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Preputial Discharge 821

○ UTI or incontinence • Endoscopic exam of prepuce (foreign body, PEARLS & CONSIDERATIONS
mass, etc.)
○ Poor hygiene • Biopsy and/or cytologic exam of preputial Comments
VetBooks.ir ○ Trauma (penile or preputial) masses • A small amount of yellow-white discharge Diseases and Disorders
• Hemorrhagic discharge
○ Foreign body
is normal in male dogs of any age and/or
neuter status.
○ Infectious (canine herpesvirus, B. canis,
abnormal microbiologic flora) TREATMENT • Juvenile cases may be more of an annoy-
○ Balanoposthitis or prostatitis (p. 827) Treatment Overview ance than a real disease, except in cases of
○ Benign prostatic hyperplasia (BPH [p. 824]) Treatment depends on the cause and can vary anatomic defects or with systemic illness (e.g.,
○ Neoplasia from improving hygiene to surgery or systemic infection, coagulopathy)
○ Hormonal imbalance (exogenous steroids, antibiotics. ○ Generally resolve spontaneously without
endogenous estrogens) treatment.
○ UTI or urolith Acute General Treatment • In older animals, preputial discharge is often
○ Coagulopathy • Varies, depending on origin or causative agent secondary to an underlying disease.
○ Poor hygiene • Excessive discharge should be flushed with
• Purulent discharge warm saline (98°F/38°C), dilute (weak Prevention
○ Persistent penile frenulum tea-colored) povidone-iodine solution, or a • In prepubertal (juvenile) dogs, hormonal
○ Hypospadias 0.05% chlorhexidine diacetate. imbalances are impossible to prevent.
○ Trauma • Surgical correction may be necessary for • Avoid exposure to dogs infected or potentially
○ Foreign body anatomic defects or removal of masses. infected with canine herpesvirus and B. canis.
○ Phimosis • Benign neglect is reasonable for hormonal
○ Infectious (B. canis) imbalances Technician Tips
○ Balanoposthitis, prostatitis (p. 827), • Removal of foreign body • Preputial discharge can be normal and of no
orchitis, epididymitis • Discourage licking clinical significance in most dogs, except if
○ Neoplasia • Antibiotics based on culture and sensitivity abundant or associated with other clinical
○ UTI or urolith (e.g., prostatitis, cystitis) signs.
○ Poor hygiene • Analgesia should be considered at the time
Chronic Treatment of exam and during treatment if the dog
Initial Database • Probiotics are recommended if patient is appears to be painful.
• General health exam treated with long-term antibiotics. • Dogs used for breeding may need to be
○ CBC, serum chemistry panel • Treat benign prostatic hyperplasia (neuter, cleaned with physiologic saline before semen
○ Urinalysis and urine culture (p. 232) antiandrogens or gonadotropin agonists). sample collection to minimize discharge
○ B. canis screening • For recurrent infection, investigate primary contamination of the ejaculate.
○ If hemorrhagic discharge, coagulation source of infection (e.g., prostatic, urinary
profile and platelet count tract). Client Education
• Complete reproductive exam • Chronic cases refractory to basic treatment • The benign nature of most discharge should
○ Retraction of the prepuce caudal to may be referred to a theriogenologist, espe- be discussed with the client. Do not begin
the bulbus glandis (sedation or general cially if the future reproductive potential is antimicrobial therapy without culture of
anesthesia may be required) a concern. bacterial pathogens.
○ Rectal exam to evaluate prostate • Clients should call their veterinarian if the
• Preputial/penile culture and cytology (p. 1071) Behavior/Exercise discharge seems excessive or is associated with
○ Culture (preputial swab, prostatic wash) Owners should prevent the dog from excessive extensive licking or apparent pain.
Heavy growth of a single bacterium in licking of the prepuce and/or penis.
■
combination with clinical signs suggests SUGGESTED READING
infection. Possible Complications Foster RA: Common lesions in the male reproductive
Antibiotics are not indicated if a mixed • Recurrent and/or chronic infections (e.g.,
■ tract of cats and dogs. Vet Clin North Am Small
flora is cultured. UTI, prostatitis) Anim Pract 42(3):527-545, 2012.
Normal flora may include Escherichia • Canine herpesvirus and B. canis are associated
■ AUTHOR: Eleas M. Wu, DVM, DACT
coli, Pseudomonas spp, Streptococcus with infertility and are transmissible to other EDITOR: Michelle A. Kutzler, DVM, PhD, DACT
spp, Pasturella spp, Staphylococcus dogs.
spp, Klebsiella spp, Mycoplasma spp,
Ureaplasma spp. Recommended Monitoring
○ Cytology (preputial swab, prostatic wash) Varies with cause; if discharge worsens, addi-
Cornification may indicate hyperestro- tional diagnostic testing may be warranted.
■
genism
PROGNOSIS & OUTCOME
Advanced or Confirmatory Testing
• Advanced imaging • Good for juvenile animals
○ Ultrasound of the prostate, bladder, • Fair to guarded for adults; depends on cause
urethra of secretions
○ Radiographs (e.g., os penis, bladder)

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