Case Study

Bladder mass in a 15 year old MN DSH cat with inappropriate urination behavior

A 15-year-old MN DSH was presented on emergency for a one year history of increasing inappropriate urination as well as straining to urinate or defecate. The cat also had a medical history of reanl issues (resolved), hyperthyroidism, and constipation. Abnormalities on physical examination included pyrexia (103.2В°), tachycardia, tachypnea, muscle wasting dorsally, and a soft non-painful bladder. The patient’s penis was dark purple-pink, but no grit was seen at the urethral opening. Abnormalities on CBC were leukocytosis and neutrophilia. Serum biochemistry was within normal limits. Radiographs showed an empty stomach, a small amount of gas throughout the small intestines, a full urinary bladder with no evidence of radiopaque calculi, and a feces-filled colon. The patient was initially treated with subcutaneous fluids, ampicillin, and Vitamin B Complex, and discharged with Clavamox and instructions to follow up at rDVM.

DX

Transitional cell carcinoma or possible bladder lymphoma.

Sonographic Differential Diagnosis

These images are most consistent with transitional cell carcinoma or possible bladder lymphoma.

Image Interpretation

The urinary bladder in this patient was largely normal except for a 2.8 cm mass in the area of the cystourethral junction and urethra. The mass initiated at the cystourethral junction with a maximum width of 0.6 cm (from the serosal to luminal interface of the mass). This mass extended in a concentric manner to the proximal urethra.

Outcome

No further outcome.

Clinical Differential Diagnosis

Hyperthyroidism. Inappropriate urination and stranguria – pyelonephritis, bladder pathology (neoplasia, uroliths, bacterial cystitis, interstitial cystitis), spinal disease (trauma, neoplasia, disc disease).

Sampling

Urethral stent placement was recommended with a urinary catheter as a interim and palliative measure. The patient was discharged with phenoxybenzamine and Zenequin. Recheck urinalysis was within normal limits. The stent placement was performed successfully and the patient was asymptomatic with minimal to no regrowth of the lesion after 8 months.