- 12 year old mn Bichon with hx of increased frequency of urination but no stranguria
- U/A showed atypical cells with no bacteruria and no hematuria
- Urinary tract US shows multiple, gravity dependent, echogenic shadowing denisities, multiple 0.3-0.6 focal wall massess at the bladder apex, and micropolypoid changes at the trigone
- R/O’s are urolithisias with concurrent polyps, or neoplasia (TCC)
- Plan is to perform cystotomy and bladder wall biopsy. Any other thoughts?
- 12 year old mn Bichon with hx of increased frequency of urination but no stranguria
- U/A showed atypical cells with no bacteruria and no hematuria
- Urinary tract US shows multiple, gravity dependent, echogenic shadowing denisities, multiple 0.3-0.6 focal wall massess at the bladder apex, and micropolypoid changes at the trigone
- R/O’s are urolithisias with concurrent polyps, or neoplasia (TCC)
- Plan is to perform cystotomy and bladder wall biopsy. Any other thoughts?
The uroliths appear strange to me as they do not have discreet boundaries and vary in degree of echogenicity and shadowing. Pics of dog in a standing position show echogenic densities at the ventral portion of the bladder, but they appear fewer in number, smaller in size, and more discreet. Is this typical? I could not find any dorsal wall masses with the dog standing, however, he was not a very cooperative patient at this point.
Comments
Melissa, the good thing is
Melissa, the good thing is that all of the polyps appear apical so may be resected with removal of 1/3 of the apical UB. Whether TCC or polypoid cystitis it can all be resected. The bad thing is the CUJ and proximal urethra looks infiltrated with likely TCC but i never confirm this without video as stills can create something from nothing. Needs traumatic catherization or scope to know for sure. The echogenic structures are mucous balls with sand…like graphite and water mixed together mixed together with overt stones in image 3 with solid shadowing. if the urethra and cuj is clean on video then the UB apical wall needs bx and culture and resection in my opinion along with stone removal. That way its in a jar and not in the dog causing or potentially causing issues. When in doubt cut it out:)
Melissa, the good thing is
Melissa, the good thing is that all of the polyps appear apical so may be resected with removal of 1/3 of the apical UB. Whether TCC or polypoid cystitis it can all be resected. The bad thing is the CUJ and proximal urethra looks infiltrated with likely TCC but i never confirm this without video as stills can create something from nothing. Needs traumatic catherization or scope to know for sure. The echogenic structures are mucous balls with sand…like graphite and water mixed together mixed together with overt stones in image 3 with solid shadowing. if the urethra and cuj is clean on video then the UB apical wall needs bx and culture and resection in my opinion along with stone removal. That way its in a jar and not in the dog causing or potentially causing issues. When in doubt cut it out:)
Thanks Eric!
Thanks Eric!
Thanks Eric!
Thanks Eric!