J Vet Intern Med 2002;16:593–597
Bacterial Prostatitis in a Cat
Xavier Roura, Maria A. Camps-Palau, Albert Lloret, Félix Garcı́a, and Ivonne Espada
A 7-year-old intact male outdoor Siamese cat weighing
5.5 kg was referred to the Autonomous University of
Barcelona, Veterinary Medical Teaching Hospital, with a
21-day history of dyschezia and intermittent constipation.
From the Veterinary Teaching Hospital (Roura, Lloret), and the
Department of Animal Medicine and Surgery (Camps-Palau, Garcı́a,
Espada), Facultat de Veterinària, Universitat Autònoma de Barcelona,
Barcelona, Spain. Dr Camps-Palau is presently affiliated with the An-
imal Medical Center, New York, NY. Previously presented at the 11th
ESVIM Congress in Dublin, Ireland, September 5–8, 2001.
Reprint requests: Xavier Roura, DVM, PhD, Hospital Clı́nic Veter-
inari, Facultat de Veterinària, Universitat Autònoma de Barcelona,
08193 Bellaterra, Barcelona, Spain; e-mail: xavier.roura@uab.es.
Submitted October 9, 2001; Revised January 17 and March 4, 2002;
Accepted April 15, 2002.
Copyright 䉷 2002 by the American College of Veterinary Internal
Medicine
0891-6640/02/1605-0016/$3.00/0
Fig 1. Lateral abdominal radiograph with barium contrast performed at the referring veterinarian and showing dorsal deviation of the colon
(arrows).
There was no history of past medical problems, nor was
there a history of trauma, but the cat was allowed to roam
freely in the neighborhood. Abdominal radiographs using
barium for contrast and performed at the hospital of the
referring veterinarian disclosed a 1.8-cm dorsal deviation
of the colon approximately 5 cm proximal to the anus (Fig
1). Treatment with antibiotics, anti-inflammatory drugs, and
enemas by the referring veterinarian resulted in partial im-
provement of the clinical signs.
On physical examination, a full urinary bladder that was
difficult to express was palpated, despite the owners’ report
that the cat appeared to be urinating normally. The rest of
the physical examination showed no abnormalities. Rectal
examination, abdominal radiographs, and abdominal ultra-
sound were performed under sedation. On rectal examina-
tion, a firm, smooth, symmetric, nonpainful, 2-cm mass was
palpated ventral to the rectum at the pelvic brim. Abdom-
inal radiographs showed dorsal deviation of the colon, con-
594
Fig 2. Longitudinal ultrasound image of the caudodorsal abdominal mass. Note the well-defined mass (arrows) with echogenic rim and hypoe-
choic contents.
sistent with the presence of a soft tissue mass in the cau-
dodorsal abdomen. Abdominal ultrasonography disclosed a
distended urinary bladder with echogenic material in its
ventral aspect, suggestive of cystitis. A well-defined oval
mass (3.65 by 2.72 cm) with echogenic margins and hy-
poechogenic content was found caudal to the bladder (Fig
2). This mass was compatible with a prostatic abscess or
prostatic neoplasia. No other abnormalities were detected
by abdominal ultrasonography. Cytologic examination of a
percutaneous, ultrasound-guided fine needle aspirate of the
mass revealed numerous neutrophils and a small number of
macrophages. Bacteria were not observed. Results of CBC
and serum biochemistry were within normal limits. Tests
for feline leukemia virus (FeLV) antigen and feline im-
munodeficiency virus (FIV) antibodies were negative.a
Analysis of a urine sample collected by cystocentesis re-
vealed a specific gravity of 1.040 with 2⫹ proteinuria and
numerous neutrophils but no bacteria. Aerobic bacterial cul-
ture of the urine yielded no growth.
On the basis of the clinical and laboratory findings, dif-
ferential diagnoses for the caudal abdominal mass included
prostatic neoplasia, bacterial prostatitis, prostatic abscess,
and benign prostatic hyperplasia. Neoplastic, infectious, or
inflammatory diseases of other structures adjacent to the
prostate gland also were considered. The cat was hospital-
ized, and lactated Ringer’s solutionb with 10 mEq/L of KCl
Roura et al
was administered IV at 30 mL/h. To confirm the diagnosis,
exploratory laparotomy was performed and disclosed a
well-circumscribed spherical mass caudal to the bladder,
suggestive of an enlarged prostate gland (Fig 3). The mass
was closely adhered to the bladder neck and urethra but
was not attached to any other adjacent structures. On inci-
sion, suppurative material leaked from the mass. Excisional
biopsies and exudate were obtained and submitted for his-
topathology and aerobic bacterial culture, respectively. The
cat also was castrated at the time of surgery.
