male clinical cases

Question 1

Orchitis + Epididymitis possible causes

Answer 1

Infectious:
-Hematogenous spread
-Ascending infection
-Penetrating wound

Non-infectious/Immune mediated:
-2nd to testicular trauma/inflammation – testicular barrier is no longer intact > sperm granuloma
-Occur 2nd to infection or part of widespread autoimmune disorder
-Idiopathic

Question 2

Orchitis + Epididymitis treatment plan

Answer 2

Remove the affected testis
◦ If leave in could damage the other testis
◦ Want to preserve breeding potential

Sperm granuloma is likely to occur as a sequelae to
orchitis/epididymitis in the testis
◦ Sperm production will already be affected anyway

Antibiotics
◦ Consider sensitivity results in your decision
◦ Treat before removing the testis > reduces the risk of scirrhous cord formation

◦ In non-breeding males > bilateral castration

Question 3

Tim
Recently rescued DSH male cat
Suspected to be an adult
Owners are bringing him in because they want to know if he’s intact or has been neutered
◦ They do not want to keep an intact male cat

Where could we start with Tim?

Answer 3

Physical exam:
◦ Visual inspection/palpate for testes
◦ None are present/you can’t feel any

What next?
◦ Can extrude the penis
> Cats are unique in that they have a band of cornified papillae on the cranial 2/3rds of the penis
◦ Under the influence of testosterone (@ sexually mature age) = penile spines

Other diagnostic methods:
◦ Testosterone stimulation test (GnRH or hCG)
◦ Abdominal ultrasound

Question 4

Ways to get prostatic sample:

Answer 4

Manual collection:
◦ 3rd fraction

Prostatic massage + wash:
◦ Can be used when can’t get a collection
◦ Dog is sedated/anesthetized
◦ Urinary catheter is placed, urine is removed & bladder is rinsed > catheter is placed at level of the prostatic urethra & more saline injected > prostate is massaged rectally > aspirate to get sample

Prostatic fine-needle aspirate (FNA)
◦ Perirectal & rectal are described; trans-abdominal (ultrasound guided)
◦ Obtain fluid (cysts) + tissue

Prostatic biopsy
◦ Can do percutaneous (peri-rectal or cutaneous) or @ surgery
◦ Wedge biopsy or Tru-Cut

Question 5

suspected orchitis/epididymitis; always test for what?

Answer 5

Brucella canis

Question 6

differential diagnoses for blood dripping from the penis

Answer 6

◦ Penile injury, inflammation (tip of penis or elsewhere)
◦ Prostatic disease
◦ Urethral prolapse
◦ Epididymitis/Orchitis
◦ Bleeding mass from prepuce, penis, etc.
◦ Urethra: urethral damage from trauma, mass, urinary calculus(i)

Question 7

Differentials for mammary enlargement in a cat:

Answer 7

◦ Benign mammary hyperplasia
◦ Mammary neoplasia

Question 8

What is required for Luna to have benign mammary hyperplasia?

Answer 8

high progesterone

Question 9

What needs to happen for queens to have high progesterone?

Answer 9

ovulation

Question 10

Where could she get hormones from? She is supposed to be spayed

Answer 10

◦ Exogenous
◦ Adrenal glands
◦ Ovary (ies)