Effects of finasteride on size of the prostate gland and semen quality in dogs with benign prostatic hypertrophy.

OBJECTIVE: To determine the effect of the 5alpha-reductase inhibitor finasteride on prostatic diameter and volume, semen quality, and serum dihydrotestosterone (DHT) and testosterone concentrations in dogs with spontaneous benign prostatic hypertrophy (BPH). DESIGN: Double-blind placebo-controlled trial. ANIMALS: 9 dogs with BPH. PROCEDURE: Five dogs were treated with finasteride for 16 weeks (0.1 to 0.5 mg/kg [0.05 to 0.23 mg/lb] of body weight, PO, q 24 h); the other 4 received a placebo. Prostatic diameter, measured radiographically, prostatic volume, measured ultrasonographically, semen quality, and serum DHT and testosterone concentrations were evaluated before and during treatment. After receiving the placebo for 16 weeks, the 4 control dogs were treated with finasteride for 16 weeks, and evaluations were repeated. RESULTS: Finasteride significantly decreased prostatic diameter (mean percentage decrease, 20%), prostatic volume (mean percentage decrease, 43%), and serum DHT concentration (mean percentage decrease, 58%). Finasteride decreased semen volume but did not adversely effect semen quality or serum testosterone concentration. No adverse effects were reported by owners of dogs in the study. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that finasteride can be used to reduce prostatic size in dogs with BPH without adversely affecting semen quality or serum testosterone concentration.

Prostatic disorders in the dog.

Common canine prostatic disorders include benign prostatic hypertrophy (BPH), prostatitis, prostatic cysts and prostatic adenocarcinoma. BPH is a spontaneous and age-related disorder of intact male dogs, which occurs in more than 80% male dogs over 5 years of age, and which is associated with clinical signs of sanguinous prostatic fluid, constipation and dysuria. BPH signs respond to castration or to finasteride treatment (0.1-0.5 mg/kg per os once daily), as finasteride inhibits conversion of testosterone to dihydrotestosterone, causing prostatic involution via apoptosis. BPH often occurs concurrently with prostatic infection, abscessation, cysts and neoplasia in the intact dog, and finasteride-induced prostatic involution may be beneficial in treatment of all of these conditions except neoplasia. Two studies suggest that risk of prostatic adenocarcinoma is increased in neutered, compared to intact male dogs. Although canine prostatic neoplasia, unlike human prostatic neoplasia, usually does not respond to androgen deprivation, recent reports of prostatic intraepithelial neoplasia (PIN) in a high percentage of older male dogs, with and without prostatic adenocarcinoma, suggests that PIN may be a precursor to adenocarcinoma in the dog as it is believed to be in man.

Ultrasonographic features of intestinal adenocarcinoma in five cats.

Adenocarcinoma, followed by lymphosarcoma, are the most common feline intestinal neoplasms. Clinicopathological, survey radiographic, and ultrasonographic findings of five cats with intestinal adenocarcinoma are reported. An abdominal mass was palpable in all five cats, but the mass could be localized to bowel in only two cats. Radiographically an abdominal mass was detected in only one cat. Ultrasonographically there was a segmental intestinal mural mass in all five cats. The mass was characterized by circumferential bowel wall thickening with transmural loss of normal sonographic wall layers. In one cat, the circumferential symmetric hypoechoic bowel wall thickening was similar to that reported for segmental lymphoma. In the other four cats, the sonographic features of the thickened bowel wall were varied, being mixed echogenicity and asymmetric in 3 cats and mixed echogenicity and symmetric in one. The results of the present report suggest that sonographic observation of mixed echogenicity segmental intestinal wall thickening in the cat represents adenocarcinoma rather than lymphosarcoma, although other infiltrative diseases should be considered.

Acalculous cholecystitis in four canine cases: ultrasonographic findings and use of ultrasonographic-guided, percutaneous cholecystocentesis in diagnosis.

