Canine Prostate Diseases and Other Male Conditions Flashcards

(76 cards)

1
Q

What does the prostate produce in the dog?

A

Seminal plasma

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2
Q

What is the prostate responsible for?

A

Fluid components of all 3 fractions of ejaculate

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3
Q

What pathway converts testosterone to dihydrotestosterone?

A

5α-reductase

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4
Q

What diagnostics should be done when evaluating the prostate?

A

Collect and evaluate prostatic fluid
Color, volume, pH, motility, morphology of sperm-rich fraction
Color, pH, cytological evaluation of prostatic fluid
US, radiographs, culture, FNA, biopsy

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5
Q

What is the most common disease of the canine prostate?

A

Benign prostatic hyperplasia

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6
Q

What dogs most commonly get BPH?

A

Older, intact male dogs
>80% of dogs over 5 years have gross or microscopic evidence of BPH
95% of dogs affected by 9 years of age

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7
Q

What is BPH the result of?

A

Natural aging and hormonal influences on the prostate gland

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8
Q

What is BPH dependent on?

A

Testosterone and age

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9
Q

What is the key to prostatic stimulation leading to stromal and glandular growth?

A

DHT

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10
Q

What sensitizes the prostate to DHT?

A

Estrogen

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11
Q

What are the clinical signs of BPH?

A
Usually absent
Bloody urethral discahrge
Hemospermia
Tenesmus
Hematuria
Stranguria
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12
Q

What is seen on physical exam of BPH?

A

Usually unremarkable except for prostatic changes
Enlarged prostate on digital exam
Generally symmetrical however some dogs will have an irregular pattern
Non-painful to mild discomfort

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13
Q

What is seen on diagnostic imaging with BPH?

A

Prostatomegaly
Homogenous, hyperechoic pattern
May have small cystic areas

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14
Q

What is used to diagnose BPH?

A

Often made base on clinical signs, history, and PE findings
Prostatic massage and wash
FNA
Tru-cut biopsy

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15
Q

What is the treatment of BPH?

A

Required only if clinical signs are present
Castration is TOC
Finasteride (Proscar and Propecia) for 2-3 month

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16
Q

What does finasteride do?

A

Inhibits 5α-reductase

Stops conversion of T to DHT

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17
Q

Is the resolution of BPH faster with castration or medical management?

A

Castration

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18
Q

What are prostatic cysts typically associated with?

A

BPH

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19
Q

What are prostatic cysts?

A

Fluid retention from obstructed canaliculi

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20
Q

What do prostatic cysts create?

A

Cavitating lesion filled with fluid that can become an abscess

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21
Q

What is prostatitis more common in?

A

Older dogs with BPH

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22
Q

What is the pathophysiology of prostatitis?

A

Glandular changes occur which leads to a disruption of prostatic fluid or urine flow and predisposes the gland to infection (secondary to squamous metaplasia or cysts)
Ascending infection

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23
Q

What are the defense mechanisms against prostatitis?

A

Frequent urination
Urethral pressure
Local production of IgA, IgG
Breakdown in the face of bacteria predisposes the prostate to infection

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24
Q

What are the clinical signs of prostatitis?

