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Prostate Disease in the Breeding Male Dog

Benign Prostatic Hyperplasia (BPH) in Dogs

In dogs, the prostate serves as the lone accessory sex gland. Among intact (non-neutered) dogs, this gland undergoes enlargement and weight increase as they age. This condition, observed commonly in dogs over six years old, represents the most prevalent disorder of the prostate. While not inherently life-threatening, it can predispose a dog to other ailments and cause significant discomfort.

Benign prostatic hyperplasia (BPH) in dogs entails a hormone-driven proliferation of cells typically observed in middle-aged and older dogs. This disorder impacts the glands and connective tissues of the prostate, leading to glandular swelling that exerts pressure on the rectum, narrowing the passage and causing painful defecation for the dog.

BPH arises from an age-related elevation in estrogen levels within the prostate. The balance between estrogen and androgen hormones is thought to contribute to the development of BPH in older dogs, as both types of hormones are necessary for substantial prostate enlargement to occur.

In most dogs, the clinical manifestations of BPH are minimal or absent. However, in chronic cases, BPH can heighten the prostate’s susceptibility to urinary tract infections and subsequent bacterial prostatitis development.

Types

Prostatitis/Prostatic Abscess

The prostate gland and urinary tract of normal intact dogs maintain a sterile environment; microbial growth within the prostate is inhibited by a prostatic antibacterial factor. Prostatitis, characterized by inflammation of the prostate, typically occurs alongside bacterial infection and may manifest as acute (sudden and severe) or chronic (long-term). Bacterial prostatitis can progress to the formation of abscesses. It is often associated with BPH due to changes in prostatic architecture. Bacterial urinary tract infection may not always accompany bacterial prostatitis.

Prostatic Cysts

Prostatic cysts can be primary or secondary to hyperplasia, cancer, or inflammation. Multiple cysts may be linked to BPH and squamous metaplasia, where the transformation of one cell type to another occurs. Squamous metaplasia results from estrogen exposure or alterations in the estrogen:androgen ratio. Estrogen converts prostatic epithelium to a stratified squamous type, leading to duct occlusion and contributing to cyst formation.

Paraprostatic cysts, fluid-filled sacs found adjacent to the prostate, are connected to the prostate, lined by skin cells that secrete fluids, and vary in size. Larger cysts containing excess collagen and bony extensions resembling cauliflower are not uncommon but are typically sterile.

Prostatic Neoplasia (Cancer)

Prostatic adenocarcinoma, originating in the glandular tissue, is the most frequently reported form of prostate cancer associated with BPH. Other tumor types include fibrosarcoma, leiomyosarcoma, and squamous cell carcinoma. Transitional cell carcinomas of the prostate usually arise from the prostatic urethra rather than the prostate gland itself.

The incidence of prostatic neoplasia in intact versus castrated dogs is similar. Prostatic adenocarcinoma, a malignant form of abnormal cell growth, is not correlated with benign hyperplasia. Bone metastasis occurs in over one-third of prostatic adenocarcinoma cases, typically spreading to nearby pelvic and back bones.

BPH incidence is high in non-neutered dogs. By the age of five, 50 percent of intact dogs show histologic evidence of BPH. The exact incidence of prostatitis is unknown but is considered common in veterinary practice. However, the occurrence of neoplasia is low; carcinomas are reported at rates of 0.29–0.60 in the dog population. Prostatic cysts in intact dogs generally occur before the age of four. Prostate cancer typically manifests before the age of ten.

