A 12-year-old MN Cairn Terrier dog with prior history of increased ALP activity (1 year ago) was presented for recent inappropriate urination in the house. Abnormalities on physical examination were severe dental tartar, tachypnea with an easily elicited cough, hepatomegaly, and bilateral nuclear sclerosis. The patient was treated with a course of antibiotics pending urinalysis. At recheck exam nine days later, the owner reported that the patient was polyuric/polydypsic, and his gums had been bleeding.
A 12-year-old MN Cairn Terrier dog with prior history of increased ALP activity (1 year ago) was presented for recent inappropriate urination in the house. Abnormalities on physical examination were severe dental tartar, tachypnea with an easily elicited cough, hepatomegaly, and bilateral nuclear sclerosis. The patient was treated with a course of antibiotics pending urinalysis. At recheck exam nine days later, the owner reported that the patient was polyuric/polydypsic, and his gums had been bleeding. Proteinuria, hematuria, and leukocyturia were present on urinalysis, but the specific gravity was normal. CBC showed lymphopenia and monocytosis; blood chemistry showed elevated ALP activity and mild hyperglycemia.
Case Study
Trigonal bladder mass in a 12 year old MN Cairn Terrier
Sonographic Differential Diagnosis
Dorsal trigonal bladder mass, which is likely not resectable.
Image Interpretation
The urinary bladder contained a dorsal trigonal mass measuring approximately 3.5 x 2cm slightly obstructing the left ureter. No hydronephrosis was noted.
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Outcome
Ultrasound guided laser ablation was given as an option for long term palliative therapy, but was declined by the owner. The patient was treated with piroxicam and antibiotics. A month later, the owner reported that the patient was taking longer to urinate than usual but otherwise was doing well. The patient was euthanized a few weeks later due to poor quality of life.
Clinical Differential Diagnosis
Incidental dental disease. Urinary bladder disease – cystitis, uroliths, neoplasia. Polyuria/polydypsia -hyperadrenocorticism. Respiratory disease – allergic, bronchitis, neoplasia, pneumonia.
Sampling
None
Video
Patient Information
Clinical Signs
- Inappropriate Urination
- PU-PD
History
- Elevated Liver Enzymes
Exam Finding
- Coughing
- Hepatomegaly
- Tachypnea
Images
Blood Chemistry
- Alkaline Phosphatase (SAP), High
- Glucose, High
CBC
- Monocytes, High
- WBC, Low
Clinical Signs
- Inappropriate Urination
- PU-PD
Urinalysi
- Bacteria Present
- Blood Present
- Protein Present
- WBCs Present