A 5-YEAR-OLD, 114-lb (51.8-kg) neutered male German shepherd was examined because of a three- to four-week history of bloody
preputial discharge and prostatomegaly. Initial evaluation by this dog's veterinarian had revealed marked prostatic enlargement
on rectal palpation. Cytologic examination of a prostatic wash sample had revealed degenerative neutrophils but no bacteria
or neoplastic cells. A two-week course of oral trimethoprim-sulfadiazine had been dispensed. The discharge resolved initially
but returned when the antimicrobial therapy was discontinued. The dog was then referred to the University of Georgia College
of Veterinary Medicine for further evaluation.
Initial diagnostic procedures
A review of this dog's history revealed that it was born unilaterally cryptorchid and had been castrated at 6 months of age.
The testicle removed through an abdominal approach was not submitted for histopathologic examination. The location of the
scrotal testicle (right or left side) was not noted.
Table 1: Complete Blood Count Results
The dog was bright, alert, and responsive. Thoracic auscultation revealed an intermittent arrhythmia (consistent with a past
diagnosis of atrial premature contractions) with normal lung sounds. Abdominal palpation was unremarkable, and rectal palpation
revealed moderate to severe, symmetric prostate enlargement. Additionally, the prostate was nonpainful on palpation, and the
median prostatic groove was easily palpable. A blood-tinged, serosanguineous discharge constantly dripped from the dog's prepuce
during the examination (and throughout the dog's hospital stay). Occasionally, frank blood was seen in the discharge.
Table 2: Serum Chemistry Profile Results
A complete blood count showed mild hemoconcentration and thrombocytopenia (Table 1). A serum chemistry profile revealed mild azotemia, hypercalcemia, and hypercholesterolemia (Table 2). Complete urinalysis of a urine sample obtained by cystocentesis revealed microscopic hematuria but no bacteria or neoplastic
cells (Table 3). The urine was adequately concentrated, suggesting prerenal azotemia. A bacterial culture from this sample produced only
light growth of Staphylococcus species (colony count about 2,000/ml). The result indicated a contaminant, so sensitivity and susceptibility testing was
Table 3: Urinalysis Results
An abdominal radiographic examination showed moderate prostatomegaly with no evidence of sublumbar lymph node enlargement
(Figure 1). Additionally, mild hepatosplenomegaly was noted. A uniformly enlarged prostate of mostly uniform echotexture was seen on
abdominal ultrasonographic examination. One small prostatic cyst was seen dorsal to the urethra (Figure 2). Splenomegaly was noted, but the splenic architecture was of uniform echotexture. The liver and both kidneys appeared to
be normal. Despite an extensive evaluation, no evidence of a retained abdominal testicle was found. An ultrasound-guided fine-needle
aspiration of the prostate was performed, and microscopic review of this sample revealed only normal prostatic epithelial
cells with no evidence of neoplasia or inflammation.
Figure 1: A lateral radiograph of the dog's caudal abdomen obtained on admission revealing marked prostatomegaly (black arrow).
The white arrow indicates the cranially displaced urinary bladder.