Canine cholecystitis is diagnosed infrequently. Clinical signs, physical examination findings, and clinicopathological abnormalities are nonspecific. Few reports exist of associated ultrasonographic findings which also are nonspecific for the disorder. Ultrasonographic-guided, percutaneous cholecystocentesis has been suggested for diagnostic confirmation. The present report further documents ultrasonographic findings associated with canine acalculous cholecystitis and demonstrates the utility of ultrasonographic-guided, percutaneous cholecystocentesis in confirmation of the diagnosis in a prospectively acquired clinical case series.

Clinical and radiographic evaluation of intertrochanteric osteotomy in dogs: a retrospective study of 18 dogs.

OBJECTIVE: To determine whether intertrochanteric osteotomy (ITO) can prevent the progression of degenerative joint disease (DJD) in dysplastic hip joints. STUDY DESIGN: The results of ITO were assessed retrospectively by using owner questionnaires, physical examination, and radiographic evaluation. ANIMALS: Eighteen client-owned dogs (29 coxofemoral joints were evaluated). METHODS: Lameness was scored according to a grading system. A scoring system was also developed to assess radiographically evident osteoarthritis on a ventrodorsal projection of the coxofemoral joints in extension. RESULTS: Twenty-nine ITO were performed in 18 dogs with varying degrees of hip dysplasia. The dogs were lame on 19 of 29 rear limbs on physical examination before surgery. In 22 of the 29 hip joints, palpation caused signs of pain. The median age at the first and second surgical procedure was 14.5 months and 18 months, respectively. Follow-up evaluation was performed on average at 9.77 (FU I), 22.52 (FU II), and 47.50 months (FU III) after surgery. Based on the owners' evaluation, there was a tendency toward improvement after surgery. The results of the physical examination at the preoperative examination and at the three follow-up examinations did not differ significantly. The follow-up radiographic scores showed significantly worse DJD than the preoperative scores. CONCLUSIONS: ITO does not prevent progression of DJD in the dysplastic hip. CLINICAL RELEVANCE: Knowledge of the long-term effects of ITO is essential for surgeons trying to achieve improvement in dogs with hip dysplasia.

Canine gastric neoplasia: utility of ultrasonography in diagnosis.

The utility of ultrasonography in the diagnosis of canine gastric neoplasia was evaluated prospectively in a series of six cases subsequently confirmed as having adenocarcinoma by cytological or histological examination or both. Gastric neoplasia was associated with mural thickening with loss of normal wall sonographic layers and decreased or absent local motility. Sonographic findings were consistent with tumor localization obtained by other diagnostic methods employed. Ultrasonographic-guided, percutaneous, fine-needle aspirations biopsies were successful in two of the three cases in which they were performed. Ultrasonography appears useful in the diagnostic of canine gastric neoplasia.

Long-term results of treatment of traumatic coxofemoral joint dislocation in dogs: 64 cases (1973-1992).

OBJECTIVE: To determine long-term results of various treatments for traumatic coxofemoral joint dislocation in dogs. DESIGN: Retrospective case series. ANIMALS: 64 dogs that underwent closed reduction and bandage stabilization, extracapsular suture stabilization, transacetabular pinning, toggle pinning, DeVita pinning, or femoral head and neck excision. PROCEDURE: Follow-up evaluations included owner evaluation (64 dogs), physical evaluation (23), and radiography (19). Follow-up time ranged from 8 to 156 months. RESULTS: Owner evaluation scores after closed reduction were significantly better than scores after DeVita pinning, extracapsular suture stabilization, and femoral head and neck excision. On physical examination, 6 of 23 dogs were lame on the side of the previous dislocation. Signs of pain and crepitation were evident during palpation of 12 and 8 of 25 joints, respectively. Thirteen of 21 joints had radiographic evidence of degenerative joint disease. There was a greater progression of degenerative joint disease in previously dislocated joints than in unaffected joints. There were not any significant differences between treatments in regard to results of physical and radiographic evaluation. Time between trauma and treatment and existence of concomitant injuries did not influence follow-up results, but there was a significant association between body weight and radiographic evaluation score. CLINICAL IMPLICATIONS: Concomitant injuries do not appear to justify a worse prognosis in dogs with traumatic coxofemoral joint dislocation, nor does a delay in treatment of > 3 days. Gait abnormalities and degenerative joint disease might develop in the long term. Proper body weight should be maintained regardless of treatment.

