The prostate gland is the most important sex gland in male dogs. It is located behind the bladder and surrounds the beginning of the urethra. The secretion produced by the prostate gland is a component of semen and is ejaculated together with the sperm produced in the testicles. Prostate disorders are usually diagnosed in older, unneutered male dogs. These disorders can cause various changes in the gland.
The exact cause of this enlargement is not yet fully understood. It is believed that as dogs age, an imbalance between sex hormones occurs, causing the prostate to enlarge.
Even though this is a benign change, it can cause significant symptoms. An enlarged prostate puts pressure on the rectum, making it difficult to pass stool. As a result of the altered blood flow within the prostate, blood dripping from the penis is often observed, regardless of urine output. As the disease progresses, fever, weight loss, loss of appetite, malaise, a wide-legged gait, and weakness in the hindquarters may also occur.
A possible complication of the disease can be a drainage disorder of the bladder, which is caused by the pressure of the enlarged prostate and often leads to a bladder infection, which also needs to be treated.
In addition to a general examination and review of your pet's medical history, your veterinarian has various examination methods at their disposal. In the first step, they can manually palpate the prostate via a rectal examination to determine the size and consistency of the gland.
Further X-ray examinations are usually used to determine changes in the size and position of the prostate. An ultrasound image can be used to determine the exact size of the gland and also show its internal structure.
In some cases, it may be necessary to take a tissue sample to confirm the diagnosis. This can be done either by fine needle aspiration under ultrasound guidance, which usually does not require anesthesia, or, in rare cases, by surgical tissue removal under general anesthesia.
The aim of treatment is to reduce the influence of testosterone on the prostate. The most effective long-term treatment is therefore castration of the affected dog. With the elimination of testosterone, a reduction in size of up to 70% can be observed in the first two months after the operation.
Hormone treatment to reduce testosterone levels is now also possible with modern preparations, but due to its limited effectiveness and higher financial cost, it is usually only used in breeding dogs or very old dogs.
The prognosis is favorable if enlargement occurs without complications and castration is performed in a timely manner.
Since almost all unneutered male dogs experience prostate enlargement during their lifetime, prostate examination should always be part of the annual routine check-up for intact male dogs from the age of five.
The safest prevention of the disease is castration, although it must always be considered on an individual basis and discussed with the veterinarian whether an otherwise healthy male dog should be castrated.
In most cases, infection of the prostate is caused by bacteria ascending from the urinary tract. A distinction is made between acute and chronic inflammation.
In acute prostate inflammation, the dog shows severe general distress with high fever, cramps, constipation, and bloody, purulent discharge from the penis. Affected dogs are often in severe pain and do not like to be touched on the abdomen. In most cases, there is also a bladder infection, and the dog has difficulty passing stool and urine.
Chronic prostate inflammation is accompanied by significantly less pronounced symptoms and is therefore often only detected at a late stage. Chronic inflammation also tends to lead to hardening and shrinkage of the prostate, so that typical symptoms such as difficulty defecating do not occur. The male dog is usually only taken to the vet when purulent discharge from the penis is noticed.
The diagnosis is made by the veterinarian based on clinical symptoms and with the help of an ultrasound examination. Additional blood and urine tests provide information about the type and severity of the disease, not only when chronic inflammation is suspected.
Acute inflammation should be treated with effective antibiotics as soon as possible. Even if treatment is started at the same time, it is always advisable to perform an antibiogram, i.e., a laboratory test to determine the sensitivity of the bacteria to specific antibiotics, so that targeted treatment can be initiated if necessary. Treatment should last at least four weeks to prevent chronic inflammation or an abscess from developing. After the first week, it is advisable to check the status of the treatment using ultrasound and laboratory tests.
In the case of chronic prostate inflammation, surgical castration in combination with antibiotic treatment is the safest and most promising measure.
The chances of recovery depend on the effectiveness of the antibiotic and the course of the disease and can therefore range from favorable to doubtful.
Acute inflammation of the prostate that is not treated or is treated inadequately can develop into an abscess (an accumulation of pus in a cavity). Prostate abscesses can cause high fever and, in the worst case, rupture, leading to life-threatening peritonitis (inflammation of the peritoneum).
Prostate abscesses usually need to be removed surgically, and follow-up care is often very difficult and complications are not uncommon. The prognosis is therefore rather cautious and, in cases where the abscess has already ruptured, even very unfavorable.
A distinction is made between intraprostatic (located within the glandular tissue) and extraprostatic (located outside the glandular tissue) cysts. These are fluid-filled capsules that develop during prostate enlargement due to drainage problems in one or more excretory ducts. They only cause noticeable symptoms once they reach a certain size or become infected. Smaller cysts are often discovered by chance during an ultrasound examination. Very large cysts can displace surrounding organs and cause problems with bowel movements and urination.
Diagnosis is not always easy for the veterinarian, as cysts are difficult to distinguish from abscesses during rectal examination as well as on X-rays and ultrasound images. However, corresponding clinical symptoms and further laboratory tests can confirm the diagnosis.
Larger, fluid-filled cysts must be surgically removed. At the same time, the dog must be neutered. Smaller cysts usually disappear spontaneously after neutering. The prognosis is favorable.
Malignant tumors of the prostate are rare in dogs. Ninety percent of these tumors are adenocarcinomas that originate in the cells of the glandular tissue. Older, neutered male dogs of large breeds aged ten years or older are most commonly affected. The tumors have a high tendency to metastasize (spread), and in up to 80% of all cases, the tumor has already spread to surrounding organs and lymph nodes at the time of diagnosis.
Affected animals show significant problems with urination and urinary dribbling. In addition, emaciation, loss of appetite, reluctance to move, and pain are common.
As with all other changes in the prostate, a general and subsequent special rectal examination is performed. An important characteristic of a tumorous change is the distinct painfulness of the prostate when touched. However, as this characteristic is not conclusive, X-rays, ultrasound, and laboratory tests should always be performed.
If metastasis has not yet occurred, treatment with castration can be attempted. However, due to the high probability of metastasis, the prognosis is generally poor and euthanasia is unavoidable in most cases.
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