A
Urethral discharge
Hematuria
Pollakiuria or dysuria
Tenesmus
Fever
Caudal abdominal pain
Painful prostate on rectal exam
Anorexia
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25
What does CBC with prostatitis depend on?
Severity and duration
26
What could possibly show up on a CBC with prostatitis?
Neutrophilia with a left shift
27
What does serum chem show with prostatitis?
Generally unremarkable
28
What does UA show with prostatitis?
Pyuria, heaturia, urine culture is usually positive (cysto sample)
29
What is seen on the semen evaluation with prostatitis?
Leukospermia, excessive WBCs in prostatic fraction | Hemospermia
30
What is found on US with prostatitis?
Profound changes in echogenicity, "moth eaten" look | Small cystic areas with flocculent fluid
31
Which is harder to diagnose, acute or chronic prostatitis? Why?
Chronic | Very subtle clinical signs, prostate may not be enlarged or painful
32
What is the common bacteria found with prostatitis?
``` E. coli** Klebsiella sp Staphylococcus sp Streptococcus sp Proteus sp Pseudomonas sp ```
33
How frequently is prostatitis caused by one organisms?
70% of the time
34
What should be used for treatment of prostatitis?
Highly lipid soluble drugs that enter the prostate (fluoroquinolones, chloramphenicol, TMS) Antibiotics with high pH that enter the acidic environment very well (enrofloxacin, TMS)
35
How long does treatment of prostatitis take?
It is long-term, at least 4-6 weeks
36
What is a severe sequela to prostatitis?
Prostatic abscess
37
What can a prostatic abscess create if it ruptures?
Fulminating peritonitis
38
How is a prostatic abscess treated?
Surgical drainage with omentalization is older option US guided aspiration is gaining popularity Don't treat with antibiotics alone
39
Why does a prostatic abscess rarely result in cure?
Inability of antibiotics to penetrate the prostate and/or abscess
40
What are the adjunctive treatments of a prostatic abscess?
Castration or finasteride | Surgical drainage if needed
41
What is the incidence rate of prostatic neoplasia?
0.2-0.6%
42
What is the age at diagnosis of prostatic neoplasia?
Range: 5-17 years Median: 10 years
43
What has an increased risk of prostatic neoplasia?
Neutered males compared to intact males
44
What is the most common prostate condition found in neutered males?
Prostatic neoplasia
45
What should a palpable prostate in a neutered male be assumed to be?
Neoplasia until proven otherwise
46
What are the clinical signs of prostatic neoplasia?
``` Tenesmus (colon impingement) Weight loss Stranguria Dysuria Systemic illness Hindlimb weakness or pain (skeletal metastasis) Asymmetrical enlargement ```
47
What is seen on radiographs in a dog with prostatic neoplasia?
``` Prostatomegaly Irregular border Mineralization** Lymphadenopathy Periosteal new bone formation ```
48
What are prostatic tumors independent of?
Androgen
49
What is the success rate of treating prostatic neoplasia?
Poor, survival time is typically only a few months after diagnosis
50
What is the only contagious tumor in small animals?
Transmissible venereal tumor (TVT)
51
What geographical areas does TVT usually occur?
Tropical and subtropical areas
52
What is the original cell type of TVTs?
Histiocyte
53
What is the primary site of TVT in males? Females?
Penis | Vagina
54
Does metastasis occur with TVT?
Rarely
55
How do you diagnose TVT?
Cytology | Biopsy
56
How do you treat TVT?
Vincristine (TOC) | Adriamycin
57
What is the prognosis with TVT?
Good
58
When is persistent frenulum seen?
In young dogs prior to puberty
59
When is the frenulum normally lost?
At the time of pberty
60
What does a persistent frenulum prevent?
Copulation
61
How is a persistent frenulum corrected?
With surgery
62
Is a persistent frenulum heritable?
It is in other species, but it is unknown in the dog
63
What is paraphimosis?
Failure of the penis to retract into the prepuce
64
What can paraphimosis lead to?
Ischemic necrosis of the penis
65
How can paraphimosis be prevented?
Facilitate retraction of penis into the prepuce following breeding
66
What is needed in severe cases of paraphimosis?
Surgical amputation
67
What is the most common disorder of sexual development in dogs?
Cryptorchidism (~13%)
68
Is cryptorchidism heritable?
Yes, but the mode of heritability is unknown
69
When should a case of cryptorchidism be confirmed? Why?
Should not confirm a case until 4-6 months of age because testicular descent is not normally completed until birth or shortly thereafter
70
What is there a risk for with cryptorchidism?
Neoplasia in the retained testicle
71
How can you test to see if an animal is cryptorchid?
Cox test: GnRH of hCG followed by measurement of testosterone levels
72
How is cryptorchidism treated?
Castration
73
What is balanoposthitis?
Non-specific inflammation of the penis
74
What are causes of balanoposthitis?
``` Trauma Neoplasia Infection Herpes virus Foreign bodies ```
75
What can provide a more accurate diagnosis of balanoposthitis?
Histopathology
76
How do you treat balanoposthitis?
Symptomatically