– 13 year old MN DSH ADR and history if hematuria
– rDVM noted a grade 2-3 holosystolic heart murmur (unfortunately I did not get a chance to listen to the heart)
– bloodwork, electrolytes unremarkable
– echo showed no evidence of structural heart changes with a small AI jet (likely not cause of the heart murmur); Ao max velocity was normal
– AliveCor ECG showed intermittent wide complexes (VPCs) and a noticeable intermittent pause was noted during contractions when performing the echocardiogram
– 13 year old MN DSH ADR and history if hematuria
– rDVM noted a grade 2-3 holosystolic heart murmur (unfortunately I did not get a chance to listen to the heart)
– bloodwork, electrolytes unremarkable
– echo showed no evidence of structural heart changes with a small AI jet (likely not cause of the heart murmur); Ao max velocity was normal
– AliveCor ECG showed intermittent wide complexes (VPCs) and a noticeable intermittent pause was noted during contractions when performing the echocardiogram
– bladder mass with positive colour Doppler found in the dorsal wall
– rest of scan unremarkable
– I have recommended a BP check, Cardiopet ECG evaluation and chest rads, bladder mass biopsy/possible removal (would like to rescan with a more distended bladder if possible)
Two questions:
1. Could cause of VPC’s be result of systemic disease in this patient?
2. Is taking the pet to surgery the only way to get a bladder biopsy on this one? I suspect suction biopsy would be extremely difficult in a cat!
Comments
JP Its a MN so us guided
JP Its a MN so us guided suction bx is possible here but yes sx here is best cut to the chase as long as not in the urethra… old cat with that lesion tcc until proven otherwise.
Heart looks unremarkable so check BP T4 and systemic disease. Murmur likely trivial MR or flow turbulence.
JP Its a MN so us guided
JP Its a MN so us guided suction bx is possible here but yes sx here is best cut to the chase as long as not in the urethra… old cat with that lesion tcc until proven otherwise.
Heart looks unremarkable so check BP T4 and systemic disease. Murmur likely trivial MR or flow turbulence.
I don’t know the answer to
I don’t know the answer to your specific questions, however, I just wanted to share with you that I see a lot of bladder wall irregularities when the bladder is only distended 1-2cm. These irregularities oftentimes dissappear after using lasix, fluids, or time to allow the bladder to fill. Your lesion looks real, but it would be nice to confirm it with a more fully distended bladder.
I don’t know the answer to
I don’t know the answer to your specific questions, however, I just wanted to share with you that I see a lot of bladder wall irregularities when the bladder is only distended 1-2cm. These irregularities oftentimes dissappear after using lasix, fluids, or time to allow the bladder to fill. Your lesion looks real, but it would be nice to confirm it with a more fully distended bladder.
I agree ont he distention
I agree ont he distention issue but those distend-away irregularities that are benign polyps or chronic changes form past cystitis are nearly always apical ventral or apical dorsal whereas this on is solitary and dorsal bladder wall… i.e more of a TCC pattern and rather large especially for a cat so even distending it out will still give a pathological lesion.
Any lesion that is solitary and mid to caudal is suspect until proven benign.
If you search the archive under cystitis and also TCC you will see the pattern difference to judge whether to go aggressive right off or sit and watch. Not histopathological ultrasound because the opposite of the usual can occur but knowing the tendencies helps manage the owners intent and input.
I agree ont he distention
I agree ont he distention issue but those distend-away irregularities that are benign polyps or chronic changes form past cystitis are nearly always apical ventral or apical dorsal whereas this on is solitary and dorsal bladder wall… i.e more of a TCC pattern and rather large especially for a cat so even distending it out will still give a pathological lesion.
Any lesion that is solitary and mid to caudal is suspect until proven benign.
If you search the archive under cystitis and also TCC you will see the pattern difference to judge whether to go aggressive right off or sit and watch. Not histopathological ultrasound because the opposite of the usual can occur but knowing the tendencies helps manage the owners intent and input.