CASE REPORT 2
A 2-year-old neutered male Yorkshire terrier presented to our hospital for evaluation of priapism of two days' duration.
History
The owners indicated that their bitch had been in heat and that when that had occurred, the patient had an intermittent erection
and was continually licking its penis. Then a few days before presentation to our hospital, after the female was out of heat,
the dog's penis was completely out if its sheath, and the dog was still continually licking it.
Physical examination
On physical examination, the dog was in excellent body condition and weighed 6 lb (2.7 kg). Temperature, pulse, and respiratory
rates were normal. The dog exhibited a popliteal lymphadenopathy. The penis was erect, out of the prepuce, and beginning to
show signs of desiccation. The rest of the physical examination results, including the neurologic examination results, were
unremarkable.
Initial diagnostic tests
The dog was hospitalized, and a CBC, serum chemistry profile, and urinalysis were performed. The CBC results showed lymphocytosis
and eosinopenia (Table 1). The results of the serum chemistry profile, electrolyte measurement, and urinalysis were unremarkable. Abdominal and spinal
radiography revealed no significant findings.
Treatment
An intravenous catheter was placed in a cephalic vein. The patient was then given intravenous diphenhydramine hydrochloride
(2.2 mg/kg slowly). Then atropine sulfate (0.022 mg/kg) was drawn up in a syringe with normal saline to a total of 1 ml. Electrocardiography
was performed during atropine treatment, and treatment was stopped when the heart rate went above 180 beats/min, resulting
in a total of 0.16 mg of atropine given. Ampicillin (11 mg/kg subcutaneously) was administered. The penis was cleaned with
a dilute chlorhexidine solution. A liberal amount of 50% dextrose was applied to the penile tissue to attempt to shrink the
tissue via osmosis, and then a small amount of antibacterial-plus-cortisone ointment was applied.
At discharge, the dog's priapism had resolved slightly (30% to 40%). The owners were instructed to give cefadroxil (22 mg/kg
orally b.i.d.), chlorpheniramine (2 mg orally b.i.d.), and terbutaline sulfate (1.25 mg orally b.i.d.) The owners were instructed
to clean the affected area once a day with chlorhexidine solution and to apply the antibacterial-plus-cortisone ointment to
the affected area twice a day. A follow-up examination was scheduled for the following day.
Follow-up
At the follow-up, the owners reported that the penis had come out of its sheath once the previous evening, and they had applied
a small amount of antibacterial-plus-cortisone ointment and manually pushed it back in. The owners also reported that the
dog was urinating normally. The physical examination showed that the patient was bright, alert, and responsive. The dog's
heart rate while receiving terbutaline was 190 beats/min, but the owners reported no evidence of hyperexcitability.
The following day, the owners returned, stating that the penis was in its sheath about 90% of the time but then it would become
erect and the dog would lick it. We cleaned the penis with chlorhexidine solution and placed it back in its sheath. An Elizabethan
collar was placed on the dog to prevent licking. The owners were counseled about the possibility that the presence of other
unneutered and unsprayed pets in the house may be leading to the erectile activity. The owners were counseled to try dog pheromones
(D.A.P.—Ceva Santé Animale) to attempt to modify the behavior. Terbutaline and chlorpheniramine were continued for one week.
At the recheck examination one week later, the penis was completely in its sheath, and the owners reported no clinical signs
of hyperexcitability from the terbutaline therapy. At the writing of this article, this dog has completely recovered without
any need for surgery.
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