Case Study

Bladder mass in a 16 year old MN DSH cat with a history of IBD

A 16-year-old neutered male DSH cat with a history of weight loss and inflammatory bowel disease was presented for poor appetite. Dehydration, dental disease, and nasal discharge were noted on physical examination. Hematuria was present on urinalysis. Initial CBC showed leukocytosis and anemia, which remained fairly unchanged after a month of antibiotic therapy.

DX

Presumed transitional cell carcinoma or other malignant neoplastic condition of the bladder. Nodules of unknown etiology in liver and spleen.

Sonographic Differential Diagnosis

Nodular splenic and hepatic changes, which are likely benign. Focal intestinal dilation with probable dysfunctional bowel and slight reactive omentum. Inspection and biopsy of the bowel at the time of surgery for the bladder mass would be recommended.

Image Interpretation

The bladder presented a 1.38 cm mineralizing mass in the dorsal apex, which appears resectable. Strong mineralization of this mass suggests transitional cell carcinoma or other malignant neoplastic condition. The liver in this patient was largely normal in structure, although mildly increased portal markings and swollen contour were noted. There was a hyperechoic nodule in the left lateral lobe; this nodule measured 0.6 cm with loss of structural architecture. There were nodular splenic changes. The gastrointestinal tract was largely unremarkable. However, there were areas of dilated small intestine or echogenic debris and gas artifact. Areas of empty small intestine were noted. Colonic gas artifact was also noted, which is indicative of adequate transit. However, focal dysfunctional bowel is likely given that some echogenic changes are noted associated with the wall and periserosal region. No overt foreign body was noted, yet could not be ruled out due to gas artifact occluding any potential foreign matter.

Outcome

Cat doing ok for now.

Clinical Differential Diagnosis

GI disease – neoplasia, ulceration, foreign body, IBD, abscessation/granulomatous disease. Pancreatic disease – pancreatitis, neoplasia. Hematuria – interstitial cystitis, neoplasia, uroliths, pyelonephritis, renoliths. Dental disease.