Intravesical instillation of dilute formalin for treatment of cyclophosphamide-induced hemorrhagic cystitis in two dogs

Sterile hemorrhagic cystitis induced by cyclophosphamide therapy was diagnosed in 2 dogs. Clinical signs included pollakiuria, hematuria, and stranguria. The signs were progressive and referable to long-term oral cyclophosphamide administration. Dilute (1%) formalin was used to treat the hemorrhagic cystitis. Clinical control of hemorrhage was achieved in both cases, and hemorrhage did not recur.     

Successful treatment of Corynebacterium urealyticum encrusting cystitis with systemic and intravesical antimicrobial therapy

A 6-year-old Saint Bernard dog was diagnosed with encrusting cystitis caused by Corynebacterium urealyticum. The infection persisted despite the prolonged use of antimicrobials and surgical debridement of the urinary bladder. Resolution occurred following intravenous vancomycin, urine acidification, and intravesical gentamicin. The challenges involved in the treatment of encrusting cystitis are described.     

RADIOGRAPHIC AND ULTRASONOGRAPHIC FINDINGS OF EMPHYSEMATOUS CYSTITIS IN FOUR NONDIABETIC FEMALE DOGS

The urinary bladder of four dogs with emphysematous cystitis was assessed radiographically. Ultrasonography was also performed using a 7.5-MHz microconvex probe in dorsal recumbency and in a standing position. Ultrasonographically there were bright echoes and reverberations typical of gas in all dogs. This was entrapped in the bladder wall as it appeared in the same location in recumbent and standing positions. Bladder size was reduced and bladder content was echogenic in all dogs. In only one out of the four dogs was a gas stripe seen in the bladder on radiographs. Proteus mirabilis was isolated from the urine of all patients. Diabetes was ruled out on the basis of urine and blood analysis. A small amount of gas can be difficult to detect on radiographs. Ultrasonography appears to be a more sensitive technique for detection of gas within the bladder at an early stage of emphysematous cystitis. Prevalence of emphysematous cystitis may be underestimated if only radiographs are made.     

Emphysematous cystitis in a chemically-induced diabetic dog

Emphysematous cystitis is a rare disorder caused by bacterial infection and characterized by gas accumulation within the bladder wall with cyst formation. This report describes the histopathological characteristics of emphysematous cystitis found in a diabetic female beagle induced by streptozotocin and alloxan. Macroscopically, multiple cyst-like structures were observed on the cut surface of the urinary mucosa. During fixation, small specimens cut from the mucosa floated on the surface of the fixative solution. Histopathologically, multiple cysts were lined with a single layer of flattened cells found to be immunohistochemically positive for vimentin, partially positive for α-smooth muscle actin or macrophage scavenger receptor, class A, and thought to be myofibroblasts, fibroblasts or macrophages. Multinucleated giant cells were observed around the cysts, and gram-negative short bacilli were observed in the lumen of the urinary bladder. From these findings, this case was diagnosed as emphysematous cystitis.     

Emphysematous cystitis and bladder trigone diverticulum in a dog

A 14-month-old, male German shepherd dog was evaluated for chronic, recurrent Escherichia coli urinary tract infection. An initial diagnosis of emphysematous cystitis was made, which resolved with appropriate antibacterial therapy. The urinary tract infection, however, did not resolve and on further investigation a bladder trigone diverticulum was evident, thought to be congenital in origin. This report describes the apparent ultrasonographic and radiological changes, and surgical repair of the diverticulum, and reviews the literature with regard to both congenital bladder trigone diverticulum and emphysematous cystitis. The former has never been documented in the dog and the latter is an unusual finding in a non-diabetic dog.     

Emphysematous cystitis due to Clostridium perfringens in a non-diabetic dog

This paper describes a case of emphysematous cystitis in a non-diabetic dog. The organism isolated from a urine specimen was identified as the gas producing anaerobe Clostridium perfringens.     

Emphysematous cystitis due to Escherichia coli associated with prolonged chemotherapy in a non-diabetic dog

An 11-year-old male Labrador retriever dog with chronic recurrent complicated urinary tract infection due to Escherichia coli and a history of prolonged multi-drug chemotherapeutic protocol due to lymphoma was diagnosed with emphysematous cystitis. Diagnosis was based on ultrasonographic and radiographic findings. The immunosuppressive effects of the long glucocorticoid treatment were probably the main underlying mechanism involved in the pathogenesis, however, chemotherapy and/or the presence of lymphoma might have also been involved.     

Emphysematous Cystitis due to Escherichia coli Associated with Prolonged Chemotherapy in a Non‐Diabetic Dog

An 11‐year‐old male Labrador retriever dog with chronic recurrent complicated urinary tract infection due to Escherichia coli and a history of prolonged multi‐drug chemotherapeutic protocol due to lymphoma was diagnosed with emphysematous cystitis. Diagnosis was based on ultrasonographic and radiographic findings. The immunosuppressive effects of the long glucocorticoid treatment were probably the main underlying mechanism involved in the pathogenesis, however, chemotherapy and/or the presence of lymphoma might have also been involved.     