Postoperative therapy included enrofloxacinc (5 mg/kg
SC q24h) and lactated Ringer’s solution administered IV.
On the day after surgery, the cat was stable and began to
eat. Enrofloxacinc (5 mg/kg PO q24h) was continued, and
lactulosed (0.5 mL/kg PO q12h) was added to facilitate def-
ecation.
Histopathologic examination of the abdominal mass re-
vealed prostatic gland tissue with pyogranulomatous in-
flammatory infiltrates in the interglandular stroma, focal ne-
crosis of the acini, and accumulation of variable amounts
of purulent exudate within acini. Large numbers of degen-
erate neutrophils, moderate numbers of macrophages, and
cellular debris also were present in some areas (Fig 4). Be-
cause of the small size of the biopsy specimen, it was not
possible to differentiate focal necrosis from an abscess with
a central necrotic area in the prostate gland. No histologic
 Prostatitis in a Cat
Fig 3. Caudal exploratory laparotomy. A well-circumscribed spherical mass (arrows) caudal to the bladder (B) and compatible with an enlarged
prostate gland is present. U, urethra.
evidence of prostatic neoplasia or hyperplasia was ob-
served.
Many colonies of Escherichia coli (sensitive to amoxi-
cillin-clavulanate, gentamicin, trimethoprim-sulfadiazine,
and enrofloxacin) were isolated by aerobic bacterial culture
of the biopsy specimen. Aerobic bacterial culture of the
suppurative material yielded no growth. These results con-
firmed bacterial infection of the prostate gland.
On the 5th postoperative day, the cat was urinating nor-
mally but still had some tenesmus upon defecating. The cat
was discharged from the hospital, and, on the basis of in
vitro susceptibility testing, instructions were given to the
owners to continue enrofloxacin (5 mg/kg PO q24h) for 1
month. The referring veterinarian removed sutures at 10
days after surgery and reported that the cat was recuper-
ating satisfactorily.
One month later, the owners reported that dyschezia and
constipation were improved and that the cat was doing well.
On rectal examination, the prostate gland was approxi-
mately half its previous size. The cat was released with
instructions to the owners to discontinue all medications.
Seven weeks postoperatively, the cat continued to do
well, and physical examination identified no abnormalities.
Abdominal ultrasonography disclosed a 50% decrease in
the size of the prostate gland compared to its preoperative
size. No abnormalities were observed on urinalysis, and
595
aerobic culture of urine failed to grow any bacteria. Five
months later, the client reported that the cat was urinating
and defecating normally and was doing very well.
Diseases of the prostate gland in the cat have been re-
ported rarely, with neoplastic lesions such as prostatic ad-
enocarcinoma being the most frequently diagnosed.1–6 To
the authors’ knowledge, bacterial prostatitis has not been
reported previously in a cat. In contrast, bacterial prostatitis
is common in dogs and may follow an acute or chronic
course with variable clinical signs.1,7–10 Dogs with acute
prostatitis or prostatic abscess usually present with fever,
lethargy, and a painful prostate gland on rectal examination.
In contrast, dogs with chronic prostatitis may be presented
with no clinical signs or pain on palpation of the prostate
gland, or they may be presented for evaluation of signs of
lower urinary tract disease.1,7–10
In cats with prostatic neoplasia or periprostatic cysts,
lower urinary tract signs have been most commonly re-
ported, but constipation and dyschezia also have been de-
scribed.3–6 The cat in this report exhibited gastrointestinal
signs (eg, constipation and dyschezia) due to partial large
bowel obstruction, despite the presence of an active urine
sediment detected on urinalysis.
The active urine sediment presumably was due to reflux
of prostatic secretions and exudate into the urinary bladder,
similar to reflux cystitis described in dogs.7–9,11 Failure to
596 Roura et al

Fig 4. (a) Histopathologic section of the abdominal mass showing pyogranulomatous inflammatory infiltrates in the interglandular stroma of
the prostate gland. U, urethra. Bar ⫽ 100 ␮m (hematoxylin and eosin [H&E]). (b) Higher magnification showing a large number of neutrophils
and a moderate number of macrophages. Acini (arrowhead). Bar ⫽ 200 ␮m (H&E).

