Prostate Diseases in Dogs: How to Recognize and Treat Them?
Prostate disease in dogs
Prostate disease in dogs is a common problem in small animal veterinary medicine.
In the era of the ubiquitous, widely available Internet, we derive a lot of information about health and everyday life from this source, sometimes treating it as the mines of the only, certain, correct and scientifically proven knowledge.
Meanwhile, apart from texts of undoubtedly high educational value, informative articles addressed to various groups of recipients and written in a very diverse language, we can also find a lot of untrue or even harmful and erroneous information, especially on medical issues.
Sometimes when looking for valuable content on a given topic, we have great difficulties, how to find the information that will be useful for us, explain our doubts in an understandable way and will not give rise to new information.
We can come across a particularly large amount of myths and content, not entirely true, when looking for publications about the so-called. diseases of the male nature in which he takes the lead prostate.
Everyone has heard of this gland, knows it exists and sometimes causes problems.
We are informed about this by, for example, TV commercials, which allegedly offer proven means to deal with this ailment.
So how much truth is there in what we hear or see in the mass media and is it really enough to swallow a small tablet every day to live happily ever after??
Do similar problems also apply to our animals, which are also mammals??
I answer these questions in the article below.
Prostate diseases in male dogs are extremely important and it is worth knowing something about it, especially since some of them concern almost all older dogs.
- What is a dog's prostate?
- What is the role of the prostate in the body?
- Why is the prostate problem in dogs so important?
- And what is the situation with dogs?
- Dog prostate disease symptoms
- Prostate disease in dogs
- Benign hypertrophy of the prostate gland: BPH
- Squamous cell metaplasia
- Inflammation of the prostate gland
- Tumors of the prostate gland
- Prostate cysts
- Abscesses of the prostate gland
- Diagnosing prostate diseases
- Prostate Disease in Dogs: Treatment
- Surgical treatment
- Pharmacological treatment
What is a dog's prostate?Prostate? What is this?
Prostate, that is prostate gland or prostate (pour. prostate), is the only sex gland, additional in a dog, which is worth mentioning at the beginning, because canines do not have follicular and bulbourethral glands.
In humans, being an odd muscle-glandular organ, it is a very important element in the structure of the reproductive system, producing a sperm component in which sperm are suspended.
It is characterized by a two-lobed, lobular structure in the dog and, what is extremely important, it surrounds the urethra from the side of the bladder neck.
In healthy individuals, it is usually oval in shape and has a visible furrow between the lobes and consists predominantly of a glandular epithelium with ducts leading to.The prostate gland has no fixed position in the body and is gradually moving as the male ages.
In sexually immature dogs, it is small and locates ventral in relation to the rectum, while with age, due to enlargement, it is displaced headwise from the pelvic cavity to the abdominal cavity.
We may be tempted to generalize and say that on average in young dogs (up to the age of 4-5 years) is located in the pelvic cavity, and in older individuals (above 10 years old) in the abdomen.
This process, of course, is faster when dealing with prostate related conditions.
The development of the prostate depends on testosterone levels and runs most intensively between 4 and 16 months of age of the dog.
We must also remember that the size of the gland depends on the size of the dog, according to the principle that the larger the dog, the proportionally larger the prostate.
For example: the size of a dog's prostate weighing approx 30 kg are 1.7 cm by 2.5 cm.
The norms for the size of a healthy prostate can be found in the tables (according to Ruely and WSP. 1988.) which is extremely helpful in diagnosing later gland enlargement usg.
The prostate has a vesicle-urethral structure and leads leading to the urethra.
The prostate changes its structure with age, and while the connective tissue stroma dominates in young dogs, the glandular tissue in the form of lobules in older dogs.
What is the role of the prostate in the body?
The essential role of the prostate gland is the production of the secretion constituting the I and III semen fractions, containing inorganic and numerous organic components, constituting an optimal environment, source of energy and proper metabolism for sperm cells.
- citric acid,
- ascorbic acid,
- amino acids.
At the end of the introductory word, it is worth saying that the prostate gland is heavily influenced by male sex hormones, i.e androgens With testosterone at the forefront.
It is with age that it increases in size, as a result of the process of glandular hyperplasia, while at the same time moving in the head, from the pelvic cavity to the abdominal cavity.
