Surgical management of perineal paraprostatic cysts in three dogs

Three intact male dogs were presented with faecal tenesmus and obvious perineal swelling. All three animals had paraprostatic cysts originating within the abdominal cavity and extending caudally through the pelvic canal, causing perineal swelling. Two of the dogs were found to have concurrent benign prostatic hyperplasia, while the third had chronic active prostatitis. This report describes the investigations, surgical management and outcome for the three dogs presented.     

ULTRASONOGRAPHIC FEATURES OF PARAPROSTATIC CYSTS IN NINE DOGS

The ultrasonographic features of paraprostatic cysts in nine dogs are described along with historical, clinical, surgical and pathologic findings. Cysts occurred predominantly in older, large breed dogs (mean age 8 years, range 3–11 years). The most common presenting complaints were depression, inappetance, stranguria, tenesmus and bloody penile discharge. A palpable abdominal mass was the most common physical finding. Ultrasonographically, paraprostatic cysts were usually large anechoic structures; many contained internal septa. Moderately large anechoic cavities or cysts were also detected in the prostatic parenchyma of five dogs, and in two of these communication with the paraprostatic cyst was visualized. There were no clearly distinct ultrasonographic criteria to discriminate septic from nonseptic paraprostatic cysts.     

Two cases of paraprostatic cysts in castrated male dogs

Two castrated male dogs presented for evaluation of tenesmus. Presurgical evaluations included complete physical examinations, serum biochemistry, abdominal ultrasonography, and MRI (case 2 only). Paraprostatic cysts were diagnosed in both cases based on the results of abdominal ultrasonography, MRI, and histopathology of tissue samples obtained during exploratory laparotomy. To the authors' knowledge, the two cases presented herein are the first documented cases of paraprostatic cysts that developed after castration in male dogs. Paraprostatic cysts should be considered in the differential diagnoses for castrated male dogs with prostatic disease.     

The diagnosis and management of paraprostatic and prostatic retention cysts in the dog

Eleven dogs were diagnosed as having solitary or multiple prostatic cysts in an abdominal, pelvic or perineal position. Common presenting signs included urinary dysfunction, faecal tenesmus and abdominal distension. Cystography was found to be the most consistently accurate technique for differentiating the cysts from the bladder and other abdominal soft tissue masses whilst urethrography often highlighted their prostatic origin. Complete surgical resection of the cysts was attempted in nine dogs, the complexity of dissection being dictated by cyst size and the extent of adhesions to adjacent organs. Nine dogs were castrated. Urinary incontinence continued post-operatively in four dogs but later resolved in three of these. Seven dogs were alive and symptom-free over post-operative periods ranging from one to three years. Despite some of its technical difficulties, surgical excision appears to be a successful approach to even the larger prostatic cysts. Few of the post-operative complications associated with other surgical procedures described for the management of cysts were encountered.     

Serum testosterone and estradiol 17-beta concentrations in 15 dogs with perineal hernia

Serum testosterone and estradiol 17-beta concentrations, and serum testosterone-to-estradiol ratio were evaluated in 15 dogs (greater than or equal to 5 years old) with perineal hernia (9 sexually intact males and 6 castrated males) and in 9 clinically normal sexually intact male dogs greater than or equal to 5 years old. There was no significant difference in serum testosterone-to-estradiol ratio between sexually intact male dogs with perineal hernia and clinically normal sexually intact male dogs. In castrated dogs with perineal hernia, serum testosterone concentration and testosterone-to-estradiol ratio were significantly (P less than 0.05) lower, compared with those values in sexually intact dogs with perineal hernia and in clinically normal sexually intact male dogs. There was no significant difference in serum estradiol 17-beta concentration among sexually intact male dogs with perineal hernia, castrated dogs with perineal hernia, and clinically normal sexually intact male dogs. Serum testosterone and estradiol 17-beta concentrations in dogs with perineal hernia did not differ from those values in clinically normal male dogs of the same age. Castration cannot be recommended for the treatment of perineal hernia unless a castration-responsive contributing factor such as prostatomegaly is identified, unless the pelvic diaphragm of dogs with perineal hernia has high sensitivity to normal or low serum testosterone and estradiol 17-beta concentrations, or unless there is documentation that other androgens and/or estrogens are involved.     

