PDF(Pubmed)
Abstract：
BACKGROUND: Priapism is defined as erection that lasts for more than 4 h without sexual stimulation. There are various causes of priapism, but there are no reports of sildenafil-induced priapism in dogs. In human medicine, there were no pre-marketing reports of priapism caused by sildenafil, but post-marketing surveillance has shown that it is rare. In cases of pulmonary hypertension in dogs, sildenafil is the first-line drug of choice for symptomatic relief.
METHODS: An 11-year-old neutered male Maltese dog that presented with tachypnea and cough was diagnosed with myxomatous mitral valve disease, American College of Veterinary Internal Medicine (ACVIM) stage C, and was treated medically. Eighteen months after the diagnosis, severe pulmonary hypertension occurred due to left heart disease. At 20 months postdiagnosis, pleural effusion occurred, and sildenafil (2 mg/kg twice daily) was added to the existing treatment. Two weeks later, the dyspnea recurred, confirming pleural fluid recurrence, and sildenafil was increased to 2 mg/kg thrice daily. One day later, the patient developed persistent erections and penile pain. Penile amputation and urethrostomy were recommended but were refused; therefore, analgesia and palliative care were provided. The patient died of acute dyspnea 22 months after the first presentation, with no specific priapism recurrence at the time of death.
CONCLUSIONS: To the best of our knowledge, this is the first report of sildenafil-induced priapism in a dog with pulmonary hypertension.
METHODS: An 11-year-old neutered male Maltese dog that presented with tachypnea and cough was diagnosed with myxomatous mitral valve disease, American College of Veterinary Internal Medicine (ACVIM) stage C, and was treated medically. Eighteen months after the diagnosis, severe pulmonary hypertension occurred due to left heart disease. At 20 months postdiagnosis, pleural effusion occurred, and sildenafil (2 mg/kg twice daily) was added to the existing treatment. Two weeks later, the dyspnea recurred, confirming pleural fluid recurrence, and sildenafil was increased to 2 mg/kg thrice daily. One day later, the patient developed persistent erections and penile pain. Penile amputation and urethrostomy were recommended but were refused; therefore, analgesia and palliative care were provided. The patient died of acute dyspnea 22 months after the first presentation, with no specific priapism recurrence at the time of death.
CONCLUSIONS: To the best of our knowledge, this is the first report of sildenafil-induced priapism in a dog with pulmonary hypertension.
摘要：
背景：阴茎异常勃起被定义为勃起持续4小时以上而没有性刺激。阴茎异常勃起的原因有很多,但目前还没有关于西地那非诱发犬阴茎异常勃起的报道。在人类医学中，没有西地那非引起阴茎异常勃起的上市前报告，但上市后的监测表明，这是罕见的。在狗的肺动脉高压的情况下，西地那非是缓解症状的首选一线药物。
方法：一只11岁的男性马耳他犬，出现呼吸急促和咳嗽，被诊断为黏液性二尖瓣疾病，美国兽医内科学院（ACVIM）C阶段，并接受了医学治疗。确诊18个月后,左心疾病导致严重肺动脉高压。诊断后20个月,发生胸腔积液,和西地那非（每天2次2mg/kg）加入现有的治疗。两周后,呼吸困难复发,确认胸腔积液复发，西地那非每天三次增加到2mg/kg。一天后,患者出现持续性勃起和阴茎疼痛。建议进行阴茎截肢和尿道造口术，但遭到拒绝；因此，提供镇痛和姑息治疗.患者在首次就诊22个月后死于急性呼吸困难，在死亡时没有特定的阴茎异常勃起复发。
结论：据我们所知，这是西地那非诱导肺动脉高压犬阴茎异常勃起的首次报道。
方法：一只11岁的男性马耳他犬，出现呼吸急促和咳嗽，被诊断为黏液性二尖瓣疾病，美国兽医内科学院（ACVIM）C阶段，并接受了医学治疗。确诊18个月后,左心疾病导致严重肺动脉高压。诊断后20个月,发生胸腔积液,和西地那非（每天2次2mg/kg）加入现有的治疗。两周后,呼吸困难复发,确认胸腔积液复发，西地那非每天三次增加到2mg/kg。一天后,患者出现持续性勃起和阴茎疼痛。建议进行阴茎截肢和尿道造口术，但遭到拒绝；因此，提供镇痛和姑息治疗.患者在首次就诊22个月后死于急性呼吸困难，在死亡时没有特定的阴茎异常勃起复发。
结论：据我们所知，这是西地那非诱导肺动脉高压犬阴茎异常勃起的首次报道。