Percutaneous needle biopsy of the kidney. Indications, applications, technique, and complications.

During the past three decades, percutaneous renal biopsy has evolved as a valuable method of clinical evaluation of patients with various forms of glomerular proteinuria and primary renal failure. The advent of automated core biopsy needles and ultrasound guidance has substantially improved the safety of needle biopsy techniques and almost eliminated the need for surgical wedge biopsy.

Feline perineal urethrostomy: a potential cause of feline lower urinary tract disease.

Perineal urethrostomies are associated with complications that may mimic primary causes of feline lower urinary tract disorders. Though postoperative urethral strictures may be minimized by proficiency with an effective surgical technique, removal of the distal urethra may result in bacterial urinary tract infections in 25% to 30% of patients after surgery. Urinary tract infections caused by urease-producing microbes may induce struvite urolith formation. Thus the prophylactic benefits of minimizing recurrent urethral obstruction by urethrostomy must be weighed against a long-term predisposition to recurrent bacterial urinary tract infection and urolith formation.

Medical management of iatrogenic rents in the wall of the feline urinary bladder.

Surgical closure may not be necessary to successfully manage all patients with ruptured urinary bladders. If the margins of the walls of tears in the bladder wall are not devitalized, and if they remain in close apposition via maintenance of the bladder lumen in a nondistended state for an appropriate period, these conditions may simulate those created by use of surgical sutures. This is not advocating an all-or-none choice. Because the clinical status of patients with ruptured urinary bladders can range from that characterized by only hematuria and dysuria to life-threatening postrenal uremia, a range of surgical and medical options should be considered.

Prednisolone therapy of idiopathic feline lower urinary tract disease: a double-blind clinical study.

A double-blind clinical study was performed to evaluate prednisolone as treatment for idiopathic feline lower urinary tract disease. No differences in response were observed in prednisolone- and placebo-treated cats.

Diagnostic imaging of the feline lower urinary tract.

Survey radiography, double contrast cystography, and antegrade urethrocystography are valuable imaging tools available to the clinician for evaluation of cats with lower urinary tract disease. However, to be cost effective during patient evaluation, diagnostic radiographic procedures should be used only when needed. An algorithm is presented that describes when radiographic imaging techniques may be most cost effective in providing useful information during the clinical workup of cats with lower urinary tract disease.

Efficacy of radioprotective agents in preventing small and large bowel radiation injury.

PURPOSE: A variety of adjuvant treatments and cytoprotective agents have been proposed to lessen the toxicity of radiation therapy. The following study was designed to evaluate the benefit of six agents or combinations using anastomotic bursting strength as a measure of transmural radiation injury. METHODS: The 40-Gy study consisted of the following. Seventy-two male Sprague-Dawley rats were divided into eight equal groups: nonradiated control, radiated untreated control, and six radiated treated groups. The radioprotective treatments included ribose-cysteine (Rib-Cys), WR-2721, glutamine, vitamin E, MgCl2/adenosine triphosphate, and RibCys/glutamine in combination. Radiated animals received 40 Gy to the abdomen. Two weeks after radiation, all animals underwent small bowel and colonic resection with primary anastomosis. Animals were sacrificed one week postoperatively, at which time anastomoses were evaluated and bursting strengths determined. The 70-Gy study consisted of the following. The same protocol was repeated for five groups of nine rats divided into nonradiated, radiated untreated, and three radiated treated groups receiving RibCys (8 mmol/kg), RibCys (20 mmol/kg), and WR-2721. All radiated animals received 70-Gy doses. RESULTS: In the 40-Gy group, there were 10 radiation-related deaths and 6 anastomotic leaks among 70 rats studied. None of the differences between groups were significant. Nonradiated control group small bowel and large bowel anastomotic bursting pressures were significantly elevated compared with all radiated groups. Compared with radiated controls, there were significant improvements in small bowel bursting strength in the RibCys, WR-2721, RibCys-glutamine, and vitamin E groups and significant improvement in colonic bursting strength in MgCl2/adenosine triphosphate, WR-2721, and RibCys groups. In the 70-Gy group, all nine nonradiated control rats survived. All eight untreated radiated control rats died, four of eight WR-2721 animals died (P = 0.03), all RibCys (8 mmol/kg) animals died (P = 0.03), and three of nine treated with RibCys (20 mmol/kg) survived (P = 0.08). CONCLUSIONS: WR-2721 and RibCys gave consistent protection against large and small bowel radiation injury. The lower incidence of treatment-related toxicity and potentially equal or greater radioprotective effects may make RibCys more clinically useful than WR-2721.

