Urinary Bladder incarceration and Infarction by an Intra-Abdominal Fat Pad in a Virginia Opossum (Didelphis Virginiana)

A 2.5-year-old, female opossum had acute stranguria. Based on radiography and ultrasonographic examination a cystic structure was identified in the caudal abdomen associated with bilateral hydroureter and hydronephrosis. This structure contained a neutrophilic fluid, determined to be urine. There was a neutrophilic leukocytosis. Serum chemistry values were within normal limits. The opossum was euthanized. An intra-abdominal fat pad incarceration of the urinary bladder above the trigone was present, resulting in complete obstruction of the urinary bladder and partial obstruction of the ureters. Vessels to the bladder were involved in the incarceration which resulted in vascular compromise and infarction of the bladder. Mild to moderate hydroureter and hydronephrosis were present.     

URETERAL DUPLICATION IN A DOG

A male neutered dog of unknown age had recurrent urinary tract infection and caudal abdominal pain. Using sonography, large dilated tubular structure filled with echogenic fluid was seen extending from the left kidney to the level of the bladder neck. In an excretory urogram there was left hydronephrosis with a normal ureter. Computed tomographic evaluation of the abdomen confirmed a large tubular structure extending from the kidney with a blind ending caudally. The left kidney, ureter, and associated tubular structure were surgically removed. No connection was found between the tubular structure and the ureter. Gross evaluation and histopathologic evaluation confirmed the tubular structure to be a ureter, consistent with a diagnosis of ureteral duplication.     

Papillary ovarian cystadenocarcinoma in a dog

An 11-year-old female German Shepherd dog was presented for investigation of progressive enlargement of the abdomen, periodic bloody discharge from the vulva and rapid exhaustion. Transabdominal ultrasonography and lateral abdominal radiography demonstrated an echogenic formation with anechogenic cavities located cranial to the urinary bladder and a homogeneous shadow with an elliptical shape was located caudal to the rib arc. Both showed indistinct borders. Exploratory laparotomy identified bilateral ovarian masses and ovariohysterectomy was performed. Histopathology confirmed ovarian cystadenocarcinoma. The dog remained clinically normal without evidence of metastatic disease 4 months after surgery. Papillary cystadenocarcinoma in the bitch could affect both ovaries and manifests with a rapid growth rate and clinical signs such as rapid exhaustion, abdominal enlargement and vulval discharge. Ovariohysterectomy is the treatment option.     

Computed tomographic retrograde positive contrast cystography and computed tomographic excretory urography characterization of a urinary bladder diverticulum in a dog

A one‐year‐old intact male German shepherd dog was referred with a 3‐month history of dysuria and pollakiuria. Physical examination revealed a large firm mass in the caudal abdomen. Findings from survey radiography, negative contrast cystography, computed tomographic (CT) retrograde positive contrast cystography, and CT excretory urography were consistent with a large urinary bladder diverticulum. An exploratory laparotomy revealed a normal wall appearance in the ventral compartment (true bladder) and marked thinning of the wall in the dorsal compartment (diverticulum). Both ureters inserted into the ventral compartment. The dorsal compartment was excised and histopathology confirmed the diagnosis of urinary bladder diverticulum.     

Traumatic urethral avulsion at the preputial fornix in a cat

A cat with pelvic fractures from being hit by a car had voided no urine in 13 hours despite iv administration of fluids. Abdominal radiography had revealed the pelvic fractures and apparently intact urinary bladder. Urine did not flow from a urethral catheter, and contrast radiography revealed the catheter to be extra-urethral within the penis. Intravenous pyelography revealed intact ureters and urinary bladder; celiotomy confirmed intact urinary bladder. Cystotomy and normograde urethral catheterization allowed localization of the ruptured urethra within the deep subcutaneous tissues of the caudal portion of the abdomen. After closure of the cystotomy and celiotomy incisions, perineal urethrostomy was performed.     

COMPUTED TOMOGRAPHIC CHARACTERISTICS OF EOSINOPHILIC PULMONARY GRANULOMATOSIS IN FIVE DOGS

Canine pulmonary eosinophilic granulomatosis is a rare inflammatory pulmonary disease characterized by formation of eosinophilic granulomas that tend to obliterate the normal pulmonary architecture. The purpose of this retrospective study was to describe the CT characteristics of confirmed idiopathic pulmonary eosinophilic granulomatosis in a group of dogs. Five dogs met inclusion criteria. All patients were young adult dogs of variable breeds. No dog had concurrent occult heartworm disease. Computed tomographic characteristics most commonly included pulmonary masses and nodules of variable size, and lesions were most commonly located in the caudal lung lobes. Four dogs had large pulmonary masses with or without additional nodules and one dog had nodular lesions disseminated throughout the entire lung parenchyma. All large eosinophilic granulomas were smoothly margined, heterogeneous pulmonary masses displaying heterogeneous contrast enhancement. A honeycomb‐like enhancement pattern was observed in all but one mass and consisted of multiple hyperattenuating rims delineating central hypoattenuating areas, suggestive of bronchiectatic lung with peripheral enhancing airway walls and fluid‐filled, necrotic bronchial lumen. One dog had evidence of tracheobronchial lymphadenopathy. Findings indicated that canine eosinophilic pulmonary granulomatosis should be included as a differential diagnosis for dogs with CT characteristics of multiple pulmonary masses and/or nodules in caudal lung lobes, and a honeycomb‐like enhancement pattern in masses after intravenous administration of iodinated contrast medium.     

