Prostatic disease Flashcards
What are three ways to get a sample of prostatic fluid or cells?
Ejaculate sample,
prostatic wash or urethral brushing, or biopsy
Briefly describe how to collect a sample from a prostatic brushing.
a catheter with a small brush on the end is inserted into the urethra to the level of the prostate, and the prostate is stimulated rectally to give off fluid. That fluid is then collected through the catheter into a syringe.
What signs of neoplasia might you see in cells?
Clustering and different sizes of nuclei
In dogs, which part of the prostate tends to hypertrophy?
The glandular part. It grows from the inside out, and presses up on the colon.
Why does prostatic Hyperlasia happen with age?
Static estrogen levels as androgens falls with age. The change in the ratio of testosterone to estrogens
What are some signs of prostatic hyperplasia?
Tenesmus (straining to poo), hematuria, discharge, infertility
What is the generally reccomended treatment for hyperplasia/cysts?
Castration- prostate should shrink palpably within 10 days.
What types of drug can be used to treat hyperplasia if the owner is unwilling to neuter?
5-a reductase inhibitors- blocks conversion of testosterone to DHT (Finasteride)
-Progestins- suppresses LH release by negative feedback and decreased androgen receptors
What will happen if you stop treatment with a 5-a reductase inhibitor?
The prostate will return to pretreatment size within weeks.
How do progestins and fiasteride affect libido and sperm qualtiy?
They are minimally affected
What are the disadvantages to using progestins long term?
Diabetes mellitus
mammary tumors
development of female characteristics
How do prostatic cysts form?
Glandular tissue proliferates and increases secretion, the connective tissue also becomes disorganized and secretions get blocked up and form fluid bubbles
What are the three presentations of prostatic infections?
Acute bacterial prostatitis
Chronic bacterial prostatitis
Prostatic abscess
What are the signs of acute bacterial prostatitis?
Dog will be very sick- fever, lethargy, vomiting, etc.
Will have neutrophilia and and slightly high liver enzymes and bilirubin
Urinalysis will suggest infection (active sediment)
What further tests do you need to confirm acute bacterial prostatitis?
NONE- don’t want to do a wash, etc to avoid spreading infection so treat based on history, signs and urinalysis
What is the treatment for acute bacterial prostatitis?
initial antimicrobials IV
Supportive care
Long term oral antibiotics
Castration strongly reccomended after acute illness is resolved
What are the signs of chronic bacterial prostatitis?
Mild clinical signs
enlarged prostate
Possible mineralization on imaging
Localized to prostate gland
Should you want to do a brushing or aspirate if you suspect chronic bacterial prostatitis?
You sure would.
What is an additional consideration when dealing with chronic bacterial prostatitis?
There is probably an underlying disease condition causing the chronic infection.
What might you worry about with a prostatic abscess?
The abscess rupturing and spilling its contents into the abdomen.
What causes prostatic abscesses?
Assumed to be a sequela to prostatitis and is favored by hyperestrogenism (sertoli cell tumor or iatrogenic)
What prostatic disease might you expect if a dog has PU/PD
a prostatic abscess because the E. coli infection has a toxin that can cause PU/PD
What is the treatment of prostatic abscesses?
surgical drainage
Antimicrobials
What type of drugs are better at entering the prostate?
Non-ionized weak bases
Lipid soluble
and poorly protein bound
Give one example of a drug that can enter the prostate and one that generally cannot
Fluorquinolones (esp enrofloxacin) can, penicillins and cephalosporins cannot (but those two are often used for UTI’s, so be careful)
