Clinical Disease of SA Repro Tract 2 Flashcards
What is the most common congenital defect seen in the dog?
Cryptorchidism
By what age should testicles be descended?
6 months
Where is the commonest site for undescended testcile to be stuck?
inguinal canal (may also be abdo or prescrotal)
Which dogs are predisposed to cryptorchidism?
Pedigree
What are retained testicles more susceptible to?
Torsion and neoplasia
WHat is the treatment of cryptorchidism?
Castration afvised to prevent future problems (removal of undescended testicle)
Is anarchism/monarchism common?
no
- testicular hypoplasia possible
What are common causes of different sized testicles? Do they usually grow or shrink?
- usually increase in size
- Commonest cause neoplasia
- Orchitis/epidydmitis
- Torsion (rare)
How is Dx of differnet sized testicles decided?
- Hx, Pe
- Ultrasound
- Aspiration/Biopsy
Is testicular neoplasia common in cats?
NO
What are the 3 most common testicular tumour types?
- Interstitial cell (leydig)
- Sertolli cell
- Seminoma
> === incidence
> often multiple tumour types in single testicle
Are testicular tumours generally bening or malignant?
Scrotal = benign Retained = Malignant (potentially just due to diagnosed later?)
Where do metastases usually go to?
- regional LNs
- viscera (occasionally)
Which tumours produce hormones when functional? What paraneoplastic effects may this have?
- Leydig = testosterone -> dominance
- Sertoli = oestrogen -> feminisation
- Seminomas -> rarely feminisation
> Infertiility due to hormones and replacement of functiuonal tissue
Why may one testicle become smaller?
- Feminising hormones secreted by functional tumour of other testicle
Is orchitis/epidydmitis common?
No
What clinical signs are associated with orchitis/epidydmitis?
- epidydmal enlargement
- testicular pain
- tenseness, scrotal oedema
- abscessation
- systemic disease
Where do infections of the testciles originiate from>?
- urinary tract
- direct penetration
- haematogenous
What are the clinical signs of chronic epidydmitis/orchitis?
- small firm testicle
- epidydmal enlargement
- adhesions between tunics and scrotum v testicular mobility
What is the usualy treatment of orchitis/epidydmitis?
castration
When is testicular torsion more common and what is the general treatement?
- retained testicle
- castration
What are DDx for protruding penis?
- Paraphimosis
- Priapism
- Trauma
What is priaphimosis? What are potential causes?
- non erect penis protrudes from prepuce
> causes - narrowed preputial orifice (congenital or acquired)
- penile enlargement after mating
- failure of penis to stay in prepuce (short prepuce congen/acq, weak preputial/retractor penis mm., contracture following wound)
What is the treatment of paraphimosis?
- symptomatic
- Sx enlarging preputial orifice
- phallopexy (weak mm)
- preputial lengthening/reconstructive Sx
- partial penile amputation
What is priapism? Is it common?
Persistent erection >4 hours not associated with sexual excitement
- uncommon in cats and dogs
What are the potential causes of priapism?
- trauma
- perineal abscess
- neurological disease
How can priapism be classified?
- non-ischaemic (arterial) entire penis partially rigid and non painful (penis may not be extruded)
- ischaemic (veno-occlusive) painful rigid shaft, soft head
What further diagnositcs can be carried out in priapism?
- ultrasound
- blood gas analysis
Tx of priapism?
- buster collar, analgesia, topical Tx of penis (prevent self trauma and exposure)
- Aspiration of blood, flushing of corpus cavernosum, injection of phenylephrine
- if conservative measures fail or ischaemia present, amputation with perineal urethrostomy (cat) or scrotal urethrostomy (dog)
Ddx of penile masses? Diagnostics?
- inflammatory disease
- Neoplasia
- Urethral prolapse
> Bipsy to distinguish inflam v neoplasia
Which dogs are predisposed to urethral prolapse?
Brachycephalic
Penile tumour types? Neoplasia of the penis common?
- TVT, SCC, papilloma, lymphoma, adenocarcinoma, MCT
- Osteosarcoma, ossifying fibroma, chondrosarcoma
> uncommon but seen more in dog than cat
What are common clinical signs of penile trauma?
- haemorrhage
- dysuria
- extravasion of urine (check swellings, if contained urine will -> necrosis of tissues [more common in cats])
When is extravasian of urine commonly seen?
- cats, incorrect catheter placement -> damaging urether
What is hypospadias?
