– 11 yr old male intact Brittany Spaniel – owners complaining that he is licking and eating mud outside (never has done this before) – eating very well – had some diarrhea but then normal BM’s – increased urination with some episodes of straining – caudal abdomen painful on palpation – urine culture positive for streptococci – sensitivities pending – bloodwork shows very mild neutrophilia only – prostate enlarged on rectal exam – smooth and not painful on palpation – u/s: prostatmegaly, heterogenous and 1cm diameter cyst or abscess present; pet painful over prostate when imaging with probe
– 11 yr old male intact Brittany Spaniel – owners complaining that he is licking and eating mud outside (never has done this before) – eating very well – had some diarrhea but then normal BM’s – increased urination with some episodes of straining – caudal abdomen painful on palpation – urine culture positive for streptococci – sensitivities pending – bloodwork shows very mild neutrophilia only – prostate enlarged on rectal exam – smooth and not painful on palpation – u/s: prostatmegaly, heterogenous and 1cm diameter cyst or abscess present; pet painful over prostate when imaging with probe – sublumbar lymphadenopathy – kidneys and urinary bladder normal – pet was started on oral Baytril on the weekend and booked for neuter this week – today presented in worse shape – arched back, uncomfortable – clavamox and Metacam added to Baytril pending culture DDx: BPH with prostatitis, prostate cyst or abscess, neoplasia What do you think of this prostate?
Comments
I am surprised that he is not
I am surprised that he is not painful. The cyst looks echogenic so is likely abscessed and the caudal echogenic aspect that enters the pelvic inlet in an expansive manner. Concerned for neoplasia when irregular like this> I would sedate, drain the cyst/abscess and fna variable areas of the prostate especially the caudal part and set up for neuter if benign and inflammatory. If the cyst is pus filled then you can inject with baytril (bw dose) as well. You can see how I do it in the us guided drainage on this link for members
I am surprised that he is not
I am surprised that he is not painful. The cyst looks echogenic so is likely abscessed and the caudal echogenic aspect that enters the pelvic inlet in an expansive manner. Concerned for neoplasia when irregular like this> I would sedate, drain the cyst/abscess and fna variable areas of the prostate especially the caudal part and set up for neuter if benign and inflammatory. If the cyst is pus filled then you can inject with baytril (bw dose) as well. You can see how I do it in the us guided drainage on this link for members
Strange that he is not
Strange that he is not painful on rectal exam, but painful when examined with u/s probe over the prostate and painful when his caudal abdomen is palpated.
Do you think I can get to this abscess with a needle? It looks like I may risk going through the urethra to get to it.
Strange that he is not
Strange that he is not painful on rectal exam, but painful when examined with u/s probe over the prostate and painful when his caudal abdomen is palpated.
Do you think I can get to this abscess with a needle? It looks like I may risk going through the urethra to get to it.
The prostate may be hanging
The prostate may be hanging into the abdomen so much that the painful part is not where the rectal palpation accesses. Yes you can sample this its 3 cm deep and angle away from the urethra. See the interventional instructions i linked above but if you are right handed put the probe in the left hand and use the probe hand and fingers to press down on the body wall until you get the abscess as close to the body all and your probe as possible…like shooting pool the closer the 8 ball is to the cue ball the less likely you will miss:) Then do the same for the various echogenic presentations of the parenchyma for the fna especially the caudal part. With passive pressure you can get close to anything you need to sample.A 22 x 1.5 inch cysto needle should be all you need. See the attached image and needle placement with distance from the Atlas pathology 400 CD
The prostate may be hanging
The prostate may be hanging into the abdomen so much that the painful part is not where the rectal palpation accesses. Yes you can sample this its 3 cm deep and angle away from the urethra. See the interventional instructions i linked above but if you are right handed put the probe in the left hand and use the probe hand and fingers to press down on the body wall until you get the abscess as close to the body all and your probe as possible…like shooting pool the closer the 8 ball is to the cue ball the less likely you will miss:) Then do the same for the various echogenic presentations of the parenchyma for the fna especially the caudal part. With passive pressure you can get close to anything you need to sample.A 22 x 1.5 inch cysto needle should be all you need. See the attached image and needle placement with distance from the Atlas pathology 400 CD