Since we already know the role of the prostate, where it is located and what it is, it is worth explaining why its diseases are so important in dogs.
Why is the prostate problem in dogs so important?Most old dogs are affected by prostate disease
In human medicine, the topic of prostate diseases is widely known and extremely mediaized, as evidenced by, for example, numerous advertisements targeted at middle-aged and older men.
Specialist doctors encourage every gentleman over the age of 40 to perform a control examination of the prostate by making an antigen test PSA (prostate specific antigen).
It is a specific antigen, characteristic of the prostate, the level of which increases in the case of the disease of this gland, especially in the situation of an ongoing neoplastic process.
Male prostate neoplasms may be asymptomatic for a long time, which complicates early diagnosis and prompt treatment.
In addition, it is important that late diagnosis is characterized by high mortality, hence the unusual emphasis, otherwise right, on the prevention and early diagnosis of the disease, thanks to which in many cases treatment is effective.
And what is the situation with dogs?
Prostate tumors in dogs are relatively rare, although they are usually malicious and therefore unsuccessful.
A common medical condition is for this benign prostatic hyperplasia (BPH bening prostatic hyperplasia).
According to various sources, BPH occurs in approx 80% of dogs at the age already above 5 years and approx 100% dogs over the age of 10 years old, hence it is a common problem and hence the great interest in uncastrated male dogs.
We also have other diseases of the prostate that afflict dogs, also common ones, such as:
- Squamous metaplasia,
- gland inflammation,
Therefore, the knowledge of disease symptoms, or even the diseases themselves in general, seems necessary in the case of having a dog.
Dog prostate disease symptomsDog prostate disease symptoms
Diseases of the prostate gland, although on a different basis, they cause the occurrence inflammation with any symptoms and an enlargement of the gland and displacement into the abdominal cavity.An attentive owner of a sick dog will be able to notice disturbing symptoms that affect various systems, not only the urinary system.
It is important to remember that in many cases these symptoms will be slowly increasing, gradually manifesting and not immediately noticeable, hence I am allergic to being very vigilant and not underestimating even minor symptoms.
Any symptoms related to the urinary tract, especially its lower segment, will be extremely important, so:
- droplet urination with an admixture of blood,
- soreness during the voiding process (urine output).
Droplets of blood often leak from the penis of a male suffering from prostate disease, which should immediately be a warning sign for the owner.
An enlarged prostate usually does not cause problems such as obstruction of the urethra, although painful urination does not.
Instead, it causes problems with passing faeces that manifest tap-like feces if painful tensing during the process defecation (defecation).
When the prostate is significantly enlarged and moves to the abdominal cavity, these symptoms disappear.
Diseases of the prostate cause changes in semen, which consequently lead to its low quality, disorders in the ejaculation process or the presence of blood in it. All this results in decreased fertility due to the fault of the male.
An enlarged, inflamed prostate can cause inflammation of the intervertebral discs of the spine and thus give symptoms of disorders of the locomotor system in the form of:
- soreness when moving,
- various degrees of numbness of the muscles of the pelvic limbs.
Finally, it is worth mentioning the systemic symptoms, often very nonspecific, making it difficult to make a certain diagnosis, that is:
- reluctance to eat,
- avoiding traffic,
- soreness of unknown origin.
So we can see that the range of symptoms in the case of prostate diseases can be really extensive.
Since we already know the general symptoms of prostate diseases, it is worth getting acquainted with specific diseases related to this gland.
Prostate disease in dogsProstate diseases in dogs
Benign hypertrophy of the prostate gland: BPH
It is undoubtedly the most common male prostate disease over 6 years of age and thus it needs as much space as possible.
Older dogs (above 10 years almost 100%), but it is also found in young individuals, even 2 years old and younger.The immediate cause of the disease is hormonal androgen stimulation, accumulation 5α of dihydrotestosterone (DHT) and increasing the number of androgen receptors in the prostate gland.
The disease process involves the multiplication of gland cells, i.e hyperplasia simultaneously with their enlargement, that is, with hypertrophy.
Benign hyperplasia may not show clinical symptoms or cause constipation, painful pressure or excretion of "ribbon-like" faeces as a consequence of pressure on the rectum.
It can also cause droplets of blood from the urethra or purulent discharge.
The enlarged prostate can also put pressure on the urethra, causing symptoms oliguria or anuria and consequently life-threatening uremia.
