Using drug therapy to treat priapism in two dogs - Veterinary Medicine
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Using drug therapy to treat priapism in two dogs
Instead of surgically treating two patients with priapism, this practitioner tried a novel pharmacologic therapy with a successful outcome. Here he shares details of these cases—and advises you on how to treat affected dogs.


VETERINARY MEDICINE


CONCLUSION

Priapism is a rare disorder in dogs. However, when it is diagnosed, if the condition does not subside quickly (within 24 to 48 hours), surgical treatment is usually the only option. Reported pharmacologic treatments and supportive care for this condition in dogs include pseudoephedrine, lubricants, topical anti-inflammatories, oral and injectable antibiotics, penile injections of phenylephrine, anticholinergics (e.g. benztropine, atropine, and diphenhydramine), Elizabethan collars to avoid self-mutilation, and, possibly, terbutaline.

Case reports 1 and 2 detailed here are cases of successful treatment of priapism in dogs with terbutaline, which has been shown to be effective in randomized controlled trials in men. This is the first report of the use of terbutaline for priapism in dogs. The limitations of these case reports are clearly that they were not randomized, controlled studies, and combinations of therapies used to treat priapism of other species (men, horses) were used concurrently. However, because of the infrequency of this condition in companion animals, it is unlikely that any larger-scale randomized, controlled studies will be performed.

Despite this, I hope that practitioners faced with this disorder will attempt to use these pharmacologic treatments (after discussing the extralabel usage with owners and getting informed consent), including terbutaline, before subjecting patients to penile amputation.

Benjamin H. Cassutto, DVM
Lightbeacon Veterinary Services
18 Ward Way
Millsboro, DE 19966

REFERENCES

1. Lavely JA. Priapism in dogs. Top Companion Anim Med 2009;24(2):49-54.

2. Shantha TR, Finnerty DP, Rodriquez AP. Treatment of persistent penile erection and priapism using terbutaline. J Urol 1989;141:1427-1429.

3. Priyadarshi S. Oral terbutaline in the management of pharmacologically induced prolonged erection. Int J Impot Res 2004;16(5):424-426.

4. Lowe FC, Jarrow JP. Placebo-controlled study of oral terbutaline and pseudoephedrine in management of prostaglandin E1-induced prolonged erections. Urology 1993;42(1):51-53.

5. Plumb DC. Terbutaline. Veterinary drug handbook. 4th ed. Ames: Iowa State University Press, 2002;806, 182.

6. Rochat MC. Priapism: a review. Theriogenology 2001;56:713-722.

7. Feldman EC, Nelson RW. Disorders of the penis and prepuce. In: Canine and feline endocrinology and reproduction. 3rd ed. St. Louis, Mo.: W.B. Saunders, 2004; 953-960.

8. Carati CJ, Creed KE, Keogh EJ. Vascular changes during penile erection in the dog. J Physiol 1988;400:75-88.

9. Burnett AL. Therapy insight: priapism associated with hematologic dyscrasias. Nat Clin Pract Urol 2005;2(9):449-456.

10. Guilford WG, Shaw DP, O'Brien DP, et al. Fecal incontinence, urinary incontinence, and priapism associated with multifocal distemper encephalomyelitis in the dog. J Am Vet Med Assoc 1990;197:90-92.

11. Kustritz MV, Olsen PN: Theriogenology question of the month: Priapism or paraphimosis. J Am Vet Med Assoc 1999;214:1483-1484.

12. Wilson DV, Nickels FA, Williams MA. Pharmacologic treatment of priapism in two horses. J Am Vet Med Assoc 1991;199:1183-1184.

13. Abber JC, Lue TF, Luo JA, et al. Priapism induced by chlorpromazine and trazadone: mechanism of action. J Urol 1987;137:1039-1042.

14. Orima H, Tsutsui T, Waki R, et al. Surgical treatment of priapism observed in a dog and a cat. Jpn J Vet Sci 1989;51:1227-1229.

15. Erectile Dysfunction Guideline Update Panel. The management of priapism. Baltimore, Md.: American Urological Association, 2003.


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