrupiçinayr› sonrayenidenöstrüsgörülenekadargeçensüreiçerisinde ayr›kaydedilmifltir. yap›lanklinikkontrollersonucuPRGgruplar›nda Çal›flmabulgular›,standartsapmavepde¤erleri hormonaba¤l›olarak,di¤erprogestagenlerde Minitabbilgisayarprogram›ylahesaplanm›flt›r. görülebilen,pyometravememetümörüoluflumu gözlenmemifltir.MAgrubundaise%6.6(n=2)oran›nda pyometraolgusunarastlanm›flt›r. Bulgular Çal›flmadakullan›lankedilerinenjeksiyonsonras›
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