Is Canine Prostate-Specific Esterase a Reliable Marker for Benign Prostatic Hyperplasia Progression in Dogs?

Abstract

Benign prostatic hyperplasia (BPH) is a common condition in intact male dogs, often progressing from subclinical to symptomatic stages with increasing clinical and structural impact. This study evaluated canine prostate-specific esterase (CPSE) as a biomarker for BPH progression, focusing on clinical severity, complexity, and ultrasonographic features. Seventy-one dogs were included: subclinical-BPH (n = 14), clinical-BPH (n = 26), BPH-prostatitis (n = 9), and controls (n = 22). CPSE levels, measured using a canine-specific enzyme-linked immunosorbent assay, were significantly correlated with clinical severity (ρ = 0.800, p ≤ 0.001) and complexity (ρ = 0.818, p ≤ 0.001). CPSE predicted mild (OR = 1.260, B = 0.231, p ≤ 0.001) and moderate severity (OR = 1.300, B = 0.262, p ≤ 0.001), as well as low (OR = 1.225, B = 0.203, p ≤ 0.05), moderate (OR = 1.235, B = 0.211, p ≤ 0.01), and high (OR = 1.346, B = 0.297, p ≤ 0.001) clinical complexity. CPSE showed a trend toward predicting structural alterations (OR = 1.227, B = 0.204, p = 0.069) and was associated with larger stippled areas, increased prostatic volume, and larger cysts/abscesses (all p ≤ 0.001). CPSE appears to be a promising marker for BPH progression.

Keywords: BPH; CPSE; biomarker; clinical severity; disease progression; ultrasonography.

Figure 1

Ultrasound image of the prostatic parenchyma with pixel analysis performed within a defined region of interest (ROI). Stippled areas were identified based on a standardized pixel intensity threshold. Red indicates stippled areas within the ROI, while green marks regions excluded due to their location outside the ROI.

Figure 2

Bar graph displaying median CPSE levels (ng/mL) and interquartile ranges (IQR), along with intergroup differences. Statistical significance is indicated above the bars (* p < 0.05, **** p < 0.0001, ns = not significant); CPSE = canine prostatic specific esterase; BPH = benign prostatic hyperplasia.

Figure 3

Scatter plot showing the distribution of CPSE levels (ng/mL) across all four groups. Each dot represents an individual measurement. CPSE = canine prostatic specific esterase; BPH = benign prostatic hyperplasia.

Figure 4

Forest plot showing the odds ratios (ORs) and 95% confidence intervals (CIs) for the predictive value of CPSE levels on clinical severity (mild and moderate severity) and complexity (low, moderate, and high complexity). The solid circles represent the ORs, and the whiskers indicate the CIs. The dotted line at OR = 1 serves as a reference. ORs greater than 1 indicate a positive predictive effect. CPSE = canine prostatic specific esterase.

Figure 5

Scatter plot showing the distribution of the actual/expected prostatic volume ratio across all four groups and its positive correlation (ρ = 0.685, p ≤ 0.001) with CPSE levels (ng/mL). Each dot represents an individual measurement. CPSE = canine prostatic specific esterase; BPH = benign prostatic hyperplasia.

Figure 6

Scatter plot showing the distribution of the intraprostatic stippled area (%) across all four groups and its correlation with CPSE levels (ng/mL). Larger stippled areas were strongly correlated with higher CPSE levels (ρ  = 0.861, p ≤ 0.001). Each dot represents an individual measurement. CPSE = canine prostatic specific esterase; BPH = benign prostatic hyperplasia.

Figure 7

Forest plot showing the odds ratios (ORs) and 95% confidence intervals (CIs) for the predictive value of CPSE levels on the degree of ultrasonographic structural alteration. The solid circles represent the ORs, and the whiskers indicate the CIs. The dotted line at OR = 1 serves as a reference. The OR greater than 1 indicates a positive predictive effect, while the lower than one a negative prediction. CPSE = canine prostatic specific esterase.