Benign prostatic hyperplasia (BPH) -- enlarged prostate

Discussion in 'Labrador health' started by MF, Jan 8, 2017.

  1. MF

    MF Registered Users

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    My friend said she has never known a dog to have as many medical issues as Snowie! I said perhaps it is me -- I'm neurotic when it comes to his health and well being! But he is a bull in a china shop when he is over excited and can get himself into trouble when he's racing around at top speed.

    Anyway... to add to my worries, the blood dripping from Snowie's penis came back yesterday morning (well, first we noticed) so I called the vet and she said it is most likely an enlarged prostate -- benign prostatic hyperplasia (BPH).

    She said the blood drops from the penis was not an emergency if Snowie was showing no other signs of illness and that anyway she wants to know what happens over a few days before seeing him, ie not to bring him in immediately. I am to take in a urine sample on Monday for her to rule out a urinary tract infection. She'll want to examine him and then decide on the next step, most likely a scan to see the prostate gland.

    She did say that either we leave it be (and live with the drops of blood) or sterilisation if the scan comes back and indicates sterilisation is required.

    I have noticed that there is more blood first thing in the morning, but no blood after our walk (and a ton of wees) and he is weeing (and marking) with no problems. Also more blood in the evening at bedtime, which I also suspect to do with a full bladder -- so tonight he'll be getting a night-time walk to empty out his bladder. In the past month or two he has also appeared to be incontinent when sleeping -- on occasion. The vet was not worried, said quite normal in intact dogs and dogs on epilepsy meds, it is not actual incontinence. But perhaps it is related to BPH?

    I have been doing a little research into BPH and it appears that it is quite common in intact dogs from 5 years of age -- that's exactly Snowie. I don't recall all the numbers at each age, just that 95% of intact dogs at age 10 will have BPH.

    Has anyone had experience with this and can advise me on what we can do to reduce the enlarged prostate (if that is indeed what Snowie has). I am not keen on neutering him if there is non-invasive treatment out there. There is a herbal treatment, saw palmetto, but the brief reading I've done showed that a placebo had the same effect, even the same side effects! This was a study done I think over 10 years ago. A more recent study showed it did work to some extent to reduce androgen levels. I have a whole lot of studies open on my laptop and will continue to read through them. There is also electro-magnetic therapy (looks similar to laser), to increase circulation to the area.

    It might not be BPH. Does anyone have experience of blood drops from the penis that is not BPH? We have mentioned a few times to the vet over the past couple of years that he licks the sides of his penis a lot (he has a lick granuloma there), that we wonder if there is something under the skin that is causing all the licking. The response has always been it is an allergy. I'm wondering if it is perhaps something in the penile sheath that is now bleeding?

    Any info will be greatly appreciated so that I can ask my vet some intelligent questions when I see her next week (we also have to go in for a follow-up on Snowie's eye, which looks to my bare eyes to have healed completely -- thankfully!!)
     
  2. Snowshoe

    Snowshoe Registered Users

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    Yup, went through this a year ago. We even had the neuter planned for January 2016. Oban had cavitations (pockets) of infection on his prostate. When palpation showed the prostate seemed a bit smaller, after TCM, I opted for another ultrasound and lo and behold the cavitations were GONE, no sign of them at all. Based on that we decided to continue with TCM and we did not neuter. The bloody urine that had prompted this was very red and copious and sudden and it was long gone by then. Oban is still intact at 9 years old. We have seen faint blood in urine three times since, each time we tried to ease back on the dosage of TCM, feeling the dose needed to shrink the prostate back down was not needed for maintenance but it seemed it was. Interestingly, though my readings too showed intact dogs are more at risk of this, my VEt had only seen it in neutered dogs. But she doesn't see as many intact males.

    My Vet is a HOlistic, Integrative Vet with certifications in accupuncture, homeopathy, TCM and cold laser. I can write out the TCM Oban is on for you but he is also treated for skin health, Lymphangiectasia and pain in his hurt elbow so the mixture of TCM he takes likely would not be the same for Snowie.
     