So we see how serious consequences can have innocent looking ones BPH and how important it is to diagnose and treat it.
Squamous cell metaplasia
It is a disease that develops as a consequence of stimulation with endogenous or exogenous estrogens due to the presence of a hormonally active testicular tumor - Sertoli cell tumor.
Less often, it is caused by the administration of estrogens or disorders of the adrenal glands.
Estrogens in high concentrations they are toxic to the prostate epithelium and output lines, as a result of which the single-layer cylindrical epithelium is rebuilt, which is replaced with a multilayer flat epithelium.The consequence of this process is keratinization and excessive exfoliation of cells and clogging of the outgoing ducts.
The secretion of the prostate then stagnates and then becomes overgrown with bacteria, and as a result, they form cysts and abscesses.
Inflammation of the prostate gland
This is a very extensive group of diseases which, due to their etiology, can be divided into bacterial and non-bacterial, and due to their course into acute and chronic.
Infection of the prostate gland is most often carried out through the ascending route, i.e. from the urinary system, with which the prostate is integrally connected, and less often through the blood, i.e. hematogenesis.
So all favors them urinary tract infections, even the subclinical ones, benign prostatic hyperplasia if excess estrogens in the body that lower general immunity (have an immunosuppressive effect).
The inflammation of the prostate will be manifested by:
- reluctance to cover,
- blood in urine or semen,
- soreness of the gland itself,
- systemic symptoms:
- lack of appetite.
The differentiation of acute from chronic is undoubtedly very important due to the permeability of the blood-prostate barrier and the possible therapeutic effect.
Tumors of the prostate gland
The neoplastic process most often affects older dogs over 10 years.
The most common cancer is adenocarcinoma.
Less commonly, the prostate gland develops transitional epithelial carcinoma of the urinary tract, myosarcoma, fibrosarcoma if lymphosarcoma.
The very bad news is that there is prognosis in any case unsuccessful, they are built quickly metastases to other tissues and organs.Prostate tumors in dogs are also androgen independent, so castration will not be of any benefit in this case.
Therefore, only palliative measures are possible, minimizing to some extent the clinical symptoms and ensuring the best possible comfort of being ill, followed by euthanasia.
These can be cavernous intra-glandular or extriglandular fluid-filled structures.
Most often they arise as a consequence squamous metaplasia or benign prostatic hyperplasia.
They also accompany the ongoing inflammatory process or cancerous.
Importantly, they often do not show clinical symptoms and are diagnosed accidentally on a follow-up ultrasound examination.Cysts within the prostate, when they are very large, predispose to formation perineal hernia.
Abscesses of the prostate gland
They most often develop as a result of duration chronic inflammation or as a result cyst infections.
They are not common.
Being a bacterial infection they cause significant soreness and systemic symptoms, such as:
- bad mood,
- reluctance to move.
In the video below you can see what an abscess of the prostate gland looks like on an ultrasound examination
prostate gland abscess - dog
Watch this video on YouTube
Diagnosing prostate diseasesProstate diseases in the dog: diagnosis
As in the case of any disease entity, we start with an accurate diagnosis intelligence with the pet owner who describes the dog's symptoms and behavior that are troubling him or her.
This is important because many symptoms may give rise to suspicion of prostate diseases, for example:
- band-like, thin faeces,
- droplet bloody discharge from the urethra during micturition.
Only later do we move on to research that is more focused on the prostate gland.
So we start with rectal examination (through the handpiece), which we can often find enlargement of the gland and its pain.
This test is used to assess the size, shape, symmetry, displacement, consistency of the gland and, as I have already mentioned, possible soreness.Imaging diagnosis is the routine, standard method in diagnosing prostate disease.
We can make X-ray examination, which will help assess the location and size of the gland.
It will not give us important information about the flesh itself, which should be considered a limitation in this method.
So we will be able to find an enlargement of the organ, but we will not determine the causes of this enlargement (overgrowth, tumor, metaplasia).
Thus, the imaging technique used by choice seems to be ultrasound examination, thanks to which we can assess not only the size of the gland, measure its length and width, but also accurately assess the flesh.Ultrasound is a non-invasive examination, easily available in veterinary offices and, most importantly, reliable.