Emphysematous pyelitis and cystitis associated with vesicoureteral reflux in a diabetic dog

A 12-year-old female dog with a 3-month history of poor response to diabetes treatment had an acute worsening of symptoms, including weakness and blindness. The dog had elevated blood glucose, alkaline phosphatase and urea concentration, hyposthenuria, glycosuria, hematuria, and pyuria. Escherichia coli was isolated from the urine. Radiographs and ultrasound examination showed that the dog had unilateral emphysematous pyelitis and concurrent cystitis associated with vesicoureteral reflux.     

Infectious endocarditis caused by gas-producing Escherichia coli in a diabetic dog

A 10-year-old, female West Highland white terrier was presented with poorly controlled diabetes mellitus and a previously undetected heart murmur. Emphysematous cystitis, emphysematous peritonitis and infective endocarditis of the tricuspid valve with gas accumulation were diagnosed with radiographs, including non-selective angiocardiography. The diagnoses were confirmed by post-mortem examination and positive cultures for Escherichia coli in blood, urine and tricuspid valve tissue samples.     

Acute sterile hemorrhagic cystitis after a single intravenous administration of cyclophosphamide in three dogs.

Three dogs receiving cyclophosphamide IV as part of a combination chemotherapeutic regimen developed macrohematuria, stranguria, and pollakiuria within 24 hours of administration of the first dose of this drug. An 11-year-old spayed mixed-breed dog with an oral squamous cell carcinoma was administered 250 mg of cyclophosphamide/m2 of body surface, whereas a 4-year-old castrated male Gordon Setter was treated with 100 mg of cyclophosphamide/m2 and a 6-year-old male German Shepherd Dog with a cutaneous hemangiosarcoma was administered 140 mg of cyclophosphamide/m2. Aerobic bacterial culture, antimicrobial susceptibility testing, and urinalysis were performed on urine obtained by cystocentesis from all 3 dogs after hematuria was observed. Sterile hemorrhagic cystitis was diagnosed on the basis of large numbers of RBC in the urine, lack of pathogens on bacterial culturing of urine, and clinical signs. Although cyclophosphamide-induced cystitis in dogs has been reported in the literature numerous times, acute episodes developing within 24 hours of administration of the first dose have not been reported in this species with the use of therapeutic doses. Therefore, appropriate precautionary steps should be taken, even when the drug is being administered intermittently.     

Treatment of cyclophosphamide-induced hemorrhagic cystitis in five dogs

Sterile hemorrhagic cystitis developed in 5 dogs after treatment with cyclophosphamide. Four dogs were being treated with various antineoplastic protocols, and the fifth dog had recurrent immune-mediated thrombocytopenia. In all instances, clinical signs of hematuria and stranguria persisted after cyclophosphamide administration was discontinued. Three dogs required cystotomy to remove necrotic mucosa and calculi. The other 2 dogs were treated with intravesicularly administered dimethyl sulfoxide to decrease inflammation and to inhibit fibroplasia of the bladder wall. In 4 dogs, clinical signs resolved after treatment. The fifth dog, treated surgically, continued to have intermittent urinary incontinence attributable to residual bladder wall fibrosis.     

Polypoid cystitis, pyelonephritis, and obstructive uropathy in a cow

Polypoid cystitis, pyelonephritis, and obstructive uropathy was found in a cow with hematuria, dysuria, and colic. The cow was treated with penicillin, multiple B vitamin supplementation, and isotonic sodium chloride. Polypoid cystitis, diagnosed in this cow by use of endoscopic examination, is a common response to chronic inflammation of the bladder and can lead to obstructive uropathy. Although endoscopic confirmation of this diagnosis may not always be feasible, recognition of corresponding clinical signs can allow timely, appropriate treatment.     

Intravenous formalin for treatment of haemorrhage in horses

There is limited information in the literature regarding the clinical use of formalin for the treatment of haemorrhage in horses. This uncontrolled retrospective study summarises 11 cases that were treated with intravenous formalin at the Veterinary Health Center at Kansas State University from 2009 to 2019. The objective of this study was to describe signalment, clinical and laboratory findings, treatment and outcome of horses treated with intravenous formalin for potentially life-threatening haemorrhagic conditions. This study does not attempt to prove efficacy of intravenous formalin, but rather to report its clinical use and the associated details of those cases. Horses ranged in age from 2 to 23 years old. There were nine Quarter Horses, one Thoroughbred and one Appaloosa. Treated conditions included haemoabdomen (4/11), uterine haemorrhage (1/11), epistaxis (3/11), haemorrhage secondary to a mandibular laceration (2/11) and haemothorax (1/11). The most utilised dose was 0.476% formalin (50 mL 10% neutral buffered formalin diluted in 1 L of isotonic fluid). Some horses were also treated with aminocaproic acid, Yunnan Baiyao, whole blood transfusions and surgery. Ten out of the 11 horses survived to discharge with one horse reported by the owner to have died 2 weeks later of an unknown cause.     