Vaginal septa in dogs: 15 cases (1983-1992).

Medical records of 15 dogs with vaginal septa, examined between April 1983 and December 1992, were reviewed. Overall prevalence of vaginal septation at the hospital during the study period was 0.03%. Thirteen breeds were represented; mean age at the time of initial examination was 2.4 years. Owners' original complaints included inability to breed naturally, dysuria, urinary incontinence, infertility, recurrent vaginitis, ambiguous external genitalia, and dystocia. One dog did not have clinical signs associated with the vaginal septum. In 11 of the 15 dogs, the septum could be palpated during digital vaginal examination. The septum could be seen in 6 of the 7 dogs in which vaginoscopy was performed. Twelve of the 15 dogs underwent positive-contrast vaginography; in all 12, the septum could be easily seen. Four of the 15 dogs underwent removal of the septum, with or without episiotomy, and 4 others were ovariohysterectomized. One dog was bred by means of artificial insemination and became pregnant. The remaining 6 dogs were lost to follow-up.

Protective effect of RibCys following high-dose irradiation of the rectosigmoid.

UNLABELLED: Ribose-cysteine (RibCys) is a prodrug of L-cysteine that stimulates glutathione biosynthesis. Increased glutathione levels have been shown to have a protective effect against radiation-induced injury and oxidative stress. Surface oximetry has previously been used successfully to predict anastomotic leakage. PURPOSE: The following study was done to evaluate the protective effect of RibCys and the predictive value of PtO2 determinations in a swine model. METHODS: Domestic swine were divided into three groups: Group A served as a nonradiated control; Group B received 6,000 to 6,500 rad to the rectosigmoid; and Group C received RibCys (1 g/kg) prior to receiving 6,000 to 6,500 rad. Radiated animals and controls underwent rectosigmoid resection after a three-week rest period. Intraoperative anastomotic PtO2 was checked with a modified Clark electrode. Anastomoses were evaluated radiographically at three and seven days; animals were sacrificed, and bursting strength was recorded at 10 days. RESULTS: Mean bursting pressures were 243.8 +/- 59.4, 199.5 +/- 37.8, and 209.5 +/- 54.9 mmHg (NS) for Groups A, B, and C, respectively. Anastomotic PtO2 ranged from 19 to 98 mmHg and could not be correlated with anastomotic leaks or bursting pressure. There were 11/15 radiation-related deaths and leaks (eight deaths and three leaks) in the radiated group and 4/12 radiation-related deaths and leaks (three deaths and one leak) in the group receiving radiation and RibCys (P < 0.04). CONCLUSIONS: 1) RibCys protected animals against radiation-related deaths and anastomotic leaks following high doses of pelvic irradiation; 2) anastomotic PtO2 levels did not correlate with anastomotic healing in this model.

A retrospective evaluation of stifle osteoarthritis in dogs with bilateral medial patellar luxation and unilateral surgical repair.

The effects of surgical and nonsurgical therapy on the development of osteoarthritis were compared in 12 dogs with bilateral medial patellar luxation and unilateral surgical repair. Evaluations included severity of lameness and patellar luxation, ligamentous stability, range of motion, and radiographic evidence of osteoarthritis before surgery and at a mean of 33 months after surgery. Stifles without surgical treatment served as controls for the contralateral stifles with surgery. All stifles treated surgically had reduced patellofemoral joints, normal range of motion, and improved limb use. Osteoarthritis progressed significantly and comparably in both groups of stifles. Progression of osteoarthritis was not correlated with luxation grade, body weight, or interval from surgery to follow-up. Age at surgery was correlated positively with severity of osteoarthritis in the stifles treated surgically.