culture bacteria from the urine may have led to the use of
antibiotics by the referring veterinarian. A long-term course
of an antibiotic that features good penetration into prostatic
tissue is necessary when treating bacterial prostatitis. In
dogs with bacterial prostatitis, treatment with enrofloxacin,
trimethoprim-sulfa, or chloramphenicol for 4–6 weeks has
been recommended.1,7–11 On the basis of bacterial sensitivity
results and the high penetration of enrofloxacin into pros-
tatic tissues, enrofloxacin was chosen to treat the affected
cat.
The history, physical examination, laboratory findings,
and imaging features in this cat were similar to those pre-
viously described for cats with prostatic neoplasia, and test
results did differentiate among the various prostatic diseas-
es.1,3–6 In this cat, histopathology and culture of the prostatic
samples obtained by surgery were necessary to rule out
 Prostatitis in a Cat
neoplasia. The diagnostic findings in this cat were similar
to those observed in dogs with chronic bacterial prostati-
tis.1,7–10 In dogs, 70% of the cases of prostatitis are caused
by an ascending infection of a single organism that is part
of the normal urethral flora. E coli is the most common
bacterial organism identified in dogs with prostatitis, fol-
lowed by Staphylococcus sp., Klebsiella sp., Proteus sp.,
Mycoplasma sp., Pseudomonas sp., Streptococcus sp., En-
terobacter sp., Pasteurella sp., Haemophilus sp., and Bru-
cella canis.1,8–10 As observed in dogs, culture findings in
this cat indicated that prostatitis was due to infection by a
single microorganism (E coli).
The pathogenesis of prostate infections is not completely
understood in dogs.1,8,9 Prostatitis in dogs often is secondary
to a primary disorder such as benign prostatic hyperplasia,
squamous metaplasia, or prostatic neoplasia. These primary
disorders alter the normal defense mechanisms of the lower
urinary tract, predisposing the dog to bacterial infection.1,7,8
Prostatic hyperplasia or metaplasia has not been reported in
cats. In this cat, a primary disorder was not identified by
histopathology. Bacterial prostatitis may be uncommon in
cats because benign prostatic hyperplasia is rare, and be-
cause anatomic and physiologic features of their lower uri-
nary tract create an adverse environment for bacterial
growth.12
As in most dogs with prostatitis, the cat of this report
was sexually intact.1,7–9 Experimentally, castration has
been shown to increase the speed of resolution of infection
in dogs with bacterial prostatitis, and it is recommended
routinely.7–9,11 Histopathologic evaluation of the biopsy
specimen revealed no evidence of prostatic hyperplasia,
but castration still was used as adjunctive therapy in this
cat. It is unknown why the prostate gland was still iden-
tifiable 7 weeks postoperatively. Fibrosis that may have
been present could have required more time to resolve.
On the other hand, although histopathologic evidence of
hyperplasia was not found, the prostate gland may have
needed more time to return to its normal size after castra-
tion, as described in dogs, in which decreases of 50% in
the size of the prostate gland within 3 weeks and decreases
of 70% within 9 weeks after castration are reported.9 Sim-
ilar to the situation in dogs, in which bacterial prostatitis
is associated with a good prognosis after castration and
appropriate treatment with antibiotics, a complete resolu-
tion of clinical signs ultimately was seen in this cat. As
in dogs, bacterial prostatitis should be considered when
formulating a differential diagnosis for prostatic disorders
in sexually intact cats.
597
Footnotes
a
Snap Combo Plus FeLV antigen-FIV antibody test kit, Idexx Labo-
ratories Inc, Westbrook, ME
b
Lactated Ringer’s solution, B. Braun AG, Melsungen, Germany
c
Enrofloxacin, Baytril, Bayer AG, Leverkusen, Germany
d
Lactulose, Duphalac, Solvay Pharma SA, Brussels, Belgium
Acknowledgments
The work for this paper was done at the Veterinary
Teaching Hospital, Facultat de Veterinària, Universitat Au-
tònoma de Barcelona. We thank our colleagues from the
Novavet Veterinary Clinic for referring the case and our
colleagues from the Department of Pathology, Facultat de
Veterinària, Universitat Autònoma de Barcelona, for per-
forming the histopathologic studies. We acknowledge Drs
Mike G. Davidson and Edward B. Breitschwerdt for their
helpful review of the case.
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