Symptoms

  • Prostatic Disease – General
  • Often asymptomatic
  • Tenesmus (difficulty with bowel movements or constipation)
  • Presence of bloody urethral discharge
  • Decreased frequency of urination or defecation
  • Stranguria (difficulty and straining during urination)
  • Benign Prostatic Hyperplasia
  • Hematuria (blood in urine)
  • Hematospermia (blood in semen)
  • Prostatitis – Acute
  • Manifestation of systemic illness (such as vomiting, lethargy, loss of appetite, weight loss)
  • Presence of purulent urethral discharge
  • Pyuria (presence of pus in urine)
  • Hematuria
  • Potential infertility
  • Stiff-legged gait
  • Prostatitis – Chronic
  • Recurring or chronic urinary tract infections
  • Hematuria
  • Stiff gait
  • Potential infertility
  • Prostatic Cyst
  • Refer to the description provided for Benign Prostatic Hyperplasia (BPH) above
  • If accompanied by infection, symptoms may resemble those of prostatitis
  • Prostatic Neoplasia
  • Emaciation
  • Dyschezia (difficulty with defecation, often resulting in painful defecation)
  • Difficulty in moving rear limbs
  • Experience of lumbosacral pain (pain between the ribs and pelvis)

Causes

  • Benign Prostatic Hyperplasia (BPH)
  • Typically observed in intact breeding males
  • Occurs in dogs over the age of five
  • Prostatitis
  • Caused by infection of the prostate gland
  • Common in dogs over five years old
  • Squamous Metaplasia
  • Result of estrogen administration
  • May lead to cellular changes in the prostate
  • Paraprostatic Cyst
  • A cyst that develops in the tissues surrounding the prostate
  • Often seen in dogs over eight years old
  • Prostatic Neoplasia
  • Not influenced by intact or non-intact status
  • Tends to occur in dogs over the age of ten

Diagnosis

To diagnose your dog’s condition, your veterinarian will first gather a comprehensive history of your dog’s health leading up to the onset of symptoms. Standard laboratory tests, including a complete blood profile, chemical blood profile, complete blood count, and urinalysis, will be conducted initially. Due to the multitude of potential causes for this condition, your veterinarian will employ a process called differential diagnosis. This involves systematically ruling out each of the more common causes based on the observed symptoms until the correct disorder is identified and can be treated accordingly.

Your veterinarian will conduct a thorough physical examination of your dog and make initial assessments based on their findings. However, ultrasound imaging is the preferred method for assessing the prostate, as the results provide crucial information for diagnosis. X-ray imaging may also be used to gather additional information not revealed by ultrasound. Samples from the urinary tract and semen will be collected for analysis. If a tissue mass or tumor is discovered, your veterinarian may perform a biopsy to further characterize the mass.

Treatment

For benign prostatic hyperplasia, treatment is only necessary for dogs exhibiting symptoms. Castration is the preferred treatment for dogs without breeding value, effectively resolving the issue.

However, if the dog holds breeding value, medications can be administered to temporarily reduce prostate size, allowing the dog to remain functional. This treatment is primarily aimed at alleviating clinical signs, enabling the collection and freezing of sufficient semen for future use. It is not intended as a long-term solution, and the prostate typically returns to its original size eight weeks after treatment cessation. Castration is often recommended once an adequate amount of semen has been stored.

In cases where bacterial infection is identified as the cause, antibiotics will be prescribed based on specific culture and sensitivity results. For chronic infections, antibiotics tailored to treat more severe infections may be necessary. Castration is advised if the infection persists despite antibiotic therapy. Treatment for cysts depends on factors such as location, type, and size, with castration potentially being recommended once again.

In instances of cancer, metastasis commonly occurs by the time of diagnosis. Chemotherapy may be considered depending on the cancer’s nature, although it’s essential to acknowledge that there is no cure or long-term remedy for cancer. Pain relief medication will be prescribed to help manage your dog’s discomfort.

Recovery and Management

Your veterinarian will schedule follow-up visits to repeat prostatic fluid cultures. Semen evaluation should be conducted in all breeding dogs, but only after 65 days following the resolution of bacterial prostatitis. Additionally, abdominal ultrasound may need to be repeated to assess prostate size post-medical therapy.

Dogs testing positive for Brucella (Gram-negative bacteria) should not be utilized for breeding due to the highly infectious nature of the disease. It’s important to recognize that Brucellosis is a zoonotic infection that can be transmitted from dogs to humans, although it remains uncommon in humans. If your dog is diagnosed with Brucellosis, you must take necessary precautions when handling any secretions from your dog.

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