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Therio - Canine 2

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drraythe's version from 2017-09-10 03:54

Conditions 3 (prostate)

Question Answer
4 common probs w/ the prostate?Benign prostatic hyperplasia (BPH)
Prostatic cysts
Prostatitis
Prostatic neoplasia
What is the most commonly diagnosed prostatic Dz in dogs?Benign Prostatic Hyperplasia
How common is Benign Prostatic Hyperplasia? Who gets this most often?Most commonly diagnosed prostatic Dz in dogs! Usually Older (>6 yrs old), intact dogs
CSs of benign prostatic hyperplasia?May be asymptomatic
Serosanguineous preputial discharge not associated w/ urination
Rectal tenesmus/straining to defecate
Dysuria
Caudal abdominal pain
Infertility
How does benign prostatic hyperplasia present w/ palpation?Loss of "Barbie butt"
How does benign prostatic hyperplasia present w/ semen collection?Hematospermia may be present
If you are taking Radiographs to try to Dx Benign Prostatic Hyperplasia, what must you look out for??Remember to check lumbar vertebrae & sublumbar lnn. consider doing a Pos-contrast retrograde urethrogram
2 ways to Tx benign prostatic hyperplasia?(1) Castration
(2) If breeding dog so you can't castrate, can Tx w/ 5α-reductase inhibitors (trade name finasteride) (Testosterone is converted into Dihydrotestosterone (DHT) w/ the 5-alpha-reductase inhibitors)
2 categories of Prostatic cysts?(1) True retention cysts w/in parenchyma of prostate
(2) Periprostatic cysts adjacent to parenchyma
What are True retention cysts (of the prostate) like?Unknown pathogenesis...Dilated prostatic acini due to hormonal imbalances
What are Periprostatic cysts (of the prostate) like?Adjacent to parenchyma. Postulated to be remains of paramesonephric (Müllerian) ducts
CSs of prostatic cysts?Usually asymptomatic unless become infected or too large
Anorexia & lethargy
Abdominal distention
Rectal tenesmus
Dysuria
Intermittent serosanguineous preputial discharge
How does a prostatic cyst appear on US?
How do you Tx prostatic cysts?Ideally, total surgical excision of cyst. Otherwise excision & omentalization of cyst. Beneficial to castrate simultaneously
Prostatitis is MOST commonly czd by?Most commonly ascending bacterial prostatitis
Prostatitis often occurs concurrently w/?Benign prostatic hyperplasia
CSs of ACUTE prostatitis?Anorexia
Pyrexia & lethargy
Pain on palpation of prostate
CSs of CHRONIC prostatitis?Usually asymptomatic
Hematuria
Lethargy
Anorexia
Straining to defecate
Poor semen quality
Urethral discharge (clear/bloody/purulent)
How does prostatitis affect blood lab values?CBC: left shift neutrophilia
How does prostatitis affect the urinalysis?Hematuria
Pyuria
Bacteruria
How does prostatitis present on radiographs?Can get mineralization w/ chronic prostatitis. Pos-contrast retrograde urethrogram → May get leakage of contrast media into prostatic parenchyma
How does prostatitis appear on U/S?Parenchyma has a mottled/”motheaten” appearance. Abscessation?
What is a prostate-unique test you can do to try to Dx some prostate problems?Prostatic massage & wash → allows you to get cytology & cultures
Should you FNA a prostatitis?NO! CONTRAINDICATED!
How do you Tx prostatitis? (How long?) What if there is abscessation?In acute prostatitis, blood-prostate barrier disrupted, so almost any antibiotic would work. MOST effective is highly lipid soluble ABx (Eg. Chloramphenicol, Erythromycin, Fluoroquinolones)
Long term Tx 4-6 wks, & Often need to treat any concurrent prostatic disorder eg. BPH
IF THERE IS ABSCESSATION: ABx, Castration/finasteride (the 5α-reductase inhibitors), Surgery to endure drainage
Most common Prostatic Neoplasia?Malignant adenocarcinoma
Is prostatic neoplasia more common in castrated or intact dogs?Most common in castrated dogs (weird!!!)