  3. MF

    MF Registered Users

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    Thank you @Snowshoe, really appreciate your response so quickly and with all the detail. I'd be very keen to read the TCM Oban is on so that I can compare if we go that route. Our vet is new to us, recently having taken over the practice of our vet who moved cities. I don't know her stance on holistic vet care, although she appears non-judgemental and has not commented on the fact that Snowie is not neutered or that he eats raw food (unlike our experience with the first vet we took Snowie to as a puppy who berated us). Our vet who moved cities recommended the holistic vet for Snowie's back, and clearly that treatment worked well (laser treatment and TCM) so we might well go back to him for Snowie's prostate (if it is BPH). Funnily enough, the rural vet who attended to Snowie's eye last week recommended we go to the holistic vet to treat Snowie's epilepsy as the rural vet said Snowie has a very slow heart rate which might be contributing to seizures. (The holistic vet is a 45-min drive away hence why he is not our go-to vet; we wanted someone 2 mins away in case of emergency.)

    What was the reason you didn't want to neuter Oban? While I have read reports that neutering solves the problem, I have read comments by people on various sites saying it made no difference and their dog, after being neutered, still continued to have prostate and urinary tract problems.
     
  4. mandyb

    mandyb Registered Users

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    My Pointer had problems with an enlarged prostate aged just 3. He too had blood dripping from his penis but also had flattened poos, almost like ribbon. Unfortunately with him blood tests/tests showed the enlarged prostate was causing back pressure on his kidneys so we had no choice other than to neuter before any permanent damage was done to them.
    Have to say neutering was a total cure, kidney function went back to normal and he had no further problems. I was gutted at the time as it put paid to a promising show career but his health came first.
     
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  5. MF

    MF Registered Users

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    Thanks @mandyb for replying. How long did he have blood dripping before you had the scan? And how much blood was coming out?

    Interestingly, this morning Snowie has no blood dripping from his penis. This is why the vet wanted me to wait before bringing him in: she wanted to know if it would clear up or persist. Not sure what this will tell her. Unfortunately yesterday it seemed the entire day his penis had a little blood coming from it -- every time he lay on the floor and got up, there was a little patch; it wasn't dripping obviously when he walked. He is fastidious with cleaning so it might well be there has been more blood before but we've not noticed.

    Now... I am off to collect a urine sample! I wanted to get one first thing but I was too late! I was too busy sterilising the glass jar and Snowie finished his breakfast much faster than I thought he would.
     
  6. Snowshoe

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    Sorry for delay, internet access problems with our ancient phone lines when it's cold here. This jis waht Oban is on now, as maintenance. I think a few we gave three times a day, the drops, but now down to twice. When we tried to go to once a day he reacted with blood again.

    But here are the things he consumes in case it helps. He gets acupuncture and cold laser now too, the later for his sore leg. I had no idea before we went to this Vet that acupuncture could target digestion and not just muscular aches and pains.

    Gemmo Ribes nigrum, Rosmarinus officinalis, Betula pubescens - liquid 2 x day, this was at 2 x day

    GEmmontherapy: Juniperus officinalis- liquid 1 x week

    Rx Vitamins Hepato Support - 2 x day, 1/meal

    Golden Flower Chinese Herbs - GF Tang Kuei and Peony - 6 x day, 3/meal think this was at 9 x day

    Kan Herb Company - Dispel Stasis in the Lower Palace - Shao Fu Zhu Yu Tang - 6x day, 3/meal

    When his Vet suggested neuter yet said all her previous experience with this was in neutered dogs it was not very reassuring. At his age, 8 years, the operation would be much more serious than in a young dog, more invasive since everything was deeper and bigger and healing would take longer. We opted for that one last ultrasound as it would help her see where she would have to go with the knife and so glad we did as the problems were gone. She has no idea why, she was aiming for shrinkage of the prostate but was taken by surprise when the pockets of infection simply disappeared in one month. The prostate was smaller but still enlarged but continued to shrink. I have never had any of the problems sometimes associated with intact males behaviour wise, no marking or mounting or aggression
     
  7. MF

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    Thanks Snowshoe. Really appreciate your writing that all out. I will take with me to our vet to discuss for Snowie.
     
