Radiographic features of suspected suture-associated cystic calculi in dogs

Excretory urographic, ultrasonographic, and cystoscopic characteristics of urinary bladder abscesses in a dog

A 7-year-old male neutered, 6.5 kg, Maltese breed dog was referred with a history of dysuria after undergoing two cystotomies to remove calcium oxalate uroliths. Survey radiographs were inconclusive. Excretory urography allowed visualization of two filling defects in the cranioventral urinary bladder region. Ultrasonography showed urinary bladder sediments, a diffusely thickened wall, and two circumscribed intramural/intraluminal structures with an anechoic interior and a smooth and regular surface. The cystoscopic diagnosis was urinary bladder abscesses and urine cultures were positive for Escherichia coli. Antimicrobial/anti-inflammatory therapy was started with good clinical outcomes and negative culture after 21 days.

Bladder wall adhesion causing a vesicular septum in a dog following surgical cystotomy

CASE DESCRIPTION

An 8-year-old spayed female Yorkshire Terrier-Poodle dog was evaluated for persistent pollakiuria and stranguria following routine cystotomy for calcium oxalate cystoliths.

CLINICAL FINDINGS

The dog presented for a cystotomy with intermittent hematuria. Postoperative radiographs revealed no remaining cystoliths. Urine, cystolith, and bladder mucosal aerobic cultures were negative. Pollakiuria, stranguria, and hematuria developed immediately after surgery and persisted despite antibiotics. Ultrasound revealed suspected fibrous adhesions within the urinary bladder lumen connecting the dorsal and ventral bladder wall creating a septum. This was confirmed cystoscopically 4 weeks after surgery.

TREATMENT AND OUTCOME

Cystoscopic-guided laser ablation was performed to incise abnormal tissue connecting the ventral and dorsal bladder wall using a holmium:yttrium-aluminum-garnet laser. Three weeks later, ultrasound revealed adhesion resolution though mild pollakiuria and stranguria persisted. Oxybutynin was prescribed and clinical signs resolved. At 27 months after ablation, hematuria occurred with recurrent cystoliths. These cystoliths were removed by percutaneous cystolithotomy, documenting a cystoscopically normal bladder wall. The patient had normal urination for 55.5 months after ablation, with normal bladder wall thickness on ultrasound repeated at 27 and 36 months after ablation.

CLINICAL RELEVANCE

To the authors' knowledge, an adhesion creating a septum between the dorsal and ventral bladder wall has not been previously reported as a complication after cystotomy in any species and should be considered as a cause of persistent lower urinary signs after surgery. Ultrasound identified the lesion in this dog. Because bladder abnormalities can develop quickly after surgery, ultrasound might be considered if urine testing is not supportive of infection. Cystoscopic-guided laser ablation was a successful minimally invasive treatment in this case.

Ultrasonographic diagnosis of a hair foreign body in the urinary bladder of a dog

A 13-year-old male neutered mixed-breed dog with a history of gallbladder mucocele and urolithiasis was evaluated by ultrasound. Two hyperechoic, linear foreign bodies with no distal acoustic shadowing were detected in the urinary bladder and urethra. Following the ultrasound examination, the patient underwent cystoscopy, and two single hairs were found and successfully retrieved. Considering that urinary bladder foreign bodies may be a source for urinary tract infection and can act as a nidus for urocystolith formation, removal is recommended. This is the first published report describing ultrasonographic diagnosis of a hair foreign body in the canine urinary bladder and urethra.