I would appreciate your help with this bladder.

-14 year old, FS, mongrel dog, with very chronic history of UTI for years.

-Recently, the UTI seems to return very often. I scanned her few months back and suspected interstitial cystitis + secondary infection. Antibiotic therapy has been given based on cultures from mid-stream voided urine as owner is very concerned about anything invasive, even cystosample. However, We persuaded her to do a cysto saple today because we feel stuck at interpreting culture results accurately.

I would appreciate your help with this bladder.

-14 year old, FS, mongrel dog, with very chronic history of UTI for years.

-Recently, the UTI seems to return very often. I scanned her few months back and suspected interstitial cystitis + secondary infection. Antibiotic therapy has been given based on cultures from mid-stream voided urine as owner is very concerned about anything invasive, even cystosample. However, We persuaded her to do a cysto saple today because we feel stuck at interpreting culture results accurately.

-When I saw the bladder, I decided against cystosample based on the possibility of potential underlying neoplasia (lymphoma more than TCC, right?). I still see some layering but not all the tie and the vascular pattern concernes me; it is so thick and the dog had just emptied the bladder so there is little urine for a more extended wall. I suspect there is a chronic interstitial cystitis and my fear is that after so many years there is now neoplasia…(is this a logical thinking?).

Rest of abdominal scan: liver some poorly defined hypoechoic lesions, DDx nodular hyperplasia, any other neoplasia, Spleen is similar and only there appears to be a hypoechoic nodule/cystic formation in pancreatic area. Bloodwork is all WNL.

Questions, do you agree taking a cysto is risky if neoplasia??

I strongly suggested full thickness biopsy or at least, cystoscopy for mucosal sample (for culture for treating the bacteria accordingly if any and histopath, in case we are lucky and get a diagnosis from it).

Owner is very reluctant to do anything invasive but loves this dog. What do you think of the wall and what would you do? in the end, we still do not have a sterile collected urine sample for culture and dog is been placed on high dose baytril at night for 3-5 days and cerenia, and after baytril we were considering pyroxicam, but…what is your input?

Thank you very much.