Clinical disease of the reproductive tract in the dog and cat 2 - MALE Flashcards
What is the incidence of cryptorchidism?
3.3-3.5% dogs
1-1.3% cats
2003 - large study
Where will an undescended testicle be found?
abdominal, inguinal (commonest) or prescrotal
Is crytorchidism heritable?
Yes - ausomal recessive
What are retained testicles more susceptible to?
torsion and neoplasia
suggested that function of contralateral scrotal testicle may be abnormal (but lacks firm evidence)
Why do you see testicular hypoplasia with cryptorchidism?
because they’re kept at a high temperature
How common is anorchism/ monorchism?
extremely rare
What are 3 causes of testicles of different sizes?
Neoplasia
Orchitis/ epididymitis
Torsion
How do testicles change size?
MOST COMMON - one increases
One increases, other decreases in size
LEAST COMMON - one decreases in size
What is the second commonest site for tumours of male dogs?
testicles
What are the 3 most common testicular tumours?
Seminoma
Interstitial cell tumour
Sertoli cell tumour
Roughly equal indicence
Other tumour types reported but rare.
May have more than one tumour type
Are testicular tumours bengin?
Those affecting scrotal tissues are usually benign, thoses affecting cryptorchid testicles are more likely to be malignant
Where do malignant testicular tumours metastasise to?
LN usually, rarely to the viscera
Which testicular tumours are functional?
Interstitial/ leydig cell tumour - may produce testosterone
Sertoli clel tumours - may produce oestrogen causing feminisation
(seminomas may rarely be associated with feminisation)
Can all tumour types be associated with infertility?
Yes - production of hormones and replacement of functional tissues
Diagnosis and treatment of testicular tumours?
usuallly combined with castrated
When do orchitis and epididymitis occur?
usually occur together
What are the signs of orchitis/ epididymitis? 5
epididymal enlargement testicular pain tenseness and scrotal oedema may abcessate via scrotum animal may be systemically ill
What might chronic infections leads to orchitis/ epididymitis result in?
small and firm testicle with epididymal enlargements
adhesions between tunics and scrotum may reduce testicular mobility
Where might orchitis/ epididymal infections arise? 3
from urinary tract, direct penetrations or haematogenous spread
What does orchitis/epididymal treatment depend upon?
severity of signs
use of dog
frequently = castration
How common is testicular torsion?
Unusual, more common in retained testicles. Signs can be variable and confused with disease of other body systems.
What are the presenting signs for a protruding penis?
social problems for owner
low grade irritation
pain, bleeding and trauma
What are 3 causes for a protruding penis?
Paraphimosis
Priapism
Trauma
What is paraphimosis?
When a non-erect penis protrudes from prepuce and cannot be retracted or retained in its normal position.
Why might paraphimosis occur?
narrowed preputial orifice
penile enlargement preventing retraction
failure of penis to stay in prepuce (abnormally short prepuce, weak preputial mm, weak retractor penis m, contracture following wound)
CONGENITAL OR ACQUIRED. CAUSE MAY BE CLEAR OR NOT APPARENT.
What are the treatment options for paraphimosis?
Depends of SEVERITY and CAUSE:
- symptomatic
- surgical enlargement of preputial opening
- phallopexy
- preputial lengthening/ reconstructive procedures
- partial penile amputation
Define priapism and what are 3 causes?
persistent erection of > 4 hours not associated with sexual excitement. uncommon in cats and dogs. associated with:
- trauma
- perineal abscess
- neurological disease
How is priapism categorised in humans?
How can these be differentiated?
NON- ISCAEMIC - arterial, high flow
ISCHAEMIC - veno-occulusive, low flow
Differentiation = via clinical signs
Non-ischaemic entire penis is partially rigid and non-painful, rarely an emergency
Ischaemic - painful rigid shaft with a soft glans. EMERGENCY!!!
Other than clinical signs, how else can priapism be diagnosed?
Ultrasound
Blood gas analysis of aspirated blood
What are the treatment options for priapism?
