Prostate Disease
By Dr. Karen Burgess

 What is the prostate?
The prostate is a gland located beyond the bladder in the male urinary tract.  The urethra passes through the prostate.  In young dogs the bladder is within the pelvis while in intact adult males it can naturally drop into the abdominal cavity.  The prostate is responsible for providing fluid to transport and nutritionally support sperm.  Depending on when a pet is neutered the prostate will either discontinue further growth or shrink as much as 80% in size.

What are symptoms of prostate disease?
Common signs include difficult, painful, or bloody urination or defecation as the diseased prostate puts pressure on the urethra below or colon above.  Narrowing of the urethra an also cause a thinner stream or prolonged time to complete urination.  Incontinence may also be noted.  While in some dogs with prostate disease there be no visible signs, in severe cases systemic signs such as fever, abdominal pain, vomiting, anorexia, or abnormal gait may also be noted.

What diseases affect the size and health of the prostate?
The prostate enlarges naturally in intact males with age.  This is termed benign prostatic hyperplasia.  While not harmful in and of itself, the enlargement can predispose to other issues (infection, cysts) and lead to pressure on the urethra and thus urination issues.  The prostate gland can become infected with bacteria typically secondary to a urinary tract infection.  This can then lead to abscesses or pus filled pockets of fluid.  Prostatic abscesses can be life threatening.  Tumors of the prostate gland while less common in dogs than humans can also develop.  In some cases tumors in other locations such as the testicles can also secondarily affect the prostate.

What testing is involved with prostate disease?
Palpation of the prostate via rectal exam is often the first step looking for abnormal size, shape, or discomfort.  Radiographs may further help define the prostate gland.  Ultrasound is another imaging option to look at the interior structure of the prostate.  This may performed externally through the abdominal wall or via the rectum.  General blood and urine tests are used to determine other potential complicating factors.  A sample can be obtained directly from the prostate via a needle or in some cases a urinary catheter.  In some cases a surgical biopsy may be necessary.

How is prostatic disease treated?
Treatment is based on the involved disease process.  Very commonly castration (neutering) is necessary to lower hormone levels and thus decrease the size of the prostate.  Bacterial infections, some tumors, and benign prostatic hypertrophy all require castration for any decent chance of successful treatment.  Oral antibiotic therapy if necessary is often for a prolonged period of time.  With some forms of prostatic disease surgery may also be necessary.  Prognosis is directly dependent on the specific disease diagnosed.