Prostatic cysts after neuter


Oct 4, 2016 – dog presented to our clinic for stranguria. 9 year old intact male Lab x. Had previous episodes of bloody preputial discharge that cleared up with homeopathic remedies, but stranguria was not resolving after treatment so she presented to us for diagnostics. No change on PE according to her, but dog has been less excited about eating lately.
– PE – NSF other than prostate palpated enlarged, but symmetrical and non-painful.
– Abdominal rads – NSF other than large bladder and large prostate.

Oct 4, 2016 – dog presented to our clinic for stranguria. 9 year old intact male Lab x. Had previous episodes of bloody preputial discharge that cleared up with homeopathic remedies, but stranguria was not resolving after treatment so she presented to us for diagnostics. No change on PE according to her, but dog has been less excited about eating lately.
– PE – NSF other than prostate palpated enlarged, but symmetrical and non-painful.
– Abdominal rads – NSF other than large bladder and large prostate.
– Ultrasound – urinary bladder and regional lymph nodes WNLs, but prostate is enlarged with multiple anechoic circular structures (cysts) measuring up to 3cm diameter. Unfortunately no images are available.
– Dog was catheterized and removed 500cc very dark urine. Suspected BPH, so recommended neutering and intermittent catheterization prn.
 
Oct 6, 2016 – dog was neutered by O – at time of sx she noticed a bony swelling of LH (not previously seen, not previously lame). She did not work this up further.
 
Oct 7, 11, 16, 2016 – dog was catheterized as he was straining. Did ok for the next year, but O regretted decision to neuter as he seemed like an old dog afterwards – not as energetic. Did have episodes of thin stream, straining to urinate, not emptying bladder about once/month since (about 50% of time associated with full moon).
 
Oct 6, 2017 – was treated with a homeopathic remedy (Silica 1M) – seemed hunched up, painful, off food, T-39.5, increased pulse, panting but improving the next day and seemed much better overall – peeing improved, coat became shiny, much more active, more strength in hindered – jumped no problem into truck which hadn’t done in a long time.
 
Over the next month – started to decline in his energy, weaker in HL, trouble peeing a month later. No further improvement with repeat of Silica.
 
Nov 9 2017 – Did UA:
– USG 1.039, pH 7.0, 2+ blood, 1+ bilirubin, 3+ protein, hematuria/pyuria on sediment. Put on Amoxil 500mg TID x 7d. Still had trouble urinating, poor appetite. Put on homeopathic remedy Lycopodium LM and urinating better.
 
Dec 6, 2017 – Cultured E coli – sensitive to everything – started on Baytril 375mg SID (ongoing).
 
Dec 12, 2017 – Has been no better/maybe worse so far on Baytril – trouble urinating, frequent attempts, unable to empty bladder, thin stream, dribbles after at times so start back on Lycopodium with the antibiotics.
– We ultrasounded him and found several large round to oval anechoic structures within the prostatic parenchyma that we interpreted as prostatic cysts. The largest cyst was on the right side – it bulged onto the urethra and measured 1.5cmx3.5cm. The left side had several smaller cysts that did not appear to bulge onto the urethra. The urinary bladder/urethra/draining lymph nodes appeared otherwise unremarkable.
 
Unfortunately, the previous images are not available (new machine, backup from previous machine corrupted! 🙁 However, it sounds exactly the same, but I would have thought the cysts would have responded to neutering a year ago?… Thoughts?
 
Thanks in advance. Of course it has to happen to a friend’s dog… I realize a reflex dyssynergia is possible as well…
Jennifer 

One response to “Prostatic cysts after neuter”

  1. Hello Jennifer, this is

    Hello Jennifer, this is really a long post for the forum as the rules of forum engagement are a few short bullet questions and images otherwise it becomes a full consult which is what telemed is for. See the upload telemed tab on the home page for telemedicine options.

    https://sonopath.com/

    Sorry to be bad cop but its my job to keep the forum tight:)

    That being said any prostate with cysts in my book should be drained and cultured and fna the parenchyma to ensure a carcinoma doesnt pop up which being a year out is a potential here. Often males are neutered with prostatic abscesses that need to be drained before they resolve or ADAIN it at neuter like in interventional procedures amnd can be used as palliative treatment for cystic carcinomas:

    https://sonopath.com/resources/instructional-library-interventional-procedures-sonopodcasts

    So if you drain and fna let us know what you come up with.

    Regards

     

     

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