Case Of the Month

Hematuria

The patient is an 8 year old, MN, canine Queensland Healer Cross that presented for hematuria. Clinical exam was uneventful. CBC and chemistry panel was unremarkable. Hematuria and evidence of UTI was present in the urinalysis.

The patient is an 8 year old, MN, canine Queensland Healer Cross that presented for hematuria. Clinical exam was uneventful. CBC and chemistry panel was unremarkable. Hematuria and evidence of UTI was present in the urinalysis.

Outcome

The patient recovered uneventfully. Oncology consultation pending.

Comments

Special thanks to Dr. Doug Casey of English Bay Ultrasound, Vancouver, BC, Canada and Dr Phil Anderson and Staff Animal Care Clinic (http://animalcareclinicvancouver.com) for the excellent management of this case

Clinical Differential Diagnosis

(Lobetti)

Bladder – neoplasia, uroliths, bacterial cystitis, trauma
Prostate – neoplasia, abscess
Kidney – neoplasia, renolith, pyelonephritis, trauma

Sampling

(Dr. Doug Casey): US-guided FNA of the ureteral mass revealed epithelial atypia. Surgical biopsy of the right ureteral mass revealed ureteral sarcoma with hemorrhage. Right kidney: Hydronephrosis, pelvic hemorrhage, parenchymal atrophy, fibrosis, mild interstitial lymphoplasmacytic nephrosis.

Sonographic Differential Diagnosis

(Lindquist): Obstructive right ureteral mass with extension into right renal pelvis and secondary hydronephrosis. Potential pelvic blood clot. Mass appears resectable with right nephro-ureterectomy. Suspect transitional cell carcinoma or sarcoma.