- 16 yr old FS DSH presented for hematuria on 12/16/19. Urinalysis (free catch) revealed numerous red blood cells, white blood cells and mild cocci and rod bacteria. No stones see on radiographs.
- Initially Rx with Orbax then changed to Clavamox after urine culture came back.
- Cat has history of calcium oxalate stones removed by cystotomy in 2009.
- Recheck exam on 1/2/2020 showed persistent moderate hematuria and mild cocci on urinalysis.
- 16 yr old FS DSH presented for hematuria on 12/16/19. Urinalysis (free catch) revealed numerous red blood cells, white blood cells and mild cocci and rod bacteria. No stones see on radiographs.
- Initially Rx with Orbax then changed to Clavamox after urine culture came back.
- Cat has history of calcium oxalate stones removed by cystotomy in 2009.
- Recheck exam on 1/2/2020 showed persistent moderate hematuria and mild cocci on urinalysis.
- Abdominal ultrasound performed 1-3-20 showed a bladder stone.
- Patient was placed on a stone dissolution diet (S/O I think) and antibiotics were continued.
- Follow up ultrasound performed yesterday shows no significant change in the stone appearance.
- I am concerned that this is a nondissolvable calcium oxalate stone. Because the echogenic density is not much higher than the bladder wall itself, I want to make sure that there is actually a stone there and not just small 1mm stones or bladder sand. When I agitate the transducer, nothing resuspends. When I place the cat in ventral recumbency, the stone drops immediately again with no suspended debris.
- Appropriate to send this cat to surgery?
Comments
Loks like sand grouping to me
Loks like sand grouping to me and one tirck i found in practice is to push iv fluids assuming no heart disease and tx the uti with injectables and flush and dissolve the sand that way and get a jump on the uti based on culture results first and you can moniotor in house with the probe. The sand may be secondary to the uti. Otherwise if you go to sx ensure the sand is there right before sx as i have documented cases where the bladder sand in cats is there one day gone a few days later and back again a few days later. Its crazy.
Ok, thanks Eric. I have had
Ok, thanks Eric. I have had cats, too, where it looks like something is there, and then nothing is seen at surgery. Because they are often chronic cystitis cases, I usually advise bladder biopsy while they are in there so that some diagnostic information can be obtained from the procedure.