ULTRASONOGRAPHIC APPEARANCE OF THE LOWER URINARY TRACT IN FIFTEEN NORMAL HORSES

The purpose of this study was to describe the normal ultrasonographic appearance of the caudal portion of the equine ureters, pelvic urethra, and urinary bladder and to assess ureteral contractility. Fifteen horses with no evidence of urinary tract disease (five females, five intact males and five geldings) were studied. The lower urinary tract was evaluated ultrasonographically using a transrectal approach. The normal ultrasonographic appearance and anatomic location of structures of the lower urinary tract were evaluated and anatomic relationships described. Both ureters were identified dorsal to the bladder and at their openings into the bladder. Their relationship and different appearance from the male deferent ducts/ampullae and vesicular glands was noted. Ultrasonographic measurements of the diameter of the ureters and urethra were obtained and the ureteral, urethral, and urinary bladder wall thickness recorded. The normal parameters established in this study will be useful during sonographic examination of horses with suspected urinary tract disease. Transrectal ultrasonographic examination is valuable in assessing the presence and frequency of ureteral contractions as well as in detecting structural abnormalities of the lower urinary tract. The use of high-frequency transrectal ultrasound transducers allows for excellent visualization of the structures of the equine lower urinary tract.     

Pelvic bladder in dogs without urinary incontinence

Double-contrast cystography was performed simultaneously with cystometrography in 6 male and 6 female dogs. All dogs were continent, and results of urinalyses were normal. Initial radiographs were made following intravesical infusion of 0.88 ml of positive contrast medium/kg of body weight. Additional radiographs were made during infusion of CO2. The last radiographs were made at the time of detrusor reflex (11 dogs) or when intravesical pressure reached 50 cm H2O (1 female). An average of 34% (range, 11% to 67%) of bladder length was within the pelvic canal when only the positive contrast medium was infused into the bladders. By the end of CO2 infusion, the bladder neck was more cranially located in 5 of 6 males and in 5 of 6 females. On the last radiographs made, an average of 19% (range, 10% to 35%) of bladder length was within the pelvic canal in 3 of 6 males and in 4 of 6 females. The bladder neck was rounded in 10 of 12 dogs. Thus, it was concluded that previous reports associating pelvic urinary bladder with urinary incontinence and other urologic abnormalities are questionable.     

ULTRASONOGRAPHIC FINDINGS IN 14 DOGS WITH ECTOPIC URETER

To evaluate ultrasonography as an alternative to contrast radiography for diagnosis of ectopic ureter in dogs, ultrasonography of the urinary tract was performed prospectively in a series of urinary incontinent dogs anesthetized for contrast radiography. Fourteen dogs had ectopic ureter based on surgical, necropsy or unequivocal contrast radiographic findings. There were eight females and six males of a variety of breeds; five were Labrador retrievers. Mean (range) age at the time of diagnosis was 1.2 (0.2–4) years for females and 3.5 (0.3–5) for males (p < 0.05). Ectopic ureters were unilateral in five dogs (2 left; 3 right) and bilateral in nine dogs. Both ultrasound images and contrast radiographs were positive for 21 (91%) ectopic ureters; the same two ectopic ureters were not detected using either modality. The termination of each of the five normal ureters was visible on ultrasound images; two (40%) were visible on radiographs. Other ultrasonographic findings included dilatation of the ectopic ureter and/or ipsilateral renal pelvis in ten (43%) instances, evidence of pyelonephritis in two dogs (with enlargement of the contralateral kidney in one dog), and urethral diverticuli in one dog. Ultrasonography is a practical diagnostic test for ectopic ureter in dogs. In this series there was close correlation between the ultrasonographic and contrast radiographic findings for each ectopic ureter, but ultrasonography enabled more accurate determination of normal ureteral anatomy.     

