Encrusting cystitis in a cat secondary to Corynebacterium urealyticum infection

An 18-year-old male neutered domestic shorthair cat was presented for investigation of haematuria and lethargy. The cat had sustained a traumatic T3-L3 lesion 5 years prior resulting in upper motor neuron incontinence. On further investigation the cat was found to be hyperkalaemic, hypothermic and dehydrated. Ultrasonography of the bladder revealed a markedly hypoechoic, thickened bladder wall with an irregular, hyperechoic mucosal layer. The patient responded to symptomatic and supportive care and was discharged. Despite initial improvement, the patient returned 10 days after discharge with recurrence of haematuria and lethargy. Ultrasound-guided aspiration and culture of the material on the mucosal surface of the bladder confirmed diagnosis of UTI caused by Corynebacterium urealyticum. On post-mortem examination, gross and histopathological features were consistent with encrusting cystitis. This is the first case report of encrusting cystitis in a cat. C urealyticum, an uncommon urinary tract pathogen in small animals, should be considered in patients with predisposing conditions.     

Presumptive pseudohypoaldosteronism secondary to chronic urinary tract obstruction from sloughed urinary bladder mucosa and urinary tract infection in a cat

Objective – To describe a case of presumptive secondary pseudohypoaldosteronism (PHA) in a cat with urinary tract infection and chronic urethral obstruction. The obstruction was believed to have resulted from sloughed urinary bladder mucosa secondary to pressure necrosis. Case Summary – A 5‐year‐old, 4 kg, castrated male Siamese cat presented for vomiting and stranguria. Medical history included a perineal urethrostomy for urethral obstruction. Physical examination revealed a large, painful, nonexpressible urinary bladder. Point‐of‐care testing demonstrated electrolyte derangements consistent with a postrenal azotemia and metabolic acidosis. Results of urine culture was positive for bacterial growth. Diagnostic imaging revealed presence of retroperitoneal fluid, marked urinary bladder wall thickening, bilateral hydroureter, mild bilateral pyelectasia, and small nephroliths. The patient was treated for a urinary tract obstruction and infection. In the 3 weeks following initial discharge, the patient was evaluated on multiple occasions for lethargy, intermittent vomiting, inappropriate urination, and progressive polyuria and polydipsia. Although the urinary bladder was easily expressed during repeat examinations, it was persistently distended and subjectively thickened upon palpation. Repeat ultrasound of the urinary tract showed evidence of sloughed tissue in the bladder lumen, likely secondary to chronic urethral obstruction and pressure necrosis. A cystotomy was performed to remove the necrotic tissue, and a revised perineal urethrostomy was done due to a partial urethral stricture. Bladder biopsies were obtained at this time. Postoperatively, the cat was reported by the owners to be urinating normally but continued to be polyuric and polydipsic in the week following discharge. One week after surgery, the cat presented in hypovolemic shock with laboratory findings consistent with a presumptive diagnosis of secondary PHA. New or Unique Information Provided – PHA has not been reported previously in a cat. This case report suggests that aldosterone resistance should be considered in cats with consistent laboratory findings and a history of documented obstructive uropathy and urinary tract infection.     

Herniation of the urinary bladder through a congenitally enlarged inguinal canal in a cat

A two-year-old, castrated male Main Coon cat was referred because of chronic, recurrent pollakiuria, haematuria, and acute vomiting. On clinical examination, a smooth, soft-tissue mass, suspected to be the urinary bladder, was palpable outside of the abdominal wall in the inguinal area. On radiographs, the urinary bladder was found to be extra-abdominal, and herniated through an enlarged right inguinal canal at exploratory coeliotomy.The left inguinal canal was also enlarged. The urinary bladder was repositioned and fixed to the caudal abdominal wall by incisional cystopexy and both enlarged inguinal canals were partially closed with an interrupted suture pattern.     

