Benign Prostatic Hypertrophy (BPH) in Dogs


Overview of Canine Benign Prostatic Hypertrophy (BPH) 

Benign prostatic hypertrophy (BPH), or cystic hyperplasia, is an age related change of the prostate where the prostate increases in size. This increase in size, or hyperplasia, is a non-cancerous change that generally does not cause clinical problems. BPH is the most common disease of the prostate, and occurs in almost all intact male dogs as they age.

The increase in size is caused by hormonal changes in the ratio of androgens, like testosterone, and estrogens. Most dogs act normal, but if there is a very large amount of prostatic hyperplasia, a dog might become symptomatic.

What to Watch For

Signs of Benign Prostatic Hypertrophy (BPH) in Dogs may include: 

  • Straining to defecate
  • Intermittent or persistent bloody urine
  • Intermittent bloody or clear yellow discharge from the penis

    Even if a dog is showing symptoms, he usually feels fine.

  • Diagnosis of Benign Prostatic Hypertrophy (BPH) in Dogs

  • History and physical exam including digital rectal exam
  • Urinalysis
  • Culture and sensitivity
  • Cytologic (microscopic) evaluation of seminal or prostatic fluid
  • Abdominal radiographs (x-rays)
  • Clotting profile
  • Abdominal ultrasound with or without prostatic aspiration – inserting a needle and syringe into the tissue and obtaining a small sample for cytologic analysis – or biopsy
  • Treatment of Benign Prostatic Hypertrophy (BPH) in Dogs

  • No treatment is needed if the dog is asymptomatic
  • Neutering
  • Estrogen therapy
  • Ketoconazole (Nizoral®)
  • Home Care and Prevention

    If your pet is asymptomatic, that is he has no clinical signs, observe for symptoms associated with an enlarging prostate. If he’s neutered, any clinical signs previously present should improve significantly within a few weeks.

    If the treatment involves neutering, the incision should be monitored for any swelling or discharge.

    If medical management is attempted, careful monitoring of clinical signs and blood tests will be needed.

    The only prevention for BPH is having your dog neutered.

    In-depth Information on Benign Prostatic Hypertrophy (BPH) in Dogs

    Dogs and men are the only two species that experience BPH, but it is so common that nearly every intact dog is affected as they age. The prostate is located just behind the bladder and has two main parts or lobes. Above the prostate is the colon. Dogs with BPH usually have a symmetrical enlargement of both lobes. The enlargement is not painful. Some dogs, specifically the Scottish terrier, normally have larger prostates than other dogs. Most animals with BPH have no symptoms and feel fine. Many times the diagnosis is made on routine yearly physical examination.

    When an enlarged prostate (prostatomegaly) is found on physical, it is important to rule out the causes of pathologic (disease causing) prostatic enlargement. The diagnosis of BPH, itself, is a benign condition that often requires no treatment. As dogs age, testosterone and estrogen levels change, and the prostate cells become larger and more numerous and often form multiple small cysts throughout the prostatic tissue. With time, this leads to a prostate gland that gradually enlarges.

    Unlike in people, the enlarged prostate gland usually does not cause problems urinating, but occasionally may cause changes in bowel movements. A prostate may grow large enough to put pressure on the colon and compress its diameter. Straining to defecate (produce a bowel movement) may be noted. Occasionally, stools formed may be flat and long, like a ribbon, because as the prostate enlarges, the diameter of the colon becomes flattened.

    Along with the increase in prostatic size comes an increase in prostatic blood vessels, or vasculature, and the increase in blood supply may lead to the occasional clinical sign of bloody urine or a bloody discharge from the penis. Other diseases that cause an enlarged prostate gland or similar clinical signs include:

  • Prostatitis. Prostatitis is a bacterial infection of the prostate gland. Usually, the prostate is painful to palpation, and the dog often acts ill. A large prostate and a bloody discharge from the penis or blood in the urine are common signs. Prostatitis may be acute (sudden) or chronic (long term).
  • Prostatic abscess. An abscess is a walled off pocket of infection containing white blood cells, bacteria, and cellular debris. Abscesses occasionally form within the prostate gland in cases of chronic prostatic infections. They may get to be quite large and cause compression of both the colon and urethra. Straining to defecate or urinate may be seen, and most animals are feeling ill.
  • Paraprostatic cyst. Paraprostatic cysts are fluid-filled sacs that are connected to the prostate by a thin stalk. These can occur as a singular cyst or multiple cysts, and they can get very large.
  • Prostatic neoplasia (cancer). Prostatic cancer may closely mimic other types of prostatomegaly, but usually dogs with prostatic cancer have an asymmetric enlargement of one of the lobes of the prostate. Animals with prostatic neoplasia also tend to be systemically ill and have a history of weight loss. Tumors of the prostate are almost always malignant. The most common tumors involving the prostate are adenocarcinoma and transitional cell carcinoma. In contrast to most other types of prostatic disease, prostatic cancer occurs with the same frequency in both intact and neutered dogs. In a neutered male dog with significant prostatomegaly, prostatic neoplasia would be high on the list of potential causes.
  • Squamous metaplasia. Squamous metaplasia is a change in the prostate gland due to elevated blood estrogen levels. The prostate gland generally becomes bilaterally symmetrically enlarged. The main cause of this is an estrogen-producing tumor (Sertoli cell tumor). Long-term oral estrogen supplementation can also cause these changes.
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