Immediate urodynamic and anatomic response to colposuspension in female Beagles

OBJECTIVE: To characterize urodynamic function and anatomy before and after colposuspension in anesthetized female Beagles. ANIMALS: 12 adult female Beagles. PROCEDURE; During general anesthesia (thiopental sodium induction and halothane maintenance), urethral pressure profiles, leak point pressure measurements with a 50-ml bladder volume, positive contrast cystograms, and retrograde vaginourethrocystograms were performed. A caudal midline laparotomy was used to perform colposuspension. Urodynamic and radiographic studies were repeated after surgery. RESULTS: Leak point pressures were increased (120 to 168.9 cm H2O), and maximum urethral closure pressures decreased (43.7 to 19.3 cm H2O ) after colposuspension. The urethra and bladder were moved cranially; the external urethral orifice was positioned closer to the pelvic cavity, and the neck of the bladder was positioned more cranially into the abdomen. Length of the urethra, as measured by use of vaginourethrocystograms, was increased by 3%. As measured by use of urethral pressure profiles, total profile length was increased by 19.9%, and functional profile length was increased by 19.2%. CONCLUSIONS AND CLINICAL RELEVANCE: Increased leak-point pressure correlated with the expected clinical improvement attributable to colposuspension. Increased exposure of the urethra to abdominal and pelvic cavity pressures may be the mechanism by which incontinent dogs become continent after colposuspension. Results of the leak-point pressure test may correlate with clinical behavior before and after colposuspension for treatment of incontinence.     

Inguinal-Scrotal Urinary Bladder Hernia in an Intact Male Domestic Rabbit (Oryctolagus cuniculus)

An 8-year-old intact male dwarf rabbit (Oryctolagus cuniculus) was presented with a 2-month history of unilateral scrotal swelling. The external physical examination of the rabbit patient confirmed the severe, unilateral, fluid-filled scrotal distention. Radiographic images of the effected scrotum revealed a soft tissue swelling in the area of the left testicle, and the absence of the urinary bladder in the caudal abdomen. Ultrasonography verified the presence of a fluid-filled mass in the scrotum, enveloping the left testicle. A fine-needle aspiration of the scrotal mass yielded urine, thus a diagnosis of a nonreducible herniation of the urinary bladder into the scrotum was made. An inguinal herniorrhaphy was performed, and the bladder was successfully reduced into the abdominal cavity. A bilateral routine castration and left scrotal ablation were also performed. Two months after surgery no recurrence was noted, and the patient had normal urinary function. Inguino-scrotal bladder herniation is rare in both humans and animals. Male rabbits are predisposed to inguinal and scrotal hernias because their inguinal rings remain open throughout life. Herniation of the urinary bladder should be considered as a differential diagnosis when intact male rabbits are presented with unilateral scrotal swelling.     

Bilateral segmental aplasia with unilateral uterine horn torsion in a pomeranian bitch

Bilateral segmental aplasia of the uterine horns with unilateral pyometra and uterine horn torsion were diagnosed in a Pomeranian bitch that presented with chronic abdominal distension and an acute onset of anorexia and lethargy. Because radiographic and ultrasonographic findings revealed the presence of markedly enlarged bilateral uterine horns filled with fluid in the caudal abdomen, a tentative diagnosis of either pyometra or hydrometra with uterine horn torsion was made. Exploratory laparotomy showed bilateral, segmentally distended uterine horns with unilateral uterine horn torsion. Ovariohysterectomy was performed, and bilateral segmental aplasia of the uterine horns with the development of unilateral uterine horn torsion was diagnosed histopathologically. To the authors' knowledge, this is the first report of uterine horn torsion in conjunction with segmental aplasia of the uterine horn in a bitch.     

Hydrosalpinx in a goat

A two year old Swiss Alpine goat was referred to our clinic because of sterility. Ultrasound examination revealed a nonechogenic area cranially to the urinary bladder. As hydrometra was suspected, the goat was treated repeatedly with PGF2 alpha. Success of this therapy, however, was unsatisfactory and estrus was therefore induced by progesterone in combination with eCG and the goat mated. As conception failed and ultrasonography remained unchanged, laparoscopy was performed and a fluid filled structure could be located in the region of the right oviduct. After ovariohysterectomy and histo-pathological examination of the genital organs hydrosalpinx was diagnosed on both sides.     

Presumptive migrating gall bladder mucocoele in two dogs with gall bladder rupture

A 10‐year‐old neutered female soft‐coated wheaten terrier and a 10‐year‐old, entire female Pomeranian were presented for vomiting and anorexia. Using ultrasound, an oval structure with a stellate, kiwifruit‐like appearance typical of a gall bladder mucocoele was observed in the caudal abdomen of the soft‐coated wheaten terrier and adjacent to the liver in the Pomeranian. There was also a moderate volume of abdominal effusion in both dogs. Cytology of the peritoneal fluid indicated a sterile exudative process but varied between the two dogs, with an absence of bile pigment in the soft‐coated wheaten terrier and marked bile peritonitis in the Pomeranian. An entire free‐floating ectopic mucocoele was confirmed via exploratory laparotomy with concomitant gall bladder rupture and common bile duct obstruction. Both dogs recovered completely after surgery. This is the first report of cases of gall bladder rupture with entire free‐floating gall bladder mucocoeles in dogs.     