A URINARY BLADDER FIBROSARCOMA IN A YOUNG DOG

A 14-month-old female dog, Gos d'Atura Catala was presented for a 7-month-history of reoccurring urinary tract infection. Using sonography, a focal multilobulated thickening of the urinary bladder wall was discovered. The solid mass was arising from the area of the ureteral papllDae and bulging into the lumen of the bladder neck. The wall of the urethra was uniformly thickened. These findings were not considered typical for a generalized urinary tract infection but more indicative of local severe inflammation, neoplasia or hyperplasia in the area of the ureteral openings. The thickening of the urethra was suggestive of urethritis or neoplastic infiltration. Signs of metastasis were not detected on the thoracic radiographs or in the remainder of the abdominal ultrasound examination. A surgical excision of the multilobulated mass was performed and histologic examination was conducted. A fibrosarcoma in the lamina propria of the urinary bladder wall was diagnosed. Because of reoccurence of hematuria and unresponsiveness to therapy the dog was euthanized. Postmortem examination confirmed the diagnosis of fiborsarcoma in the urinary bladder. Additionally, neoplastic infiltration of the urethral wall and metastasis in the lungs and liver were detected histopathologically.     

Prostatic carcinoma causing urethral obstruction and obstipation in a cat

A 9-year-old intact male cat was presented for vomiting and straining to defecate. A large abdominal mass was palpated. The urinary bladder was full and non-expressible. Exploratory laparotomy revealed that the mass was compressing the colon and encircling the urethra caudal to the bladder. The mass was removed, the urethra transected, and the urinary bladder marsupialized to the ventral abdominal wall to allow urine drainage. Histopathologic examination of the mass revealed a prostatic carcinoma. The cat died approximately 6 weeks after removal of the mass. This is the first reported case of a prostatic carcinoma causing urethral obstruction and obstipation in a cat.     

URETEROLITHIASIS AND PAPILLOMA FORMATION IN THE URETER OF A GUINEA PIG

A 5-year-old guinea pig with suspected urolithiasis was presented for radiology and ultrasound examinations of the abdomen. Radiographically, an irregular-shaped mineral opacity was detected in the area of the urinary bladder. Ultrasonographically, pyelectasia of the right kidney, hydroureter with an ureterolith cranial to a thickened ureter wall close to the ureterovesical junction, and a thickened urinary bladder wall were detected. Histopathologically, the thickened ureter wall was found to be a papilloma. The ureter calculus consisted of 100% calcite.     

Rectal prolapse associated with urinary bladder neoplasia in a cat

A case of feline rectal prolapse which appeared to be secondary to transitional cell carcinoma of the urinary bladder is described. The cat was reported to be incontinent and treatment was declined by the owners. Euthanasia was performed and necropsy revealed an extensive nodular thickening of the entire urinary bladder wall. A diagnosis of urinary bladder transitional cell carcinoma was made on histopathological examination.     

Leiomyosarcoma of the urinary bladder in a cat.

An 81/2-year-old female domestic short-haired cat was admitted with signs of chronic cystitis. Radiography revealed marked and irregular thickening of the bladder wall. Biopsy revealed the thickening to be a malignant tumor of muscle origin and treatment with proteolytic enzymes was instituted. After one month, the cat was euthanatized because of uremia associated with progressive tumor growth. At necropsy the bladder was grossly thickened. The histopathologic diagnosis was leiomyosarcoma.     

Central diabetes insipidus in a cat with central nervous system B cell lymphoma

A 6-year-old male neutered cat presented with blindness, lethargy, polydipsia, hyposthenuria and severe hypernatraemia. Central diabetes insipidus was demonstrated by means of a low measured anti-diuretic hormone (ADH) concentration in the face of hypernatraemia, and clinical response to supplementation with desmopressin. Magnetic resonance imaging of the brain showed a discrete mass in the region of the hypothalamus. The cat was euthanased and post-mortem histological examination demonstrated B cell lymphoma involving the brain, optic nerves, urinary bladder wall and diaphragm. To the authors' knowledge, this case report is the first to describe central diabetes insipidus caused by central nervous system lymphoma in the cat.     

Malignant peripheral nerve sheath tumour of the urinary bladder in a cat

A 14-year-old domestic shorthair cat presented with a 5-month history of urinary incontinence and inappro-priate elimination. Ultrasonography revealed a well-marginated, vascular mass of mixed echogenicity ex-tending from the dorsal wall of the urinary bladder into the lumen. Partial cystectomy was performed for re-moval of the urinary bladder mass; histopathological evaluation revealed a spindle cell neoplasm with a prominent palisading pattern. Histomorphologic features and immunohistochemical demonstration of vimentin, glial fibrillary acidic protein and S-100 protein, combined with negativity for smooth muscle actin and desmin were consistent with malignant peripheral nerve sheath tumour. This case report describes a novel location of malignant peripheral nerve sheath tumour; to the authors' knowledge, the bladder has not been described as a site of origin in the cat or any other domestic species.     

