Treating a Prostate Problem in Dogs

Overview

Just as men have a prostate gland, so do male dogs. The prostate gland surrounds the urethra and lies just behind the rectum. Just like in humans, it stores and secretes a clear fluid that makes up part of the seminal fluid that makes up semen.

When a dog is neutered, most of the prostate gland is removed. Therefore prostate problem in dog is almost never seen in neutered dogs. It is very common, however, in unaltered dogs as they grow older. Prostate cancer is one of the few prostate conditions you can see in castrated dogs.

There are several kinds of problems dogs may develop with their prostate glands. The most common is called benign prostatic hyperplasia, or BPH. This simply means the prostate gland becomes enlarged. The second problem is an infection of the prostate gland. A third, and uncommon problem in dogs, is cancer of the prostate gland.

Symptoms

When the prostate gland becomes enlarged, it presses upward against the rectum. This causes constipation. Dogs with enlarged prostates often walk abnormally, as well. They keep their rear legs stiff and straight and take very small steps. Other signs of a prostate infection include straining to urinate and discharge from the penis of blood or pus.

Diagnosis

Dog prostate problem showing a prostatic adenocarcinoma (most common type of canine prostate cancer). Diagnostic X-Ray shows a soft tissue mass in the region of the prostate
Source: Washington State University

If your dog has symptoms of prostate problems, you should take him to the vet for an evaluation. Most vets will perform a prostate exam as part of a yearly physical for all un-neutered males. The vet inserts a finger into the rectum and palpates the prostate gland, feeling its size and shape. If anything abnormal is detected, an x-ray or ultrasound may be ordered. Most prostrate problems in dogs are not cancerous, but if this is suspected, a biopsy may be taken. Without taking a biopsy, it is impossible to know for certain what is causing the prostate problem.

BPH:

The diagnosis process for BPH in dogs usually involves several steps:

1. Clinical History and Physical Examination: The veterinarian will begin with a thorough physical examination and review of the dog's history. Symptoms of BPH may include straining to urinate or defecate, blood in the urine, frequent urination, and potentially urinary tract infections.
2. Rectal Examination: This examination allows the vet to feel the size of the prostate gland. In BPH, the prostate gland is usually uniformly enlarged and may push up into the abdomen. However, the gland is typically not painful to the touch in dogs with BPH, unlike with conditions like prostatitis or abscess.
3. Urinalysis: A urine sample may be tested for the presence of infection or blood, which could suggest prostate disease.
4. Blood Tests: These can help to rule out other conditions that might be causing similar symptoms.
5. Imaging: Ultrasound is the most common imaging method used to assess the prostate gland. It allows the vet to visualize the size and structure of the gland and can help to distinguish BPH from other prostatic conditions, like tumors or cysts. Radiographs (x-rays) can also be helpful, particularly if there's concern about whether the condition has spread to other areas of the body.
6. Cytology or Biopsy: These are more invasive tests where a sample of cells or tissue is taken from the prostate gland for analysis. This is generally only done if there is a concern about prostate cancer, as BPH can usually be diagnosed with less invasive methods.

Remember that while BPH is common and generally less serious than conditions like prostate cancer, any changes in urination or general health should be checked by a vet to rule out more serious conditions and to discuss treatment options. Neutering is often recommended to treat and prevent BPH in dogs, as the condition is driven by male hormones.

Prostatits:

The diagnosis of prostatitis in dogs can be complex due to the wide range of potential symptoms, which can include anything from changes in urination and defecation patterns, to systemic signs like fever and lethargy. Diagnostics can include a physical examination, urine tests, blood tests, imaging (like ultrasound), and sometimes more invasive tests like a biopsy of the prostate.

Visit our guide on Canine prostate cancer to learn more about this disease and treatment options.

Prostatic Abscessation:

Diagnosing prostatic abscessation often involves several steps:

1. Clinical History and Physical Examination: The vet will begin with a thorough physical examination and review of the dog's history. Symptoms may be similar to those seen in prostatitis, such as fever, changes in urination, abdominal pain, and lethargy.
2. Rectal Examination: During this exam, the vet will be able to palpate the prostate gland. In the case of an abscess, the prostate may feel enlarged, irregular, and could be painful to the touch.
3. Urinalysis and Urine Culture: A sample of the dog's urine will be tested for the presence of bacteria and white blood cells, which are signs of infection. A urine culture can help identify the type of bacteria causing the infection, which can guide treatment decisions.
4. Blood Tests: Blood tests may show signs of systemic infection, such as an elevated white blood cell count. Blood tests can also rule out other systemic conditions that could be causing similar symptoms.
5. Imaging: Imaging is a critical part of diagnosing a prostatic abscess. An ultrasound can often visualize an abscess within the prostate, and it can help distinguish an abscess from other conditions, like tumors or BPH. In some cases, an x-ray or CT scan might be used for additional detail.
6. Cytology or Biopsy: In some cases, a fine needle aspirate or biopsy may be performed to confirm the presence of an abscess. This involves inserting a needle into the prostate (under ultrasound guidance) to collect a sample of the fluid or tissue.
7. Semen Evaluation: In breeding dogs, an evaluation of the semen might be performed to look for signs of infection.

