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- Swollen vulva
- Bloody discharge from the vulva
- Vocalizing and rolling or rubbing on the floor affectionately
- Swollen mammary glands
- Shrunken penis or testicles in males
- Excess hair loss
- Pale gums indicating anemia
- Exposure to hormone replacement therapy (HRT) drugs, typically in the form of sprays, creams or gels that rub onto the cat during holding or petting
- Ingestion of human HRT drugs
- Sensitivity to HRT drugs prescribed for the cat by a veterinarian, most commonly used to reduce or prevent estrus
- Blood tests to check hormone levels as well as red and white blood cell counts
- Urinalysis to screen for infection
- Ultrasound to screen for tumors in adrenal glands and to look for ovarian cysts female cats or prostate tumors in male cats
- X-rays if the ultrasound is inconclusive or indicates the presence of masses that need further diagnosis
- Skin scrapings in the case of hair loss to rule out other potential causes
- Exploratory surgery if tumors or ovarian remnants are suspected
- Bone marrow biopsy to test for aplastic anemia
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