Treatment Outcome and Follow-up in Dogs with Benign Prostatic Hyperplasia

Introduction and aim: Benign prostatic hyperplasia (BPH) is the most common prostatic condition in intact male dogs. Both pharmacological (osaterone acetate, finasteride and deslorelin) and surgical (orchiectomy) approaches are available. The aim of this study was to assess therapeutic choices after initial treatment and impact on quality of life of the different treatment modalities. Materials and methods: clinical records of 50 dogs diagnosed with BPH between 2015 and 2025 were retrospectively assessed, with the highest concentration of cases recorded between 2021 and 2025. Diagnosis was based on signalment, physical and reproductive examination, hematobiochemistry, and reproductive ultrasound. Treatment choices were determined by the severity of symptoms, biochemistry results, and owners’ intention to preserve reproductive potential. Results: The mean age and weight of the subjects was 8.57 ± 3.06 years and 28.16 ± 14.46 kg, respectively. Out of the 50 dogs evaluated, 16 cases (32 %) were classified as asymptomatic. Among the symptomatic population, the most common clinical signs were penile blood discharge (26 %), hematuria (12 %), tenesmus (12 %), and hemospermia (10 %). Seven dogs did not undergo treatment. Osaterone acetate was prescribed as a first approach to 34/50 dogs, from which 28 did not switch to alternative treatment. One dog presented partial alopecia on the neck and hips, and another abundant hair shedding accompanied by character change. Over 6 months after administration, 6 dogs experienced recurrence of symptoms, and required a change in treatment: orchiectomy n=2, deslorelin n=3 and finasteride n=1. Deslorelin (4.7 or 9.4 mg - dosage chosen in agreement with the owner based on expected duration of efficacy) was administered as first approach to 4 dogs and repeated in one. In another BPH had not recurred 6 months post-implantation. One dog never returned for control appointments, and another switched to osaterone acetate and subsequently underwent orchiectomy. Finasteride (0.1-0.5 mg/kg SID) was prescribed to 3 dogs with intermittent treatment cycles of 3-4 months duration followed by 1-2 months interval. One subject was transitioned to osaterone acetate and subsequently managed via a deslorelin acetate implant, remaining under its active therapeutic effect. Another dog was switched to repeated, sequential deslorelin acetate implantations, remaining continuously covered at the study's conclusion. For this latter patient, the protocol was modified due to diffuse hair loss in the neck and forelimbs induced by the deslorelin treatment. The remaining individual within this group was lost to follow-up after the primary consultation. 1 Surgical castration was initially performed in 2 dogs. Thirty-nine of the initial 50 dogs were eventually lost to follow-up as they did not return for control appointments, presumably due to absence of symptoms. Conclusion: All treatment options were effective in eliminating clinical signs, though differences emerged in therapeutic duration and recurrence rates. In two cases, osaterone acetate led to hair-related side effects. Finasteride was the least preferred approach, probably due to the inconvenience of daily administration for extended periods. Alopecia was reported for the first time after deslorelin treatment. Surgical castration prevents recurrence while permanently altering hormonal balance. Treatment choice should be tailored to patient characteristics and owner preferences, considering long-term management goals. Further studies are needed to assess the impact of repeated pharmacological treatments on canine health.