Ultrasonography of the kidney and prostate gland. Has gray-scale ultrasonography replaced contrast radiography?

Beginning in the late 1970s with the first reports of two-dimensional, gray-scale ultrasonography used to image small-animal abdominal organs, the question of whether to use contrast radiographic or ultrasonographic techniques for urogenital assessment has become increasingly important. In the last five to seven years, the volume of veterinary literature on ultrasonographic imaging equals or exceeds that on contrast radiographic imaging of the small-animal urogenital tract. While the advantages of ultrasonographic over contrast radiographic imaging are obvious for some situations (eg, renal failure or paraprostatic cyst), no overviews critically comparing these techniques have been published to our knowledge. With the increasing availability of ultrasonographic equipment in private veterinary practice, choices between these imaging techniques must be made. Imaging the kidney and the prostate gland are discussed because both techniques are applicable to these organs. Our intent was to determine which of these techniques would be appropriate for the common clinical conditions. This article addresses the advantages and disadvantages of both techniques for renal and prostatic imaging. The perspective provided is based on ten years of clinical experience with both techniques by each of the authors. Clinical scenarios and specific diseases are discussed and the consensus of the authors on the procedure(s) of choice for these situations are described.

Ultrasonographic features of testicular neoplasia in dogs: 16 cases (1980-1988).

For 16 dogs with testicular neoplasia (n = 19 tumors), ultrasonography was performed to determine whether a correlation exists between ultrasonographic features of testicular tumors and cell type. The echogenicity of the tumors varied depending on the size of the tumor and whether the tumor had focal or diffuse distribution within the testis. The ultrasonographic characteristics of Sertoli cell tumors were variable, with no predominant pattern. This variation may be related to tumor size, because 6 of 7 Sertoli cell tumors were greater than 5 cm in diameter. Focal seminomas and interstitial cell tumors less than 3 cm in diameter had hypoechoic texture. Focal seminomas and interstitial cell tumors greater than 3 cm in diameter had mixed echogenicity. Tumors of multiple cell types were greater than 5 cm in diameter and had mixed echogenicity. In valuable breeding dogs with a small (less than 3 cm) focal intrascrotal lesion, testicular ultrasonography would be of benefit for localization of the mass to the testis or epididymis for subsequent biopsy. In dogs with intraabdominal neoplastic testes, ultrasonography may be of benefit in determining intra-abdominal metastases and invasion of contiguous structures.

Experience with the biofragmentable anastomotic ring (BAR) in bowel preoperatively irradiated with 6000 rad.

Previous studies from the authors' laboratory using the biodegradable anastomotic ring (BAR) have demonstrated the safety of this device in animals irradiated preoperatively with the equivalent of 5000 rad; sutured, stapled, and BAR anastomoses all had leak rates of 10 percent or less in this setting. This study was undertaken to assess the safety of the BAR after irradiation with the equivalent of 6000 rad. Thirteen mongrel dogs underwent preoperative irradiation to the rectum and rectosigmoid, receiving 6000 rad according to the nominal standard dose equation. After a three-week rest period, each dog underwent anterior resection of the rectosigmoid and anastomosis with the BAR. The anastomoses were evaluated for early and late healing and anastomotic leaks. The results were compared with previous data from the authors' laboratory using an identical model. Radiographic leaks were found in 7 of 10 sutured anastomoses, 8 of 10 stapled anastomoses, and 3 of 13 BAR anastomoses (P less than 0.01). Comparative clinical leaks were 5 of 10 for sutured, 5 of 10 for stapled, and 3 of 13 for BAR anastomoses. These data suggest that the BAR may offer added safety to an anastomosis after preoperative irradiation. Whether this effect is due to the atraumatic technique of placing the device, improved blood flow to the anastomotic margins, or other factors, is still underdetermined.