Polypoid cystitis in 17 dogs (1978-2001)

Polypoid cystitis is a rare disease of the urinary bladder in dogs characterized by inflammation, epithelial proliferation, and development of a polypoid mass or masses without histopathologic evidence of neoplasia. Medical records of 17 dogs with polypoid cystitis were reviewed to determine the clinical and laboratory features of this disorder and to assess treatment and outcome. Most affected dogs (15/17) were female and presented for evaluation of hematuria or recurrent urinary tract infection (UTI). Proteus spp were the most common bacterial isolates (12/52 or 23.1%) identified when all urine samples obtained for culture at any time during the course study were considered. Other commonly isolated organisms included Escherichia coli , Staphylococcus spp, and Enterococcus spp. Several dogs (7/17) also had cystic calculi at some time during the course of their disease. Most of the masses (11/14) were located cranioventrally in the bladder as opposed to transitional cell carcinoma, which has a predilection for the bladder neck or trigone area. It is unknown whether persistent or recurrent UTI predisposes to polyp formation or if polyps predispose to UTI. Surgery and removal of all polyps was the most efficacious treatment in dogs of this study. The question of whether or not polyps represent preneoplastic lesions remains unanswered and constitutes an area for future investigation.     

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.     

Canine polypoid cystitis.

The clinical, laboratory, and radiographic characteristics of polypoid cystitis in 2 dogs were similar to those commonly associated with neoplasms of the urinary bladder. Gross appearance of the polyps did not permit differentiation between inflammation and neoplasia; microscopic examination of excised tissue was required to establish a definitive diagnosis. Following surgical extirpation of the polyps, remission of clinical signs was induced by prolonged antibacterial therapy.     

ULTRASONOGRAPHIC FINDINGS RELATED TO PROGNOSIS IN CANINE TRANSITIONAL CELL CARCINOMA

In human bladder cancer patients, ultrasonography is extensively used not only to identify tumor masses but also to evaluate tumor size, shape, echogenicity, location, and degree of tumor invasion into the bladder wall. The information revealed by ultrasonography delineates the tumor's biological features and facilitates prediction of prognosis. However, in veterinary medicine the feasibility of using ultrasonography for these purposes has not been fully investigated. In this retrospective study, we reviewed cases of dogs with histologically confirmed bladder mass lesions, including transitional cell carcinoma (n = 22) and polypoid cystitis (n = 5), to determine whether ultrasonography could reliably predict bladder wall involvement. By following patients with transitional cell carcinoma until death, we also determined whether ultrasonographic tumor size, shape, echogenicity, and mass location were related to prognosis. Wall involvement as revealed by ultrasound was significantly (P = 0.00005) associated with histological muscular layer involvement with a sensitivity of 93% (95% Confidence interval, 79–98%) and specificity of 92% (95% Confidence interval, 76–98%). Ultrasonographic wall involvement (P = 0.03, vs. noninvolvement), heterogeneous mass (P = 0.02, vs. homogeneous mass), and trigone location (P = 0.01, vs. other locations) characteristics were significantly associated with shorter survival times in transitional cell carcinoma cases. Findings indicated that ultrasonographic characteristics such as wall involvement, heterogeneous mass, and trigone location could be reliable prognostic indicators in canine transitional cell carcinoma.     

Polypoid eosinophilic cystitis with pseudosarcomatous proliferative tissue in a dog

A dog presented with hematuria, and two small polypoid masses were detected in the urinary bladder. Histopathologically, the masses were located in the mucosal or submucosal layer. That tissue consisted of a random proliferation of spindle-shaped, round and pleomorphic cells with single or multiple large atypical nuclei and abundant cytoplasm, and eosinophil infiltration. These large cells were confirmed by immunohistochemical staining as fibroblasts, myofibroblasts and macrophages. Mitotic figure was rarely seen. These masses were diagnosed as eosinophilic polypoid cystitis with pseudosarcomatous proliferative tissue, since they consisted of a wide variety of cells and showed low growth activity.     

