My five year old competition dog has been diagnosed with a swollen prostate. My veterinarian has strongly suggested that I have him neutered. I am very concerned that neutering may affect his work, and given his value for breeding, I am very reluctant to neuter him at this time. Are there any other options available to me?
Enlarged prostates can be a very troublesome and frustrating problem for you and your dog. Indeed neutering may ultimately be necessary, however there are a number of steps that can be taken both from a diagnostic and therapeutic standpoint that may be beneficial.
Symptoms of a prostatic problem can vary widely from those that are extremely obvious to those that are very subtle. Those symptoms that are obvious would include: blood dripping from the end of the penis, straining to urinate, and straining to pass stools. (Frequently with prostatic problems, those stools will be normal or slightly soft but may be smaller in diameter than is typical for your dog). In some dogs the only symptom that will be manifest will be a slight abnormality in the dogs gait, or a slight reluctance to jump. Gait abnormalities that could be recognized would be a slightly wider stance and movement of the hind legs, as well as slight reluctance to move the hind legs over a full range of flexion and extension, in other words, a shortened stride. Any one of these symptoms would suggest the prostate should be evaluated.
The initial evaluation of the prostate is done by palpation. Your veterinarian should be able to tell you if the prostate is enlarged. Curiously a very enlarged prostate might not be able to be palpated, as it's additional weight may pull it forward in the pelvic canal making it impossible to be palpated on rectal exam.
The most common reasons for a prostate to be enlarged would be: prostatic hypertrophy (a swelling of the prostate in response to hormones being produced in the testicles), infection, cysts or tumors. Differentiating the cause of the enlargement is of paramount importance if an appropriate treatment regimen is to be undertaken.
The diagnostic tests used for prostatic enlargement can be performed in a sequence from the least expensive and involved all the way to the opposite end of the spectrum.
1) Complete urinalysis. This is typically done on a voided specimen. Urinalysis does not commonly yield conclusive results but can infer what the problem might be.
2) Cytology and bacterial culture. These tests usually are done under a light anesthetic. A catheter is passed to the proximity of the prostate, the prostate is massaged gently and an aspirate is taken through the catheter. Samples are then submitted to a lab to be evaluated for cell types from the prostate, and to culture the secretion to see if bacteria are present. In some cases an ejaculate can be harvested for the same purpose.
3) Ultrasound. This procedure can be an extremely valuable tool if the first two tests are inconclusive. Ultrasound is best done by a specialist who has experience with this problem.
4) Biopsy. While this is a dramatic step to take, it is in some cases the only way to confirm a suspected diagnosis.
Once a diagnosis has been established, an appropriate treatment regimen can be initiated.
Prostatic infections typically require a prolonged course of antibiotics. The prostate is relatively impervious to many antibiotics, so the choice of therapy is important. Two of the more successful antibiotics are enroflaxin or one the sulfa-trimethoprim combinations. If the culture results suggest that enroflaxin is appropriate, it would be an excellent choice to use, as it can be given at high doses for a lengthy interval of time while being relatively free of side effect. In addition, it has been my experience that this antibiotic causes very minimal if any effect on working ability and energy levels, so that most dogs can be worked while being medicated.
Prostatic cysts or abscesses almost invariably require surgical intervention for drainage. Surgical specialists are typically required for this type of procedure, and will usually recommend a biopsy be taken at the same time as surgery.
Tumors of the prostate are usually severe, and while surgery is required, the prognosis at best is very guarded.
Prostatic hypertrophy requires medical treatment, and results can be highly variable. For many years estrogenic compounds were used, but these products have fallen into sharp disfavor due to the their potential for consequential side effect, and in some cases they can even exaggerate the problem. There are two drugs that have been used with relative success with this problem. While neither is approved for use in male dogs, both have been used with some frequency and reports have been promising. Progestagens can be used to relieve symptoms and maintain sperm counts, but there are some concerns with the overall general health of the animal when these products are used long term. Proscar (finasteride) is a product used in humans with a high level of success, and reports are surfacing regarding its use in dogs. It is however, expensive and there are concerns (at least in humans) about its potential to create birth defects. Both of these products show considerable promise for treatment of prostatic hypertrophy and hopefully additional research will alleviate the concerns regarding their use.
Once the cause of prostatic swelling is established, the hope would be that an appropriate treatment regimen would lead to a long term correction or cure. However, this problem can be very resistant to even aggressive treatment protocols. In those cases in which treatment is not creating desirable results, unfortunately neutering needs to be seriously considered for the well-being of the dog. Neutering eliminates the hormonal influence on the secretory cells of the prostate, thereby helping to decrease its size. This effect is most noticeable when the swelling of the prostate is being caused by hypertrophy, infection or cysts. Neutering has no meaningful effect on prostatic tumors.
If your dog is a valuable breeding animal and it develops prostatic problems, it would be advisable to collect semen and have it frozen once the problem is controlled. The reality of this disorder is that if treatment is unsuccessful, neutering may be necessary, and given the recent improvements in the use of frozen semen, you would be ensured of your ability to have offspring from him.
It has been my experience that neutering a dog in the age group that would typically have prostatic disease would have minimal if any effect on his work. Given the fact that almost all of us, as working dog owners, are primarily concerned with the health of our dogs, the tradeoff of health for future breedings and work should not be much of a contest. With appropriate diagnostic and treatment regimens, hopefully you won't be faced with that decision.
Dr. Henry De Boer Jr. practices veterinary medicine at his Pioneer Valley Veterinary Hospital in western Massachusetts. An accomplished competitor in the sport of Schutzhund, his involvement with working dogs dates to the mid 1960's when he began training and handling hunting dogs. In 1984 he became involved with the sport of Schutzhund and has gradually risen to the level of national competitor. Known primarily as a motivational trainer, he also provides training assistance to others to help them achieve their training goals. His wide range of experience lends a unique understanding to the special veterinary problems of working canines and their handlers. Dr. De Boer provides specialized online veterinary services to working dogs and their owners on his innovative web site http://www.workingk-9vet.com Working K9 Veterinary Consultation Services.