Yesterday I had the honor of treating “the most handsome dog in Hertfordshire.”
This gorgeous, wide-browed Labrador did indeed have a lovely face — there’s no disputing that.
But it was the other end I had to examine.
Lenny the Labrador
Lenny was full of energy and a regular participant in the local dog show. At 12 years old, he’d come to see me because of repeated episodes of constipation, which his human put down to recently worming his dog (in case you’re wondering, there is no link between deworming and constipation).
But from a clinical perspective, Lenny had started walking oddly on his back legs. (More on this later.)
Long story short, I was suspicious of prostate disease, and a rectal exam was necessary, especially as Lenny was not neutered.
What Is the Prostate Gland?
The prostate is a gland that circles the urethra (through which the dog urinates) below the rectum. It doesn’t normally cause a problem, but when enlarged, the prostate pushes up on the rectum, narrows it and stops feces from passing.
This is why vets assess the prostate via a rectal examination; it’s a useful way of feeling the prostate to see if it’s enlarged or tender.
When Things Go Wrong With the Prostate
Lenny’s rectal exam revealed a huge prostate, causing an almost total block of his rectum. His human took it all in good humor, as he also had prostate problems and was amused his dog had come out in sympathy. (Too much information?)
Prostate disease is common in older male dogs. The male hormone, testosterone, “feeds” the glandular tissue. Over time, this causes prostatic enlargement and associated problems. This is known as benign prostatic hyperplasia (BPH) and is readily treatable. However, I was concerned about Lenny’s strange gait because another differential, prostatic cancer, can damage the nerves to the back legs, causing lameness.
But hormones and cancer aren’t the only possibilities, and the problem list of common canine prostate problems is summarized below:
Benign Prostatic Hyperplasia (BPH)
- This is the enlargement of the prostate due to long-term testosterone stimulation.
- Symptoms include difficulty passing feces and blood spotting from the penile tip.
- This is by far the most common prostatic problem in dogs, occurring in unneutered (entire) dogs.
- Rarer than BPH, there is a slightly higher chance of a dog suffering from prostatic cancer if he is neutered.
- Symptoms include constipation but also difficulty passing urine.
- As the cancer progresses, some patients develop a hind leg lameness that doesn’t improve with pain relief.
Prostate Gland Infections (Prostatitis)
- This is uncommon, but it more often occurs in unneutered dogs.
- The signs often involve fever, poor appetite, abdominal pain and extreme lethargy.
- Prompt treatment with antibiotics and pain relief is required.
BPH and prostatitis respond well to therapy, whereas prostate cancer is difficult to treat. If your vet suspects prostate disease, she may either run diagnostic tests to be 100% certain of the diagnosis, or if there is a strong suspicion of either BPH or prostatitis, she may start treatment to help resolve the issue.
Those tests include an ultrasound exam of the prostate to check its size and texture, and a procedure known as a prostatic flush, where a sample of cells is harvested and sent away for analysis.
Treatment varies depending on the condition:
- Key to treatment is removing the stimulatory effect of the testosterone hormone by surgical neutering or chemical neutering using an implant or anti-testosterone hormone injections.
- New treatments are available in pill form that block testosterone receptors in the prostate gland, depriving it of its “food” source and causing the malnourished prostate to shrink and wither.
- Antibiotics to combat the infection are essential. Ideally, the vet cultures a sample of the prostatic wash to decipher precisely which antibiotic will kill the bugs.
- Pain relief is important to make the dog more comfortable while the antibiotics get to work.
- The position of the prostate gland wrapped around the urethra, like pastry around a sausage roll, makes surgical removal difficult or impossible.
- Often the best that can be done is helping the dog to pee and poop until his quality of life deteriorates.
Happily, it looks like Lenny has BPH, and his lameness is due to arthritis. He’s expected to respond well to treatment on both counts.
A final thought: Although neutering decreases the risk of BPH and prostatitis, it does not reduce the risk of cancer. If your only reason for neutering is to protect against cancer, then think again.
This pet health content was written by a veterinarian, Dr. Pippa Elliott, BVMS, MRCVS. It was last reviewed Sept. 30, 2016.