THE MERCK VETERINARY MANUAL
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Balanoposthitis in Small Animals

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Inflammation of the penile or preputial mucosa is common in dogs. The normal preputial secretions usually do not result in overt clinical signs. Mild balanoposthitis, resulting in a slight mucopurulent preputial discharge, is present in many sexually mature dogs, resolves spontaneously, and is of little clinical significance. Diagnostic tests and treatment are not necessary, except as needed for reasonable hygiene. Trauma, lacerations, neoplasia, foreign bodies, urinary tract infection, urolithiasis, or phimosis may result in development of more severe balanoposthitis. A mucopurulent preputial discharge is the most common clinical sign. Excessive licking of the prepuce may also be noted. Swelling of the prepuce and pain are rarely present except in cases of trauma, snake bite, or foreign bodies. If signs of systemic illness are present, the possibility of a more serious concomitant disorder should be considered. Balanoposthitis is rare in cats.

The penis and prepuce should be thoroughly examined, to the level of the fornix, for underlying predisposing factors. The use of saline infusion through a rigid endoscope faciitates this examination, but an otoscope can be used if necessary. Sedation or general anesthesia may be needed. Preputial cytology may be helpful. Bacterial cultures of the preputial cavity, although sometimes difficult to interpret because of the presence of normal preputial flora, may help identify unusual organisms and determine antibiotic sensitivities for refractory cases. Foreign bodies can be submucosal and difficult to see, so tiny tracts should be explored.

Treatment includes correcting any predisposing factors, clipping long hair away from the preputial orifice, and thoroughly flushing the preputial cavity with a mild antiseptic (eg, dilute povidone-iodine or chlorhexidine) or sterile saline solution. If bacterial infection is suspected, an antibiotic ointment may be infused into the preputial cavity for 7–10 days. Recurrence of mild balanoposthitis is common irrespective of therapy. Castration may diminish genital secretions but will not abolish them.

Last full review/revision October 2013 by Autumn P. Davidson, DVM, MS, DACVIM

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