QUESTIONS

1. What does it mean if there is fresh blood in ejaculate?
    
2. The normal flora of the urethra is primarily (choose one) Gram negative/gram positive?
    
3. Why has zinc supplementation been recommended for prostate disease?
    
4. What accessory sex glands does the male cat have? The male dog?
    
5. Does prostatitis cause infertility?
    
6. What kind of bacterial numbers in ejaculate signify infection?
    
7. Is the blood/prostate barrier intact in acute prostatitis? How about chronic  prostatitis?
    
8. What does the parasympathetic NS make the prostate do?  What does the sympathetic NS make the prostate do?
    
9. List the DDX for preputial discharge.
    
10. Why might there be a hepatopathy associated with acute prostatitis?
     
11. The canine ejaculate has 3 fractions. Which is the prostatic fluid in?
     
12. Dihydrotestosterone - what does it have to do with benign prostatic hyperplasia?
     
13. How long after neutering does it take for a prostate to finish shrinking?
     
14. What does intraprostatic pH have to do with treating prostatitis?
    
    
    
    
     

ANSWERS

1. Fresh blood in ejaculate is a sign of prostate disease. It does not clue you to neoplasia, inflammation, hyperplasia or anything specific. Just tells you "prostate disease."
   
   
   
   
    
2. Urethral flora is mostly gram positive.  The prostate is an important barrier preventing infection from ascending to the bladder. The prostate produces an actual antibacterial factor. Other helpful barriers are urethral peristalsis, urine flow, urethral high pressure zone, & bacterial trapping properties of the urethral mucosa.
   
   
   
   
    
3. In humans, low prostatic zinc levels were associated with decreased prostate anti-bacterial factor & prostatitis.  Sounded promising & many DVM's jumped on the zinc bandwagon but - too bad- it doesn't work. Giving zinc orally does not increase prostate zinc levels in dogs plus, in dogs, low prostate zinc is NOT associated with prostatitis.
   
   
   
   
    
4. The male cat has a prostate & bulbourethral glands. The male dog only has a prostate.
   
   
   
   
    
5. Hell yes. Prostatitis can cause infertility.  Bacteria can climb into the epididymus & testis.
   
   
   
   
    
6. > 10 to the 5th bacteria  per ml is compatible with infection but it is best to compare to a urethral culture. You should have 2 logs (2 powers of ten) more bacteria in the ejaculate than in the urethra for a 90% chance of prostate infection.
   
   
   
   
    
7. The blood/prostate barrier is intact in chronic prostatitis but probably not intact in acute prostatitis.
   
   
   
   
    
8. During erection, the parasymp. NS increases prostate fluid production.  The symp NS causes the ejection of the fluid ejaculation. If there is no erection (most of the time), prostate fluid just kind of oozes inconspicuously into the bladder.
   
   
   
   
    
9. DDx for preputial discharge:
   
   Urethritis (generally secondary to calculi or prostatitis)
   Preputial injury (esp foxtail)
   Prostate disease leading to increases in fluid production (could be from any prostate disease)
   
   
   
   
    
10. I recently had an icteric young dog with acute prostatitis & couldn't figure out why he was icteric. I thought maybe it had to do with his ability to excrete bilirubin or something but this is not so.  In reality, E coli endotoxin causes "reactive hepatopathy" in association with sepsis, endotoxemia, fever, dehydration & hypoxia.
    
    
    
    
     
11. The last fraction is the prostate fluid. This is also the largest fraction. The second fraction is the sperm rich fraction.
    
    
    
    
     
12. Dihydrotestosterone is made when testosterone is converted into it by the prostate.  Local DHT levels may be the secret to benign prostate hyperplasia. Ettinger mentions some upcoming drugs which act on 5-alpha-reductase (the key enzyme in conversion).
    
    
    
    
     
13. It takes 7-16 days to shrink a prostate after neutering.
    
    
    
    
     
14. Due to differences between the pH of prostate fluid vs. interstitium, negatively charged antibiotics will get trapped inside the prostate (Tmps can reach prostate levels 2-10x higher than serum levels)  Of course you need a lipid soluble drug if the blood/prostate barrier is intact.