The hemolytic activity of bracken extracts in guinea pigs

This study was conducted to elucidate the hemolytic activity of a new toxic substance in bracken fern. A crude extract (CE) was prepared from the methanol extracts of bracken by the column chromatography. When the CE was injected subcutaneously in guinea pigs, the hemoglobinuria and hemolysis were observed within 6 hr, and 3 days later edema and hemorrhages in the urinary bladder were observed. The CE was then fractionated by high performance liquid chromatography (HPLC), and three (HF, BF and CF) of the fractions showed the toxic activities in guinea pigs. The HF caused the hemolysis, whereas both the BF and the CF caused the hemorrhagic cystitis without any hemolytic activities. The HF was further fractionated by the HPLC, resulting of the 3 fractions (HF-I, II and III). The hemolysis was caused only with the HF-II, and HF-II as well as HF did not cause the hemorrhagic cystitis. HPLC analysis revealed that both BF and CF contains braxin B and braxin C, respectively, and both HF and HF-II do not contain braxin A, B or C. These facts suggest that bracken fern contains a new toxic substance (hemolysin) which induces the acute hemolysis in guinea pigs.     

Pathological findings of hemorrhagic bowel syndrome (HBS) in six dairy cattle cases

Six adult dairy cows clinically diagnosed as hemorrhagic bowel syndrome (HBS) were the subjects of this study. The involved intestinal lesions were fixed in formalin and examined macroscopically and histopathologically. Pathological examinations revealed large intramural hematomas with necrotic foci, resulting in luminal obstruction. The mucosal layer in the lesions was detached from the intestinal wall, and there were no hemorrhagic changes in the lumen. The intramural hematomas were sometimes covered with histologically intact mucosal layer. These pathological findings were not consistent with those of “intraluminal blood clots” reported previously. Gram-positive and anti-Clostridium antibody-positive short bacilli were found in hemorrhagic necrotic areas. However, the exact relationship between Clostridium spp. observed in the lesions and HBS remains unclear, because this bacterium is a normal inhabitant in cattle.     

Intravesicular administration of clotrimazole for treatment of candiduria in a cat with diabetes mellitus

A 12-year-old spayed female domestic longhair cat developed fungal cystitis (Candida sp). The cat had a history of chronic diabetes mellitus, hyperadrenocorticism, and bacterial cystitis caused by Escherichia coli. Antifungal agents (itraconazole and fluconazole) were administered orally without noticeable effect on the candiduria. Because of the ineffectiveness of these treatments, intravesicular administration of 1% clotrimazole solution was performed weekly for 3 treatments. Complete resolution of urinary candidiasis was detected after the third infusion. Intravesicular administration of clotrimazole solution appears to be a safe and effective treatment of fungal cystitis in cats.     

小动物肠道异物性梗阻和出血性胃肠炎诊治的比较研究

小动物肠道异物引起犬肠道梗阻是犬常见肠道疾病之一。在临床上容易和出血性胃肠炎发生混淆。本试验通过一例患犬的病史,结合血常规检查、CRP检查、内窥镜检查,并与出血性胃肠炎鉴别诊断,确定为犬肠道异物性梗阻,并对患犬尝试使用剖腹探查术治疗,术后以消炎、补充营养和体液、修复胃肠道粘膜为主,取得明显的治疗效果。研究结果可为宠物犬肠道异物性梗阻和出血性胃肠炎的鉴别诊治提供可参考的诊治方案。     

Polypoid cystitis as a cause of haematuria in a pony mare

A 15-year-old pony mare was presented for investigation of haematuria of 2 weeks' duration. On cystoscopy, multiple small pedunculated soft tissue structures were observed on the bladder mucosa. Histopathological analysis of the masses was consistent with chronic polypoid cystitis. The polypoid lesions and associated haematuria resolved following prolonged antibiotic treatment. Polypoid cystitis has not previously been described in horses. This condition should be considered a differential for haematuria, requiring cystoscopy and biopsy to confirm a diagnosis.     

Intralesional administration of formalin for treatment of epidermal inclusion cysts in five horses

Five horses with unilateral epidermal inclusion cysts located in the nasal diverticula were sedated and treated with intralesional injection of neutral-buffered 10% formalin (volume range, 2 to 4.5 mL). After aspiration of the cyst, formalin was injected intralesionally until leakage of fluid around the needle was observed. After several weeks, desiccation of the cyst was evident; it was excised 2 weeks after treatment in 3 horses, digitally removed by the owner of 1 horse, and never removed in 1 horse, because the owner declined further treatment after resolution of the original swelling of the nasal diverticulum. Swelling of the cyst after treatment was observed in all horses; nasal discharge (2 horses) and a mild episode of epistaxis (1 horse) were the only other complications of the treatment. Intralesional administration of formalin appears to be a simple and effective treatment for epidermal inclusion cysts in the nasal diverticula of horses.