Management of prostatic disease

image of Management of prostatic disease
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Prostatic disease is common in dogs but rare in cats. In the dog, prostatic disease is the most common disorder of the male reproductive tract. Diseases of the prostate gland include benign prostatic hyperplasia, cystic benign prostatic hyperplasia; squamous metaplasia, paraprostatic cysts; infectious prostatic abcessation and prostatic neoplasia. This chapter discusses anatomy, physiology, diagnostic tests and prostatic disorders.

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25.1 (a) The relationship of the prostate gland to other structures in the caudal abdomen of the dog. (b) The relationship of the prostate gland to other structures in the caudal abdomen of the male cat. Note that the prostate gland is more caudal to the neck of the bladder than in the dog. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
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25.2 Rectal palpation of the prostate gland in a male dog. One hand should apply pressure on the caudal abdomen while the other palpates rectally. The prostate gland, when abdominal, can be palpated in the caudal abdomen as well as per rectum. The hand palpating the caudal abdomen can both evaluate the cranial aspects of the gland and push the prostate gland into or near the pelvic canal for better palpation per rectum. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
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25.3 Examples of equipment for semen collection and evaluation: light microscope, slide warmer, centrifuge, automated sperm counter, frosted slides and cover slips.
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25.4 SpermaCue (Minitube) automated sperm count machine (in this case 350 million sperm/ml are present).
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25.5 Haemocytometer.
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25.6 Semen collection examination room set-up: non-slip rug, ‘teaser’ treated with pheromone and no white coats.
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25.7 Latex artificial vagina, plastic vented and unvented semen collection tubes in rack.
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25.8 (a) Stud dog approaches and mounts the ‘teaser’. (b) The collector places the artificial vagina in position.
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25.9 (a–b) Proper extrusion of the penis into the artificial vagina. (b) The bulbus glandis is inside the artificial vagina, with the preputial skin pushed caudally. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
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25.10 (a–b) The collector simulates the tie by bringing the penis caudally, permitting visualization of the ejaculate.
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25.11 Position of the penis in the vagina during the canine copulatory tie. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
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25.12 Assistant fractionating the collected ejaculate by switching tubes.
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25.13 Fractions of ejaculate: sperm rich (left tube), and prostatic fluid (remaining three tubes).
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25.14 Artificial vagina left in place during detumescence.
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25.15 Paraphimosis of the tip of the penis following semen collection.
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25.16 (a) Normal clear prostatic fluid in third fraction (right tube). (b) Haemospermia.
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25.17 Benign prostatic hyperplasia. A sagittal ultrasound image of an intact canine prostate (between callipers) with multiple ‘wagon wheel’ striations radiating from the urethra to the capsule; a typical ultrasonographic finding for this disease.
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25.18 Benign prostatic hyperplasia. A transverse ultrasound image of an intact canine prostate showing hyperplastic parenchymal change. The urethra (>) is noted centrally.
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25.19 Cystic benign prostatic hyperplasia. A transverse ultrasound image of a canine prostate (between callipers) with hypoechoic parenchymal cysts.
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25.20 A sagittal ultrasound image of a dog suspected to have cystic benign prostatic hyperplasia (x–x); the more cranial (left) echogenic cystic structure (+–+) was an abscess.
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25.21 (a) Squamous cells in the prostatic fluid of a dog with squamous metaplasia of the prostate gland. (b) Sagittal ultrasonographic image of an intratesticular neoplasm (between callipers). (c) Sagittal ultrasonographic image of prostatic squamous metaplasia. Note the asymmetrical prostatic outline and hyperechoic parenchyma lacking striation, and parenchymal cysts. (d) Sagittal ultrasonographic image of an intra-abdominal testis (between callipers) in a 6-month-old Labrador Retriever. Normal intratesticular anatomy is evident. (e) Transverse ultrasonographic image of an intra-abdominal, malignantly transformed testis (between callipers) in a 9-year-old unilaterally cryptorchid Flat Coated Retriever.
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25.22 (a) Paraprostatic cysts (between callipers) seen in a sagittal ultrasound image of the prostate. (b) Uterus masculinus (between callipers) adjacent to the urinary bladder (UB) diagnosed in a neutered dog 6 months post-orchiectomy.
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25.23 Infectious prostatitis. (a) Sagittal ultrasound image of prostatic abscessation (>). (b) Transverse ultrasound image of a cavitated intraprostatic abscess (between callipers).
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25.24 (a) Normal prostate of a neutered dog: homogeneous and small. (b) Prostatomegaly (between callipers) in a neutered dog with transitional cell carcinoma; the parenchyma is mottled, with calcification and mass effect.
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25.25 A cluster of cells aspirated from a prostatic carcinoma which exhibit criteria of malignancy: anisocytosis, anisokaryosis, multinucleated cells with prominent nucleoli, increased nuclear to cytoplasmic ratio and multiple nucleoli.
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25.26 Sagittal ultrasound image of a prostatic adenocarcinoma (between callipers). Note the mineralization evident in the parenchyma.
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25.27 Sagittal ultrasound image of a prostatic transitional cell carcinoma. Note extension into the neck of the urinary bladder. The prostatic parenchyma retains striations, suggestive of benign prostatic hyperplasia.
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25.28 Marked sublumbar lymphadenopathy (between callipers) in a 10-year-old neutered Samoyed causing compression of the urethra.
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25.29 Sagittal ultrasound image of hydroureter resulting from extension of prostatic neoplasia into the trigonal region of the urinary bladder (colour-flow image).
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