Introduction

Prostatitis refers to infection of the prostate gland, with or without abscess formation. When abscessation occurs, localized accumulations of purulent material develop within the prostatic parenchyma. Infection occurs as a result of bacteria colonizing the prostatic parenchyma. Normal host prostatic defense mechanisms may be compromised by urinary tract infection, disruption of prostatic parenchymal architecture, altered urine flow, or urine retention. Prostatic cystic hyperplasia, squamous metaplasia, prostatic cysts, and prostatic neoplasia (e.g., Sertoli cell tumor) increase the risk of infection. Abscesses may rupture, resulting in septic peritonitis.

Abscesses primarily occur in older, sexually intact males with prostatitis, squamous metaplasia, or cysts. In a cohort of dogs with prostatic disease, 7.7% had prostatic abscesses.¹ Although prostatic abscesses may occur in dogs as young as two years of age, most are older than eight years. Feline prostatic infections are rare. Dogs are usually brought in because of an acute onset of depression or lethargy, straining when urinating or defecating, hematuria, vomiting, discomfort, and polyuria/polydipsia. Other clinical signs include fever, anorexia, diarrhea, dehydration, and pelvic limb stiffness.

Physical examination may find discomfort on abdominal palpation or lumbar spine palpation. Rectal palpation is typically painful, and abscessed prostates are generally enlarged and asymmetric with fluctuant areas. Scrotal and testicular palpation may reveal masses, enlargement, or increased sensitivity. Additionally, signs of tachycardia, pale or injected mucous membranes, delayed capillary refill, and/or weak pulses may be evident if the dog is in septic shock.

Point‐of‐care ultrasound may reveal abdominal effusion consistent with peritonitis. Abdominal radiographic findings include prostatomegaly with indistinct borders and occasional mineralization. Ultrasonographic prostatic evaluation may reveal alterations in echogenicity and fluid‐filled spaces with irregularly defined margins (Figure 29.1). Fluid within the lesion may have mixed echogenicity or a flocculent appearance. To confirm diagnosis of abscess, aspiration of fluid‐filled pockets in the prostate is tempting, but the concern for rupture and resulting peritonitis is high. Escherichia coli has historically been the most common organism associated with prostatitis and prostatic abscessation. However, a recent study found Staphylococcus spp. to be the most frequently detected in prostatic aspirates.² This same study found that sampling the urine in dogs with prostatic disease may be consistent with bacteria isolates in the prostate. This is supported by another recent study of dogs with prostatic neoplasia;³

Stay updated, free articles. Join our Telegram channel

Join