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Theriogenology > Canine Prostate Diseases > Flashcards

Canine Prostate Diseases Flashcards

1
Q

Prostate anatomy

A

2 lobes, prominent median septum that surrounds urethra

  • deep in pelvic canal, not easily found in large breeds
  • produces seminal plasma, responsible for fluid components of all 3 ejaculate fractions
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2
Q

Testosterone conversions

A

Testosterone from Leydig cells –> 5alpha reductase (prostatic epithelium) –> dihydrotestosterone

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3
Q

Physical exam

A

Necessary to palpate prostate per rectum in older dogs, when pelvic obstruction suspected, BSE, semen collection abnormalities

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4
Q

Diagnostics

A
  • collect and evaluate prostatic fluid
  • color, volume, pH, motility, morphology of sperm rich fraction
  • color, pH, cytological evaluation of prostatic fluid
  • ultrasound
  • radiographs
  • culture
  • FNA, biopsy
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5
Q

Benign prostatic hyperplasia

A

Most common disease of K9 prostate!!

  • older, intact male dogs: >80% of dogs over 5 years have gross or microscopic evidence of BPH (hyperplasia and hypertrophy)
  • no breed predisposition
  • result of natural aging and hormonal influences on prostate gland
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6
Q

BPH pathogenesis

A

Dependent on testosterone, age

  • testosterone converted to DHT in epithelial cells via 5a-reductase pathway
  • DHt is key to prostatic stimulation leading to stromal and glandular growth
  • estrogen sensitizes prostate to DHT (target of some therapeutic agents)
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7
Q

BPH clinical signs

A
  • usually absent
  • bloody urethral discharge
  • hemospermia
  • tenesmus
  • hematuria
  • stranguria
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8
Q

BPH - physical exam

A

Usually unremarkable except for prostatic changes

  • enlarged prostate on digital exam
  • generally symmetrical
  • non painful to mild discomfort
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9
Q

Diagnostic imaging

A

Prostatomegaly

  • dorsoventral prostate dimension is >70% of distance between the sacral promontory and pubis on lateral view
  • homogenous, hyperechoic pattern
  • small cystic areas
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10
Q

BPH - diagnosis

A

Made based on clinical signs, history, PE

  • prostatic massage and wash
  • FNA
  • tru-cut biposy
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11
Q

BPH - treatment

A

Required only if clinical signs are present

  • castration: 1/2 size within 3 weeks, 70% reduction by 9 weeks
  • finasteride
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12
Q

Finasteride

A

Inhibits 5a-reductase

  • stops conversion of T to DHT
  • wide dose range
  • treat for at least 2-3 months
  • libido is maintained
  • castration recommended once breeding is done
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13
Q

Prostatic cysts

A

Associated with BPH

  • fluid retention from obstructed canaliculi
  • creates cavitating lesion filled with fluid (can become an abscess)
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14
Q

Prostatitis

A

Acute or chronic

  • occur at any age (more common in older dogs with BPH)
  • rare in castrated males (concurrent neoplasia)
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15
Q

Prostatitis - pathophysiology

A

Glandular changes occur which leads to a disruption of prostatic fluid or urine flow and predisposes gland to infection –> secondary to squamous metaplasia or cysts

  • ascending infection
  • rarely does prostatits occur in an otherwise normal prostate
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16
Q

Defense mechanisms

A
  • frequent urination
  • urethral pressure
  • local production of IgA, IgG
  • breakdown in face of bacteria predisposes the prostate to infection
17
Q

Prostatitis - clinical signs

A
  • urethral discharge
  • hematuria
  • pollakiuria or dysuria
  • tenesmus
  • fever
  • caudal abdominal pain
  • painful prostate on rectal exam
  • anorexia
18
Q

Prostatitis - diagnostics

A
  • CBC changes depend on severity and duration (possible neutrophilia with a left shift)
  • serum chem unremarkable
  • UA shows pyuria, hematuria (urine culture is positive)
  • semen evaluation: leukospermia, excessive WBCs in prostatic fraction, hemospermia
19
Q

Ultrasound

A

Profound changes in echogenicity

  • focal to diffuse hypoechoic areas
  • moth eaten look
  • small cystic areas with flocculent fluid
20
Q

Chronic prostatits

A
  • much harder to diagnose
  • subtle clinical signs
  • prostatic massage with culture
  • prostate may not be enlarged or painful
21
Q

Common bacteria

A
  • E coli!!
  • kelbsiella
  • staphylococus
  • streptococcus
  • proteus
  • pseudomonas
  • will be a single organism 70% of the time
22
Q

Prostatitis treatment

A

Culture and sensitivity results

  • highly lipid soluble drugs enter prostate (fluoroquinolones, chloramphenicol, TMS)
  • antibiotics w/ high pH enter acidic environment of prostate well (erythromycin, TMS)
  • long term treatment (at least 4-6 weeks!!)
23
Q

Prostatic abscess

A

Severe sequela to prostatitis

  • abscess can rupture, creating fulminating peritonitis
  • treat aggressively
  • surgical drainage with omentalization
  • US guided aspiration gaining popularity
24
Q

Prostatic abscess - treatment

A

Don’t treat with antibiotics alone

  • rarely results in cure due to inability of antibiotics to penetrate prostate and/or abscess
  • castration or finasteride
  • surgical drainage if needed
25
Q

Prostatic neoplasia

A

Incidence of 0.2-0.6%

  • age at diagnosis: 5-17 years
  • increased risk in neutered males compared to intact males
26
Q

What is the most common prostate condition found in neutered males

A

Prostatic neoplasia

  • always palpate prostate at physical exams
  • palpable prostate in neutered male should be assumed to be neoplasia until proven otherwise
27
Q

Prostatic neoplasia - clinical signs

A
  • tenesmus (colon impingement)
  • weight loss
  • stranguria
  • dysuria
  • systemic illness
  • hindlimb weakness or pain (skeletal metastasis)
28
Q

Neoplasia radiographs

A

Prostatomegaly, irregular border, mineralization, lymphadenopathy, periosteal new bone formation
- met check is warrented

29
Q

Prostatic tumors in dogs are typically _______

A

Androgen independent

- poor success rate with dogs (survival time is only a few months)

30
Q

Transmissible venereal tumor

A

Tropical and sub tropical areas

  • only contagious tumor in small animals
  • histiocyte cell line
  • penis is primary site in males, vagina in females
  • cauliflower like mass, very friable, ulcerated mass
31
Q

TVT treatment

A
  • metastasis is rare
  • diagnose via cytology, biopsy
  • treat with vincristine, adriamycin
  • prognosis is good
32
Q

Persistent frenulum

A

Young dogs prior to puberty

  • frenulum is normally lost at time of puberty
  • prevents copulation
  • corrected with surgery
  • heritable in other species
33
Q

Paraphimosis

A

Failure of penis to retract into prepuce

  • lead to ischemic necrosis of penis
  • prevent by facilitated retraction of penis into prepuce following breeding
  • surgical amputation is needed in severe cases
34
Q

Cryptorchidism

A

Most common disorder of sexual development in dogs (13%)

  • heritable trait
  • testicular descent not completed until birth
  • should not confirm a case until 4-6 months of age
35
Q

Risk for _____ is higher in retained testicle

A

Neoplasia

36
Q

How to diagnose cryptorchidism

A

Cox test

- GnRH or hCG followed by measurement of testosterone

37
Q

Balanoposthitis

A

Non specific inflammation of penis

  • trauma, neoplasia, infeciton, herpes virus, foreign bodies
  • histopath provides a more accurate diagnosis
  • treat symptomatically

Theriogenology (25 decks)

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