A 7-year-old FS DSH was presented for evaluation of recurrent hematuria and stranguria. Urinalysis showed protein and blood and a normal specific gravity. Culture was negative.
A 7-year-old FS DSH was presented for evaluation of recurrent hematuria and stranguria. Urinalysis showed protein and blood and a normal specific gravity. Culture was negative.
Interstitial cystitis bladder pattern with bladder calculi. Urethral calculi as well which were nonobstructive at this time.
The bladder calculi may be a primary issue; however, the bladder wall thickening is likely indicative of a chronic disease. There is a minor potential for bladder TCC or bladder lymphoma. However, I am not suspecting this.
The urinary bladder presented concentric, irregular wall thickening that measured 0.45 cm. Echogenic ulcerative changes were noted within the bladder wall. A slight amount of sand accumulation was noted. A 0.6 cm calculus was noted and another measured 0.5 cm. Urethral calculi were also noted.
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Cystotomy, bladder wall biopsy and culture as well as stone analysis with normal and retrograde flushing is recommended. Expulsion of the urethral calculi at the time of surgery with normal grade flushing should prove adequate given that this is a female. Regardless, histopathology of the bladder wall as well as culture of the bladder wall would be warranted. Predominant inflammatory cell type should be investigated as well for future management in this case once the stones are removed.
bladder pathology- Interstitial cystitis, urolith, neoplasia, polyploid cystitis
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