Iatrogenic proximal urethral obstruction after inadvertent prostatectomy during bilateral perineal herniorrhaphy in a dog

Proximal urethral obstruction was diagnosed 2 days after bilateral perineal herniorrhaphy in a 12-year-old male Pomeranian-cross dog. The obstruction was caused by ligation of the proximal urethra during resection of a presumed paraprostatic cyst. Surgical repair involved reconstruction of the urethra and bladder wall, but urinary incontinence persisted.     

Paraprostatic cyst in a cat

A paraprostatic cyst and lymphosarcoma were found in a neutered male cat that was being evaluated for monoparesis and pollakiuria. The cyst was first detected on physical examination as a palpable caudal abdominal mass. Survey radiography, intravenous urography and ultrasonography were used to further evaluate the cyst. The exact histological nature of the cyst was determined by post mortem examination to be a paraprostatic cyst of prostatic origin that communicated with the urethra. The lining of the cyst consisted of one to two layers of transitional epithelium which was continuous with prostatic ductules in several locations. This is the first reported paraprostatic cyst of prostatic origin in a cat.     

Sciatic perineal hernia in two dogs

A sexually intact, male Chihuahua and a spayed female poodle were presented with left perineal masses. The masses were identified as perineal hernias by rectal palpation. Surgical exploration of the perineal region in each dog revealed retroperitoneal fat protruding between the sacrotuberous ligament and the coccygeus muscle (sciatic perineal hernia). The hernias were repaired using modifications of the standard or internal obturator flap herniorrhaphies. The levator ani muscle was grossly and histologically normal in the Chihuahua and grossly normal in the poodle. No short- or long-term complications were reported in either case. The management of sciatic perineal hernia is similar to the more common caudal perineal hernia.     

TREATMENT OF UNILATERAL PERINEAL HERNIAS IN 2 MALE CHINCHILLAS (CHINCHILLA LANIGERA)

Two sexually intact adult male chinchillas were presented with a swelling in the perineal region. Radiographically both masses had a soft tissue opacity. Ultrasonography confirmed the tentative diagnosis of perineal hernia. In the first case the ultrasonographic examination revealed a fluid-filled structure inside the swelling, which was determined to be the urinary bladder. In the second case the hernia sac was filled with homogeneous tissue, belived to be fat. Subsequently, unilateral perineal herniorrhaphies including an internal obturator muscle flap transposition technique were performed. Both chinchillas recovered well with subsequent uneventful healing of the surgical sites. No long-term complications or recurrences of the perineal hernias were reported. This clinical report shows that perineal hernias occur in chinchillas and can be surgically treated with success.     

Evaluation of Internal Obturator Muscle Transposition in Treatment of Perineal Hernia in Dogs

A technique that utilizes transposition of the internal obturator muscle for repair of perineal hernias was evaluated. Forty-two male dogs were followed for at least one year after surgery. The repair failed in only one animal, a dog with previously operated bilateral hernias. Microangiography demonstrated an adequate blood supply to the transposed internal obturator muscles of two dogs examined at three weeks and three months after surgery.     

Ventral intraspinal cysts associated with the intervertebral disc: magnetic resonance imaging observations in seven dogs

Objective— To report clinical and diagnostic imaging features, and outcome after surgical treatment of ventral intraspinal cysts in dogs.
Study Design— Retrospective study.
Animals— Dogs (n=7) with ventral intraspinal cysts.
Methods— Clinical signs, magnetic resonance imaging (MRI) findings and surgical findings of 7 dogs and histologic findings (1 dog) with intraspinal cysts associated with the intervertebral disc were reviewed.
Results— Ventral intraspinal cyst is characterized by: (1) clinical signs indistinguishable from those of typical disc herniation; (2) an extradural, round to oval, mass lesion with low T1 and high T2 signal intensity on MRI, compatible with a liquid-containing cyst; (3) cyst is in close proximity to the intervertebral disc; and (4) MRI signs of disc degeneration. Although the exact cause is unknown, underlying minor disc injury may predispose to cyst formation.
Conclusion— Intraspinal cysts have clinical signs identical to those of disc herniation. Given the close proximity of the cyst to the corresponding disc and the similarity of MRI findings to discal cysts in humans, we propose the term "canine discal cyst" to describe this observation.
Clinical Relevance— Discal cysts should be considered in the differential choices for cystic extradural compressing lesions.     

