Case Study

Bladder mass and adrenal nodule in a 15yr old, MN Australian cattle dog

A 15-year-old MN Australian Cattle dog was presented for evaluation of hematuria and weight loss. Urinalysis showed SG of 1.012, proteinuria, and hematuria. The only abnormality on serum biochemistry was mildly elevated ALP (174) activity. On survey radiographs, a soft tissue calcified opacity within the urinary bladder was evident.

Sonographic Differential Diagnosis

Dorsal bladder mass. This appears resectable and is consistent with transitional cell carcinoma.
Left adrenal gland nodule. This is likely adenoma. Serial blood pressure measurements are recommended if the urine specific gravity is less than 1.020 then LDDST is warranted.
Nodular hyperplasia liver pattern. There was no evidence of metastatic disease from the bladder tumor.

Image Interpretation

The urinary bladder presented a mineralizing mass deriving from the dorsal wall measuring 2.9 x 2.12 cm. The bladder mass is moderately vascular. The cystourethral junction and urethra appeared free of evident pathology. Both ureteral papillae appeared free of evident pathology, as did the cystourethral junction and urethra. The mass appears resectable. There appears to be mild repletion of about 1-2 cm from the right urethral papilla.

The left adrenal gland revealed a hyperechoic nodule in the cranial pole measuring 1.29 cm, caudal pole measured 0.77 cm and the left adrenal gland length measured 3.07 cm. This is most consistent with an adenoma. The right adrenal gland measured 3.94 x 1.94 cm at the cranial pole and 1.51 cm at the caudal pole.

Exam of the cranial abdomen demonstrated excessive liver size, irregular contour, and diffuse micronodular architecture. Parenchymal echogenicity was mixed and generally hypoechoic to the spleen. Macroscopic congestion was noted with mildly dilated gall bladder with considerable precipitate. The gall bladder wall was somewhat echogenic. These changes are consistent with benign hyperplasia, chronic inflammatory or, less likely, neoplastic disease.