Case Study

Prostatic carcinoma diagnosed by FNA in a 9 year old MN Shetland Sheepdog

A 9-year-old MN Shetland Sheepdog with history of clinical signs of UTI. Blood work showed progressive elevation of ALP activity and cholesterol but improved triglycerides and low T4. Abnormalities on urinalysis were 1+ proteinuria, hematuria, marked leukocyturia, 4+ bacterial rods, and few epithelial cells. The patient was subsequently treated with Baytril, and on recheck fasted blood work, a mild improvement in cholesterol and ALP activity was evident. Urinalysis, however, still showed trace hematuria, leukocyturia, and 4+ bacterial rods. Urine culture yielded growth of E. coli.

Sonographic Differential Diagnosis

Prostatic carcinoma with localized cystic changes is suspected. Chronic degenerative renal changes.

Image Interpretation

The urinary bladder, trigone, and pelvic urethra presented normal wall thicknesses with anechoic urine and normal tone. No uroliths or sediment were visualized. No evidence of inflammatory or neoplastic changes was noted. The ureters were not visible. The prostate was enlarged and mineralizing with focal, hypoechoic cystic changes; this is highly suggestive of prostatic cancer. This measured 2.9 cm.

DX

Prostatic carcinoma

Outcome

Treatment with Deramaxx and Baytril as a palliative measure was recommended. The patient was referred for consultation with an oncologist. Palliative stent placement, chemoembolization or potential experimental laser therapy possible in this case.

Clinical Differential Diagnosis

Endocrine disease (Cushing’s disease, hypothyroidism), bladder pathology (cystitis, neoplasia, uroliths), prostatic pathology (neoplasia, infection), hepatopathy (cholangitis/cholecystitis).