Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Ettinger General - 9th Ed EW > Ch314 Prostatic diseases > Flashcards

Ch314 Prostatic diseases Flashcards

1
Q

What percentage of prostatic diseases are subclinical?

A

75% of prostate diseases are subclinical.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Which breeds are predisposed to BPH?

A

Large breed dogs, including:

  • Doberman Pinscher
  • German Shepherd Dog
  • Rhodesian Ridgeback
  • Labrador Retriever
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the frequency (in order of most common to least common) of prostatic disorders in dogs?

A
  • BPH: 45%
  • Acute or chronic prostatitis: 38.6%
  • Abscesses: 7.7%
  • Cysts: 5%
  • Neoplasia: 2.6%
  • Squamous metaplasia: 0.2%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How common is prostatic disease in cats?

A

Prostatic diseases are exceedingly rare in intact or neutered cats

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the three main factors that contribute to BPH development?

A
  1. Older age
  2. Functioning testes
  3. Dihydrotestosterone (DHT) that concentrates in hyperplastic prostatic tissue
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

hat are the common clinical signs of BPH?

A
  • Blood dripping from prepuce
  • Hematospermia (1st and 3rd fraction of semen)
  • Hematuria
  • Tenesmus with thin tape-shaped feces
  • Constipation
  • Dyschezia
  • Less commonly: dysuria or urinary incontinence
  • Subfertility
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How quickly does the prostate decrease in volume after castration for BPH?

A

The prostatic volume begins decreasing within 7-14 days after castration.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the two types of BPH and their characteristics?

A
  1. Glandular BPH:
    * characterized by thickened epithelium with developed “alveoli” especially in the periurethral area.
  2. Complex BPH:
    * characteristics of the glandular form plus areas of atrophic epithelium and, eventually, cyst formation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the medical treatment options for BPH in breeding dogs and what are their actions?

A
  1. Finasteride (5-alpha-reductase inhibitor):
    * 1. Prevents conversion of testosterone to DHT
    * 1. Doesn’t reduce libido or sperm production
  2. Osaterone acetate (progestogen/antiandrogen)
    * Reduces prostate volume
    * Minimal effect on fertility
  3. Deslorelin acetate (GnRH analog):
    * Subcutaneous implant
    * Reduces prostate volume >50% after ~6 weeks
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Deslorelin acetate (GnRH analog) reduces prostatic volume by how much and for how long?

A

Reduces prostate volume >50% after ~6 weeks
Effect lasts up to 48 weeks with 4.7 mg implants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the most common bacterial organisms found in septic prostatitis?

A

Aerobic organisms are most common, including:
* Escherichia coli
* Staphylococcus sp.
* Streptococcus sp.
* Proteus sp.
* Pseudomonas spp.
* Brucella canis
* Klebsiella sp.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the characteristics of antibiotics that best penetrate the prostate?

A
  • High lipid solubility
  • Low protein binding
  • High pKa (like trimethoprim, clindamycin, chloramphenicol)
  • Zwitterion characteristics (fluoroquinolones)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How long should antibiotics be given for prostatitis?

A

Acute prostatitis: 4-6 weeks

Chronic prostatitis or prostatic abscess: 6-8 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the key differences between acute and chronic prostatitis symptoms?

A

Acute Prostatitis:
* Fever, anorexia, lethargy
* Vomiting, caudal abdominal pain
* Difficulty rising, painful stiff gait
* Low sperm quality
* Hematospermia, pyospermia
* Possible peritonitis/septic shock

Chronic Prostatitis:
* Often subclinical
* Recurrent urinary tract infections
* Low sperm quality
* Mild lethargy
* Urethral discharge
* Hypo/infertility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

When should prostatic cultures be repeated during antibiotic treatment for prostatitis?

A
  • 7-10 days after starting antibiotics
  • 30 days after antibiotics are discontinued
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the two main types of prostatic cysts?

A
  1. Retention cysts
  2. Paraprostatic cysts (PPCs)
17
Q

How are retention cysts classified by size?

A
  • Large: ≥3 cm in greatest diameter
  • Medium: >1 to <3 cm
  • Small: ≤1 cm
  • Micro: ≤1 mm
18
Q

What are the key characteristics of paraprostatic cysts?

A
  • Usually associated with remnants of uterus masculinus
  • Typically single structures around the prostate
  • Attached to prostate capsule
  • Large cysts can invade abdominal or pelvic cavity
  • May be asymptomatic or show signs similar to BPH
19
Q

What are the treatment options for prostatic cysts?