Prostatic abscesses in dogs are serious and can be life-threatening if not treated promptly.

Treatment

The simplest treatment of prostate problems is to have the animal neutered. Neutering will prevent problems from occurring, but if an un-neutered male develops problems (and most unaltered males will by age eight), neutering him then will solve the problem.

PBH: 

Here are some of the treatment options for PBH:

1. Neutering (Castration): This is the most definitive treatment for BPH. Neutering removes the source of testosterone, which is the hormone that stimulates the growth of the prostate gland. Within a few weeks of castration, the prostate will usually shrink significantly.
2. Hormonal Therapy: In some cases, hormonal therapy may be considered as an alternative to neutering, particularly for dogs that are used for breeding. Medications such as finasteride or osaterone acetate can inhibit the effects of testosterone on the prostate gland, helping to reduce its size.
3. Antibiotics: If there is a concurrent urinary tract infection or prostatitis, antibiotics may also be necessary.
4. Pain Relief and Supportive Care: If the dog is experiencing discomfort or difficulty defecating, pain relief may be needed, along with other supportive care.
5. Monitoring: If the BPH is mild and not causing any discomfort or other problems for the dog, sometimes the best approach may simply be to monitor the situation. Changes in the dog's urination or general health should be reported to the vet promptly.

In any case, the best course of treatment should be discussed with a vet, taking into account the dog's age, overall health, and the severity of the BPH. While BPH itself is not a life-threatening condition, it can lead to complications such as urinary tract infections, and it can cause discomfort for the dog. Also, it's important to note that the presence of BPH can make it harder to diagnose other, more serious conditions like prostate cancer, so regular check-ups are important.

Prostatitis:

• Small (ie, diameter, <10 mm) prostatic abscesses can be treated with castration (surgical or medical) and antimicrobials alone, with or without percutaneous needle drainage. This treatment is safe, has a relatively high success rate, and may be preferable to surgical intervention.⁽¹⁾
• Medical castration with osaterone acetate, delmadinone acetate, or deslorelin acetate is less invasive and safer than surgical castration in systemically ill and potentially unstable patients. In addition, surgical castration during active prostatic infection can increase the likelihood of scirrhous spermatic cord formation.⁽¹⁾

Treatment for prostatitis generally involves the following steps:

1. Antibiotics: Since most cases of prostatitis are due to bacterial infections, antibiotics are the mainstay of treatment. The course of antibiotics may be quite long, often several weeks to a few months, because it is difficult for antibiotics to penetrate the prostate gland. The exact antibiotic used will depend on the type of bacteria causing the infection, which is typically determined through a urine culture.
2. Pain Relief: Pain relief medications may be needed, as prostatitis can cause significant discomfort. Nonsteroidal anti-inflammatory drugs (NSAIDs) are often used.
3. Supportive Care: This can include fluids to prevent dehydration, especially if the dog has been vomiting or has diarrhea, and dietary changes if the dog is having trouble defecating due to an enlarged prostate.
4. Neutering: For intact males, neutering is often recommended once the acute infection is under control. This reduces the level of circulating hormones that can contribute to prostate enlargement and make infections more likely. 
5. Surgical Drainage or Prostatectomy: In severe cases or if there is an abscess in the prostate that doesn't respond to antibiotics, surgical intervention may be required. This might involve draining an abscess or, in rare cases, removing the prostate gland entirely.
6. Frequent Follow-ups: Regular follow-up visits will be necessary to monitor the dog's response to treatment and to adjust the treatment plan as necessary.

It's important to note that prostatitis can be a serious and life-threatening condition if not properly treated. If you suspect your dog has prostatitis, it is critical to consult with a veterinarian as soon as possible.

Prostatic Abscesses:
Treatment generally involves long-term antibiotic therapy, and often surgical intervention is required to drain the abscess. If the dog is intact, neutering is generally recommended to reduce the influence of male hormones on the prostate gland.

Prostate Cancer: 

Cancer of the prostate is rare in dogs, but it is a possibility. If it is cancerous, then there is a possibility that cancer may have spread to other parts of the body. Your vet can talk to you about treatment options. Treatment will include a combination of surgery, chemotherapy and radiation. 