What is metastasis like of prostatic neoplasia?Malignant adenocarcinoma most common.... & this means High rate of metastasis
CSs of prostatic neoplasia?GIT: Tenesmus, constipation
Urinary: Stranguria & hematuria. Also Weight loss, neck pain, ataxia
How does prostatic neoplasia affect blood lab values?CBC: Leukocytosis & neutrophilia
Biochem: Increased ALKP
How does prostatic neoplasia present on rads?Prostatomegaly, Mineralization of prostatic tissue
How do you treat prostatic neoplasia?Palliative!! There is a Total prostatectomy but this is NOT recc bc there is a High incidence of urinary incontinence. Also, Radiation therapy also Often results in urinary incontinent. On the bright side, NSAID’s like Piroxicam or Carprofen increased mean survival time by about 6 mo
You are presented w/ a 5 yr old male intact Golden Retriever w/ the Hx of a non-painful scrotal enlargement over the last 3 weeks. This is a valuable working dog, who is used regularly at stud. On physical examination, the scrotum is enlarged but not turgid or painful on palpation. The right testis is grossly enlarged & the left testis barely palpable. Which of the following is your most likely DDx?Scrotal herniation (non-painful, 3 weeks duration)
You are presented w/ an 8 yr old castrated male Rottweiler. The owner reports that they have seen a bloody preputial discharge for the past week & the dog appears to be straining to defecate. They also report that he appears to have gradually lost weight over the past couple of mos & appears to be more lethargic. Which of the following is your most likely DDx? (options: Xmissible venereal tumor, Benign prostatic hyperplasia, Periprostatic cyst, Prostatic adenocarcinoma)Prostatic adenocarcinoma (common in CASTRATED dogs)
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Components of a BSE

Question Answer
What are the 3 fractions of sperm?(1) Pre-sperm
(2) Sperm-rich
(3) Post-sperm
What does pre-sperm look like, where does it come from? (How much on avg?)Clear; 0.5-5ml, Prostatic fluid
What is the Sperm-rich fraction of semen like? (How much on avg?)Milky; 1-4ml
What is Post-sperm look like, where does it come from? (How much on avg?)Clear; 1-80ml, Prostatic fluid
On macroscopic exam of semen... what should the color, consistency, & pH be?White, milky, 6.2-6.8
How can you gauge the concentration of the sperm?Photometer/hemocytometer
To reliably achieve pregnancy, what is the total dose of progressively motile normal sperm required?Total dose of 150-200 million PMN (progressively motile normal) sperm must be introduced into the bitch during her fertile period to reliably achieve pregnancy
What do you want for Individual motility of sperm?Want >70% progressively motile
What must you do to accurately assess individual motility of sperm? What categories do you split the sperm into?Dilute w/ extender to be able to assess correctly. % progressively motile: % aberrantly motile: % immotile
To assess morphology of sperm, how many do you need to be normal? What stain do you use?Stained w/ Eosin-nigrosin. Normally >80% morphologically normal
What are you looking for w/ a Foreign Cell Smear?Epithelial cells, WBC’s, RBC’s, etc
Do you do gross, microscopic, both, or neither motility exams for sperm?Only do individual!! Don't do gross motility bc conc. of sperm isn't high enough so just do individual motility
Subfertility → when is a dog considered subfertile?Whelping rate of <75% when bred appropriately to a normal bitch
What is Infertility in the dog?Complete failure to impregnate a normal bitch when bred appropriately
What is sterility (in the dog)Inability to produce or ejaculate normal spermatozoa
Some general health things you should consider during the BSESystemic Dz, Medications, Trauma/thermal injury to testes
What kinda things should you be asking about Reproductive Hx of dog?Incld. age, parity & fertility of any bitches bred, Type of breeding management, Brucella testing
"Was copulation normal" flow chart (pic)
Failure to achieve erection generally stems from what 2 problems? Examples of each.(1) Psychological issues - Disciplined for sexual BHs, Subordinate male, Aggressive female, Strange environment (usu have to take bitch to dogs territory)
(2) Pain - During thrusting/mounting, Joint/back pain, Prostatitis/Orchitis
Failure to ejaculate can be from what 3 major problems?(1) Sexual immaturity
(2) Pain (Especially joint/prostate pain)
(3) Retrograde ejaculation
What is going on in Retrograde ejaculation?Retrograde ejaculation occurs when semen, which would normally be ejaculated via the urethra, is redirected to the urinary bladder. Normally, the sphincter of the bladder contracts before ejaculation forcing the semen to exit via the urethra, the path of least resistance.
