18 Male Infertility

10 days post partum

At the latest, both testicles should be distended into the scrotum by 16 weeks but not considered cryptoorchid until *6 MONTHS*

When should testicles be distended into the scrotum by?

TRUE

TRUE OR FALSE: cryptorchidism in dogs is hereditary

*Administer hCG* = it will more than double testosterone if testes are present

May also test for Anti-Mullerian hormone

What do you administer to diagnose cryptoorchidism in dogs?

Give 500 IU (small/medium dogs) or 1000 IU (large dogs). Test at 4 and 8 hours, baseline Testosterone should more than double if testicles are more than present

You can administer hCG to dogs to determine whether or not they are cryptoorchid. How does it work?

Bilateral orchiectomy (because if one is torsed, it is likely the other will)

How do you treat testicular torsion?

Testicular tumor

What broad category of tumor is second most common tumor (after skin tumors) in dogs?

Sertoli

What is the *most common* testicular tumor of the dog?

May feminize dog bc of estrogen secretion

What do steroli cell tumors in dogs tend to do? What effect do they have?

With testicular tumors there will be lack of pain on palpation, but you may also use ultrasound and biopsy

How do you differentiate testicular tumors from Brucellosis?

true, some tumors may just cause atrophy of the OPPOSITE testicle (like sertoli)

TRUE OR FALSE: ALL tumors cause testicular enlargement

Cryptorchidism

What increases incidence for tumors in testicles?

A shows an atrophied testicle

B shows enlargement

tumors: sertoli or seminoma

What is happening here? Likely differential?

Enlargement in inguinal testes

Differential: sertoli cell tumor

What is this?

FEMINIZATION (hyperestrogen): alopecia, comedones, hyperpigentation, testicular atrophy, nipples enlarged (gynecomastia)

Tumor: sertoli cell tumor

Describe what you're seeing in this male dog and what could be causing it

ALP is low in seminal fluid (under 5000 U/L) = not able to ejaculate fully

How can incomplete ejaculation be related to azoospermia in dogs (lack of sperm in ejaculate)? What causes it?

Low sperm count in ejaculate

What is oligospermia?

200 million progressively motile spermatozoa

How many spermatozoa do you need in ejaculate to ensure good conception rates in a dog?

Penis, prepuce, vagina, mucous membranes

Name the common places to see TVT's (transmissible venereal tumor)

Transmissible venereal tumor

This tumor is transmitted by contact with mucous membranes and physically has a different number of chromosomes (*59 +/-5 chromosomes, when dogs have 78*)

TVT (transmissible venereal tumor)

What is your top differential here?

TVT

What is your top differential here?

Urethral prolapse

What is this pathognomonic "red pea" at the tip of the penis?

English Bulldogs

Which animal is genetically predisposed to urethral prolapse?

Surgical removal

How do you treat urethral prolapse in male dogs?

Priapism

This is unnatural penile temescence, an erection that won't go away

Benign prostatic hyperplasia

What is the most commonly diagnosed prostatic disease in dogs?

Older *intact* male dogs

What is the most common signalment for benign prostatic hyperplasia?

Benign Prostatic hyperplasia

A dog presents with serosanguinous urethral discharged. Owner says the poop looks "ribbon-y" (which you determine is rectal tenesmus), and on palpation the dog has caudal abdominal pain. You palpate the prostate transrectally to find it is normally smooth, bilobed, symmetrical, not painful, with no lumps or bumps. Thoughts?

Younger = lies on pelvic floor close to pelvic brim

Older = prostate lies over pelvic brim, falling cranially into abdomen

What is the difference in size of the prostate in older versus younger dogs?

BASCIALLY incidence increases as the dog gets older and by 10-12 years old basically ALL intact stud dogs have it

5 years = 60% of intact dogs have it

6 = 80%

9 years = 95% have it

10-12 years = 100%

Talk about the clinical relevance of benign prostatic hyperplasia in dogs at the ages of:

1. 5 years old

2. 6 years old

3. 9 years old

4. 10-12 years old

Prostatic enlargement (benign prostatic hyperplasia)

What is this?

1. acute bacterial prostatitis

2. chronic bacterial prostatitis

3. prostatic adenocarcinoma

4. prostatic and paraprostatic cysts

Name a couple things that should be on your differentials list for benign prostatic hyperplasia?

Acute bacterial prostatitis

This BPH differential is typically associated with *FEVER*, depression, pain on rectal palpation, neutrophilia, and bacteriuria

Chronic bacterial prostatitis

This BPH differential is associated with *recurrent lower urinary tract infections*

Prostatic adenocarcinoma

This BPH differential is typically associated with *poor appetite, weight loss, hind limb weakness*, dysuria, hematuria, and dyschezia

Prostatic and paraprostatic cysts

This BPH differential can cause palpable abdominal cystic masses filled with yellow orange fluid

Hemorrhage, which likely would've shown hematuria

What is this, seen with prostate disease?

Chronic prostatitis

What is this, shrunken and hard with scar tissue?

*Prostatic Wash*

BPH = uniform cells

Neoplasia = variable cells

Septic = inflammatory cells

Palpation is great to tell if there is a prostate problem. But what is the BEST way to differentiate between BPH, Neoplasia, and septic prostate?

E. coli

What is the most common cause of bacterial prostatitis?

*Castration*

What is the treatment of choice for prostatic disease, the only DEFINITIVE TREATMENT?

Prostatic enlargement

What do you see?

a. BPH

On ultrasound, the prostate is enlarged, symmetrical and still biloped, but echogenicity is mottled and there are small cystic regions present

a. BPH

b. prostatitis

c. neoplasia

d. abscess

b. prostatitis

On ultrasound, the prostate is enlarged, symmetrical and mottled

a. BPH

b. prostatitis

c. neoplasia

d. abscess

c. neoplasia

On ultrasound the prostate is enlarged, asymmetrical, with heterogenous echogenicity with some hyperechoic foci, and the texture is distorted

a. BPH

b. prostatitis

c. neoplasia

d. abscess

d. abscess

On ultrasound, the prostate is enlarged, asymmetrical, mottled, and shows echogenic fluid for texture

a. BPH

b. prostatitis

c. neoplasia

d. abscess

DES (diethylsilbestrol), 5a-reductase inhibitors (Finasteride)

CASTRATION is the treatment of choice for prostatic disease like BPH. If the owner doesnt want to do that, what else can you do?