SCREENING FOR PROS TAT E DISE A SE S : CPSE : A p owe r f u l to o l fo r d eve lo p i n g yo u r g e r i a tr i c s e r v i ce A s p e c if i c m a r ke r f o r p r o s t a t e d i s e a s e ODELIS ® CPSE, > CPSE (Canine Prostatic Specific arginine Esterase) is a hormone that is secreted by the prostatic epithelial cells, under the control of the sex hormones. Indications for use: > Confirm or exclude a diagnosis of BPH and rapidly adapt the treatment. > CPSE is present in sperm (more than 90% of the proteins in the prostatic fluid) and in blood. > A simple method for the early screening of BPH, from the first signs. > This protein belongs to the family of kallikreins, like PSA in man. > A simple and reliable alternative to rectal examination, which is often poorly tolerated by the animal and their owner. > When the prostatic cells become hyperplastic, the serum concentration of CPSE increases (4). Now, there is a n easier a n d m o r e p r e c i s e m et h o d … > Justify the performance of additional examinations and exclude other concomitant diseases (cysts, abscess, prostatitis, etc.). A RANGE OF SERVICES AND DOCUMENTS TO ASSIST THE VETERINARIAN The serum concentration of CPSE is an excellent indicator of benign prostatic hyperplasia in the dog (5) (6) (7) Poster and client information sheets: to inform your clients about the importance of regular screening in elderly dogs. PROS TAT E DISE A SE 1600 More than Poster 40x60 and client information sheet 800 affected! * New methods are now available to detect prostate disease 200 Tests are distributed by: 100 50 0 * * * BPH N=34 CPSE concentration as a function of clinical status: results from 89 dogs (7) BVT-ADV 3 volets A4 fermé-GB.in1 1 Ask your veterinarian for more information 2009 - Photos © Droits réservés 400 elderly dogs are 2009 - Photos : © Droits réservés CPSE (ng/mL) of * Normal N=48 Prostatitis N=5 Laboratory tests Adenocarcinoma N=5 Diagnostics at the Veterinarian’s Service www.bvt.fr 20/04/09 17:09:06 : Benign Prostatic hyperplasia (BPH): The Performance of The fir st ELISA test to screen and diagnose BPH A co m m o n co n d i t i o n w i t h s e r i o u s co n s e q u e n c e s A study was undertaken in 89 un-castrated male dogs in collaboration with the CERCA – Maisons Alfort (France) and the CRECS – L’Isle Jourdain (France) BPH CAN HAVE SERIOUS CLINICAL CONSEQUENCES (1) : Vertebral column Prostate Bladder Urethra Description of the sample population: 55 dogs diagnosed without BPH* 34 dogs diagnosed with BPH* (From Fontbonne and al. 2006 (9)) • Constipation, tenesmus • Dysuria, haematuria • Pain, lameness, and behavioural problems • Infertility in breeding dogs • Haematospermia * The BPH / non-BPH status was determined following clinical examination, ultrasonography, and histology for some dogs Clinical status BPH Non-BPH 33 4 1 51 Testicles Diagram : Photostock of GERES Odelis® CPSE The increased volume of the prostate leads to compression of the rectum, urethra, blood vessels, and nerve fibres. Sensitivity = 97,1% / Specificity = 92,7 % THE HISTOLOGICAL LESIONS PRECEDE THE SYMPTOMS (2,3) HOW DO YOU INTERPRET THE RESULTS OF ODELIS ® CPSE ? Over 50% of dogs over 5 years of age present with histological signs of early BPH. An asymptomatic BPH may progress rapidly and predispose the animal to more serious conditions (prostatitis, voluminous cysts, prostatic abscesses etc.). ≥ 61 ng/mL < 61 ng/mL Clinical signs suggestive of prostate disease: Prostatic hyperplasia (© E. Teske) > Odelis® CPSE enables your laboratory to perform a quantitative assay of CPSE from a simple serum or plasma sample. Stud dog Dogs > 5 years and / or • Constipation • Dysuria, haematuria • Pain, lameness, behavioural problems • Infertility, haematospermia > The serum or plasma sample can be stored for 24h at room temperature or 96 hours at +4°C, enabling the sample to be sent to the laboratory by courier service.(6) REGULAR SCREENING IS RECOMMENDED IN ELDERLY DOGS Recommended by numerous authors (7,8) to: > Provide the client with clear information about the consequences of this disease, > Delay the onset of symptoms through appropriate monitoring and treatment, > Closely monitor at-risk dogs: stud males, elderly dogs, those with a previous history of BPH, etc Odelis® CPSE Test Plasma 5. 6. 7. 8. 9. Verstegen J. Managment of prostatic disorders . In : Proceedings of the International WSAVA Congress, Granada 2002- Spain Barsanti J. Canine prostatic disease. in Proceedings of the International SCIVAC Congress, Rimini 2008- Italy Johnston SD, Kustritz MVR, Olson PNS. Benign prostatic hypertrophy/hyperplasia. In: Canine and feline theriogenology. WB Saunders, Philadelphia. 2001:340-341 Chapdelaine P, Dubé JY, Frenette G et coll. Identification of arginine esterase as the major androgen-dependent protein secreted by dog prostate and preliminary molecular characterization in seminal plasma. J Androl. 1984 ; 5 : 206-210 Bell FW, Klausner JS, Hayden DW et coll. Evaluation of serum and seminal plasma markers in the diagnosis of canine prostatic disorders. J Vet Intern Med. 1995 ; 9 :149-153 Etude interne BVT Lévy X, Mimouni P. Hyperplasie bénigne de la Prostate : actualités. Point Vétérinaire. 2009. 293, 39-43 Romagnoli S. Medical importance of benign prostatic hyperplasia for the long term health of the dog. In : Prostate technical booklet, 2008, Virbac Fontbonne et al. Reproduction canine Ed. Royal Canin, 2006 BVT-ADV 3 volets A4 fermé-GB.in2 2 No clinical signs (sample collected into a heparin tube) © F.Decante Transfer of the serum or plasma to a plain tube Blood sample 1. 2. 3. 4. Normal CPSE concentration < 50 ng/ml PROCEDURE FOR SENDING A SAMPLE FOR CPSE ASSAY TO A LABORATORY (<1 hour) Serum (sample collected in a plain tube) Courier service to the laboratory * Presence of clinical signs BPH unlikely it is advisable to put an ice block in with the sample * The samples were stable after 24 hours at room temperature, 96 hours at +4°C, and several months at -20°C. Repeat test in 6 to 12 months Consider different differential diagnoses Intermediate CPSE concentration entre 50 et 70 ng/ml No clinical signs Presence of clinical signs BPH possible Repeat test in 3 to 6 months Raised CPSE concentration > 70 ng/ml Strong suspicion of BPH Prostatic ultrasonography recommended: evaluation of other associated diseases 20/04/09 17:09:21
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