Immunohistochemical expression of p63, Ki67 and β‐catenin in canine transitional cell carcinoma and polypoid cystitis of the urinary bladder

Transitional cell carcinoma (TCC) is a urinary bladder tumour associated with high mortality in dogs. In this study, we investigated the feasibility of using p63, Ki67 or β‐catenin as a clinical marker for predicting biological behaviour and prognosis in canine TCC. Expression levels of these proteins in TCC (n = 25), polypoid cystitis (n = 5) and normal urinary bladder (n = 5) were scored after immunohistochemical staining. The staining scores for p63 (P < 0.01) and β‐catenin (P < 0.05) in TCC were significantly lower than those in normal urinary bladder and polypoid cystitis. In contrast, Ki67 (P < 0.01) staining scores in TCC were significantly higher than those in normal urinary bladder and polypoid cystitis. In TCC, low p63 expression was significantly related to the presence of vessel invasion (P < 0.05) and metastasis (P < 0.01) as well as short survival time (P < 0.05). These findings show that p63 could be a reliable marker for predicting prognosis in canine TCC.     

URETERAL FIBROEPITHELIAL POLYPS IN FOUR DOGS

Four dogs with ureteral fibroepithelial polyps, ranging from 9-12 years of age, are presented in this report. The patients presented with urinary incontinence, urinary tract infection, and/or polydypsia and pollakiuria. All dogs were intact at the time of diagnosis or for the majority of their lives and three were male. Various diagnostic procedures were performed including ultrasonography, contrast radiography, and nuclear scintigraphy. Not all procedures were performed in all patients. Findings included ureteral dilation proximal to the level of an intraluminal mass and ipsilateral hydronephrosis. Unilateral ureteronephrectomy was performed in three dogs with masses in the proximal ureter; ureteral resection and anastamosis was performed in the remaining patient with a mass located in the distal ureter. The same pathologist (RAP) reviewed all four lesions. The lesions appeared polypoid and were attached to the ureteral wall by a thin stalk. Histopathologically, they contained a superficial layer of well-differentiated transitional epithelial cells overlying a prominent fibrovascular stroma with a mild (three dogs) or marked (one dog) degree of lymphoplasmacytic inflammation. This disease may represent a benign neoplasm or a chronic inflammatory reaction and has a good prognosis with surgical removal. Its histopathological characteristics, higher incidence in males, and location more commonly within the upper third of the ureter is remarkably similar to the disease in humans.     

Small intestinal adenomatous polyposis resulting in protein-losing enteropathy in a horse

A 4-year-old Quarter Horse gelding was presented with a history of weight loss of 6 months duration, along with extensive ventral subcutaneous edema. Clinicopathologic findings included a markedly low serum total protein (2.9 g/dl) and a low packed cell volume (24%). The mucosal surface of the distal jejunum and entire ileum were carpeted with numerous polypoid, papillary, and glandular masses comprised of pseudostratified tall columnar cells and large numbers of interspersed goblet cells. Neoplastic change was diffuse throughout the mucosa of each mass, but abrupt demarcation occurred between neoplastic masses and adjacent mucosa. Immunohistochemical staining for protein of the p53 tumor suppressor gene revealed only occasional cytoplasmic reactivity within polyps and normal mucosa. Nuclear staining for papillomavirus antigens was not observed. Electron microscopic examination revealed features of well-differentiated intestinal epithelial cells, including apical tight junctions and microvilli, desmosomes, and the presence of numerous goblet cells. Microorganisms were not detected. Small intestinal polyposis should be considered as a rare differential diagnosis for protein-losing enteropathy in the horse.     

Epidermal growth factor receptor expression in canine transitional cell carcinoma

Transitional cell carcinoma (TCC), a urinary bladder tumor with high mortality, is encountered commonly in dogs. Whereas overexpression of epidermal growth factor receptor (EGFR) is associated with development of human urinary bladder cancer, information on EGFR expression in canine TCC is lacking. In this study, EGFR protein and mRNA expression in canine normal bladder (n=5), polypoid cystitis (n=5) and TCC (n=25) were examined by immunohistochemistry and real-time polymerase chain reaction. EGFR protein expression was significantly higher in TCC than that in normal healthy bladder (P<0.001) and polypoid cystitis (P<0.005). High EGFR protein expression was significantly (P<0.01) associated with TCC with a sensitivity of 72% and specificity of 100%. Comparative analysis of protein and mRNA expression levels in TCC showed significant positive correlation (r=0.88, P<0.05) between mRNA and protein expression. These findings suggest that intense expression of EGFR protein could be used as a marker to help canine TCC diagnosis.     

