Benjamin H. Cassutto, DVM
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Priapism is a condition in male animals in which the penis is erect for more than four hours and is constantly engorged after
the cause of the sexual excitement is no longer apparent.1 Penile desiccation and ischemic necrosis may develop as a result of chronic external exposure of the organ and subsequent
stagnation of blood.
In dogs, there is no standard medical treatment for this condition. If the underlying cause of the priapism cannot be corrected
and the penis becomes irreparably damaged, perineal urethrostomy and penile amputation must be performed. However, in people,
terbutaline, a beta-adrenergic agonist, has been used to successfully treat priapism.2-4 In this article, I describe the successful pharmacologic treatment of priapism in two dogs with a combination of anticholinergic
therapy and terbutaline.
CASE REPORT 1
A 1-year-old miniature pinscher was presented to our hospital for treatment of priapism of three days' duration.
History
The owner had adopted the dog from a shelter one month earlier, and preventive care (vaccinations, deworming) had been performed
before adoption. The dog was then neutered at the same facility. Instead of sutures, tissue glue was used to close the skin
incision initially, and the dog had to be operated on again after reopening its incision.
One week later, the owner left the dog and an intact bitch together in the house. During that time, the patient was constantly
after the female, mounting it and trying to breed. When the owner returned home, she removed the patient from the bitch and
noticed that the patient was lethargic and its penis was completely out of the sheath and not able to be replaced. According
to the owner, the dog was still eating but was polydipsic.
Physical examination
On physical examination, the dog was in excellent body condition and weighed 6 lb (2.7 kg), but it was depressed, dehydrated
(6% to 8%), and febrile (103.9 F [39.9 C]). Oral examination revealed moderate dental tartar and tacky mucous membranes. On
inspection of the genitalia, the penis was erect and out of its sheath. It was becoming desiccated and dirty and was unable
to be replaced in its sheath. Examination of the surrounding area revealed a swelling just below the area of the bulbous penis.
The incision from the neutering procedure was healing appropriately. The penis and incision did not seem painful. The rest
of the physical examination results were unremarkable.
Initial diagnostic tests
Table 1 Abnormal Laboratory Findings
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The dog was hospitalized, and a complete blood count (CBC), serum chemistry profile, and urinalysis were performed (Table 1). The CBC revealed anemia, leukocytosis, monocytosis, and thrombocytosis. The serum chemistry profile results revealed azotemia,
hyperamylasemia, and hyperglobulinemia. The urinalysis revealed hematuria, protienuria, and cocci.
Radiographic examination of the spinal cord was recommended since it is indicated in suspected cases of priapism, but the
owner declined any further tests.
Differential diagnosis
The primary differential diagnosis for priapism is paraphimosis, which is protrusion of the nonerect penis from the prepuce.
This condition was considered to be unlikely in this case because the penis was erect and the arousal or sexual stimulation
was no longer present.
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