Purdy is a 12 yr FS, lab mix 49.7#
She is being evaluated for a chronic 6 month history of bloody vaginal discharge which seems to just drip at times.
She was spayed 1 year ago. Did not have pyometra.
She does not exhibit any stranguria or dysuria and vaginal scope exam just showed discharge. No response to antibiotics.
Urine sample collected previously by the rDVM was reportedly grossly bloody.
Could not palpate anything rectally.
Purdy is a 12 yr FS, lab mix 49.7#
She is being evaluated for a chronic 6 month history of bloody vaginal discharge which seems to just drip at times.
She was spayed 1 year ago. Did not have pyometra.
She does not exhibit any stranguria or dysuria and vaginal scope exam just showed discharge. No response to antibiotics.
Urine sample collected previously by the rDVM was reportedly grossly bloody.
Could not palpate anything rectally.
The clinical picture is more supportive of a uterine stump pyometra or pathology as it would seem if this was a utrethral mass there should be some kind of stranguria.
Thanks!
Comments
Look closely at the urethra
Look closely at the urethra and try to get back in the high resolution and increase gain and add power doppler around the hyperechoic foci (long arrow). Short arrow is the u-stump which is prominent. You may have urethral TCC in the deep pelvic urethra. See examples in the basic search here:
http://sonopath.com/members/case-studies/search?text=urethral+tcc&species=All
Nice post!
Look closely at the urethra
Look closely at the urethra and try to get back in the high resolution and increase gain and add power doppler around the hyperechoic foci (long arrow). Short arrow is the u-stump which is prominent. You may have urethral TCC in the deep pelvic urethra. See examples in the basic search here:
http://sonopath.com/members/case-studies/search?text=urethral+tcc&species=All
Nice post!
So this image didn’t post
So this image didn’t post that I saw originally. Do you think the hypoechoic rounded structure in the right far field with the refraction artifact is the uterine stump?
So this image didn’t post
So this image didn’t post that I saw originally. Do you think the hypoechoic rounded structure in the right far field with the refraction artifact is the uterine stump?
Looking at this again taking
Looking at this again taking screen shots from video 4 I think you have a lumpy and mineralizing (short arrow) deep urethral mass. The small arrows show the expanded width of the mass and the lines show the normal proximal urethra. The other still with the long arrow shows the ill defined hyperechoic area is likely part of the mass as well but very caudal in the pelvic canal and might be visible with a vaginoscopy extruding through the urethral meatus. So take a look there as its very deep and maybe try some different angles and gain settings maybe harmonics aas close as you can get the probe and your doppler will be more precie. Should be able to get that deep urethra to about < 2cm from the skin with passive manual probe hand pressure.
FYI we will be demonstrating this technique ad nauseum in our SDEP wet labs in PR and otehr sites soon to be announced this year.
http://www.sonopath.com/events/presentations-2015/save-date-sdep-site-ultrasound-lab-puerto-rico
Looking at this again taking
Looking at this again taking screen shots from video 4 I think you have a lumpy and mineralizing (short arrow) deep urethral mass. The small arrows show the expanded width of the mass and the lines show the normal proximal urethra. The other still with the long arrow shows the ill defined hyperechoic area is likely part of the mass as well but very caudal in the pelvic canal and might be visible with a vaginoscopy extruding through the urethral meatus. So take a look there as its very deep and maybe try some different angles and gain settings maybe harmonics aas close as you can get the probe and your doppler will be more precie. Should be able to get that deep urethra to about < 2cm from the skin with passive manual probe hand pressure.
FYI we will be demonstrating this technique ad nauseum in our SDEP wet labs in PR and otehr sites soon to be announced this year.
http://www.sonopath.com/events/presentations-2015/save-date-sdep-site-ultrasound-lab-puerto-rico