1 / 9

Emphysematous cystitis

Emphysematous cystitis. James Montgomery, DVM April 27, 2009. Marta. 12 years old Female Bichon frise Hx: recurrent UTIs, hematuria, stranguria, renoliths, struvite uroliths, hyperadrenocorticism, diabetes mellitus. Radiographs: Acc# 78616. Gas opacities superimposed with bladder

liang
Download Presentation

Emphysematous cystitis

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Emphysematous cystitis James Montgomery, DVM April 27, 2009

  2. Marta • 12 years old • Female • Bichon frise • Hx: recurrent UTIs, hematuria, stranguria, renoliths, struvite uroliths, hyperadrenocorticism, diabetes mellitus

  3. Radiographs: Acc# 78616 • Gas opacities superimposed with bladder • Marked hepatomegaly • Soft tissue mineralization • Bilateral stifle djd

  4. Ultrasound: Acc# 78607 • Gas shadowing from within urinary bladder walls – not gravity dependent • Mucosal irregularities or calculi • Bilateral peripelvic mineralization • Possible splenic mineralization • Hypoechoic hepatomegaly

  5. Emphysematous cystitis • In humans, reported at a higher incidence in females • Usually diabetic patients • Three radiographic stages • 1: A clear 1 mm zone seen around the contrast medium and free gas not present in the bladder lumen • 2: Bladder wall is irregular and thickened because of increased intramural gas. Still no free intraluminal gas. • 3: Free gas in the bladder lumen evident radiographically.

  6. Emphysematous cystitis • First reported in a diabetic dog in 1926 • Reported with approx. same frequency in males and females • Occurs mainly in association with diabetes, but also with primary renal glucosuria. • Glucose-fermenting bacteria or yeast ferment glucose to produce carbon dioxide  small gas bubbles which collect in the bladder wall and lumen. • Gas bubbles coalesce and rupture as the cystitis progresses

  7. Emphysematous cystitis • In nonglucosuric dogs: • Develops secondary to other conditions – • Chronic UTI • Bladder trigone diverticulum • Chronic steroid administration • Production of gas is due to bacterial breakdown of urinary albumin by bacteria • