This is a post related to a question by Tom Sherrill about bladder sparkling artifact created by color doppler and mineral in the bladder (http://sonopath.com/forum/sparkling-bladder).
This is a post related to a question by Tom Sherrill about bladder sparkling artifact created by color doppler and mineral in the bladder (http://sonopath.com/forum/sparkling-bladder).
An example case we recently had where this artifact came in handy was one where my associate scanned a dog and found a tremendous amount of debris that was organized in the bladder and she also reported probable stones suspended in the debris and recommended a cystotomy with flush of the bladder (had been a chronic problem). They waited 2 weeks to go to surgery and when they got in there they supposedly found nothing. The owner was mad then requested a radiologist review the images because they were unhappy that an “unnecessary” surgery was performed. The radiologist agreed that a cystotomy and flush was an appropriate course of action and everyone was content. I went back about a month after the surgery and rechecked the dog and low and behold…stones in the bladder. My color artifact was confirmation, as well as agitated cysto (all included below). So I’ll upload 1st images of the original scan that shows all the bazaar debris in the bladder that would NOT stir up with agitated cysto and was NOT clots. The urine sample that she collected on that day was yellow. We’re still not sure what caused that presentation. Radiologist thought it would be clots, but we had no RBCs on the cysto. Then I’ll post my follow-up showing the color sparkling and agitated cysto.
Has anyone seen debris like the original presentation in the bladder before?
Comments
Great video set Marty.
Great video set Marty. yes this happens in cats a lot. I have dcocumented somewhere in my archive a cat that had 1/2 cm solid shadowing stones one week. no tx as owner was about as non compliant as possible, scanned the cat the next week and it was a sandpile only minor shadowing, then 3 weeks later afte rtreating wiht abs for infection the stones were back shadowing again… made no sense but I wanted to say go get the stones out before they dissappear:)
Other thing that happens as well as stones in bladder, dissolve and flush out prior to sx especially if on fluids preop, and empty cystotomy sx but aleways get wall bx!!! There is usually somethign to discuss wiht the owner in the bladder wall especially with cats.
Another scenario is they pass the bladder stone or dissolve and pass naturally >> negative cystotomy>>> new stones a month later as they passed from the kidneys. Oxalates do this all the time to the point that I have backed down on rec cystotomies in females with stones of < 0.3 cm or so… hydropulsion or if not causing a problem an uti is often not present with oxalates just let them be and they pee them out. Larger stones different story or in males you get the bee bee signs of straining and hematuria>>> bang bang blood on white carpet:)
Great post guys happy 4th
Great video set Marty.
Great video set Marty. yes this happens in cats a lot. I have dcocumented somewhere in my archive a cat that had 1/2 cm solid shadowing stones one week. no tx as owner was about as non compliant as possible, scanned the cat the next week and it was a sandpile only minor shadowing, then 3 weeks later afte rtreating wiht abs for infection the stones were back shadowing again… made no sense but I wanted to say go get the stones out before they dissappear:)
Other thing that happens as well as stones in bladder, dissolve and flush out prior to sx especially if on fluids preop, and empty cystotomy sx but aleways get wall bx!!! There is usually somethign to discuss wiht the owner in the bladder wall especially with cats.
Another scenario is they pass the bladder stone or dissolve and pass naturally >> negative cystotomy>>> new stones a month later as they passed from the kidneys. Oxalates do this all the time to the point that I have backed down on rec cystotomies in females with stones of < 0.3 cm or so… hydropulsion or if not causing a problem an uti is often not present with oxalates just let them be and they pee them out. Larger stones different story or in males you get the bee bee signs of straining and hematuria>>> bang bang blood on white carpet:)
Great post guys happy 4th
This bladder seriously looks
This bladder seriously looks like one I just posted on the forum called “Chronic Cystitis” My case was a 12 year old female Cocker. Bladder looked very similar. As per EL’s suggestion I am treating for a cystitis using Baytril for 30 days. The most recent culture in mid June indicated a Staph. Be careful using Baytril with an E Coli infection. I have seen data recently that fluoroquinole antibiocs can lead to an E Coli infection resistant to all antibiotics tested (scary superbug). I will be very cautious before I suggest opening up the bladder.
This bladder seriously looks
This bladder seriously looks like one I just posted on the forum called “Chronic Cystitis” My case was a 12 year old female Cocker. Bladder looked very similar. As per EL’s suggestion I am treating for a cystitis using Baytril for 30 days. The most recent culture in mid June indicated a Staph. Be careful using Baytril with an E Coli infection. I have seen data recently that fluoroquinole antibiocs can lead to an E Coli infection resistant to all antibiotics tested (scary superbug). I will be very cautious before I suggest opening up the bladder.
Be sure the culture results
Be sure the culture results are compatible with Baytril (lots of e coli resistant now) otherwise need to switch to maybe 3rd gen cefa like ceftiofur or whatever the C&S or MIC says
Be sure the culture results
Be sure the culture results are compatible with Baytril (lots of e coli resistant now) otherwise need to switch to maybe 3rd gen cefa like ceftiofur or whatever the C&S or MIC says