Contrast‐enhanced ultrasound complements two‐dimensional ultrasonography in diagnosing gallbladder diseases in dogs

Gall‐bladder diseases are common in dogs and two‐dimensional ultrasonography is a current standard method for diagnosis and treatment planning. However, findings from this modality can be nonspecific. The aim of this retrospective, case series study was to describe conventional and contrast‐enhanced ultrasound (using SonoVue^®) findings in a group of dogs with histologically confirmed gall bladder disease. A total of 65 dogs were included. Branchlike, heterogeneous, and homogeneous contrast enhancement of echogenic intraluminal mass‐forming lesions was a contrast‐enhanced ultrasound characteristic of polypoid lesions due to cystic mucosal hyperplasia of the gallbladder and/or tumor, which had different wash‐in and washout characteristics. In dogs with mobile or immobile biliary sludge or mucocele, the echogenic intraluminal masses remained unenhanced. A double rim mark or enhancement defect in the gallbladder wall was a characteristic of edema or necrosis/rupture of the wall, respectively. Conventional ultrasonography correctly identified biliary sludge or mucocele in 36/37 dogs, cholecystitis/edema in 44/47 dogs, necrosis/rupture in 19/25 dogs, and gallbladder neoplasia in three of three dogs with these pathologies. It falsely identified biliary sludge or mucocele in eight of 28 dogs, cholecystitis/edema in three of 15 dogs, necrosis/rupture in 13/37 dogs, and gall‐bladder neoplasia in 20/59 dogs that did not have these pathologies. Contrast‐enhanced ultrasound correctly identified cholecystitis/edema in 42/47 dogs, but falsely identified cholecystitis/edema in three of 18 dogs. It correctly identified necrosis/rupture, benign polypoid lesions, and gallbladder neoplasia in all dogs with no false‐positive results. Findings supported contrast‐enhanced ultrasound as a complement to conventional ultrasonography for dogs with suspected gallbladder pathologies such as edema, necrosis, and rupture.     

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.     

Inflammatory pseudotumours of the urinary bladder in dogs resembling human myofibroblastic tumours: a report of eight cases and comparative pathology

Eight cases of inflammatory myofibroblastic tumours (IMT) of the urinary bladder in dogs are described, including their clinical, imaging, morphological, and histopathological aspects. Old small breed female dogs were more commonly affected. Haematuria was the main clinical sign, often associated with dysuria and crystalluria. The IMT appeared as single or multiple, polypoid, firm masses, measuring 1-7 cm. Histologically, the masses were well delineated, covered by a benign hyperplastic urothelium and diffusely infiltrated by a mixed inflammatory component. The cells were spindle-shaped, adopting a fascicular, pallisading or whirling organisation and were vimentin and variably desmin and actin positive. The nuclei were globular, containing open chromatin and prominent nucleoli. Mild to moderate pleomorphism and little mitotic activity were present. These morphological features are compatible with human myofibroblastic inflammatory tumours.     

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.     

Evaluation of a method using Proteus mirabilis and Pseudomonas aeruginosa to experimentally induce dual infection of the urinary bladder in dogs

OBJECTIVE: To evaluate a method using Proteus mirabilis and Pseudomonas aeruginosa to experimentally induce dual infection of the urinary bladder in dogs. ANIMALS: 6 healthy mixed-breed dogs. PROCEDURE: Dogs were anesthetized, and cystitis was induced by infusing a solution of salicylic acid in ethanol into the bladder, followed by an inoculum containing field isolates of P. mirabilis and P. aeruginosa. Dogs were examined daily for 21 days after induction of cystitis. On day 21, dogs were euthanatized, and urinary bladder, renal pelvis, and prostate specimens were submitted for bacterial culture. RESULTS: After induction of cystitis, all dogs had evidence of thickening of the bladder wall, dysuria, tenesmus, and hematuria. Urinalysis revealed proteinuria, hematuria, and pyuria. All urine samples obtained on day 21 yielded growth of P. mirabilis, but P. aeruginosa was not cultured from any of these samples. Proteus mirabilis was isolated from bladder, renal pelvis, or prostate specimens from 4 dogs; P. aeruginosa was not isolated from any of the tissue specimens. CONCLUSION: Results suggest that the method used in the present study fails to induce dual infection of the urinary bladder with P. mirabilis and P. aeruginosa. The inability to establish a persistent dual infection with this method may have been a result of insufficient pathogenicity of the Pseudomonas isolate or an inadequacy of the experimental design.     