Omentalization of Prostatic Abscesses and Large Cysts in Ferrets (Mustela putorius furo)

Neutered male ferrets are occasionally presented with cystic prostatic disease or prostatic abscesses, most often secondary to elevated, circulating sex steroid hormones caused by adrenocortical disease. Useful features of the omentum, such as tissue adhesion, angiogenesis, and stimulation of the immune system, can be used for surgical treatment of large prostatic cysts and abscesses. Two cases of prostatic abscess omentalization are described. In one case, the underlying cause was a sustentacular (Sertoli cell) tumor associated with a retained testicle. In the other case, adrenocortical disease was determined to be the underlying disease. The first ferret had a residual prostatic abscess 5 months after omentalization. A small, residual prostatic cyst was detected by ultrasound in the second ferret 9 weeks after surgery. Although omentalization may be an effective technique to surgically manage large prostatic cysts and abscesses in ferrets, clinical studies comparing omentalization with other surgical and nonsurgical methods are needed in this species.     

Use of polypropylene mesh in addition to internal obturator transposition: a review of 59 cases (2000-2004)

Fifty-nine dogs with a total of 69 perineal hernias that were repaired by internal obturator transposition and polypropylene mesh reinforcement were reviewed. Thirty-six dogs were available for follow-up at a mean of 29.4 months postoperatively. Six dogs had complications within the first 60 days of surgery, such as perineal swelling, persistent tenesmus, and incisional infections. Twenty-two dogs had excellent outcomes; seven dogs needed continued medical treatment after surgery; and seven dogs had poor outcomes. Hernias recurred in five dogs. The incisional infection rate was 5.6%; the recurrence rate was 12.5%; and the overall success rate was 80.5% for the 36 dogs with long-term follow-up.     

Intrapericardial Cysts in the Dog

Intrapericardial cysts were identified as the cause of impaired cardiac filling in six young dogs. Pneumo-pericardiography and two-dimensional echocardiography showed the cysts in 2 of 2 dogs and in 4 of 4 dogs, respectively. One dog, which was also infected with heartworms, died before surgical excision of the cyst could be performed. In the remaining dogs, surgical excision of the cysts and subtotal pericar-diectomy was successfully accomplished. Histologic examination of the excised tissue from one dog suggested that it was a pericardial coelomic cyst. The gross and histologic characteristics of the cysts removed from the other five dogs resembled those of acquired cystic hematomas. The etiopathogenesis of these cysts was uncertain, but all cysts were connected to a fatty pedicle of tissue. In one dog, a stalk of tissue was observed to enter the pericardium through a small peritoneopericardial diaphragmatic hernia. In four dogs, the stalk of tissue was adhered to the apex of the parietal pericardium. These observations suggested that intrapericardial cysts, in some dogs, develop in association with, and possibly as a result of, congenital herniation and entrapment of omentum or a portion of the falciform ligament into the pericardial sac. (Journal of Veterinary Internal Medicine 1993; 7:364–369. Copyright © 1993 by the American College of Veterinary Internal Medicine.)     

ENTERIC DUPLICATION IN TWO DOGS

Enteric duplication, a developmental malformation of the alimentary tract resulting in juxtaintestinal cyst-like formations, was diagnosed in 2 dogs. The sonographic, gross, and histopathologic characteristics of the malformation reported in people include: a fusion between the wall of the duplication cyst and the adjoining segment of the alimentary tract, a hypoechoic tunica muscularis layer in the outer free wall of the cyst, a shared muscular wall between the cyst and the adjoining normal bowel, and a similar or heterotopic epithelial lining of the lumen of the cyst. Both dogs in this series had characteristic sonographic, gross and histopathologic patterns described for enteric duplication in people. Three adjoining cysts that communicated and shared a common wall with the ileum were present in the first dog. Ectopic gastric mucosa was present in the single cyst that shared a common wall with the jejunum in the second dog. Other abdominal cystic masses may mimic the gross appearance of the duplication cyst and can potentially result in a misdiagnosis of the underlying etiology. Sonographic findings are characteristic for duplication cysts and are the preferred primary diagnostic modality, however, histopathology is warranted to confirm the diagnosis.     

