Topics in Compan An Med ] (2015) ]]]–]]]

Topical Review

Spermatocele in a South African Boerboel Dog

Andrea C. Hesser, DVMa,n, Autumn P. Davidson, DVM, MS, Dipl. ACVIMb,c

Keywords: A 2-year-old intact male South African Boerboel presented for semen cryopreservation and was
canine reproduction
discovered to be azoospermic. The dog had excellent libido and had sired litters within 6 months, so
spermatocele
a further investigation of why his collection lacked sperm was warranted. On further examination of his
sperm granuloma
granulomatous epididymitis scrotal contents, his right epididymis had an enlarged area with a hard texture. Ultrasonography
canine infertility revealed that the enlarged area of the right epididymis was fluid filled. A sample of the fluid was
semen collection aspirated for aerobic culture. No bacteria showed growth. Although the culture was negative, it was
azoospermia suspected that this dog had an epididymitis or epididymal abscess, and treatment with enrofloxacin at
cryopreservation 10 mg/kg orally was initiated for 4 weeks. The abnormal texture and fluid-filled cavity in the right
epididymis persisted, despite antibiotic therapy. Cytology of a repeat aspiration of the fluid-filled area
a
Department of Population Health and after antibiotic therapy revealed a mixture of red blood cells and sperm. Owing to the potential for
Reproduction, School of Veterinary Medicine, blood-testis barrier disruption, a unilateral orchiectomy of the right testicle was performed, as an
University of California, Davis, CA attempt to protect future sperm production of the remaining testicle. A spermatocele was confirmed on
b
Department of Medicine and Epidemiology, histopathology. After another month, an excellent-quality semen sample was collected, with 90%
School of Veterinary Medicine, University of progressive motility, good concentration, and few morphologic abnormalities. A subsequent collection
California, Davis, CA was acquired and was successfully cryopreserved for future breeding. In dogs with spermatoceles,
c
PetCare Veterinary Hospital East, Santa Rosa, semen quality can be preserved with aggressive treatment to remove the affected testicle. The
CA disruption of the blood-testis barrier in spermatoceles may result in antisperm antibody production
n
Address reprint requests to: Andrea and eventual infertility; however, cryopreservation can result in long-term options for owners seeking
Hesser, DVM, 2505 5th St. #139, Davis, to continue using an animal in their breeding program.
CA 95618. & 2015 Elsevier Inc. All rights reserved.
E-mail: [email protected] (A.C. Hesser)

Clinical Report It was confirmed that culture results yielded no bacterial growth
on broth or media after 72 hours. As no bacteria were cultured,
A 2-year-old 72.7-kg South African Boerboel presented for mycoplasma culture was requested as an additional culture diag-
semen freezing. The semen was collected using a latex artificial nostic on the sample. The external laboratory declared that the
vagina into 15-mL tubes. He had excellent libido during the sample was too old (contaminated) for further evaluation, so no
collection; however, his semen sample was completely azoosper- evaluation for mycoplasma was possible. Alkaline phosphatase level
mic. A routine physical examination was performed after collec- was 171 IU/L in the semen sample, which suggested an incomplete
tion, which revealed normal testicles bilaterally. The right ejaculation or complete bilateral obstruction of the epididymes.
epididymis was palpably enlarged and hard. The dog also had a The dog's progress was monitored by a local veterinarian, and
mild presence of dental tartar with no evidence of gingivitis. No the epididymal lesion of the right testicle remained unchanged.
other abnormalities were noted on physical examination. Accord- The dog returned after 1 month of antibiotic treatment with
ing to the owner, the dog had been healthy throughout his life, enrofloxacin for a repeat semen collection and evaluation. He
and had no problems with infertility. He is a proven male and has had moderate right epididymal enlargement, and ultrasonography
been an active part of the owner's breeding program, having sired revealed that a fluid-filled pocket was still present. Fine-needle
litters within the last 6 months. Owing to his azoospermia and aspiration was repeated on the fluid-filled area with the dog under
suspicion of disease process in the right epididymis, testicular and sedation; cytology revealed a hemorrhagic fluid with high num-
epididymal ultrasonographies were performed. Flocculent fluid bers of nonmotile spermatozoa. Unilateral orchiectomy of the
was noted within a large cavitation in the caudal epididymis of the right testicle was advised owing to the potential formation of
right testicle. The scrotal contents were otherwise unremarkable antisperm antibodies resulting from the epididymal lesion.
(Fig 1). Subsequent aspiration of the fluid noted within the Unilateral orchiectomy of the right testicle was elected by the
epididymis was elected. Before the aspiration, the dog was sedated owner. The patient was placed under general anesthesia: premed-
with dexdomitor at 375 mcg/m2 intravenously. A small sample of ication with butorphanol 0.10 mg/kg subcutaneously, induction
fluid was acquired via fine-needle aspiration from the abnormal with propofol 6 mg/kg intravenously, and maintenance with
area in the right epididymis and was submitted to a local sevoforane/O2. The prescrotal region was clipped and scrubbed
laboratory for aerobic culture and sensitivity. The patient was with a dilute chlorhexidine solution. The right testicle was
reversed from sedation with antisedan. A sample of the semen advanced to the prescrotal region, and the skin and tunics were
from his collection was submitted for alkaline phosphatase eval- incised. After exteriorizing the testicle, an open castration of the
uation. Blood was obtained for canine brucellosis testing with a right testicle was performed. The subcutaneous layer was closed,
rapid slid agglutination test, and the result was negative. Enro- and subcuticular sutures were placed with 3-0 polydioxanone. The
floxacin was initiated for treatment of possible bacterial disease in skin edges were opposed with tissue adhesive. The right testicle
the epididymis for 4 weeks at 10 mg/kg orally every 24 hours. was placed in formalin and submitted for histopathology. Once the

