Canine Prostate Diseases and Other Male Conditions Flashcards
What does the prostate produce in the dog?
Seminal plasma
What is the prostate responsible for?
Fluid components of all 3 fractions of ejaculate
What pathway converts testosterone to dihydrotestosterone?
5α-reductase
What diagnostics should be done when evaluating the prostate?
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
What is the most common disease of the canine prostate?
Benign prostatic hyperplasia
What dogs most commonly get BPH?
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
What is BPH the result of?
Natural aging and hormonal influences on the prostate gland
What is BPH dependent on?
Testosterone and age
What is the key to prostatic stimulation leading to stromal and glandular growth?
DHT
What sensitizes the prostate to DHT?
Estrogen
What are the clinical signs of BPH?
Usually absent Bloody urethral discahrge Hemospermia Tenesmus Hematuria Stranguria
What is seen on physical exam of BPH?
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
What is seen on diagnostic imaging with BPH?
Prostatomegaly
Homogenous, hyperechoic pattern
May have small cystic areas
What is used to diagnose BPH?
Often made base on clinical signs, history, and PE findings
Prostatic massage and wash
FNA
Tru-cut biopsy
What is the treatment of BPH?
Required only if clinical signs are present
Castration is TOC
Finasteride (Proscar and Propecia) for 2-3 month
What does finasteride do?
Inhibits 5α-reductase
Stops conversion of T to DHT
Is the resolution of BPH faster with castration or medical management?
Castration
What are prostatic cysts typically associated with?
BPH
What are prostatic cysts?
Fluid retention from obstructed canaliculi
What do prostatic cysts create?
Cavitating lesion filled with fluid that can become an abscess
What is prostatitis more common in?
Older dogs with BPH
What is the pathophysiology of prostatitis?
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
What are the defense mechanisms against prostatitis?
Frequent urination
Urethral pressure
Local production of IgA, IgG
Breakdown in the face of bacteria predisposes the prostate to infection
What are the clinical signs of prostatitis?
Urethral discharge Hematuria Pollakiuria or dysuria Tenesmus Fever Caudal abdominal pain Painful prostate on rectal exam Anorexia
What does CBC with prostatitis depend on?
Severity and duration
What could possibly show up on a CBC with prostatitis?
Neutrophilia with a left shift
What does serum chem show with prostatitis?
Generally unremarkable
What does UA show with prostatitis?
Pyuria, heaturia, urine culture is usually positive (cysto sample)
What is seen on the semen evaluation with prostatitis?
Leukospermia, excessive WBCs in prostatic fraction
Hemospermia
What is found on US with prostatitis?
Profound changes in echogenicity, “moth eaten” look
Small cystic areas with flocculent fluid