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Prostatic Abscess

Sonopath Forum

– 5 year old male Bernese Mt Dog w history anorexia, weight loss and sore abdomen

– bloodwork neutrophilia otherwise unremarkable

– chest rads clear, abodominal rads show prostameagly with no evidence of sublumbar LN enlargement or lumbar vertebral lysis

– u/s confirmed enlarged prostate with mixed echotexture and two, irregular cavitory lesions; capsule relatively smooth

– medial iliac LN’s mildly enlarged but more reactive looking with a normal S/L ratio

– 5 year old male Bernese Mt Dog w history anorexia, weight loss and sore abdomen

– bloodwork neutrophilia otherwise unremarkable

– chest rads clear, abodominal rads show prostameagly with no evidence of sublumbar LN enlargement or lumbar vertebral lysis

– u/s confirmed enlarged prostate with mixed echotexture and two, irregular cavitory lesions; capsule relatively smooth

– medial iliac LN’s mildly enlarged but more reactive looking with a normal S/L ratio

– proximal urethral walls maybe mildly thickened but no distinct masses; mild left renal pyelecatasia

– right testicle showed mineral foci with distal shadowing in cranial pole  (incidental?)

I performed my first ADAIN in this case. Aspirated about 1ml of white, thick foul-smelling discharge from one of the cavitory lesions (could not access the other) then injected 50mg enrofloxacin. Then performed several FNA’s of the solid parenchyma. Culture and cytology pending. I beleive this looks more like BPH and prostatitis with abscess formation but being a Berner I am concerned about possible neoplasia. I do see some hyperechoic regions in the prostate parenchyma but nothing that looks like real mineral. Any thoughts? Hopefully cytology will be helpful. I recommended to neuter and rescan in 4-5 weeks.

 

Comments

EL

Nice ADAIN!. If th elast

Nice ADAIN!. If th elast video is whats left post drainage likely will need more drianage and none of this will resolve completely til neuter. I don’t see anything that says carcinoma but I always do parenchymal fna for cyto as well as fluid culture and always neuter at same time to take the hormones out of the scenario. 

If you look at prostatic carcinoma in the search

http://sonopath.com/members/case-studies/search?text=prostatic+carcinoma&species=All

as the tendency of the capsular contour is key. Prostatic neoplasia nearly always blows out the capsule with an inflammatory pattern and expands like squeezing a grape wiht multifocal mini mass effects on the capsule. You can get a bit of the capsular inflammation a really bad prostatitis or abscess but the look is different and usually uniformly deviated and wihtout irregular mutifocal expansion.

This following ADAIN example is about as bad as a prostatic abscess will treat its capsule but even here with septic pelvis there is inflammation of the capsule but no multifocal mini mass effects against it like you see in prostatic neoplasia in th eprior search list.

http://sonopath.com/members/case-studies/cases/prostatic-abscess-treated-abscess-drainage-antibiotic-injection-and-neute

Pankatz

Thank-you EL. The last video

Thank-you EL. The last video was a pre-ADAIN clip but I was only able to target one of the lesions so I am hoping the combination of systemic meds and neutering will help. Will watch this one via ultrasound if the owner (a breeder) allows. $$ is an issue with this one