  8. Karen

    Karen Moderator Forum Supporter

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    Hi there, so sorry about Snowie's health issues. My Bones had an enlarged prostate and had urine in his blood. He was treated with suprelorin, which seemed to do the trick - we only had to have one lot of treatment, and after that his prostate went back to its normal size and he was never castrated. He lived to just after his 14th birthday, and was a happy boy.
     
  9. MF

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    Thanks Karen, really appreciate your finding this thread to reply. Did Bones have urine in his blood, or blood in his urine? I'm guessing the latter? How old was Bones when you discovered the enlarged prostate?

    Snowie goes in for an ultrasound tomorrow. He had a urine test yesterday, which came back normal. But the vet has now sent it to be cultured because she said there might be an infection, which she can't pick up in her lab. So it goes to be cultured for one week (I think) to identify the specific bacteria that might be causing infection (if it is indeed an infection).

    The ultrasound tomorrow will be of his prostate. If the vet doing the ultrasound sees a need, he'll be sedated and then have a needle biopsy of the bladder and I presume the prostate, too -- I forget all the details, I should've written it all down! I've asked her to also check under his penile sheath -- perhaps there is something there, a cyst or tumour -- because he has licked that area for a few years, resulting in a lick granuloma. We've always been told it was allergies, but perhaps there is something under there that causes him to lick so much.

    I am pleased to hear that one dose of suprelorin did the trick for Bones. My vet -- who is a new vet to us, having taken over our previous vet's practice -- said that the cure might be a sterilisation. I'm not that keen on that, don't believe in cutting off body parts -- particularly hormone-producing ones -- if not absolutely necessary. Of course I will consider it, will consider all options for our dog's benefit, but I prefer to find the least invasive treatment first and then work from there.
     
  10. Karen

    Karen Moderator Forum Supporter

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    Oh sorry, typing too fast - of course he had blood in his urine. I had to take in a sample, then he had the ultrasound of his bladder and prostate. He was so sweet, just lay quietly on his back for ages while the vet did all the scanning! I cannot remember exactly how old he was, but he certainly was not a young dog, maybe 10 or even 12.

    The vet at the time said that if the suprelorin didnt work, that we should consider sterilisation, but like you I was very loathe to do that, so I was doubly happy that the suprelorin did the trick. Good luck; I hope you manage to get this sorted for him.
     
  11. MF

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    Thanks Karen. Bones does sound adorable lying there quietly while he was scanned. I am guessing you were there the entire time? The vet called me now and said to drop Snowie off in the morning and that he'll go into the queue -- she has a vet coming with a mobile scanner tomorrow doing three dogs. Well I said I live close by and can work from home and can bring him in when he needs to be there, I don't want him stressed in a cage waiting his turn (although I am guessing he'll love being where all the action is).

    Anyway, when I drop him off tomorrow I'll ask if I can stay. It seems the norm is you are not present for most things -- blood being taken, scans, etc. I don't like this one bit! At the rural vet we took Snowie to two weeks ago (when we were on holiday and he had a corneal abrasion from rough play), he told us to follow him into the operating room when he stitched up Snowie's eye! This is my preference!
     
  12. Karen

    Karen Moderator Forum Supporter

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    At our vet's in Germany it is completely normal to be present with the dog at almost all times; Bones would certainly have had to be restrained if I had not been there.

    When Pops cut her paw so badly in the UK over the summer, I was stunned that we had to leave her there to be sedated and so on, and that changing of the dressing was done without me being able to hold her. I'm not used to that, and didnt like it at all.
     
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  13. Snowshoe

    Snowshoe Registered Users

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    I am with Oban for most things. He handled better for our previous Vet, who was male, with me there. Our current Vet is a woman he really likes but I'm there most times anyway. He never trusted the male Vet after he squirted the kennel cough med up his nose.
     
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  14. MF

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    Snowie spent the whole afternoon at the vet. I wanted to stay with him but they convinced me that it was easier for them to work on him when I wasn't around, said dogs play up when the owners are around. And anyway, they were going to do various things on him at different times, so it was easier to have him there and take him out when needed. Also, the vet doing the scan was coming with her portable ultrasound machine and was running late. I was not entirely happy, especially when Snowie did not want to go down the stairs to the holding area. I felt just AWFUL when he lay down and would not move! Terrible how I bow to pressure, felt awful the entire afternoon.

