16 yo NM cat presented for annual exam. Doing well according to O. No history of lower urinary or GI symtoms. Has previously diagnosed subclinical cardiomyopathy and is presently not on any medications.
Exam: Has lost 1 lb since last visit 6 months ago, bilaterally palpable thyroid glands. Otherwise NSF
Lab: Has run mildly elevated BUN/Cr for a couple of years but has not changed significantly here. Mildly elevated T4, Urine sp. gr 1.020 otherwise NSF
16 yo NM cat presented for annual exam. Doing well according to O. No history of lower urinary or GI symtoms. Has previously diagnosed subclinical cardiomyopathy and is presently not on any medications.
Exam: Has lost 1 lb since last visit 6 months ago, bilaterally palpable thyroid glands. Otherwise NSF
Lab: Has run mildly elevated BUN/Cr for a couple of years but has not changed significantly here. Mildly elevated T4, Urine sp. gr 1.020 otherwise NSF
I observed the urinary bladder mass when taking urine and took a quick look around and found additional lesions in the Kidney, Liver and Ileocecococlic area. Did not appreciate any additional lymph node changes.
The urinary bladder mass appears to be invading the wall and has blood supply though not as lit up as I’m used to seeing with TCC in the dog. It’s attached to the ventral wall and doesn’t appear to be causing any issues at the moment.
The Left kidney is a mess. Not sure if there is a mass there or not.
Liver has multiple hypoechoic lesions one in particular a bit larger than the rest.
At the ileocecocolic area I’m observing enlarged lymph nodes, hyperechoic fat and again possible mass.
Ileocecocolic area Urinary bladder mass
Sorry for the large number of images/videos, but this is not an official case and I don’t think the owners are going to allow any sampling. Just interested in anyone’s thoughts.
Comments
Yikes, the reason you should
Yikes, the reason you should always scan the bladder before cystocentesis.
Nice imaging marty!,
Nice imaging marty!, mineralized mass invading wall and vacular and 16 yr old cat TCC til proven otherwise but looks resectable in th ecaudal ventral wall but as Kelly says blind cysto could stick and trail right through this thing:(
Multifocal infarcts and sectorial cortical collapse on the kidneys not neoplastic. Mes lymphadenopathy toss up between reactive ln and lsa or similar. I would resect the tumor and bx the nodes if the patient is all stable or supportive care and let him be an old cat…. tumors tend to grow slowly in old cats… “fertile soil theory”… not a lot of nutrients in older patients to feed on:)
Thanks Eric!
Had an
Thanks Eric!
Had an interesting conversation with a local oncologist and sampling TCCs. While she agrees that seeding the tumor is possible when sampling with a direct FNA, in her experience if the animal is being treated with Nsaids +/- other chemo, it is almost always the original tumor which is the reason that the animal is ultimately euthanized and does not heisitate to perform FNA on these. She furthermore said that, again in her experiecne, as long as the animal is being treated medically, that surgical resection does not buy significantly more time unless there is an outflow obstruction. She expressed that she understands that goes against current conventional wisdom but it is what she has found.
Not trying to create controversy here, just discussion.
yes of course… there have
yes of course… there have been developments in current chemo protocols that have been successful so it really depends on the modality whether the specialist is using stents, sub, chemo, ugelab or just nsaids… it has gotten really complicated now form the time Dean Cerf and I started UGELAB back in 2003 but all for good reason because they are surviving longer:) Just the published research isnt narrowing down a policy on the “correct ” modality for the positional presentation of the tumor. We all agree though no needles wihtout looking first sonographically.