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Healing & Alternative Health
Dr. Carson's Holistic Animal Care:



SIGNS OF AGING IN THE DOG AND CAT, PART XXVII:
Organs of the Abdomen:
The Prostate: Diagnosis & Treatment



by Kathleen M. Carson, D.V.M
Last month I wrote about 3 conditions which can affect the prostate gland in older, intact (non-castrated) male dogs: 1.) benign prostatic hyperplasia (BPH), 2.) prostatitis (infection of the prostate), and 3.) cancer of the prostate. (I mentioned how the latter condition can also occur in young male dogs as well as in older dogs who were castrated when young.)


I also wrote that, if you have a male dog, especially an intact older male dog, signs of prostatic disease could include one or more of the following:

*hematuria (blood in the urine)

*urinary incontinence

*anuria (no urination)

*pain

*constipation

*locomotor dysfunction (stiffness, trouble getting up and down, a hunched stance, lameness and/or weakness and/or swelling in the hind legs).


You may also see fever, pain, prostration, anorexia (loss of appetite), and emesis (vomiting). If you see one or more of these signs, a visit to your veterinarian is warranted.


Unfortunately, these signs are not diagnostic of prostate disease; they also can be associated with kidney problems, bladder problems, digestive problems, and/or locomotor problems such as diseases of the lower back, hips, knees.


Further complicating the issue is the fact that prostatic diseases are often complex, and more than one type of disease can be observed at the same time. Also, more than one causative agent may account for the disease(s) found in the prostate.


How, then, are these prostatic diseases diagnosed? Remembering that the signs of prostatic disease can be shared by several other conditions, your veterinarian will take a detailed history and do a thorough physical exam which includes a rectal exam. To rule prostatic disease in/out, your veterinarian would look for an enlarged prostate. Remember that, as the prostate becomes diseased, it enlarges, eventually falling forward from the pelvic area into the abdominal cavity when it is very large. If the prostate is still small enough to be in the pelvic area, your veterinarian will feel it on her rectal exam; she will check for any increase over normal size, loss of normal contours, bumps, tenderness, etc. If your dog’s prostate has enlarged to the point that it is in his abdominal area, your veterinarian will palpate (feel with her hand) his posterior abdomen to see if she can find the enlarged prostate.


Your veterinarian may also find an elevated temperature and pain in the lower back and/or posterior abdomen on her exam of your dog with prostatic disease. Since these signs can be associated with other types of diseases, your veterinarian will need to do further testing. She’ll probably next take radiographs of your dog’s posterior abdomen and spine, especially if the prostate can’t be felt on the rectal exam. When she peruses the radiographs, she’ll examine the lower spine and pelvis for abnormalities as well as looking for an enlarged prostate.


If your dog’s prostate is found to be abnormally enlarged on a rectal/abdominal exam and also in radiographs, an ultrasound (U/S) of the gland will help her decide which type(s) of prostatic disease are present, and it will guide your veterinarian in the collection of prostatic fluid.


When your veterinarian examines the prostatic fluid, she will be looking for signs of inflammation/infection (white blood cells, red blood cells, and bacteria) and/or cancer (abnormal cells). If signs of infection are found, she’ll probably do a culture/sensitivity (C&S) of the prostatic fluid.


After all the testing results are in, if your dog is found to have “only” BPH, castration will be recommended as the most effective treatment. (Even if your older dog with BPH shows no signs of prostatic disease yet, castration is still a good idea to prevent future problems. Of course, castration at a young age will prevent BPH as well as prostatitis - though, unfortunately, it won’t prevent prostate cancer).


On the other hand, if prostatitis is diagnosed, antibiotics are necessary. Until culture/sensitivity results are in, your veterinarian will prescribe a broad-spectrum antibiotic. After culture/sensitivity results come in, the original antibiotic may need to be replaced if the C&S indicates a different antibiotic would be more effective.


Acute prostatitis responds better than chronic prostatitis to antibiotic therapy. This is because, in a normal prostate, there is a phenomenon called the “hemato-prostatic barrier”. This barrier interferes with the passage of substances from the blood into the prostate. In acute prostatitis this barrier breaks down, and antibiotics can get into the infected prostatic tissues fairly easily.


In chronic prostatitis, the hemato-prostatic barrier is functioning again, the blood supply to the gland is reduced, and scar tissue has replaced at least some of the normal prostatic tissue. Thus, the antibiotics have a harder time getting into the infected areas. Antibiotics must be given in higher dosages and for longer periods of time (minimum 4 to 6 weeks).


With both acute and chronic prostatitis, re-examination of the fluid as well as repeat culture & sensitivities are necessary to make sure the infection is resolved.


If prostatic abscess(es) have been found on U/S, surgery will be necessary so that the abscess(es) can be opened and drained.


Since BPH is usually a part of the picture as well with prostatitis, castration should be done. With chronic prostatitis, anti-androgen (male hormone) drugs, female hormones such as progestogens (not estrogens), or drugs called 5-alpha reductase inhibitors can also be helpful.


Treatment of prostatic cancer is, unfortunately, not often successful. It usually has metastasized (spread) to local tissues as well as spinal vertebrae (bones) and/or the lungs by the time it is diagnosed. Treatments such as anti-androgenic drugs, castration, partial prostatectomy or chemotherapy can be tried, but their success rate is low.

Dr. Kathleen Carson, DVM
Veterinarian & Author


Dr. Carson received her Doctor of Veterinary Medicine degree from the University of California at Davis in 1968. She's been a small animal practitioner (dogs and cats ) for all the years since, except for a short stint at the San Diego Zoo when she first graduated.


She belongs to the American Veterinary Medical Association and the American Holistic Veterinary Medical Association.


Since 1974 she's lived and practiced in the South Bay Area near Los Angeles. She started the area's first house call practice in 1976 and the first pet crisis/loss group in 1989. The human-animal bond is of special interest to her.


She started exploring complementary veterinary medicine in 1987. Her practice became 100% holistic in 1996. She utilizes acupuncture, herbs, supplements, Bach Flower Remedies, homeopathic remedies, nutrition and medications for her patients in her practice.


She's currently taking a leave of absence from her house call practice due to health reasons but continues to do phone consultations and to write.



E-mail:
Critterhlr@aol.com



website:
http://www.holistic
vetconsult.com


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