Jakob, 8 yo MC Beagle History Diagnosed with prostatic carcinoma 8/26/10 by cytology from...
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Transcript of Jakob, 8 yo MC Beagle History Diagnosed with prostatic carcinoma 8/26/10 by cytology from...
Jakob, 8 yo MC Beagle
History Diagnosed with prostatic carcinoma 8/26/10 by
cytology from ultrasound guided prostatic aspirate done by an internist in Richmond. Originally presented to rDVM for abdominal/hind end pain.
Referred to NCSU Oncology for further evaluation & treatment on 8/30/10. Chest radiographs were clear. A focused ultrasound was done for baseline pre-treatment measurements and showed extension of the mass into the urethra.
Chemotherapy protocol of Mitoxantrone and Piroxicam was initiated at the initial visit.
Jakob has received regular recheck chest radiographs and abdominal/focused ultrasounds approximately every 1.5 mo to monitor his disease and response to treatment
Significant Clinical & Laboratory Findings
2/14/11: Physical Exam
TPR: WNLCVR: audible low 3rd heart sound (hx of mild
MR & TR, mild-mod AR/endocardiosis)ABD: Mild hepatomegalyRectal: Prostate firm and bliaterally enlarged
(R>>L), non-painful on palpation, anal sacs normal, normal stool
CBC: WNL
Focused Prostatic Ultrasound
Mineralization
Mineralization
Prostate Right Transverse
Prostate & Urethra
Prostate Tracing
Prostate Tracing
Thoracic Radiographs
Thoracic Radiographs
Assesment Prostate has increased in size <10% =
stable disease…..
EXCEPT……Thoracic radiographs showed new nodules
=progressive disease
1/10/11 2/14/11
X-sectional area sagittal (cm2)
12.78 13.2
X-sectional area transverse (cm2)
12.2 13.2
Length-sagittal (cm) 4.3 4.6
Length-transverse (cm) 3.3 3.5
Outcome
Jakob is doing well and is not currently exhibiting clinical signs of his disease (no straining to urinate/defecate)
He does progressive disease which means he has “failed” Mitoxantrone chemotherapy.
He was switched to Carboplatin at the 2/14/11 visit
Other Differential Diagnoses Alternative appearance of Prostatic
Carcinoma Benign Prostatic Hyperplasia Prostatitis
Prostatic carcinoma (again!)
Benign Prostatic Hyperplasia (BPH)
Prostatitis
Prostatitis
How do you differentiate? Signalment
BPH: Intact or recently neutered (within 1 year) Prostatitis: usually younger males, but can be any age Neoplasia: usually middle to older animals. High index of
suspicion with a large prostate in an older long ago neutered male
Get a sample Cytology/histopathology needed for a confirmed diagnosis
of neoplasia Prostatic wash with culture to rule in/out prostatitis
Neuter! If strongly suspect BPH or have ruled out other causes
neutering should reduce the size of the prostate in BPH but can take a while to see size reduction