Clinicopathologic analysis of herpesvirus-induced urinary tract infection in specific-pathogen-free cats given methylprednisolone

The clinicopathologic manifestations of bovid herpesvirus-4 (BHV-4; FCAHV strain)-induced infection of the lower portion of the urinary tract were characterized in 12 adult neutered male and 6 female specific-pathogen-free cats, and were compared with those in 12 neutered male control cats. Six neutered male and 6 female cats were given immunosuppressive doses of methylprednisolone acetate prior to inoculation of their urinary bladders with BHV-4. Six neutered male control cats were given immunosuppressive doses of methylprednisolone acetate prior to inoculation of their urinary bladders with uninfected tissue culture control inoculum. Six additional neutered male control cats were exposed only to uninfected tissue culture control inoculum. All cats were observed for 90 days following inoculation. Dysuria and gross hematuria were observed in only 1 BHV-4-exposed cat. Radiographic abnormalities of the lower portion of the urinary tract were not observed. Microscopic hematuria, crystalluria, and lipiduria were identified with similar frequency in BHV-4-exposed and control cats. Results of urine culturing for bacteria, mycoplasma, ureaplasma, and viruses were negative. Viruses were not isolated from blood leukocytes collected from exposed or control cats. Three to 6 weeks after inoculation, high concentrations of BHV-4 serum antibodies were detected in all exposed cats by an indirect fluorescent antibody test. Light microscopic examination of the urinary tract revealed multifocal lymphoid cystitis in 2 BHV-4-exposed cats. Except for suppurative bronchitis in 1 BHV-4-exposed cat given glucocorticoids, morphologic differences in urinary and extraurinary tissues were not observed. In urinary bladder tissue collected 90 days after inoculation, BHV-4 was reisolated from urinary bladder explants of all but 1 exposed cat. Virus was also isolated from a kidney explant of 1 exposed male cat, and spleen cell co-cultures of 1 exposed female cat given glucocorticoids.(ABSTRACT TRUNCATED AT 250 WORDS)     

LYMPHOMA AFFECTING THE URINARY BLADDER IN THREE DOGS AND A CAT

Three dogs and one cat with lymphoma affecting the urinary bladder are reported and the findings on abdominal radiographs and ultrasound are described. Mural lesions representing lymphoma affecting the urinary bladder were identified ultrasonographically in all animals. The most common complications associated with urinary bladder lymphoma were hydronephrosis and hydroureter. In two patients contrast radiography was necessary to detect leakage of urine in the peritoneal and retroperitoneal space. The radiographic and ultrasonographic signs were similar to those reported with other urinary bladder neoplasms; hence urinary bladder lymphoma could not be distinguished from the more common urinary bladder neoplasms, such as transitional cell carcinoma. It is important to include lymphoma in the differential diagnosis of urinary bladder wall thickening and mural mass in dogs and cats.     

Sonographic diagnosis of a presumed ureteral tear in a horse

A 14-year-old thoroughbred gelding was presented for the evaluation of acute abdominal pain. Rectally, there was a soft fluctuant painful swelling dorsal to the bladder and to the right of the midline. The creatinine concentration of the peritoneal fluid was 15 mg/dl. Transrectal ultrasonographic examination of the urinary tract revealed a large collection of fluid dissecting from the pelvic portion of the right ureter ventrally through the right side of the bladder wall and into the retroperitoneal space, and a thickened right ureter and bladder wall at the level of the trigone. Cystoscopically there was moderate hemorrhage within the wall of the bladder. Ultrasonography revealed air within the retroperitoneal fluid collection after ureteral catheterization, confirming the preliminary diagnosis of a tear in the right ureter. The gelding was treated medically. After 48 h of hospitalization, nuclear scintigraphy revealed normal clearance from both kidneys and no apparent leakage from the right ureter. The ureteral tear and urinoma were monitored using transrectal ultrasound until resolution. The horse was successfully returned to racing. This case establishes the value of diagngstic ultrasound in the diagnosis and monitoring of a traumatic ureteral tear in a horse.     

