A 6-year-old SF DSH cat was presented for evaluation of chronic cystitis that was non-responsive to antibiotic and Adequan therapy. Both urinalysis and urine culture were within normal limits.
A 6-year-old SF DSH cat was presented for evaluation of chronic cystitis that was non-responsive to antibiotic and Adequan therapy. Both urinalysis and urine culture were within normal limits.
Interstitial cystitis pattern with a minor amount of sand and potential urinary tract infection. Surgical biopsies and bladder lavage would be ideal with bladder wall culture and histopathology (this is important to rule out possible lymphoma and to define the cell type). Minor degenerative renal changes.
The urinary bladder in this patient revealed dependent debris that measured 2.1 cm in length. The bladder wall presented minor, apical ventral wall thickening. Suspended debris was also evident. The bladder wall thickening appeared to be concentric throughout with some loss of mural detail, and measured 0.4 cm at minor repletion. The pelvic urethra was also thickened. These images are most consistent with interstitial cystitis with minor potential for bladder lymphoma. The kidneys revealed largely normal size and structure; corticomedullary definition and ratio (cortex 1/3 of medulla) were essentially maintained with minor loss of curvilinear pattern. The cortices presented largely uniform texture with some echogenic changes that are not likely of clinical significance at this time.
The patient is being treated with steroids.
Surgical biopsies, normal and retro grade flushing, and bladder wall culture would be ideal. Analysis of predominant cell type typically needs to be requested in these cases, specifically. If lymphocytic plasmocytic infiltrate is present, then cortisone therapy may prove fruitful. Utilizing cortisone in this type of bladder without histopathology is not recommended because there is potential for bladder necrosis and rupture. Antibiotics should be stopped at least 7 days prior to any surgical procedure. If bladder wall biopsies are performed and specific therapy is utilized, then a recheck sonogram would be warranted 3-4 weeks after initiation of the treatment.
Interstitial cystitis, uroliths, neoplasia, granulomatous cystitis, chronic bacterial cystitis.
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