A

Surgical options:
* Surgical excision or debridement
* Omentalization
* Marsupialization
* Penrose drain positioning

Medical options:
* Castration (alone for small cysts)
* Medical treatment to reduce prostatic size
* Combination therapy recommended for large cysts

20
Q

What constitutes a definitive diagnosis of prostatic infection based on culture?

A

Growth of >10,000 bacteria/mL

A 2-log difference between prostatic and urine colony-forming unit counts suggests bacterial prostatitis

21
Q

What are the typical ultrasound findings in prostatic neoplasia?

A
  • Focal to diffuse hyperechoic areas
  • Areas of hemorrhage or necrosis
  • Mineralization
  • Asymmetry
  • Irregular capsule outline
  • Loss of normal contour
  • May show sublumbar lymphadenopathy and visceral metastases
22
Q

What are the typical examination findings in BPH on digital rectal examination?

A
  • Large prostate
  • Symmetrical
  • Mobile
  • Normally firm
  • Not painful
  • May have asymmetrical/irregular surface with soft “fluctuant” areas if cysts present
23
Q

What are the typical laboratory findings in acute prostatitis?

A
  • Neutrophilic leukocytosis with left shift
  • Increased alkaline phosphatase activity
  • Hematuria
  • Bacteriuria
24
Q

What are the ultrasound characteristics of BPH?

A
  • Prostatomegaly
  • Uniformly echogenic parenchyma
  • May have nodular areas (usually isoechoic or slightly different from surrounding parenchyma)
  • May show increased prostatic perfusion
  • May have cysts with well-defined margins
25
Q

What three questions should guide the decision to treat BPH?

A
  1. Is the BPH life-threatening?
  2. Is the BPH adversely affecting the function of other organs?
  3. Is the BPH adversely affecting the dog’s quality of life?
26
Q

How should prostatic abscess treatment be approached?

A
  1. Supportive care: Intravenous fluids, Analgesics
  2. Appropriate antibiotics based on culture/sensitivity
  3. Drainage options: Surgical (omentalization preferred), US-guided percutaneous drainage with ethanol injection
  4. Consider castration 5-7 days after starting antibiotics
27
Q

What are the recommended monitoring intervals for untreated mild BPH?

A

Every 3 to 6 months for dogs with:
* Mild signs
* Signs that don’t affect quality of life

28
Q

What is the prevalence of BPH in intact male dogs by age?

A
  • ~80% of intact male dogs >5 years of age
  • 95% of intact male dogs >9 years
  • Can occur as early as 2 years of age
  • Most dogs don’t develop clinical signs
29
Q

What is CPSE and its significance in BPH?

A

CPSE = Canine Prostatic Specific Esterase
* Concentrations progressively increase over time in dogs with BPH
* Levels typically >90 ng/mL when prostates are estimated to be >2.5 times normal size
* Cannot differentiate between BPH, bacterial prostatitis, or prostatic carcinoma

30
Q

What conditions can predispose to prostatic infection?

A

Conditions that reduce normal defense mechanisms or alter prostatic architecture:
* BPH
* Cysts
* Squamous metaplasia
* Neoplasia

31
Q

What complications can occur with prostatic abscesses?

A
  • Tenesmus from colonic compression
  • Dysuria from urethral compression
  • Peritonitis
  • Septic shock
32
Q

What radiographic changes might be seen with prostatic neoplasia?

A
  • Prostatomegaly
  • Prostatic mineralization
  • Regional lymphadenopathy
  • Evidence of metastasis: Lungs, Skeleton (especially ventral aspects of lumbar vertebrae)
33
Q

What are the most common prostatic neoplasias in dogs?

A

adenocarcinomas and undifferentiated carcinomas

34
Q

What is the common survival time for dogs with prostatic neoplasia

A

weeks to months

35
Q

What treatment options are there for prostatic neoplasia?

A
  • Total and subtotal prostatectomy (if no metastases)
  • Treatment with nonsteroidal anti-inflammatory drugs (NSAIDs) alone
  • or in combination with chemotherapy
36
Q

What factors affect survival time in prostatic neoplasia?

A

Presence of metastasis (80% metastasized at diagnosis)

37
Q

How does castration affect prostatitis treatment?

A
  • May decrease need for long-term antibiotic use
  • Recommended 5-7 days after starting antibiotics

Ettinger General - 9th Ed EW (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions