Diagnosis and Management of Canine Prostatic Disorders
World Small Animal Veterinary Association World Congress Proceedings, 2006
Peter Holt
Professor, University of Bristol, Department of Clinical Veterinary Science, Langford, Bristol, UK

Problems affecting the canine prostate include benign enlargement hyperplasia/metaplasia), prostatitis (acute or chronic), abscessation, prostatic cysts, neoplasia, idiopathic haemorrhage and displacement into ruptures or hernias.

The clinical signs in dogs with prostate disease include haematuria, dysuria, urinary incontinence, dyschezia, pain and weight loss. These signs are not pathognomonic and so must be differentiated from similar signs due to non-prostatic disorders.

Once it is determined that the signs are associated with a prostatic condition, the nature of that condition should be determined. Useful differential features are that only acute prostatitis (± abscessation) and neoplasia are painful conditions; prostatic abscesses, cysts and tumours result in asymmetrical prostatic enlargement; in some dogs with prostatic tumours a small, irregular, painful prostate is present. Prostate cancer is also one of the few prostate conditions to affect castrated dogs. Indeed, some authors believe prostate cancer to have a higher prevalence in castrated versus entire animals.

Apart from clinical examinations, useful investigative techniques include contrast radiography (especially retrograde positive contrast urethrocystography), ultrasonography, fine needle aspirates and biopsies, cytology and histology.

Prostatic hyperplasia responds to oestrogen (or anti-androgen) therapy and more permanently, to castration. Prolonged oestrogen therapy is contra-indicated since squamous metaplastic prostatic enlargement may result. Most prostatic tumours are malignant and the prognosis is hopeless; prostatectomy is not to be recommended in the author's view although some palliation may be obtained in some animals using tube cystostomies, transurethral debulking and urethral stenting and/or non-steroidal anti-inflammatory drugs such as piroxicam or metacam. Prostatitis may respond to antibiotics and castration but abscesses and cysts require surgical drainage. The prognosis associated with prostatic cysts and abscesses is guarded and no one form of treatment (marsupialisation, drainage procedures, partial or complete prostatectomy) is 100% successful. Mild cases may respond to castration and repeated needle drainage. Omentalisation of prostatic abscesses has been used with good results. This may be combined with partial resection of the prostate. A biopsy should always be taken during surgery since a proportion of prostatic cysts and abscesses have a carcinoma of the lining.

References

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2.  Atalan, G., Barr, F.J. & Holt, P.E. (1999) Comparison of ultrasonographic and radiographic measurements of canine prostate dimensions. Vet. Radiol. Ultrasound 40, 408-412.

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Speaker Information
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Peter Holt
University of Bristol
Department of Clinical Veterinary Science
Langford, Bristol, United Kingdom


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