- developmental abnormality of male external genitalia
- failure of fusion of urogenital folds and incomplete formation of penile urethra
> puppy will usually be euthanized , but may not be noticeable if mild
What is persistent frenulum? Tx?
- immature dogs, incompletely separated penis and prepuce after puberty
- Tx = sectioning under GA or sedation
What is phimosis? Tx?
- inability to protrude penis out of preputial orifice
- congential/acquired
- Tx = surgical enlargement and Tx underlying condition (eg. autoimmune disease -> scarring at mucocutaneous junction)
Is preputial discharge normal?
- some creamy discharge in mature dogs normal
- severe/blood tinged should be investigated
What does dyschezia in the adult male dog usually indicate?
Prostatic enlargement
causes of prostatic enlargement in the dog?
- BPH (benign prostatic hypertrophy)
- Prostatitis/abscessation
- prostatic cysts
- Neoplasia
What is BPH?
- benign prostatic hypertrophy
- commonest prostatic disease in entire male dogs
- testosterone dependent
- > UNIFORM symmetrical prostatic enlargement
- dyschezia and rarely dysuria, haematuria/urethral bleeding
How is Dx of BPH made?
- PE, ultrasonography, bipsy rarely required
Tx of BPH?
> castration as testosterone dependent
-> permenant involution within 3-12 weeks
medical Tx
- antiandrogens (osaterone acetate, Ypozone)
- synthetic progestagen (delmadinone acetate, Tardak)
- GnRH analogue (Deslorelin, Suprelorion)
- Oestrgoens - NOT recommended -> squamous metaplasia and other side effects
- faecal softeners)
What pathology is the male equivalent to pyometra?
Prostatitis/prostatic abscessation
Which spp. more commonly get prostatis/abscessation?
- dogs (entire, due to secretory nature of prostate)
What is prostatitis commonly due to?
- UTI
- haematogenous spread
What clinical signs may be assocated with prostatic abscessation? What diagnostics should be carried out?
- purulent urethral discharge
- systemic illness - VD+ PUPD dysuric, painful
- occasionally collapse and septic shock
> do haem/biochem, urinalysis and culture, cytology of aspirate, culture sense)
How is Dx of prostatitis confirmed? hat else should be checked for?
- PE, ultrasonography +- aspirate
- rectal likely to be painful so not good
> check for testicular involvement
How can prostatic abscessation be differentiated from BPH on radiography?
- BPH symmetrical
- abscessation assymetrical
Tx of prostatic abscessation?
Draininge - complete (any remnants may leak into peritoneal cavity)
Which sp are more prone to prostatic (parenchymal) and paraprostatic (periprostatic) cysts?
dog
What is the aetiology of prostatic cyts?
- unknown
- likely due to secretory nature of prostate
- 2* to squamous metaplasia, neoplaisa, resolved abscess, uterus masculinis remnant
What clinical signs are asscoated with prostatic and paraprostatic cysts?
- incidental finding
- signs of rectal or UT obstruction
- urethral discharge
- NOT systemically sick
Diagnositcs and Tx of prostatic cysts
- Dx as for prostatic abscess (PE, ultrasound, +- aspirate)
- Tx depends on location, size, clinical signs
> rarely medical (aspirate)
> usually surgical (castration, omentalisation)
> biopsy cyst wall to check for neoplasia
How may prostatic neoplasia be seen on xray?
- bony changes around wings of ileum and sublumbar new bone formation
Is prostatic neoplasia common in cats and dogs?
no rare
Why is prostatic neoplasia different from many repro diseases?
Commonest prostatic disease in CASTRATED animals
What are the commonest prostatic tumour types?
- adenocarcinoma
- transitional cell carcinoma if developed from urethra
Are prostatic tumours aggressive?
Yes, locally invasive, metastasise
What clinical signs are associated with prostatic neoplasia?
- weight loss
- pain and HL lameness
- dyschezia/dysuria
- HL oedema
- Prostate NOT always enlarged*
- may be firm and irregular on palpation
How is Dx of prostatic neoplasia confirmed?
- Tru cut incisional biopsy under US guidance
Prognosis of prostatic neoplasia? Tx?
Hopeless
- Tx palliative eg. urethral stent, cystomotomy tube, NSAIDS (anticancer as well as analgesic)
- prostatectomy rarely suitable option
eg. of prostatic surgeries. Commonest?
- Drainiage (omentalisation [commonest] drain insertion, marsupialisation)
- Cyst resection
- Biopsy
- Prostatectomy (partial/total)
