The male dog pt 2 Flashcards
Primary Testicular Neoplasia; what type of animals do we find it in
Common in dogs
◦ Usually older
◦ Cryptorchids
Primary Testicular Neoplasia; types, distribution
Types:
◦ Sertoli cell tumor
◦ Seminoma
◦ Interstitial cell tumor (Leydig cell tumor)
Incidence roughly 1/3rd for each
Bilateral involvement is common
Multiple types can occur concurrently
◦ Mixed neoplasia
Sertoli Cell Tumor more common when?
More common in retained testes
Sertoli Cell Tumor symptoms
Paraneoplastic syndrome
◦ Hyperestrogenism
◦ FEMINIZATION
◦ Behavioral change, alopecia (bilateral symmetrical), gynecomastia, hyperpigmentation, pendulous prepuce, squamous metaplasia of the prostate, attraction to males, decreased libido
◦ Pancytopenia – life threatening
◦ 1st transient increased granulopoiesis with peripheral neutrophilia
◦ Then, neutropenia, thrombocytopenia & non-regenerative anemia
◦ Bone marrow replaced by fibrous tissue + fat
Metastasis
◦ Not common
Sertoli Cell Tumor physical characteristics
- White to grey
- Firm
- Greasy on cut section
Interstitial Cell Tumors (Leydig Cell Tumor) more common when?
More common in descended testes
◦ Rare reports of interstitial cell tumors in cryptorchid testes
Interstitial Cell Tumors (Leydig Cell Tumor) secrete what? signs and results?
Can secrete estrogen or testosterone
◦ Similar clinical signs to SCT if estrogen producing
◦ If hypertestosteronism:
> Perinal adenomas, perineal hernia, prostatic disease
Usually diagnosed incidentally unless steroid producing
Very rare to metastasize
Interstitial Cell Tumor appearance
- Soft
- Yellow-orange
- Cystic with serous/ serosanguineous fluid
Seminoma often occurs when?
Often occur in retained testes
seminoma can produce what? results?
Can produce steroids occasionally (estrogens)
Rarely metastasize
Carcinoma in situ (CIS)
seminoma appearance
-soft
-homogenous
-ivory colour
-+/- lobulation
-smaller but can get large
seminoma diagnosis
History
◦ Cryptorchid
◦ Hx of late testicular descent
Physical exam
◦ Signs of hyperestrogenism?
◦ Scrotal enlargement
◦ Enlarged, asymmetrical testis
◦ Testicular palpation
◦ Enlarged nipples
Preputial swab
Ultrasound
testicular tumor treatment, prognosis, and prevention
Castration
Submit tissue for histopathology
Supportive care if paraneoplastic syndrome present
◦ Blood transfusion
◦ Broad spectrum antibiotics (secondary
infections)
◦ Fluid therapy
Prognosis
◦ Unfavorable if severe pancytopenia
Prevention is key – castrate cryptorchids!!!
Important to rule out what if suspect orchitis/epididymitis
Brucella canis
Conditions of the Prostate
◦ Benign Prostatic Hypertrophy (BPH)
◦ Prostatitis
◦ Prostatic cysts
◦ Prostatic Adenocarcinoma
Benign Prostatic Hyperplasia/Hypertrophy (BPH); how does it occur?
Prostatic growth & secretion
◦ Occurs in response to testosterone metabolite
> dihydrotestosterone (DHT)
BPH = Spontaneous, age-related condition of intact males
Common condition
◦ >80% of intact males >6 age old have BPH
Causes prostate gland enlargement
◦ Prostatic volume in affected dogs is 2-6.5x greater than normal dogs of equal size
Benign Prostatic Hyperplasia/Hypertrophy (BPH) most common clinical signs
Most common clinical signs
Serosanguinous fluid dripping for the penis or blood in semen/urine
Should NOT see dysuria
BPH diagnosis
◦ Often found incidentally
◦ Detection of blood in prostatic fluid of the ejaculate/on tip of penis
◦ Uniform prostatic enlargement by palpation, radiographs, ultrasound
BPH treatment
◦ Goal = decrease prostatic size
◦ Castration – works fastest
◦ Medical
> Finasteride - works by acting on the enzyme that converts testosterone to DHT (5⍺-reductase) – breeding males
> Anti-androgens, progestagens
Important to treat as predisposes to other prostatic disease if left untreated
Cystic prostatic disease; types
Retention cysts
Paraprostatic cysts
Retention cysts: occurence, appearance, clinical signs, treatment, possible sequelae
◦ Occur as BPH progresses
◦ Can be multiple small cysts and/or 1-2 large cysts
◦ Contain serosanguineous fluid
◦ Clinical signs > similar to BPH
◦ Rarely need surgical treatment or drainage
◦ Can lead to prostatic abscess if left untreated
Paraprostatic cysts: occurence, appearance, treatment
◦ Cysts adjacent to prostate
◦ Can get quite large
◦ Clinical signs: dysuria, tenesmus, perineal hernia > space occupying
◦ Treatment
◦ Surgical removal
◦ Drainage via ultrasound guidance
prostatitis; acute: rarity, severity, symptoms
- Not common
- Severe, acute illness – systemic involvement
> Neutrophilia
Painful:
* Abdominal pain
* Pain on palpation of prostate
* Prostate is enlarged
* Difficulty walking (hunched up)
* Fever
prostatitis; chronic: rarity, severity, symptoms
- More common
- Subclinical/low grade disease
> Recurring urinary tract disease or subfertility - 2nd to BPH, urinary disease
- Urethral discharge
- Hemospermia
- Enlarged irregular prostate
- Commonly caused by commensals
> E.coli
Acute Prostatitis diagnosis, treatment
- Culture is important for diagnosis & treatment
> From urine - Prostatic barrier not intact
> Base antibiotics on sensitivity - Supportive care as needed
Chronic Prostatitis; diagnosis, treatment
- Prostatic barrier is intact
> Need to take this into account for antibiotic selection - Typically do not need supportive care
in all cases of prostatitis, what do we need to treat? how?
in both instances need to treat prostatic enlargement
-castration; fastest option’
-finasteride etc.
prostatitis leads to what if left alone
can lead to prostatic abscess
Antibiotic selection for prostatitis;
Do not use:
-Penicillins
-Cephalosporins
-Aminoglycosides
Better to use:
-Fluoroquinolones
-Trimethoprim/sulfa
-Chloramphenicol
-Doxycycline
length of treatment for prostatitis
IMPORTANT: Length of treatment
Minimum 4-6 weeks
Recheck often
Prostatic Neoplasia; where do we find it? what kind? prognosis?
Uncommon
More common in neutered males
Prostatic adenocarcinoma = most common
Transitional cell carcinoma (TCC) = also possible
HIGH rates of metastasis
Prognosis is GRAVE
If you see dysuria… is it BPH? what should we think of?
- Means it is not BPH
Indicative of something more serious:
* Prostatitis
* Abscess
* Cyst
* Tumor
what is concerning with testicular neoplasia? in one word
Hyperestrogenism
