Benign Prostatic Hyperplasia in Dogs: Etiopathogenesis, Diagnosis, Therapy, and Prospects for Targeted Drugs

The objective of the study is to analyze and evaluate the current status of benign prostatic hyperplasia (BPH) in dogs, including epidemiology, etiopathogenesis, the use of instrumental and laboratory diagnostic methods, treatment strategies, and the use of pharmacotherapeutic agents, with an emphasis on promising pharmaceutical developments. The review utilizes literature published between 2015 and 2025 on BPH in dogs. Diagnosis of BPH in dogs relies on a combination of clinical manifestations, physical examination, and instrumental examination methods, with ultrasound and radiography being the dominant methods. A serum test for determining the level of one potential biomarker for BPH in dogs, canine prostate-specific esterase (PSE), has demonstrated promise in laboratory testing. Recent data on the pathogenesis of BPH in dogs highlight its multi-layered nature (dominated by hormonal changes), requiring a comprehensive approach to BPH treatment and the development of targeted drugs. Castration is considered the primary treatment for BPH in dogs; however, it is not always appropriate. Pharmacotherapy for the disease includes antiandrogens (osaterone acetate), 5α-reductase inhibitors (finasteride, dutasteride), α1-adrenergic blockers (terazosin, tamsulosin, etc.), gonadotropin-releasing hormone (GnRH) agonists (deslorelin), and combination therapies. Prospects for new drugs focus on targeted molecular mechanisms, including selective androgen receptor modulators (SMAPs) (ligandrol), aromatase inhibitors (letrozole), and phytotherapeutic agents (saw palmetto, African pygeum, stinging nettle, etc.). Of clear interest is the design of targeted drugs based on various combinations of promising pharmacological agents, both with each other and in combination with the most effective and already used agents for the treatment of BPH in dogs (finasteride, osaterone, deslorelin), in innovative dosage forms with improved pharmacokinetic and biopharmaceutical properties.