    Thankfully all went very well to the point that they adored Snowie, said he was the perfect patient, lay quietly on his back enjoying tummy tickles while they did the scan. He was so easy that they didn't need to sedate him to take the needle biopsy of his prostate. Said he was happy, tail wagged, friendly to all the other dogs, slept in the cage while he was waiting. The vet said usually the epileptic Labs are frenzied. And Snowie was most unusual for an intact male being so chilled and friendly. When she debriefed us afterwards she stroked his ears and was happy for him to lick her face! I must say, he did us proud!

    As for his health: His prostate is enlarged and the correct size for an intact male his age. It's symmetrical (cancer might make it asymmetrical). No obvious signs of anything sinister. No cavities where infection could be. His bladder wall was very healthy and no sign of stones. No cuts on his penis and no obvious lesions inside the penile sheath that could be dripping blood. The vet will send the biopsy away for tests to make sure there is no cancer. If no cancer, then the treatment is really just to wait and watch and live with a bit of blood dripping. She wasn't happy with the blood, said never a good sign, and her treatment if it gets worse is to sterilise. She also mentioned that because he's on two urine-diluting meds (KBr and cortisone), that it could mean he is prone to infection, and with blood from the prostate, the infection could go up to the prostate.

    The vet doing the scan said that she'd give Tardak to see if the prostrate shrinks. If it shrinks within four weeks, then they know it's benign prostatic hyperplasia. If it doesn't shrink, then it is likely cancer. Unfortunately you can't get Tardak in South Africa (the medical board won't allow it to imported for some reason) and she'd not heard of Suprelorin, so more than likely it's not allowed to be imported into South Africa either. (The vet doing the scan rescanned Snowie when we came to pick him up so that we could see for ourselves.)

    I asked our regular vet what she thought about TCM. Prior to taking over this practice a few months ago, she;d worked at an animal hospital with an array of services and specialist vets, including a holistic vet who treated Snowie for his slipped disc. She said that before she met the holistic vet, she'd not believed in alternative treatments. But after working with him and seeing the brilliant results he got, she had changed her mind. She said that holistic vets have modalities available to them that regular vets don't have, and she was very happy for us to seek holistic veterinary care. Anyway, we've decided to wait for all the test results before we do anything further. As it happens, Snowie had no blood coming from his penis today!

    She also checked his cornea (that was injured while we were on holiday) and said it was completely healed.
     
  15. Snowshoe

    Snowshoe Registered Users

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    Good. :)
     
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  16. Joy

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    That sounds good news on the whole. It certainly sounds as if your vet was very thorough and great that Snowie was so relaxed while there.
     
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  17. Naya

    Naya Supporting Member Forum Supporter

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    Glad that things went better than you were expecting today. It's good that your vet is encouraging you to look at alternative treatments too
     
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  18. edzbird

    edzbird Supporting Member Forum Supporter

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    That sounds like a very positive report. Glad Snowy's eye is healed too.
     
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  19. MF

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    Yes, I was thinking doom and gloom! Totally stressed the entire afternoon! (It was good for my work -- I made myself work solidly to take my mind off Snowie and all the worst things that could be happening.)

    I'm not sure I would say she encouraged alternative treatments -- her immediate response was: sterilise. It was only after I asked her what she thought of holistic treatment that she said she was happy for us to go that route. She is certainly not judgemental and is very supportive, but I am guessing she will pursue her tried and tested conventional methods before thinking alternatively. Whereas I prefer to seek the least aggressive, least invasive treatment first.
     
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  20. Doglover12345

    Doglover12345 Registered Users

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    Hello MF, I'm new to the forum and hope I'm posting correctly, how did it turn out for you with the enlarged prostate? Are you treating it holistically? My dog also has an enlarged prostate with blood dripping occasionally as well as bloody prostate fluid leaking while he sleeps. I have been advised either to neuter or give Finasteride(the human male drug). Does anyone have experience with Finasteride? Thank you
     

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