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Diagnosis of Benign Prostatic Hyperplasia in Dogs by Ultrasonography and Computed Tomography

K. Basava Reddy M. Bhargavi N. Karunakara Rao
Vol 8(2), 313-317
DOI- http://dx.doi.org/10.5455/ijlr.20170723024825

Fifty male dogs of different breeds, aged above five years presented with a history of hematuria, dysuria, and tenesmus were screened for the presence of Benign Prostatic Hyperplasia. Radiography, transabdominal ultrasonography and computed tomography revealed the presence of enlarged prostate in three dogs. Haematology revealed no significant findings. Serum biochemistry revealed significant hypoproteinemia.


Keywords : Benign Prostatic Hyperplasia Computed tomography Dogs Ultrasonography

Introduction

Among the various prostatic disorders in dogs, Benign Prostatic Hyperplasia (BPH) is the most common one.  It is mostly noticed in older intact male dogs above 6 years of age, which results mainly because of androgenic stimulation. Specifically, it is mediated by dihydrotestosterone, which causes symmetric growth (Johnson, 2009). Clinical signs include difficulty in urination, hematuria, tenesmus, urethral discharges etc. The diagnosis of BPH can be done by palpation, radiography, ultrasonography, magnetic resonance imaging (MRI), computed tomography (CT), cytology and histopathology of biopsy specimens. Symmetrical nonpainful enlargement is noted on palpation and increased size is visible on radiography (+/- pneumocystogram, contrast urethrogram) and ultrasonography (Thomas, 2003). The diagnosis of BPH could be confirmed by histopathological studies of biopsy specimens, in which hyperplastic changes, often with microscopic cysts are found, however biopsy is rarely necessary (Johnson, 2009). Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) provide excellent means of diagnosing BPH, but remain as expensive technologies. In the present study, imaging techniques like radiography, transabdominal ultrasonography and computed tomography were employed for the diagnosis of Benign Prostatic Hyperplasia.

Materials and Methods

  A total of fifty male dogs aged above five years presented to Veterinary Hospital, Visakhapatnam with symptoms of lethargy, inappetence (Babu Prasath et al., 2015), hematuria (Das et al., 2017), dysuria (Johnston et al., 2000), tenesmus (Johnson, 2009 and Thomas, 2003) and constipation (Dhivya et al., 2012) were screened for the presence of Benign Prostatic Hyperplasia for a period of one year from January 2016 to December 2016. Detailed physical examination was carried out. Transrectal digital palpation, radiography, transabdominal ultrasonography and computed tomography were performed to evaluate the echogenecity, texture and volume of the prostate gland. Prostatic volume was determined by ultrasonographic examination using the following formula:

[1/2.6 (L×W×D)] + 1.8

where’ L’ is the greatest craniocaudal measurement, ‘W’ is the transverse measurement and ‘D’ is the dorsoventral measurement of the prostate (Memon and Sirinarumitr, 2005).

Whole blood was collected in EDTA vials for the estimation of haemoglobin (Hb), packed cell volume (PCV), total erythrocyte count (TEC), total leukocyte count (TLC) and differential leukocyte count (DLC). Serum was analysed for total protein, serum albumin, blood urea nitrogen and serum creatinine levels.

Results and Discussion

            In the present study, the prominent clinical findings noticed were dysuria, hematuria and tenesmus, previously reported by Johnston et al. (2000), Johnson (2009), Dhivya et al. (2012) and Das et al. (2017). Transrectal digital palpation revealed the presence of enlarged prostate gland localised in the abdomen, previously reported by Gadelha et al. (2009). Digital palpation is relatively easy and inexpensive to perform, but one cannot arrive at a confirmatory diagnosis by this technique alone. Out of fifty dogs, transabdominal ultrasonographic examination revealed the presence of homogenous, hypoechoic, enlarged prostate gland with increased prostatic volume (Fig. 1) in three dogs, as reported earlier by Rajkumar  and Ansarkamran (2016). Ultrasonography allows the exact determination of the size and position of the prostate, without invasive methods or the danger of side-effects (Fritsch and Gerwing, 1985). The prostatic evaluation must be firstly made by the history, clinical signs and rectal palpation but ultrasonography is an important diagnosis method that allows to characterise size, contour, parenchyma, and fluid structures in the gland (Gadelha et al., 2009).

Fig. 1: Transabdominal ultrasound scan showing increase in prostatic volume

Prostatomegaly was the important feature in CT images (Fig. 2) of the above three dogs. The CT examination can be a beneficial diagnostic tool for examining the prostatic size and for evaluating the prostatic tissue (Kuhnt et al., 2017).

Table 1: Prostatic volume of three dogs with BPH

S. No. Case No. Prostatic Volume (ml)
1 4138 128.2
2 6296 125.6
3 8854 127.4

Fig. 2: CT showing Prostatomegaly

The most common CT features in dogs with recognised BPH were symmetrical prostatomegaly and heterogeneity of the prostatic parenchyma (Pasikowska et al., 2015). Haematology revealed no significant findings (Table 2). Hypoproteinemia (Table 2) was the significant biochemical finding which might be due to prolonged period of inappetence, in accordance with the findings of Das et al. (2017).

Table 2: Haemato-Biochemical parameters of three dogs with BPH

Parameter Case No.4138 Case No.6296 Case No.8854
Hb (gm%) 12.6 12.87 13.26
PCV (%) 39.02 39.52 41.26
TEC (106/µl) 6.82 7.20 7.62
TLC (103/ µl) 9.6 10.2 10.8
Neutrophils (%) 66 69 70
Eosinophils (%) 3 2 3
Basophils(%) 1 1
Lymphocytes (%) 28 27 25
Monocytes(%) 2 2 1
Total protein (gm/dl) 3.4 3.8 3.4
Serum Albumin (gm/dl) 1.2 1.6 1.2
BUN (mg/dl) 24 18 21
Creatinine (mg/dl) 0.3 0.4 0.3

Conclusion

From the above findings of the present study, it was concluded that although the routine digital palpation and radiography revealed the presence of enlarged prostate gland, the confirmatory diagnosis of BPH was achieved by performing transabdominal ultrasonography and computed tomography. Since computed tomography is expensive and limited facilities are available in veterinary practice, we make an attempt to know the changes in prostate gland in BPH.

References

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