Retrograde ejaculation is usually due to? How do you dx? How do you Tx?Usu due to some Blockage of sympathetic α receptors. It will lead to Collection of azoospermic sample. DX: Perform cystocentesis & evaluate semen concentration in 2 samples (urine + semen). TX: Sympathomimetic drugs eg. Phenylpropanolamine
Failure to achieve normal copulation → Sexual immaturity → do what?Ideally mate w/ non-aggressive experienced female
Failure to achieve normal copulation → Sexual overuse → when is this a problem?Dogs can be used daily w/ no deleterious effects. Collection 2-3x/day may result in decreased libido & sperm numbers
How do you know if the semen sample you have received is a testicular/epididymal sample?Check ALKP (>5000 U/L = complete ejaculate) bc ALKP is produced in balls/epidid
What is Azoospermia?No sperm in semen sample
Azoospermia → Pre-testicular czs? (5)Hypopituitarism
Hyperadrenocorticism
Long-term high-dose glucocorticoid therapy
Inguinal/Scrotal hernia
Fever (usually temporary infertility)
In which breeds is being intersex more common?Cocker spaniels
Kerry blue terriers
Pugs
Beagles
GSP (German Shorthaired Pointer)
Weimaraners
Azoospermia → testicular czs? (6)(1) Intersex (More common in cocker spaniels, Kerry blue terriers, pugs, beagles, GSP, Weimaraners)
(2) Germinal cell aplasia
(3) Bilateral cryptorchidism
(4) Testicular injury due to trauma, thermal insult, Orchitis (More commonly czs oligozoospermia)
(5) Auto-immune testicular disorders
(6) Testicular neoplasia
Azoospermia → Post-testicular czs (2)(Ie. Outflow obstruction)
(1) Epididymal Segmental Aplasia
(2) Sperm granuloma
What is Oligozoospermia?Low total number of spermatozoa
Daily sperm production proportional to...Testicular size
5 common czs of Oligozoospermia?(1) Testicular hypoplasia
(2) Testicular degeneration (Often age related...often after 8yr she said in class)
(3) Orchitis/epididymitis
(4) Drugs
(5) Testicular neoplasia
Which drugs can lead to oligozoospermia?Glucocorticoids
Anabolic steroids
Androgens
Estrogens
Chemotherapy agents
Ketoconazole
Cimetidine
3 common czs of Hematospermia?Usually Benign Prostatic Hyperplasia
Trauma
Neoplasia
What is Teratozoospermia?Decreased % of morphologically normal spermatozoa
4 common czs of teratozoospermia?Senescence (the condition or process of deterioration w/ age.)
Abstinence/overuse
Orchitis
Fever
What is Asthenozoospermia?Progressive motility <70%
Common czs of asthenozoospermia?(When Progressive motility <70%) Similar to those causing teratozoospermia (Senescence, Abstinence/overuse, Orchitis, fever)
Certain lubricants
LAYTEX
Residues left on glassware/AV’s
Temp changes
How does latex affect sperm?Asthenozoospermia (dec motility)
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