Hello
We FNAd a 9 year old intact Rottweiller cross with an enlarged prostate and bloody discharge from his penis.
The prostate had what I consider to be a pattern consistent with prostatitis and possible prostatic abcessation.
Hello
We FNAd a 9 year old intact Rottweiller cross with an enlarged prostate and bloody discharge from his penis.
The prostate had what I consider to be a pattern consistent with prostatitis and possible prostatic abcessation.
My question however is: When we FNAd the prostate, we could see the needle enter the prostate. As we redirected a few times a hyperechoic pattern popped up in that location. It appears to be within the prostate. When we performed the FNA the probe had a considerable amount of pressure and was almost in direct contact with the prostate so we are confident that the needle was in the prostate as this occurred.
After reviewing the images post FNA it appears as though a gas pattern has remained within the prostate. I believe it is within the prostate. We were no where near the colon and we were off of midline so I believe we were not even close to the urethra. The prostate measured 8cm on xrays so we had a big target.
I performed a search but did not find anything. Any idea what might have occurred. I posted a post-FNA image.
Thanks. Brent
Comments
Sprry for th edelay this one
Sprry for th edelay this one slipped through the cracks.
The trail or pattern is that of air from the syringe that leaked into the parenchyma.
You can drain those abscesses and neuter and inject baytril into the abscesses as well and tx baytril clindamycin for 3 weeks. I named this the ADAIN procedure. Abscess drainage antibiotic injection & neuter:)
Here’s a similar case
http://sonopath.com/members/case-studies/search?text=adain&species=All
That’s great info!
The only
That’s great info!
The only issue I had was that my standard 1″ 1-2 needle was nowhere deep enough to reach the abscesses.
Would you use a longer needle or have you drained these through the rectum/colon, or surgically if you can’t reach them. I tried approaching from the ventral and lateral sides and while standing but was not successful.
Is something the length of a spinal needle the best option? And just keep getting longer until you reach the abscesses?
thanks Brent
spinal needle or a 2 inch
spinal needle or a 2 inch 18-20 gauge IV cather would work as well.
Long shot but consider
Long shot but consider gas-forming bacteria within the prostate with the FNA exposing a gas pocket. Has been reported in man:
Emphysematous prostatitis caused by Klebsiella pneumoniae.
Emphysematous prostatitis is a rare condition that is characterized by gas and abscess accumulation in the prostate. We report a 60-year-old man with emphysematous prostatitis caused by Klebsiella pneumoniae. He had a history of recently diagnosed diabetes mellitus and a 16-year history of alcoholic liver cirrhosis. He was admitted due to fever, dysuria and difficult urination. Physical examination revealed lower abdominal tenderness and prostatic fluctuance on digital examination. Leukocytosis, pyuria and elevated C-reactive protein were found. Abdominal radiography disclosed a collection of abnormal air pockets in the lower pelvic cavity and computed tomography scans corroborated the existence of extensive air collection in the prostate. Under the impression of emphysematous prostatitis, the patient was successfully treated with transurethral incision of the prostate and antibiotics for 6 weeks; there were no urinary sequelae during 6 months of follow-up.
Thanks. I was initially
Thanks. I was initially thinking that I released gas somehow.
It was strange. No gas visible prior to FNA and the plunger was fully depressed on the syringe.
I wish I could have recorded it. Could see the needle plainly in the prostate then suddenly the gas appeared. Was strange to watch.
We are going to re-ultrasound, drain the abscesses while we neuter. FNA came back with prostatitis and no evidence of neoplasia. Thanks for the responses. Brent