PREVENT SELF-TRAUMA AND EXPOSURE (buster collar, analgesia, topical treatment)
(therapuetic aspiration via surgical incisions and flushing of the corpus cavernosum +/- intra-cavernosal injection of phenylephrine)
If conservative measures or are inappropriate due to ischaemia, amputation with perineal urethrostom (cat) or scrotal urethrostomy (dog)
What are three causes of penile masses?
Inflammatory disease
Neoplasia
Urethral prolapse (brachcephalics)
How common are penile tumours?
Overall uncommon
Dog> cat
What are the penile tumour types?
Soft tissues - TVT, SCC, papilloma, lymphoma, adenocarcinoma, MCT
Os penis - osteosarcoma, ossifying fibroma, chondrosarcoma
How do you treat penile tumours?
depends on tumour type and location
can be medical or surgical
When might penile injury occur?
secondary to mating, fence jumping, dog fights, cat bites or RTA
Also possible iatrogenic secondary to surgery
What are the presenting sings of penile injury?
haemorrhage, may also have dysuria and/or extravasation of urine. treatment depends on degree and extent of wound.
What is a hypospadia?
developmental abnormality
failure of fusion of urogenital folds and incomplete formation of urethra
anywhere along ventral aspect of penis
may be associated with other developmental abnormalities
surgical correction not usually attempted.
When is a persistent frenulum seen?
Treatment?
usually immature dogs
penis and prepuce should be fully separated after puberty
Treatment - sectioning under short GA
What is phimosis?
inability to protrude the penis beyond ht epreputial orifice.
CONGENITAL or ACQUIRED
Treatment of phimosis = ?
surgical enlargement (prepuce) treatment of underlying condition
What is normal preputial discharge like?
slight creamy preputial discharge is normal in a mature dog since prepuce has normal commensal flora
What is abnormal preputial discharge like?
severe/ blood tinged - determine if originatiing from external urethral orifice (prostate problem?) or from prepuce.
What is an important sign of male RPT disease in dog?
dyschezia (usually indicates prostatic enlargement, may be in combination with other disorders such as perineal rupture.
What are important causes of prostatic disease in dogs?
Benign prostatic hypertrophy (BPH)
Prostatitis /abscessation
Prostatic cycsts
Neoplasia
Outline the features of BPH
Commonest prostatic disorder in entire male dogs
normal aging change that may be associated with clinical disease
testosterone depnedent
UNIFORM prostatic enlargement, may –> dyschezia and occasionally dysuria
may also be associated with haematuria / urethral bleeding
Dx = PE, ultrasonography, biopsy (rarely)
Tx = castration, permanent involution within 3-12 weeks, irreversible. Alternatively some medical treatments are available.
What are possible medical treatments of BPH
ANTI-ANDROGENS: Osaterone acetate
SYNTHETIC PROGESTAGEN: Delmadinone acetate
Less commonly, these options:
GnRH ANALOGUE: Deslorelin, a contraceptive implant –> reversible cstration by suppressing pituitary gonadal axis for 6 mo, not licensed to treat BPH
OESTROGENS: not recommended as may get squamous metaplasia and other serious side effects
FAECAL SOFTENERS
Outline the features of prostatitis/ prostatic abscessation
Infections common in dogs, v rare in cat
Usually associated with UTI
May arise from haematogenous spread
Infection more likely in entire dogs (secretory nature of prostate)
May be associated with purulent uretheral discharge, symptomatic illness, dysuric, painful, vomiting, diarrhoea, PU/PD
Occasionally presents as collapse and septic shock
How do Dx prostatits/ prostatic enlargement?
PE, ultrasonography, aspirate, rectal exam (CAREFUL!)
Check for testicular involvement
Tx options for prostatits/ prostatic enlargement?
medical or surgical
prostatic drainage
Outline the features of prostatic cysts and paraprostatic cysts
Not uncommon in dog, may occur in cat??
Differentiate prostatic and paraprostatic cysts
PROSTATIC = parenchymal cycsts PARAPROSTATIC = periprostatic cysts
What is the aetiology of prostatic and paraprostatic cysts?
unknown but probably related to secretory activity as well as secondary to possible squamous metaplasia, neoplasia, resolved abscess, uterus masculinus remnant?
