Just saw a 4 year old MI Brittany spaniel w/ hx of inappropriate urination. Free catch urinalysis has show an active sediment, but bladder cysto was clean. Ultrasound showed a bright, smooth, uniform, enlarged prostate (3 cm, so still less than the 5 cm size I have listed as normal for in tact dogs). He does not appreciate rectal exams/palpation of the prostate. I suspect prostatitis; no evidence of absesses or neoplasia grossly. I am recommending a prostatic wash w/ C&S, but just want to see your thoughts on that vs.
Just saw a 4 year old MI Brittany spaniel w/ hx of inappropriate urination. Free catch urinalysis has show an active sediment, but bladder cysto was clean. Ultrasound showed a bright, smooth, uniform, enlarged prostate (3 cm, so still less than the 5 cm size I have listed as normal for in tact dogs). He does not appreciate rectal exams/palpation of the prostate. I suspect prostatitis; no evidence of absesses or neoplasia grossly. I am recommending a prostatic wash w/ C&S, but just want to see your thoughts on that vs. FNA. I suspect I may not get much sample from FNA. Thank you!
Comments
A prostatic wash with
A prostatic wash with cytology and culture sounds like a good idea
Thank you!
Thank you!
I actually prefer fna under
I actually prefer fna under sedation and corkscrew technique; 2 sticks one for cyto and another with a touch of saline in the syringe and drawing back a bit for culture fluid. This way I can target any specifically hot regions or cysts or abscesses. prostatic wash I have found to be more vague on what we are analyzing.
Here is an old paper looking
Here is an old paper looking at various techniques for collectong prostatic material, showing not much difference between methods. Personally prefer FNA as it is quick, involves less material, and as Eric states, you can position the needle.
Powe JR, Canfield PJ, Martin PA. Evaluation of the cytologic diagnosis of canine prostatic disorders. Vet Clin Pathol. 2004;33:150-4.
BACKGROUND:
Canine prostatic disease is commonly investigated using cytologic techniques, especially now that ultrasound-guided fine needle cell aspiration (US-FNA) is widely available. Few studies, however, have evaluated the diagnostic accuracy of prostatic cytology.
OBJECTIVE:
The purpose of this study was to evaluate the usefulness of cytologic investigation of prostatic disease using US-FNA and other methods in comparison with histopathologic diagnosis.
METHODS:
Cytologic and histopathologic specimens of prostate or paraprostatic tissue from 25 adult dogs were retrospectively evaluated. Cytologic samples were obtained by US-FNA, prostatic massage, or direct impression smears or aspirates of tissue at surgery. Histopathologic sections were obtained from tissue collected by biopsy or at necropsy.
RESULTS:
Cytologic diagnoses were categorized as nondiagnostic (n = 2); cyst (n = 1); squamous metaplasia (n = 2); inflammation (n = 4); benign prostatic hyperplasia (BPH; n = 5); inflammation and BPH (n = 3); inflammation, BPH, and neoplasia (n = 1); inflammation and neoplasia (n = 3); and neoplasia (n = 4). Cytologic diagnoses agreed with final histologic diagnoses in 20 of the 25 cases (80%). Of those samples collected by US-FNA, 75% were concordant. Four samples obtained by US-FNA and 1 sample obtained by prostatic massage and wash had discordant results.
CONCLUSIONS:
The results of this study suggest strong agreement between cytologic and histopathologic diagnoses for prostatic conditions. Discordance in results obtained by US-FNA usually was the result of the pathologic process rather than a failure to obtain an appropriate sample.