A 15-year-old male neutered DSH cat was presented for evaluation of chronic UTIs that had been treated with antibiotics. The cat had been diagnosed with hyperthyroidism 4 months ago; this disease had been treated with radioactive iodine treatment.
A 15-year-old male neutered DSH cat was presented for evaluation of chronic UTIs that had been treated with antibiotics. The cat had been diagnosed with hyperthyroidism 4 months ago; this disease had been treated with radioactive iodine treatment.
There is a ventral apical bladder mass extending close to the cystourethral junction. The separation at minimal repletion from the cystourethral junction was approximately 0.5 cm. Both kidneys demonstrated an interstitial nephrosis renal pattern with cortical infarcts. There was pyelectasia in the right kidney, likely due to scaring or potential urinary tract infection.
There was no evidence of metastatic disease.
The urinary bladder in this patient presented a 2.8 x 1.6 cm ventral apical mass that extended near the cystourethral junction with ill-defined separation. The cystourethral junction itself appeared to be unaffected, as did the proximal urethra. Power Doppler assessment revealed moderate vascularity. Minor, pericapsular inflammatory pattern was noted, due to transmural pathology. The muscularis and submucosal layers were destroyed within the bladder wall where the mass was affecting the bladder structure.
Pyelectasia of the right kidney was noted and measured 0.56 cm. Interstitial nephrosis pattern was noted. The right kidney measured 3.9 cm. The left kidney measured 3.44 cm with cortical infarcts.
None
Surgical resection could be considered in this patient, given that the ureters appear to be unaffected at this time. Some palliative long-term response may come from attempt at resection, and full resection may be possible (but is less likely than debulking). Closure of the bladder wall will be difficult.
Bladder disease: neoplasia, urolith, granulomatous cystitis, polyploid cystitis, chronic bacterial cystitis, interstitial cystitis; Renal disease: neoplasia, renolith, pyelonephritis.
None. Given that this cat is a male, traumatic catheterization could be considered with ultrasound guidance. (More information on this procedure can be found at www.sonopath.com/resources.) Ultrasound-guided pyelocentesis could be considered with appropriate culture.
