What is this urinary bladder “lesion” ?

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What is this urinary bladder “lesion” ?

2YO FS Shih Tzu with significant weight loss of ~ 3# (was 9# now 6#) despite normal appetite.

There are sonographic changes that indicate that the GI tract is the cause of weight loss.

Chemistries:  mild ALT (172) elevation. Normal ALT and  BUN. Low normal ALB and Glob.

No clinical signs related to the urogenital system.

2YO FS Shih Tzu with significant weight loss of ~ 3# (was 9# now 6#) despite normal appetite.

There are sonographic changes that indicate that the GI tract is the cause of weight loss.

Chemistries:  mild ALT (172) elevation. Normal ALT and  BUN. Low normal ALB and Glob.

No clinical signs related to the urogenital system.

Two sweeps of the urinary bladder are offered. One in sagittal and the other in transverse. This lesion appears to be located in the dorsal wall at the trigone.  It does not appear to involve the wall layering.  The fluid pocket seen dorsal to the urinary bladder apex  in the sagittal sweep is actually luminal fluid in a small bowel segment.

Any thoughts about what this bladder wall finding represents ? 

 

Comments

VSI7tsherrill

After some thought this

After some thought this lesion looks like these are two distinct “polyp” lesion at the trigone. Could this be a hyperplasia of or some abnormal variation of the ureterovesical junction? It doesn’t look typical of TCC or blood clot. 

rlobetti

Agree that is does not look

Agree that is does not look typical for a TCC, wall lesion, or hematoma. Were you able to visualize the ureters and any doppler of the lesion? as it almost appears to be tubular structure that opens into the bladder so an abnormal ureter is possible.

KV CVT SonoPath

Any chance this could be a

Any chance this could be a urachocele Dr. Lobetti?

VSI7tsherrill

Yes, I did try doppler but

Yes, I did try doppler but too much motion by the patient (panting) to be of value. No permission to sedate. Good suggestion in trying to visualized ureters. They are not appreciated but maybe I could tx with lasix to determine where the UVJs enter the bladder. Thanks for your comment.

jlc960

Interesting! Let us know what

Interesting! Let us know what you find!

Jennifer

EL

The lesion is within the left

The lesion is within the left ureteral papilla and still curvilinear so i doubt tcc and too young for tcc anyway… may be a u-pap malformation…. stone movers get thickened u-paps in my experience likely formpopping stones into the bladde rperiodically but the yung age would discount this hypothesis too…. localized ureteritis possible too and a weird form of ureteral ectopy/malformation would be my primary guess.

VSI7tsherrill

Thanks to all.  Will give

Thanks to all.  Will give follow-up info if I rescan this patient.

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