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Bladder mass in a 17 year old MN Siamese cat

Case Study

Case Study

Bladder mass in a 17 year old MN Siamese cat

A 17-year-old NM Siamese was initially presented with PU/PD, increased appetite, and a bout of vomiting and diarrhea. Weight loss was noted on physical examination. The patient was later presented again with a hematuria. Bleeding from the penis, pale mucosa, and inappropriate mentation status (sitting sternal with head down) were present on physical examination. Urinalysis showed inappropriate SG (1.018), 1+ protein, and 3+ blood. Blood pressure, CBC, and coagulation panel were all within normal limits.

A 17-year-old NM Siamese was initially presented with PU/PD, increased appetite, and a bout of vomiting and diarrhea. Weight loss was noted on physical examination. The patient was later presented again with a hematuria. Bleeding from the penis, pale mucosa, and inappropriate mentation status (sitting sternal with head down) were present on physical examination. Urinalysis showed inappropriate SG (1.018), 1+ protein, and 3+ blood. Blood pressure, CBC, and coagulation panel were all within normal limits. Abnormalities on serum biochemistry included elevated ALT activity and amylase, and azotemia.

Sonographic Differential Diagnosis

Urinary bladder mass or significantly attached blood clot. Given the persistence of the problem and the loss of apical wall detail in the urinary bladder, a mass is suspected. The mass appears to be deriving from the bladder apex and appears resectable. Due to thrombocytopenia, however, it would be recommended to rule out coagulopathy and the possibility of a blood clot prior to surgery.

Image Interpretation

The urinary bladder in this patient presented a 2.0 cm, mixed echogenic blood clot or mass that appeared to be attached to the apical wall. Loss of mural detail in the wall was noted, which suggests an organized mass more so than a blood clot.

DX

Bladder mass

Outcome

No further outcome at this time.

Clinical Differential Diagnosis

Hematuria – bladder pathology (bacterial cystitis, interstitial cystitis, uroliths, neoplasia), renal pathology (neoplasia, pyelonephritis, renolith, trauma, infarction), urethral pathology (neoplasia, trauma).

Sampling

None. However, ultrasound-guided traumatic catheterization would be recommended prior to surgical intervention in order to obtain tissue or cytology for analyzing for a potential mass or blood clot.

Video

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Patient Information

Patient Name : Jordan L
Gender : Male, Neutered
Species : Feline
Type of Imaging : Ultrasound
Status : Complete
Liz Wuz Here : Yes
Code : 06_00076

Clinical Signs

  • Diarrhea
  • Hematuria
  • PU-PD
  • Vomiting

Exam Finding

  • Bleeding from penis
  • Neurologic signs
  • Pale Mucous Membranes
  • Weight loss

Images

bladderfclotjordanlosadcopy_10312012031318pdopnegubcloturoattachedbloodclot

Blood Chemistry

  • ALT (SGPT), High
  • Amylase, High
  • Azotemia

Clinical Signs

  • Diarrhea
  • Hematuria
  • PU-PD
  • Vomiting

Urinalysi

  • Blood Present
  • Protein Present
  • Specific Gravity Low