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Prostatitis diagnosed by FNA in a 14 year old MI American Foxhound

Case Study

Prostatitis diagnosed by FNA in a 14 year old MI American Foxhound

A 14-year-old M American Foxhound with history of soft stool was presented for frequent urination. Physical examination found the patient bright, alert and responsive, with normal anal glands, decreased rectal tone, and prostatomegaly. The only significant finding on urinalysis was the presence of a few sheets of prostate cells. The patient was treated with metronidazole and Ovaban but was re-presented for anorexia and tachypnea. On physical examination pale mucous membranes, tachypneic, and a tense, painful caudal abdomen was present.

A 14-year-old M American Foxhound with history of soft stool was presented for frequent urination. Physical examination found the patient bright, alert and responsive, with normal anal glands, decreased rectal tone, and prostatomegaly. The only significant finding on urinalysis was the presence of a few sheets of prostate cells. The patient was treated with metronidazole and Ovaban but was re-presented for anorexia and tachypnea. On physical examination pale mucous membranes, tachypneic, and a tense, painful caudal abdomen was present. Abnormalities on CBC and blood chemistry were neutrophilia, elevated ALP activity, and mild hyperglycemia. The patient was treated with intravenous fluids, Convenia, Rimadyl, and Pepcid.

DX

Severe suppurative prostatitis

Sonographic Differential Diagnosis

Chronic active prostatitis. Potential emerging prostatic carcinoma. Testicular nodule (no images available).

Image Interpretation

The prostate was significantly enlarged. It measured approximately 4.5 cm with hypoechoic parenchyma and micronodular changes. This is consistent with resolving prostatitis. There is a minor possibility of emerging lymphosarcoma or carcinoma. The testicles were imaged, and an isoechoic nodule was noted in the right testicle. It measured 3 x 1.6 cm.

Outcome

The patient was treated with Colace and Orbax.

Comments

 
 

The painful caudal abdomen was assumed to be related to the prostate or potentially referred spinal pain form disc disease as no other organ pathology was noted other than the prostatitis presentation. Tachypnea is often a manifestation of pain in dogs and cats and was assumed to be the case for this patient. Note the patient was very painful upon imaging the prostate (+ Murphy sign) that would support the pain premise.

 

Clinical Differential Diagnosis

Prostatic enlargement – benign hyperplasia, prostatitis, abscessation, neoplasia. Tense abdomen – peritonitis, progressive prostatic disease, acute liver disease secondary to the therapy, neoplasia with hemoabdomen.

Sampling

US-guided FNA of the prostate revealed severe suppurative inflammation.

Patient Information

Patient Name : Chuck F
Gender : Male, Intact
Species : Canine
Type of Imaging : Ultrasound
Status : Complete
Liz Wuz Here : Yes
Code : 09_00010

Clinical Signs

  • Anorexia
  • Dyspnea
  • Pollakiuria

History

  • Soft stool

Exam Finding

  • Pale Mucous Membranes
  • Prostatic enlargement
  • Tachypnea
  • Tense Abdomen

Images

FuxiaProst

Blood Chemistry

  • Alkaline Phosphatase (SAP), High
  • Glucose, High

CBC

  • Neutrophils, High

Clinical Signs

  • Anorexia
  • Dyspnea
  • Pollakiuria

Urinalysi

  • Prostatic cells present