Ultrasound also allows to assess the change in the size of the gland during treatment, which undoubtedly seems to be a great advantage of this examination.
They are performed through the abdominal wall or through the handpiece. In the latter case, it allows only the posterior areas of the gland to be assessed.
The patient for prostate ultrasound should have a full bladder, so preferably at least 3 hours does not urinate.
By making use of ultrasound examination we can also do prostate biopsy.
Of course, this is not a routine examination and requires some skills from the doctor, but on the other hand it provides important information and allows to exclude the neoplastic process or squamous metaplasia.
Sometimes it is necessary bacteriological examination of urine taken from the bladder by puncture.
This simple study allows you to approx 80% exclude bacterial prostatitis as a consequence of cystitis.
It can be of great help when suspecting prostatitis bacteriological examination fluid obtained from prostate massage.
In human medicine, the specific prostate antigen is commonly used to diagnose prostate diseases PSA.In dogs, it is a good test for diagnosing early prostate hyperplasia Odelis CPSE test, BVT.
This test detects specific arginine esterase, which is an enzyme produced by prostate epithelial cells under the influence of sex hormones.
To sum up, it still remains the most appropriate, routinely used and certain test that tells a lot about the condition of the prostate ultrasound examination.
It is worth doing them almost in every case of an older dog, as if automatically controlled, because it will help to detect many irregularities.
You already know what the symptoms of the disease can be and how it is diagnosed.
Read on to learn how to treat prostate disease in dogs.
Prostate Disease in Dogs: TreatmentSurgical treatment of a dog's prostate disease
We can prostate diseases treat pharmacologically or surgically.
It is up to the attending physician to make the final decision which methods to choose and apply to a particular patient.
The prostate, as I wrote before, is a gland that is heavily influenced by testosterone and enlarges under its influence.Removal of the source of this sex hormone in the body will therefore shrink the prostate itself over time.
And it actually is the case benign prostatic hyperplasia.
A method of choice BPH so it remains castration treatment.
By removing the testicles, we eliminate androgens and thus by eliminating their impact on the prostate, we cause the gland to shrink during several weeks (usually 4 weeks, but according to other data up to 8 weeks).
Castration unless there are medical contraindications, it is the primary treatment method for prostate diseases.
The prostate gland itself is removed much less frequently due to complicated surgery, numerous and common complications and long convalescence.
Often after surgery, the prostate is removed urethral damage and urinary incontinence.The urethra may be damaged when the prostate is removed
Generally, it is difficult to operate in this area due to the specific location of the prostate that surrounds the urethra.
In the case of the neoplastic process of the prostate, which fortunately does not occur too often, it is possible to remove the gland itself, but we must remember that the prognosis is bad, and metastases are very common, therefore is it worth doing??
The decision should always be made after careful consultation with the attending physician, after getting acquainted with the consequences of the procedure and possible complications.
The procedure itself must be performed by an experienced surgeon with great skills in this field.
In the case of prostate diseases, thanks to the use of modern, available drugs, the doctor is able to cure or control most clinical cases at a really good, acceptable level.
Sometimes surgical treatment is not accepted by the owner or there are other contraindications of a medical nature due to coexisting diseases or anesthesia itself.
Then pharmacological treatment may be an alternative.
Nowadays, thanks to the well-known physiology of the gland, its hormone dependence, the discovery of the blood-parenchyma barrier and the new generation of drugs, we are not defenseless in the fight against most diseases of the prostate.
Historically, the first drugs used to treat benign prostatic hyperplasia were estrogens (synthetic estradiol analogs).
Means of this group by inhibiting secretion luteotropic hormone (LH - stimulates the interstitial cells of the testicles to produce testosterone) reduce testosterone levels in the blood and cause apoptosis, i.e. destruction and death of prostate epithelial cells.
Unfortunately, estrogens have a number of side effects, sometimes life threatening, and are currently not used to treat these conditions.
They cause feminization, gland hyperplasia and epithelial metaplasia, bone marrow suppression, thus stopping hematopoiesis, which is sometimes a permanent phenomenon (bone marrow aplasia occurs)!).
Today, if we want to pharmacologically treat dogs with prostate diseases, we most often choose preparations that block androgen receptors in the gland or interfere with testosterone metabolism and block the formation of dihydrotestosterone, i.e. a biologically active hormone affecting the prostate.
