SA - Male Reproductive Disease Flashcards
What diagnostics are available for SA male reproductive disease?
History and PE
Semen evaluation
Palpation of prostate and external genitalia
Hormonal assays
Ultrasonography and/or radiography
Biopsy of testes, cytology, prostatic wash, and/or biopsy of prostate gland
Observation of sexual nehavior
Where is the primary site or reproductive disease in the dog?
the prostate
____ of intact dogs exhibit histologic evidence of benign prostatic hyperplasia by 5 years of age.
50%
____ of intact dogs exhibit histologic evidence of benign prostatic hyperplasia by 9 years of age.
> 95%
What clinical signs are associated with benign prostatic hyperplasia?
Hemospermia and/or hematuria is the most common
Tenesemus, ribbion like stools, possibly dysuria or stranguria
What are patients with benign prostatic hyperplasia (BPH) more susceptible to?
Ascending infection and prostatitis
The prostate is symmetrically/asymmetrically enlarged in BPH?
Symmetrically
How is BPH diagnosed?
rectal palpation, ultrasound, radiographs, cytology and/or culture
What will you feel on rectal palpation in patients with BPH?
Bilobed, firm, symmetrical structure
Enlargement and/or cranial abdominal displacement
What will you see on radiographs in patients with BPH?
Prostatic enlargement and/or mineralization
What can cytology and/or culture be taken from in patients with BPH?
Prostatic fraction, prostatic wash, ultrasound guided FNA
How is BPH treated?
Finasteride or Castration
What are prostatic cysts a sequelae to?
BPH
What may cause prostatic cysts?
Coalescing glandular hyperplasia and occlusion
Estrogenic exposure
Prostatic cysts result in symmetrical/asymmetrical enlargement.
asymmetrical
What dogs is prostatitis often seen in?
Dogs affected by BPH and/or prostatic cysts
What pathogens are frequently diagnosed with prostatitis?
E. coli, staph, strep, and mycoplasma
How do dogs present in acute prostatitis cases?
Systemically ill, pyuria, stiff gait, painful, fever, painful ejaculation
What is the treatment of choice for acute prostatitis?
Course of lipophilic antibiotics based on culture and sensitivity
How do dogs present in chronic prostatitis cases?
stiff gait, recurrent UTI, and painful ejaculation
What may or may not be associated with chronic prostatitis infections?
concurrent UTI
What is the treatment of choice for chronic prostatitis cases?
Course of lipophilic antibiotics based on culture and sensitivity
How is prostatitis diagnosed?
PE, transabdominal US, routine BW, and culture and cytology
What will you find on culture and cytology of the prostatic fraction/prostatic wash in patients with prostatitis?
red blood cells and inflammatory cells
What lipophilic antimicrobials can be used to treat prostatitis?
Fluroquinolones - Enrofloxacin and Ciprofloxacin
Trimethoprim sulfamethoxalone
What is the most severe form of protatitis?
prostatic abscess
When do prostatic abscesses often form?
under estrogenic exposure from squamous metaplasia as part of BPH
Is prostatic neoplasia most frequently noted in castrated or intact males?
castrated
What is the most frequently diagnosed prostatic neoplasia?
adenocarcinomas
Prostatic adenocarcinomas have a high rate of metastasis. Where do they like to go?
Lymph nodes, lumbar vertebrae, and pelvis
What other prostatic neoplasias occur in dogs?
TCC, fibrosarcomas, leiomyosarcoma. and SCC
When is diagnosis of prostatic neoplasia often found?
following the detection of metastatic disease
True or False: The prostate is always enlarged in cases of neoplasia.
False - it can be enlarged but it can also be ‘normal’ size
What is the treatment for prostatic neoplasia?
Total prostatectomy, radiation, or cyclooxygenase inhibitors
When are testicular, epididynal, and/or scrotal abnormalities frequently noted first?
on physical examination and testicular palpation
What is the first question you must ask yourself when you feel an abnormality in the scrotum?
Is one testicle too big or is the other too small
What neoplasias occur in the testicles?
Sertoli cell tumor, seminoma, and leydig cell tumors
Describe what the testicle will feel like if there is a sertoli cell tumor.
Testicle is irregularly enlarged and firm
What dogs have an increased risk of sertoli cell tumors?
cryptorchids
What is associated with sertoli cell tumors?
feminization, squamous metaplasia, infertility, and BM suppression
Metastasis is uncommon
Describe what the testicle will feel like if there is a seminoma.
