PROSTATE DISORDERS UNIVERSITY OF MINNESOTA College of Veterinary

PROSTATE DISORDERS UNIVERSITY OF MINNESOTA College of Veterinary Medicine

Prostate disorders - Benign prostatic hypertrophy / hyperplasia (BPH) - Prostatic neoplasia - Prostatitis UNIVERSITY OF MINNESOTA Veterinary Medical Center

Prostate growth and secretion are androgen-dependent. Testosterone is converted to 5 -alpha-dihydrotestosterone (DHT) via action of the enzyme 5 -alphareductase. UNIVERSITY OF MINNESOTA Veterinary Medical Center

Diagnosis of prostate disease - Assessment of prostate size * Rectal palpation * Imaging - Cytology / culture of prostatic fluid - +/- prostatic aspirate / biopsy - +/- measurement of secretory proteins UNIVERSITY OF MINNESOTA Veterinary Medical Center

UNIVERSITY OF MINNESOTA Veterinary Medical Center

BPH - Signalment Older, intact dogs - Pathogenesis Estrogen + androgen; DHT is the primary androgen causing prostate enlargement with age UNIVERSITY OF MINNESOTA Veterinary Medical Center

BPH -Clinical signs Bloody penile / preputial discharge Hematuria Few to no systemic signs - Diagnosis Rectal Palpation – Ultrasound? Rule out prostatitis UNIVERSITY OF MINNESOTA Veterinary Medical Center

BPH UNIVERSITY OF MINNESOTA Veterinary Medical Center

BPH - Treatment Castration Estrogen Progesterone 5 -alpha-reductase inhibitors UNIVERSITY OF MINNESOTA Veterinary Medical Center

Prostatic neoplasia - Highly malignant carcinoma - May or may not see penile / preputial discharge - Prostate asymmetrical, +/- painful - Systemic signs common - Treatment palliative - Prognosis grave; metastasis present by the time of diagnosis UNIVERSITY OF MINNESOTA Veterinary Medical Center

Prostatitis - Infection overlying BPH or neoplasia - Bloody to purulent discharge from penis / prepuce - Prostate asymmetrical, +/- painful - More likely to see systemic signs than with simple BPH - Diagnosis requires culture of prostatic fluid or tissue UNIVERSITY OF MINNESOTA Veterinary Medical Center

Prostatitis - Treatment Antibiotic choice? - High lipid solubility - Low protein binding - p. Ka complementary to p. H of prostatic fluid Treat for underlying problem concurrently UNIVERSITY OF MINNESOTA Veterinary Medical Center

ANTIBIOTIC LIPID SOLUBILITY DIFFUSION INTO PROSTATE Ampicillin Poor Cephalosporins Poor Oxytetracycline Poor Aminoglycosides Poor Erythromycin Good Chloramphenicol Good (high dose) Trimethoprim Good Ciprofloxacin / Enrofloxacin Good UNIVERSITY OF MINNESOTA Veterinary Medical Center

Prostatitis Continue antibiotic therapy for 3 -4 weeks, repeat culture of seminal fluid one week and again one month after therapy concluded. UNIVERSITY OF MINNESOTA Veterinary Medical Center

UNIVERSITY OF MINNESOTA College of Veterinary Medicine