Case Study

Prostatitis and paraprostatic cyst in an 11 year old MI German Shorthair Pointer

An 11-year-old MI German Shorthair Pointer dog with a grade II/VI systolic murmur was presented for evaluation of vomiting and gagging. Abnormalities on physical examination were prostamegaly and perianal swelling. Premature ventricular contractions were evident on electrocardiogram. Bloodwork was with normal limits.

DX

Prostatitis and paraprostatic cyst

Sonographic Differential Diagnosis

Likely paraprostatic cyst, concurrent prostatitis, and prostatic carcinoma.
A recheck sonogram is recommended in approximately 5 days on the prostate and fluid filled structure cranial to the urinary bladder.

Image Interpretation

A fluid-filled structure was present cranial to the urinary bladder and appeared to be a paraprostatic cyst. However, since a 2.0 cm shadowing structure was also present, a penetrating foreign body could not be ruled out. The prostate was significantly enlarged at 8.0 cm in long axis with a hypoechoic, relatively uniform parenchyma with pericapsular, hyperechoic, inflammatory pattern. The prostate causes deviation of the descending colon. The testicles were imaged and found to be uniform.

Outcome

None

Clinical Differential Diagnosis

Murmur/VPC’s – cardiomyopathy (dilated/hypertrophic), myocarditis, neoplasia. Prostate – neoplasia, prostatitis, abscess.

Sampling

Ultrasound-guided FNAs were performed to differentiate between prostatic carcinoma, prostatitis, and benign prostatic hyperplasia. Cytology of the prostate revealed marked neutrophilic inflammation with intralesional bacteria and prostatic epithelial cell hyperplasia. Ultrasound-guided drainage of the cystic area revealed the fluid to be serohemorrhagic. Analysis of this fluid would also be recommended to assess for possible peritonitis and help determine whether resection of this cystic area would be recommended.