Testicle homogenously enlarged and soft
What dogs have an increased risk of seminomas?
cryptorchids
Are seminomas hormonally active?
typically not
Are seminomas frequently benign or malignant?
benign
What will the testicle feel like if there is a Leydig cell tumor?
Testicle enlargement is not common - it is often incidental
What may cause leydig cell tumors?
hypersecretion of testosterone
How is testicular neoplasia diagnosed?
testicular palpation and ultrasonography
How is testicular neoplasia treated?
Unilateral vs. bilateral castration
Treatment of metastasis if applicable
Orchitis alone is generally _______.
uncommon
What causes epididymitis (+/- orchitis)?
Bacteria
What is it paramount to rule out in cases of epididymitis (+/- orchitis)?
Brucella canis
What can cause epididymitis (+/- orchitis) in cats?
FIP and trauma
How is orchitis and epididymitis treated?
Systemic antimicrobials, anti-inflammatories/analgesics
What species can cause Brucellosis in dogs?
Brucella canis
Occasionally B. suis, B. ovis, B. melitensis, or B. abortus
What clinical signs are associated with Brucellosis?
Severe epididymitis, orchitis, severe teratospermia, testicular degeneration and atrophy
IF there are systemic signs in Brucellosis patients, what can they be?
Diskospondylitis, uveitis, and generalized lymphadenitis
You have a dog that tests positive for Brucellosis, what do you do?
CALL THE STATE VET
How is Brucellosis treated?
No curable treatment, euthanasia in outbreak cases, castration and prolonged abx to decrease viremia and subsequent shedding
What history is associated with testicular degeneration?
Previous fertility and/or normal appearing testes
What happens to the testicles in cases of testicular degeneration?
Testicles decrease in size and often become softer. Severe cases may be firm due to significant fibrosis
What can testicular degeneration be secondary to?
toxins, epididymitis, orchitis, systemic disease, etc.
What is testicular degeneration associated with (reproduction related)?
decreasing fertility, poor morphology, motility, and/or decreasing sperm numbers with the presence of Germ cells
What is azospermia?
absence of spermatozoa
What is oligospermiia?
reduced number of spermatozoa
What do you need to ask yourself when dealing azospermia or oligospermia?
Did he actually ejaculate? Did he ejaculate in the correct direction?
How do you confirm ejaculation?
Measure alkaline phosphatase within seminal fluid - >5000 IU/L confirms ejaculation
What is alkaline phosphatase produced from?
The caudal epiddiymis
What is retrograde ejaculation?
ejaculation into the bladder
How do you determine if a dog ejaculated in the correct direction?
Catheterize the urinary bladder and examine for presence of spermatozoa
What is testicular biopsy often reserved for?
Cases that are azospermic, or occasionally oligospermic and those considering castration
What is lymphoplasmocytic orchitis?
A familial tendency noticed in some breeds (bermese mountain dog and bull mastiff) found on testicular biopsy
What is a common penile abnormality associated with young males?
persistent frenulum
What other penile abnormalities can happen in dogs?
Penile masses, papillomas, hair rings, preputial foreign body, paraphimosis, phimosis, and priapism
What is paraphimosis?
Paraphimosis, the inability to completely reduce the penis into the preputial cavity
What is phimosis?
Phimosis is a congenital condition where the opening of the prepuce is too narrow to allow the penis to fully extend.
What is priapism?
Persistent penile erection lasting longer than 4 hours in duration without presence of sexual stimulation
What can cause priapism?
Neurologic disease, trauma, idiopathic, drug induction
How is priapism treated?
Address the primary cause
CC flush, phenylephrine
Ephedrine/pseudoephedrine and terbutaline for idiopathic cases
What is a transmissible venereal tumor?
A contagious round cell tumor
Where are transmissible venereal tumors commonly found?
on genital and oral mucosa
How are transmissible venereal tumors treated?
Frequently they regress without intervention
Vincristine is highly effective
What is balanophosthitis?
inflammation of the penis and prepuce
What are the clinical signs/diagnosis of balanoposthitis?
Presence of increased mucopurulent preputial discharge/smegma +/- hyperemia of the penile mucosa
What is the most common cause of balanoposthitis?
nuisance or cosmetic concern for the client
What do you need to rule out in cases of balanoposthitis?
Presence of hair rings, preputial foreign bodies, penile/preputial masses, and presence of mucosal vesicles
What is the treatment for balanoposthitis?
Preputial flush with dilute betadine (often owners do it daily and then it is tapered down) or saline
Prevent licking
How can male cats get the calico coat?
If they have an abnormality that allows them to have two X chromosomes along with a Y - they are frequently infertile
