Reproductive Emergencies In The Male

Question 1

Prostate disorders

Answer 1

Prostate’s function

• store and secrete a slightly alkaline fluid, milky white in appearance
• makes up 25-30% of volume of semen
• aids in control of flow of ejaculation

Cancer:

• Adenocarcinoma - most common
• hemangiosarcoma, lymphosarcoma, and squamous cell carcinoma
• prostatic cysts - cause unknown
• abscesses can occur - caused by benign prostatic hypertrophy (BPH)
• can lead to sepsis and can lead to septic shock
• most common prostate disorder in intact male dogs
• caused by 5a-dihydrotestosterone (metabolite of testosterone) promotes accelerated growth of prostate cells
• large nodules in the periutheral region of the prostate
• can obstruct urethra causing animal to barely be able to urinate and dysuria
• similar to blocked cat
• Prostatitis Common in dogs with BPH
• occurs when bacteria grow in the prostate parenchyma

Signs:
*lethargy, fever, dehydration, bloody discharge and abdominal pain

Diagnosis:
Radiographs and ultrasound to rule out other diseases

Tx:
Antibiotics and a castration once stable

Question 2

Paraphimosis

Answer 2

*very common
*inability to retract penis
Causes:
*small preputial orifice
*ring of fur encircling the penis
*ineffective preputial muscles
*preputial hypoCl Asia
*Trauma
*infection
*neoplasia
*idiopathic

Emergency because of possible necrosis or injury which may result in amputation

• Can be replaced with lubrication with sedation
• If edema present: use hyperosmolic solution (dextrose, mannitol)
• surgery rare
• monitor for self mutilation

Question 3

Testicular/Scrotal Disorders

Answer 3

Orchitis: inflammation of one or both testicles and epididymitis: inflammation of the long coiled tube attached to upper part of each testicle
-common in young dogs

Signs:
*fever, lethargy, hunched posture, scrotal edema, or purulent penile discharge

Tx:

• antibiotics
• full or partial castration

Causes:

• trauma
• neoplasia
• vasculitis
• spermatic cord torsion
• Brucella canis

Spermatic cord torsion
*very uncommon
*ddx for dogs with acute abdominal pain, vomiting, lethargy, anorexia, dysuria, hematuria, fever
*more common in dogs with both testicles retained
Tx:
*castration of the testicle(s)

Neoplasia

• consider when there is noted changes in the size of testicles
• most common tumour is Sertoli cell tumour
• 3 most common type of scrotal neoplasia: squamous cell carcinoma, melanomas, and mast cell

Question 4

Penile trauma

Answer 4

• common in both young and older dogs
• rare in cats
• actual fracture of the os penis is rare
• should also suspect urethral injury
• contrast radiography indicated to rule out a tear
• can occur during breeding or traumatic event
• severe hemorrhage can occur as the penis is very vascular and cavernous

Tx:

• depends
• wound repair
• antibiotics
• indwelling urinary catheters
• pain management
• penile amputation

Question 5

Urethral prolapse

Answer 5

• generally in young brachycephalic breeds
• dogs usually excessively lick prepuce, blood dripping from the prepuce or a fleshy mass protruding from the penis
• usually only 3-4mm of urethra protrudes from the urethral orifice

Causes:

• repeated sexual arousal or urethral infection
• idiopathic

Tx:

• reducing prolapse and preventing reoccurrence by suturing area closed
• indwelling urinary catheter should NOT be used as can cause irritation to surgical site, hemorrhage and urinary tract infection
• amputation of prolapsed portion of the urethra