2. Jakob, 8 yo MC Beagle

3. 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

4. Significant Clinical & Laboratory Findings 2/14/11:  Physical Exam TPR: WNL CVR: audible low 3 rd heart sound (hx of mild MR & TR, mild-mod AR/endocardiosis) ABD: Mild hepatomegaly Rectal: Prostate firm and bliaterally enlarged (R>>L), non-painful on palpation, anal sacs normal, normal stool  CBC: WNL

5. Focused Prostatic Ultrasound

6. Mineralization

8. Prostate Right Transverse

9. Prostate & Urethra

10. Prostate Tracing

12. Thoracic Radiographs

14. Assesment  Prostate has increased in size <10% = stable disease…..  EXCEPT…… Thoracic radiographs showed new nodules =progressive disease 1/10/112/14/11 X-sectional area sagittal (cm 2 ) 12.7813.2 X-sectional area transverse (cm 2 ) 12.213.2 Length-sagittal (cm)4.34.6 Length-transverse (cm)3.33.5

15. 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

16. Other Differential Diagnoses  Alternative appearance of Prostatic Carcinoma  Benign Prostatic Hyperplasia  Prostatitis

17. Prostatic carcinoma (again!)

18. Benign Prostatic Hyperplasia (BPH)

19. Prostatitis

21. 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