Dog Prostate Cancer Life Expectancy:

The prognosis for a dog with prostate cancer can vary widely and depends on several factors, including the stage of the disease at diagnosis, the type of cancer, the dog's overall health, and the treatment pursued.

Prostate cancer in dogs is generally quite aggressive and often advanced at the time of diagnosis, as early stages of the disease may not show symptoms.

Without treatment, the prognosis is generally poor, with life expectancy often being a matter of weeks to a few months.

Even with treatment, prognosis remains guarded. Treatments may include surgery, chemotherapy, radiation therapy, or palliative care to manage symptoms. However, the anatomical location of the prostate and the typical extent of the disease at diagnosis often make surgery and radiation therapy difficult or not possible. The response to chemotherapy varies, and while it may help slow the disease progression and manage symptoms, it is usually not curative.

In cases where treatment is possible and successful, it can potentially extend the life expectancy of a dog with prostate cancer to 1-2 years, but this is not guaranteed.

It's important to note that the quality of life for the dog is a crucial factor to consider. Veterinarians aim to ensure that any treatment provided offers the dog a good quality of life for as long as possible.

Enlarged Prostate Treatment:

1. Antibiotics: The antibiotics are used to fight off the bacterial infection. The choice of antibiotic is usually based on the type of bacteria involved, which can be identified by a culture and sensitivity test of a urine sample, or sometimes of a prostatic fluid sample. The course of antibiotics may need to be quite lengthy, often for a minimum of 4-6 weeks and sometimes longer, to ensure that the infection is completely eradicated.
2. Anti-inflammatory drugs: These may be used to help reduce inflammation and discomfort. Non-steroidal anti-inflammatory drugs (NSAIDs) are often used for this purpose, though their use needs to be monitored by a vet due to potential side effects.
3. Supportive care: This might include pain management, fluid therapy if the dog is dehydrated, and nutritional support.

In severe cases, or in cases where the infection is not responding to medication, more invasive treatments may be needed. This might include surgery to drain abscesses or remove portions of the prostate. In some cases, neutering the dog can help prevent future infections by reducing the levels of hormones that stimulate prostate growth.

Natural Remedies for Dog Prostate Problems

Herbal remedies have been created where ingredients have a specific role to play in reducing swelling and normalizing the size of the prostate or treating the symptoms that go with prostate problems. Supplements such as herbal drops are particularly used by owners that do not want to have their male dogs neutered and want a natural remedy for a dog prostate problem. 

Common ingredients include:

• Sabal Serrulata (Saw Palmetto) and is known to be highly effective in treating the symptoms of an enlarged prostate. In human trials Saw Palmetto has been shown to be as effective as prescription drugs at reducing symptoms but without the negative side-effects. It contains natural substances for reducing inflammation of the prostate gland.
  
  
• Galium aperine(Cleavers): Regular use helps to expel toxins from the body. Clinically, it is most useful for conditions involving inflammation and swelling of glands (glandular fever, tonsillitis, mumps and prostate swelling) and for problems involving the urinary system.
  
  
• Echinacea purpurea is the best known and researched herb for stimulating the immune system. Over 500 scientific studies have documented the effectiveness of this herb. Research has shown that Echinacea increases the activity of the immune system cells, stimulates new tissue growth for wound healing, reduces inflammation and inhibits growth of bacteria, viruses and fungi. These properties make Echinacea the ideal herb for reducing prostate inflammation as well as preventing all types of infections of the prostate including bacterial prostatitis - another cause of prostate and urinary symptoms in dogs.
  
  
• Baryta carb (30C) is a homeopathic ingredient effective in reducing prostate enlargement, frequent urination as well as burning on urinating.

A good commercial source to explore for natural prostate supplements is PetAlive ProsPet for pet prostate problems.  Only use in consultation with your veterinarian.

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In addition to specific therapies recommended by your veterinarian, consider adding a homeopathic product such as Prospet Drops, which are formulated to support prostate health.

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References

(1) Diagnosis, Treatment, & Prognosis of Prostatitis in Dogs | Clinician's Brief (cliniciansbrief.com)
(2) Prostate Enlargement, Foster, Race DVM, and Smith, Marty, DVM

(3) The Canine Prostate: What It Does and Why Does It Grow So Much, Romagnoli, S.

(4) Prostatic Disease in the Dog, Holt, Peter E.

(5) Diagnosis and Management of Canine Prostatic Disorders, Professor Peter Holt, University of Bristol, Department of Clinical Veterinary Science

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