Therio- The Dog 2

drraythe's version from 2016-04-29 14:33

conditions 3 (prostate)

Question Answer
4 common probs with the prostate?Benign prostatic hyperplasia (BPH), Prostatic cysts, Prostatitis, Prostatic neoplasia
what is the Most commonly diagnosed prostatic disease in dogs?Benign Prostatic Hyperplasia
how common is Benign Prostatic Hyperplasia? who gets this most often?Most commonly diagnosed prostatic disease in dogs! usually Older (>6 yrs old), intact dogs
clinical signs of benign prostatic hyperplasia?May be asymptomatic, Serosanguinous preputial discharge not associated with urination, Rectal tenesmus/straining to defecate, Dysuria, Caudal abdominal pain, Infertility
how does benign prostatic hyperplasia present with palpation?loss of "barbie butt"
how does benign prostatic hyperplasia present with 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 Positive-contrast retrograde urethrogram
2 ways to tx benign prostatic hyperplasia?(1) Castration (2) if breeding dog so you can't castrate, can tx with 5α-reductase inhibitors (trade name finasteride)(Testosterone is converted into Dihydrotestosterone (DHT) with the 5-alpha-reductase inhibitors)
2 categories of Prostatic cysts?(1) True retention cysts within parenchyma of prostate (2) Paraprostatic cysts adjacent to parenchyma
what are True retention cysts (of the prostate) like?Unknown pathogenesis...Dilated prostatic acini due to hormonal imbalances
what are Paraprostatic cysts (of the prostate) like?adjacent to parenchyma. Postulated to be remains of paramesonephric (Müllerian) ducts
clinical signs of prostatic cysts?Usually asymptomatic unless become infected or too large, Anorexia & lethargy, Abdominal distention, Rectal tenesmus, Dysuria, Intermittent serosanguinous preputial discharge
how does a prostatic cyst appear on US?
how do you tx prostatic cysts?Ideally, total surgical excision of cyst. Otherwise excision and omentalization of cyst. Beneficial to castrate simultaneously
Prostatitis is MOST commonly caused by?Most commonly ascending bacterial prostatitis
prostatitis often occurs oncurrently with?benign prostatic hyperplasia
clinical signs of ACUTE prostatitis?Anorexia, pyrexia and lethargy, Pain on palpation of prostate
clinical signs 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 and bacteruria
how does prostatitis present on radiographs?Can get mineralization with chronic prostatitis. Positive-contrast retrograde urethrogam--> 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 and wash --> allows you to get cytology and 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. Chloramphenical, erythromycin, fluoroquinolones). Long term treatment 4-6 wks, and Often need to treat any concurrent prostatic disorder eg. BPH. IF THERE IS ABSCESSATION: Antibiotics, 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.... and this means High rate of metastasis
clinical signs of prostatic neoplasia?GIT: Tenesmus, constipation. Urinary: Stranguria and hematuria. also Weight loss, neck pain, ataxia
how does prostatic neoplasia affect blood lab values?CBC: Leukocytosis and 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 months
You are presented with a 5 year old male intact Golden Retriever with the history 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 and the left testis barely palpable. Which of the following is your most likely differential diagnosis?Scrotal herniation (non-painful, 3 weeks duration)
You are presented with an 8 yr old castrated male Rottweiler. The owner reports that they have seen a bloody preputial discharge for the past week and the dog appears to be straining to defecate. They also report that he appears to have gradually lost weight over the past couple of months and appears to be more lethargic. Which of the following is your most likely differential diagnosis? (options: Transmissible venereal tumor, Benign prostatic hyperplasia, Paraprostatic cyst, Prostatic adenocarcinoma)Prostatic adenocarcinoma (common in CASTRATED dogs)

Components of a BSE

Question Answer
what are the 3 fractions of sperm?Pre-sperm (1), Sperm-rich(2), Post-sperm(3)
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 mascroscopic exam of semen... what should the color, consistancy, an pH be?white, milky, and 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 with 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 with Eosin-nigrosin. Normally >80% morphologically normal
what are you looking for with 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 disease, Medications, Trauma/thermal injury to testes
what kinda things should you be asking abt Reproductive Hx of dog?Incl. age, parity and 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 two problems? examples of each.(1) Psychological issues- Disciplined for sexual behaviors, 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 two samples (urine + semen). TX: Sympathomimetic drugs eg. phenylpropanolamine
Failure to achieve normal copulation--> Sexual immaturity--> do what?Ideally mate with non-aggressive experienced female
Failure to achieve normal copulation--> Sexual overuse--> when is this a problem?Dogs can be used daily with no deleterious effects. Collection 2-3x/day may result in decreased libido and 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's Azoospermia?no sperm in semen sample
azoospermia--> Pre-testicular causes? (5)Hypopituitarism, Hyperadrenocortisism, 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), weimeraners
Azoospermia--> testicular causes? (6)(1) Intersex (More common in cocker spaniels, Kerry blue terriers, pugs, beagles, GSP, weimeraners) (2) Germinal cell aplasia (3) Bilateral cryptorchidism (4) Testicular injury due to trauma, thermal insult, orchitis (More commonly causes oligozoospermia) (5) Auto-immune testicular disorders (6) Testicular neoplasia
Azoospermia--> Post-testicular causes (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 causes 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 causes of Hematospermia?Usually benign prostatic hyperplasia, Trauma, Neoplasia
what is Teratozoospermia?Decreased percentage of morphologically normal spermatozoa
4 common causes of teratozoospermia?Senescence (the condition or process of deterioration with age.), Abstinence/overuse, orchitis, fever
what is Asthenozoospermia?Progressive motility <70%
common causes of asethenozoospermia?(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 laytex affect sperm?asethenozoospermia (dec motility)