ULTRASONOGRAPHIC EVALUATION OF THE PROSTATE IN HEALTHY INTACT DOGS

Sagittal and transverse ultrasonographic images of the prostate gland were obtained in 100 healthy adult intact male dogs. Prostatic length, width, and height on transverse and sagittal images as well as the presence of prostatic cysts were determined. Linear regression and correlation analysis were performed between prostatic parameters (length, width, height on sagittal and transverse images, and estimated volume) and parameters related to body size (body weight, body height, left kidney length and aortic diameter) and age of the dogs. Significant positive correlations were found between all prostatic parameters and parameters related to body size and age. Maximum predicted values for prostatic parameters for a given body weight and age were determined based on the upper limit of the 95% confidence interval of the mean predicted values. Such values should represent a useful tool for ultrasonographic evaluation of the prostate in the dog. Prostatic cysts were found in 14% of the dogs.     

Cecal-Colic Volvulus in Two Dogs

Cecal-colic volvulus was confirmed by surgery in two dogs. Both dogs were intact, male Great Danes. The clinical and diagnostic findings were not specific for large bowel volvulus. Clinical signs included peracute to acute onset of vomiting, mild abdominal distention and pain, lack of feces, and tenesmus. Abdominal radiographs demonstrated severe dilatation of bowel loops in both dogs. One dog survived.     

Evaluation of concurrent perineal hernia in adult male dogs presenting with nontraumatic,acquired inguinal hernias

A possible association between the development of nontraumatic, acquired inguinal hernias (NAIH) and perineal hernias (PH) has been postulated in adult dogs. The objective of this study was to evaluate the frequency of concurrent diagnosis of PH in dogs presented with NAIH and determine potential risk factors for concurrent PH and NAIH. Medical records of adult male dogs presented for NAIH to 4 hospitals between 2007 and 2017 were retrospectively reviewed. Twenty-one dogs with NAIH were included, 8 of which had concurrent PH. There were no significant differences between dogs with and without PH; however, among dogs with both conditions, intact dogs (8.1 ± 1.4 years) were younger than neutered dogs (11.7 ± 1.0 years; P = 0.007). Thirty-eight percent of male dogs presenting for NAIH had concurrent PH, indicating that these conditions commonly occur together. Dogs presenting for NAIH should be carefully evaluated for concurrent PH before surgical intervention.     

Tubular colonic duplication in a dog

A diagnosis of tubular colonic duplication was made via contrast radiography and colonoscopy in a six-month-old, intact female Boston terrier. Clinical signs of increased frequency of defecation, tenesmus, and constipation, which had been present since birth, resolved following surgical correction of the duplication. The literature addressing diagnosis and treatment of tubular colonic duplication in dogs is reviewed.     

Successful treatment of an unusually large corneal epithelial inclusion cyst using equine amniotic membrane in a dog

A 10‐year‐old intact male Yorkshire Terrier was referred for investigation of a large raised and nonpainful corneal lesion oculus dexter. Clinical examination revealed a pale, translucent corneal mass, which occupied half of the corneal surface and measured 11 mm × 11 mm × 13 mm. The mass was removed by superficial keratectomy and equine amniotic membrane (AM) was transplanted into the large corneal defect to cover the wound and provide tectonic support for the remaining cornea. The mass was histologically confirmed as a corneal epithelial inclusion cyst. There was no evidence of recurrence or complication at the surgical site 100 days postoperatively. Corneal epithelial inclusion cysts are uncommon in dogs. Although superficial keratectomy is the recommended treatment for corneal inclusion cyst, the combination of superficial keratectomy and AM transplantation had to be considered as an alternative for repair of large corneal defects. This is the first case report of the combined application of AM and superficial keratectomy to successfully treat a corneal inclusion cyst in a dog.