Jaci Christensen LVT Tarleton State University Lucy referred for possible bladder mass Lucy is an 8 year old Scottish Terrier History of hematuria and dysuria for approximately 3 months ID: 389824
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Slide1
Retrograde Cystography in the Canine Patient
Jaci
Christensen, LVT
Tarleton State UniversitySlide2
“Lucy”- referred for possible bladder mass
Lucy is an 8 year old Scottish Terrier
History of hematuria and dysuria for approximately 3 months
Referring veterinarian had been treating with Baytril for a suspected UTIWhen no improvement, an ultrasound was performed and a mass was seen at the apex of the bladderVeterinarian made a referral for further work-up and treatment optionsSlide3
Physical Exam
Weight- 13.6 kg
Temp- 100.4*F
Heart Rate- 130 bpmResp Rate- 40 bpmMucous Membranes- Pink/MoistCRT- <3 secondsHeart/Lungs normal on auscultation
On abdominal palpation, patient is tense and painful.
No abnormalities on rectal palpation
Patient postured to urinate several times during physical examSlide4
Preliminary Diagnostics
CBC- all values within normal limits
Chemistry Panel- BUN 54 (Range: 5-29), Creatinine 2.05 (Range: 0.3-2), all else within normal limits
Urinalysis- Blood: large amount, Protein: 3+, Bacteria: small amountA retrograde cystography was recommended for further evaluation of the bladder mass seen on ultrasound imagesSlide5
Retrograde Cystography
A retrograde cystography occurs when contrast media is infused into the bladder via a urinary catheter. The bladder can then be evaluated using radiographs.
Normal Canine Bladder
A retrograde
cystogram
may be indicated in the following situations:
Abnormal Urine
Abnormal Urinary Habits
Trauma
Suspected NeoplasiaSlide6
Procedure
Lucy was fasted for 24 hours prior to the
cystogram
to avoid the superimposition of fecal matter Lucy was sedated with 0.3 mg/kg butorphanol and a propofol CRI for urinary catheter placementA urinary catheter was placed using a sterile technique and the bladder was drainedPositive contrast media (75
mls
) was infused slowly into the bladder
Radiographs were performedSlide7
Results
Lack of contrast uptake confirmed the diagnosis of a bladder mass and assisted in evaluating the size and location of the tumor. Slide8
Contrast Studies
Contrast studies of the urinary system may evaluate the kidneys, bladder, ureters, prostate, or urethra. The method of evaluating the urinary system will vary based on the clinical signs of the animal and the treating veterinarian. Contrast used may be positive, negative, or double-contrast.
Positive Contrast
Negative Contrast
Double ContrastSlide9
Conclusion
Lucy’s bladder mass was sampled using a traumatic catheter and she was diagnosed with transitional cell carcinoma
Lucy received 8 treatments of vinblastine chemotherapy, followed by laser ablation
Lucy had a partial response to treatment and remained sub-clinical for 7 months, at which point humane euthanasia was elected. Slide10
References
Brown, M., & Brown, L. (2014).
Radiography for Veterinary Technicians, Fifth Edition.
St. Louis:
Elsevier
.