Tuesday 24 April 2018

'Movember' a good time to check on prostate problems

The 'Movember' campaign to raise awareness of male health has been a success, with men all over the world sprouting moustaches as part of fund raising efforts. I took part in the 2009 event.

It was a one-off: after growing the moustache, I quickly realised why I had never done it before. It just didn't suit me. I'm not sure what it is that makes moustaches look good on some men and not on others. It's something to do with the shape of the nose, or the size of the gap between the nose and the upper lip. In any case, I wish the best of luck to those brave individuals taking part in Movember: I'm afraid I won't be joining you.

Some vets across in the UK have jumped onto the Movember bandwagon, using the opportunity to raise awareness of male dog health. November has been titled Canine Prostate Awareness Month (CPAM), aiming to remind owners that men are not the only ones to suffer from prostate disorders. More than 80% of entire male dogs over the age of five suffer from prostate disease, but it's a problem that often remains unseen and unnoticed.

Testicular cancer- a large part of the focus of Movember - is not such a big deal in the dog world. For starters, many dogs are castrated when young, which obviously reduces the risk of cancer by 100%. In entire male dogs, tumours of the testicle are astonishingly common, with studies showing that they occur in something like 70% of older males.

Most testicular tumours are benign: they just cause an increase in size of the testicle, rather than malignant disease that spreads elsewhere in the body. But even benign disease can cause problems: some testicular tumours produce female hormones which can change the behaviour of a male dog. And some 'benign' tumours can grow so large that they cause discomfort.

I remember seeing a terrier with one testicle as large as a tennis ball. Even though the tumour was not dangerous to the dog, it was awkward, and he was a much happier animal once it had been surgically removed. If an older dog develops an enlarged testicle, it's best to talk to your local vet about the best way to deal with the issue.

The other common male-only problem involves the prostate gland, and this is as significant in the dog world as it is in humans.

The biggest challenge is the invisibility of the gland: it's like a doughnut, wrapped around the neck of the bladder. It's impossible to see the prostate with the naked eye. During a physical examination, the only way that it can be checked is with a gloved finger, via a rectal examination. It's no wonder that prostate problems in dogs often go unnoticed.

If a prostate problem is suspected, medical diagnostic imaging is needed to see what's going on. X-rays can demonstrate enlargement, ultrasound allows the internal structure of the prostate to be inspected, and the ultimate viewing technique is to use an MRI scan to obtain a detailed, three-dimensional view of what's going on.

The prostate gland is activated by the male hormone testosterone: if a male dog is neutered when young, the prostate remains small and innocuous. There is still a small chance that malignant cancer may develop later in life, but the risk is tiny. In neutered male dogs, disease of the prostate gland is something that can be more or less crossed off the list of possibilities.

In dogs that are not neutered, the prostate gland is continually stimulated by the presence of testosterone. A condition known as Benign Prostatic Hyperplasia is so common that up to 80% of male dogs over the age of five are affected. In most cases, there are no signs of ill health: the prostate is bigger than normal, but it doesn't cause a problem.

In some individuals, the enlarged gland causes a physical obstruction, causing difficulty passing urine or faeces. In other dogs, there may be blood in the urine. The good news is that if a dog develops any of these signs, the problem is easily cured by castration: without testosterone, the prostate gland shrinks back to its normal size, and the signs of illness clear up. It's also now possible to chemically castrate dogs, by giving a course of tablets.

There are two other common diseases of the prostate gland in entire dogs: prostatic cysts and prostatitis.

Cysts are like fluid-filled balloons that develop on the prostate gland: they cause similar signs to other prostate disease, but they do not shrink down after castration, and they need to be drained, either by complex surgery, or using probes guided under ultrasound. Prostatic cysts are uncommon, and they can be difficult to diagnose.

Prostatitis is defined as "inflammation of the prostate gland", and again, it's only seen in uncastrated dogs. It's caused by bacterial infection of the prostate gland. The classic signs include straining to pass urine or faeces, but vaguer signs may be seen instead, such as a high temperature, dullness and a dog being generally 'unwell.'

A full work up, including blood and urine tests, xrays and ultrasound is needed to make the diagnosis. Antibiotics are the main form of treatment, but castration is also needed for a full cure.

Male-only health problems in the dog are common. If you have an unneutered male dog, Movember is a good time to remember to check that his male health is as good as it should be.

Enniscorthy Guardian