An inhibitor 5 α reductase is finasteride, which blocks the production of dihydrotestosterone. It is included in the preparation Proscar tablets a 0.005.The reduction in the size of the prostate and the subsidence of its benign enlargement occurs over time 4 weeks, and the maximum effect is achieved after 6-9 weeks.
Another inexpensive, widely available, and safe drug is flutamide.
It inhibits the effect of testosterone on prostate epithelial cells, while causing few side effects (nipple enlargement - gynecomastia, whether a slight soreness of the mammary gland).
The prostate gland treated with this preparation grows again after 2 months after stopping therapy, this should be remembered.
Both of these formulations are human medicines and are not licensed for use in dogs, which you need to know as a dog owner.
Progestogens represented by megestrol acetate and medroxyprogesterone acetate they are also used in the treatment of BPH.
They show a strong antigonadotropic and anti-testosterone effect, inhibit the process of binding dihydrotestosterone to receptors, reduce the concentration of hihydrotestosterone, but they can also impair spermatogenesis.
Drugs from the group of analogues GnRH (leuprolide, delorelin, buserelin) by stimulating the synthesis and release of gonadotropins from the pituitary gland, they inhibit the hypothalamus - pituitary axis.
At the beginning of treatment, they may worsen your symptoms, which you should also be aware of.
A veterinary preparation used in the treatment of benign prostatic hyperplasia Ypozane, that is ozaterone acetate.
Being a strong inhibitor of testosterone receptors, it impairs the action of dihydrotestosterone in the prostate gland itself and inhibits the activity of the 5 α reductase enzyme.
It reduces testosterone levels and is available in the form of tablets that we use for a period week.Thereafter, the therapeutic effect lasts for a period of approx 5 months.
In the case of each of these preparations, we must remember that the symptoms will always return some time after stopping treatment. The obtained effect is not permanent and the treatment requires multiple repetitions.
Between the prostate gland and the body there is a barrier of blood - organ parenchyma - prostate fluid, the presence of which limits the conduct of antibiotic therapy.
This barrier is impermeable to most antibiotics, which is extremely important in the case of bacterial diseases, especially in the case of chronic inflammation.
This is determined by the use of appropriate antibiotics, which will first penetrate the prostate gland while achieving the appropriate therapeutic concentration.
In the case of acute inflammation, the barrier is "unsealed", thus creating greater treatment options - the use of drugs.
So we can give in this case trimethoprim, enrofloxacin, cephalosporins, penicillin or antibiotics from the group of aminoglycosides for a period of approx 4 weeks.
After this period it should be done urine culture and prostatic fluid to determine the presence or absence of pathogenic bacteria.
In the case of chronic inflammation, our therapeutic possibilities, due to the tight blood-prostate barrier, are very limited. We only have a small amount of antibiotics that may prove effective.
These are enrofloxacin, erythromycin, chloramphenicol and trimethoprim.The therapy itself should go on at least 6 weeks and follow similar principles as in the case of acute inflammation.
So you see that treating prostate diseases can sometimes be a lengthy process that requires a thorough diagnosis beforehand.
In many cases, however, it turns out to be effective and brings great relief to suffering dogs.
SummaryHow to prevent prostate disease in older dogs?
Summarizing the topic of prostate diseases, it is worth paying attention to one undeniable fact about this gland.
Well, being a hormone-dependent gland, under the influence of testosterone, it decreases and disappears when the level of this male hormone drops.
And this can be achieved easily and simply by neutering the male at a young age.
In many countries there is a rule of thumb for this treatment in all non-breeding animals.
Castration not only solves the problem of animal homelessness to some extent, but also plays a preventive role in the case of prostate diseases, especially the common BPH.
Therefore, in this perspective, it is worth considering whether to perform this procedure on a young dog, in his prime, clinically healthy, so that later he will not have a problem in his old age, the more that, as it turns out, prostate hyperplasia is a common process, affecting virtually every senior dog.
We should also remember about the disturbing symptoms of prostate diseases and react quickly in the event of their appearance, because an early diagnosis always creates better prospects for treatment and quick recovery.Generally diseases of the prostate, with the exception of the cancer process, do not pose a direct threat to life, but they can significantly reduce its comfort, and it is our responsibility, as owners, to ensure the best possible health of our pupils.
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