Balanoposthitis, inflammation of the glans penis and prepuce, is common in small-animal practice. It can affect male dogs of any age and breed. Chronic or recurrent cases may impair quality of life. This article gives an overview of aetiology, clinical signs, diagnosis and management.
Distinguishing physiological discharge
Healthy male dogs often show a small amount of pale to yellowish-green preputial discharge. On its own this is not a sign of disease. Increased, purulent or bloody discharge, odour, pain and licking are abnormal.
Aetiology and predisposing factors
The causes are varied:
- Bacteria: including staphylococci, streptococci and Escherichia coli. Some of these organisms are also part of the normal preputial flora.
- Fungi: Malassezia yeasts, especially with skin irritation.
- Foreign bodies: grass awns, sand or other material in the preputial cavity.
- Anatomical abnormalities: phimosis (preputial opening too narrow for the penis to extrude) or paraphimosis (the penis cannot be returned into the prepuce) and other anomalies can impair self-cleansing.
- Allergies: food, environmental or contact allergens.
- Trauma: for example from bites or blows.
- Other causes: tumours and diseases of the prostate and urinary tract as differential diagnoses.
Clinical signs
- Discharge: purulent, serous or bloody, of variable amount
- Increased licking of the prepuce
- Redness and swelling
- Pain on palpation
- Malodour
- Pollakiuria and dysuria
- Restlessness
- In severe cases, fever, inappetence and lethargy
Diagnosis
Careful history and clinical examination are the basis. Depending on the findings, the following are useful:
- Cytology of the discharge (cell types, bacteria, yeasts)
- Bacteriological culture with susceptibility testing
- Allergy work-up if an allergic cause is suspected
- Blood tests to assess general condition
- Preputial endoscopy in rare cases, to assess the mucosa and to exclude foreign bodies or tumours
Veterinary management
The approach depends on the cause and rests with the veterinarian. Besides investigating and specifically controlling the cause, preputial hygiene and regular re-examination are part of management.
Conclusion
Balanoposthitis is common and often underestimated. History, clinical examination and, where needed, further diagnostics are decisive for identifying the cause and deciding on the approach.