http://dx.doi.org/10.1053/j.tcam.2015.03.001
1527-3369/& 2015 Topics in Companion Animal Medicine. Published by Elsevier Inc.
2 A.C. Hesser, A.P. Davidson / Topics in Companion An Med ] (2015) ]]]–]]]

epididymis. Spermatoceles may precede sperm granulomas.

The addition of inflammatory cells and fibrous tissues converts
the diagnosis of a spermatocele to a sperm granuloma, but the
terms are often used interchangeably. Spermatoceles and sperm
granulomas are not seen frequently in dogs but are hypothesized to
result from trauma, infection, and congenital abnormalities.1 They
are also occasionally reported as a postoperative complication in
vasectomized animals.2 In this dog, the cause of initial insult
remains unknown. This dog had no history of trauma that may
have resulted in local inflammation and hemorrhage in the epi-
didymis, although it cannot be completely ruled out, as he was out
of the owner's care for 2 weeks before his first semen collection.
The cause of this dog's complete azoospermia is unclear.
Thermal insult relating to local inflammation may have resulted
in transient poor sperm production. It is possible that localized
inflammation owing to the insult that incited the epididymal
Fig. 1. Sagittal ultrasound image (linear 8-10 MHz scan head) showing the
disease caused a complete, transient azoospermia. Semen alkaline
spermatocele (cursor) filled with echogenic fluid. (Image courtesy Baker TW.)
phosphatase o5,000 suggests that complete ejaculation did not
occur, or that there was bilateral obstruction.3 His libido during
patient had fully recovered from anesthesia, he was discharged to this collection was excellent, so it is unclear why his ejaculation
the owner with carprofen, 2.2 mg/kg orally every 12 hours, for from the left testicle was not complete. It can be presumed that
postoperative inflammation management and pain relief. It was the right testicle was obstructed from ejaculation owing to the
recommended to return in 1 month for semen collection and spermatocele. As his ejaculation trended from azoospermic to
evaluation. In communications with the owner, the immediate normospermic, we would not expect that sperm antibodies were
postoperative period was deemed uneventful, and the surgical site responsible for the azoospermic incident. That collection may have
healed appropriately. represented an incomplete ejaculation, or local inflammation may
The pathology report confirmed the presence of a spermatocele have affected both testicles negatively.
in the right epididymis (Fig 2). Evaluation revealed a cystic, Once the blood-testis barrier has been broken, the animal's
inflamed, and partially ruptured epididymal duct with adjoining immune system will recognize the body's sperm cells as a foreign
fibrosis, granulomatous epididymitis, and mineralization with material. Antisperm antibodies will subsequently be formed and
intralesional spermatids and extensive squamous metaplasia of circulate in the bloodstream, which would then recirculate into
ductular epithelium, consistent with a spermatocele. The cystic the testicular tissue. Antisperm antibodies have been detected in
duct had ruptured, resulting in a sperm granuloma. The testicular the serum of 6% of infertile men, but very few evaluations of
tissue submitted was unremarkable. antisperm antibodies have been performed in dogs owing to cost
A month after the surgery, the dog returned for semen
collection and evaluation after unilateral orchiectomy. The owner
reported that he had been doing well at home, with a good
appetite, normal urination and defecation, and continued interest
in bitches. His semen was collected using a latex artificial vagina,
and the semen was fractionated into 15 mL tubes. Libido during
collection was good, and his semen fractionated well. The sperm-
rich fraction was immediately evaluated on a microscope and had
approximately 90% progressive motility and 90% normal morphol-
ogy. No red blood cells or white blood cells were noted in the
ejaculate. Owing to potential future fertility loss after disruption of
the blood-testis barrier, cryopreservation was recommended to
store frozen semen on the dog.
During the following month, the semen was collected for the
purposes of cryopreservation. After collection, the semen was
evaluated and 95% progressive motility was appreciated with
moderate speed. Approximately 10% of the cells had coiled or bent
tails, and some detached sperm heads were noted. This sample was
of great quality overall, and it was cryopreserved using commercial
freezing extenders and protocols. A total of 12 straws were stored
at a concentration of 50 million sperm per straw. Postthaw motility
was 40% and of average motility quality. The sample constituted
approximately 2.4 breeding doses in total, stored in liquid nitrogen.

Discussion

Spermatocele management can have a successful outcome

regarding fertility if addressed immediately following an early
clinical diagnosis. In this dog, a return to excellent-quality semen
was achieved soon after the spermatocele was removed. A sperma- Fig. 2. Gross sections of affected testicle. Tail of epididymis showing region of
tocele is described as a localized area of spermiostasis within the spermatocele (cursor).
 A.C. Hesser, A.P. Davidson / Topics in Companion An Med ] (2015) ]]]–]]] 3

and lack of availability of testing.4 It has been demonstrated that References

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