Diagnostic ultrasound of polypoid cystitis in dogs

Polypoid cystitis is a rare disease of the urinary bladder in dogs characterized by chronic inflammation, epithelial proliferation, and development of a polypoid mass or masses without histopathologic evidence of neoplasia. The ultrasonographic appearances of eight dogs with polypoid cystitis are described. Ultrasonography confirmed the presence of a bladder mass or masses in all patients. Ultrasonographic findings are mucosal projections and a polypoid to pedunculated mass of variable size and shape. Although a polypoid mass tends to be located in the cranioventral bladder mucosa, the polyps also could arise in the craniodorsal bladder mucosa. Ultrasonographic images are well correlated with contrast radiographic studies and gross morphological appearance. Ultrasound is a non-invasive, very useful diagnostic tool for detecting bladder polyps, but histopathology is required for definitive diagnosis.     

Bilateral ectopic ureters in a male dog with unilateral renal agenesis

A 1-year-old neutered male mixed-breed dog was evaluated because of signs of urinary incontinence. Retrograde positive contrast urethrocystography and excretory urography with pneumocystography revealed bilateral intramural ectopic ureters and absence of the right kidney. During abdominal exploratory surgery, only the left kidney was located. The left intramural ectopic ureter was repaired by neoureterostomy (creation of a new opening for the ureter to enable urine to empty into the bladder). The right ectopic ureter was ligated at its entrance into the urinary bladder serosa. Results of excretory urography (performed immediately after surgery and repeated 8 weeks later) revealed successful correction of the left intramural ectopic ureter. Twelve weeks after surgery, the dog remained continent. To the authors' knowledge, there are few reports of ectopic ureters in male dogs; furthermore, the urinary tract abnormalities detected concurrently in this dog are also unusual.     

Surgical treatment of a duplicated and ectopic ureter in a dog

An eight‐month old female bull mastiff was referred for evaluation of urinary incontinence. Contrast‐enhanced computed tomography identified complete duplication of the left ureter with ectopic insertion of the duplicate ureter into the proximal urethra. Ureteroneocystostomy was performed, which improved but did not resolve urinary continence. To the authors’ knowledge, this report details only the second reported case of duplicated ectopic ureter in the dog and the first documenting surgical reimplantation; thus, double‐system ureteral ectopia should be considered as a possible differential diagnosis for urinary incontinence.     

MULTIDETECTOR‐ROW COMPUTED TOMOGRAPHIC CHARACTERISTICS OF PRESUMED PREURETERAL VENA CAVA IN CATS

Preureteral vena cava (circumcaval ureter, retrocaval ureter) occurs in a third of the feline population and has been associated with ureteral strictures in humans. The aim of this retrospective cross‐sectional study was to describe the contrast‐enhanced multidetector row computed tomographic (MDCT) characteristics of presumed preureteral vena cava in a group of cats. Medical records from two institutions located in different continents were searched from 2010–2013 for cases with complete contrast‐enhanced MDCT examinations of the abdomen (i.e. included the entire course of the ureters and prerenal and renal segments of the caudal vena cava) and a diagnosis of preureteral caudal vena cava. For cases meeting inclusion criteria, CT scan data were retrieved and characteristics of the preureteral caudal vena cava were recorded. Presence of concomitant renal or ureteral diseases was also recorded. A total of 272 cats had contrast‐enhanced abdominal CT scans during the study period and of these, 68 cats (22.43 ± 4.96%) had a diagnosis of presumed preureteral vena cava. In all affected cats, a “reverse‐J ureter” was observed, i.e. a ureter running medially at the level of L4–5, passing dorsally to the caudal vena cava and then exiting ventrally between the caudal vena cava and aorta returning to its normal position. Having a preureteral vena cava resulted in an increased risk for concurrent urinary signs (OR = 3.00; CI: 95%; 1.28–6.99; P = 0.01). Findings supported the use of contrast‐enhanced MDCT for characterizing morphology of preureteral vena cava and its relation with ureters in cats.     

SONOGRAPHIC INVESTIGATION OF TRANSITIONAL CELL CARCINOMA OF THE URINARY BLADDER IN SMALL ANIMALS

This report compares results from imaging of transitional cell carcinoma of the urinary bladder in 15 dogs using intravenous urography, double-contrast cystography, and ultrasonography. Intravenous urography demonstrated filling defects in the urinary bladder in 3 of the 5 cases examined with this modality. Double-contrast cystography identified bladder masses in 8 of 10 animals. Ultrasonography was the only imaging modality which detected bladder masses in all patients.