Duplex gall bladder associated with choledocholithiasis, cholecystitis, gall bladder rupture and septic peritonitis in a cat

A 10-year-old cat was presented with a history of inappetence, pyrexia and weight loss. Clinical investigations showed anaemia, hyperbilirubinaemia, septic peritonitis and a double gall bladder with choleliths in an extrahepatic duct. Initial medical stabilisation was performed. At laparotomy, a duplex gall bladder with two separate cystic ducts was identified. The left gall bladder was thickened and had ruptured at the apex. Multiple choleliths were identified in the left cystic duct. The right gall bladder and cystic duct were grossly normal. The ruptured gall bladder was repaired, the gallstones were removed via a choledochotomy of the left cystic duct and a choledochoduodenostomy was created from the dilated left cystic duct. The cat remained depressed and anorexic, and it was euthanased 72 hours postoperatively at the owners' request. This is the first ante-mortem investigation of extrahepatic biliary disease associated with gall bladder duplication in the cat.     

SMOOTH MUSCLE NEOPLASIA OF THE URINARY BLADDER WALL IN THREE DOGS

Smooth muscle origin neoplasia of the urinary bladder wall is rare in dogs. This report describes the ultrasonographic features of two bladder wall leiomyomas and one bladder wall leiomyosarcoma. All three dogs had a single, smoothly marginated, round, hypo to mixed echogenicity intraluminal mass in the urinary bladder. Based on color Doppler examination of the masses, there was no visible blood flow.     

Gastrointestinal small-cell lymphoma with gall bladder involvement in a cat

A 13-year-old female spayed domestic shorthair cat presented for investigation of decreased appetite and increased serum liver enzyme concentrations. An abdominal ultrasound revealed multiple sessile hyperechoic structures along the luminal aspect of the gall bladder wall and a mildly enlarged liver with hyperechoic nodules. Cholecystectomy was performed and biopsies were obtained by laparotomy. Histopathologic examination with immunohistochemistry was consistent with a diagnosis of small-cell lymphoma of T cells within the gall bladder, liver and small intestine. Clonality testing confirmed the diagnosis. The cat remains clinically stable 23 months after institution of treatment with prednisolone, chlorambucil and ursodeoxycholic acid. This is the first report of small-cell lymphoma in the gall bladder of a cat.     

Management of incontinence following pre-pubic urethrostomy in a cat using an artificial urethral sphincter

A 14-year-old male neutered domestic shorthair cat presented with a 4-year history of urinary incontinence following prepubic urethrostomy. Physical examination confirmed peristomal dermatitis, urine scalding and constant urine leakage. Haematology, serum biochemistry and urinalysis were unremarkable. Ultrasonography revealed a non-distended urinary bladder. An artificial urethral sphincter mechanism, with subsequent incremental inflation of the cuff 6 weeks later, resulted in complete resolution of clinical signs, return to normal urinary function and excellent quality of life. The cat was still continent at 5-year follow-up. Further studies including additional cases are required to highlight effectiveness and harms of the procedure.     

Haemangiosarcoma of the urinary bladder in a dog

Haemangiosarcoma of the urinary bladder is reported in a dog. The bladder mass was detected incidentally during physical examination. Partial cystectomy with unilateral ureteroneocystostomy were performed to remove the tumour en bloc. Necrosis of the urinary bladder was diagnosed 10 days postoperatively and the dog was euthanased.     

URINARY BLADDER MURAL HEMORRHAGE ASSOCIATED WITH SYSTEMIC BLEEDING DISORDERS IN THREE DOGS

The sonographic appearance of three dogs with diffuse bladder wall thickening due to mural hemorrhage is described. Two dogs were diagnosed with immune-mediated thrombocytopenia and the third dog with vitamin K antagonist toxicity. Urinary bladder wall thickening ranged from 5 to 12 mm on initial sonographic examination. In the two surviving dogs, the bladder wall returned to normal thickness. One dog, euthanatized for refractory hematuria, had submucosal hemorrhage in the urinary bladder at necropsy. Urinary wall thickening sonographically resolved at a rate of approximately 1 mm per day. Mural hemorrhage should be considered in patients with concurrent bleeding disorder and urinary bladder wall thickening.