Colorectal adenocarcinoma in dogs: 78 cases (1973-1984)

Colorectal adenocarcinoma was diagnosed in 78 dogs. Clinical signs in all 78 dogs included tenesmus, hematochezia, and dyschezia; most of the dogs had clinical signs less than or equal to 12 weeks before examination. Ultimately, most dogs were euthanatized because of the severity of clinical signs. Proctoscopy and colonoscopy were essential for complete assessment of extent of disease. Tumors were classified by gross appearance and included single, pedunculated masses, 2 or more nodular masses, and annular or intraluminal masses. In dogs in which survival time was compared with location and gross appearance of the tumor, dogs with annular masses had the shortest mean survival time (1.6 months), and dogs with single, pedunculated, polypoid tumors had the longest mean survival time (32 months). The rectum was a more common site than the colon, with 48.2% of the tumors developing in the middle portion of the rectum. Six different modes of surgical treatment were used, depending on the location and type of mass. Dogs that did not have surgical treatment had a mean survival time of 15 months. Mean survival time in the surgically treated dogs varied slightly according to mode of treatment; they survived 7 to 9 months longer than the untreated dogs. Dogs that underwent cryosurgery and local excision had the longest survival times (24 and 22 months, respectively). Statistical analysis disclosed a significantly longer survival time for dogs treated by excision or cryosurgery, as opposed to dogs undergoing biopsy only (P = 0.001). Statistical difference in survival times was not found between dogs that had mass excision and those that had cryosurgery.     

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.     

Color and power Doppler ultrasonography for characterization of splenic masses in dogs

Benign and malignant splenic masses can appear similar on B-mode imaging, making ultrasound sensitive but not specific in their diagnosis. Our goal was to characterize color and/or power Doppler characteristics of vasculature within and adjacent to a splenic mass, which would distinguish benign vs. malignant lesions. The hypothesis was that malignant splenic masses will have altered vascular patterns compared with benign masses. Color and power Doppler cineloops evaluating the vasculature within the mass and normal splenic parenchyma were obtained in sagittal and transverse planes using a standardized protocol. Categories of evaluation included presence of peritoneal effusion, a large aberrant or tortuous vessel within the mass, relative blood flow within the mass compared with normal parenchyma, and path of vessels in the adjacent parenchyma entering into the mass. All patients had histopathologic or definitive cytologic diagnosis. Thirty-one dogs were included. There were 13 malignant masses and 18 were benign. Peritoneal effusion was significantly associated with malignancy (P = 0.0007). Presence of an aberrant or tortuous vessel within the mass was nearly significant (P = 0.059). There was no significant difference in any of the color or power Doppler blood flow evaluations. Ultrasonographic findings of a splenic mass and peritoneal effusion may indicate malignancy. The presence of an aberrant vessel within a splenic mass could suggest malignancy; however more data are needed.     

ULTRASONOGRAPHIC APPEARANCE OF OVARIAN TUMORS IN 10 DOGS

Signalment, clinical history, physical examination, clinicopathologic, readiographic and ultrasonographic findings of 10 female dogs with histologically confirmed ovarian neoplasms were reviewed. Ultrasonographic images and reports were reviewed for (1) location, size, outer margins, and echogenicity of the mass(es), (2) presence of free abdominal fluid, (3) evidence of uterine abnormalities, and (4) signs of metastatic disease. The masses were classified according to their ultrasonographic pattern in solid, solid with cystic component, and cystic. The masses were ultrasonographically reported as being of ovarian origin in eight dogs, and this origin was included in the list of differentials in the remaining two dogs. When present, abdominal effusions and uterine abnormalities were diagnosed by means of ultrasound.     

CYSTOGRAPHY: EFFECT OF TECHNIQUE ON DIAGNOSIS OF CYSTITIS IN DOGS

Double-constrast and positive-contrast cystograms were performed in 12 dogs. After cystography, E. coli cystitis was induced in nine of the 12 dogs. The remaining three dogs were used as controls. Double contrast and positive-contrast cystograms were repeated threee, seven and 14 days later. During cystography, bladders were distended to mild, moderate, and complete degrees of distention. Mucosal irregularity decreased with increasing bladder distention and was more likely to be seen on double-contrast than on the positive-contrast cystogram. When seen on both types of studies, mucosal irregularity was more obvious on double-contrast than it was on the positive-contrast custogram. Bladder wall thickness decreased with increasing distention; in some dogs with mild cystitis, abnormal wall thickness was masked by complete bladder distention. Bladder wall thickness could be measured more often on double-contrast than on the positive contrast cystograms. Wall thickness measurments made on both types of studies were similar. It was concluded that lesions of mild to moderate cystitis may be missed when the bladder is completely distended, and that the double-contrast cystogram is more sensetive for evaluating mucosal margivation and bladder wall thickness than is the positive-contrast cystogram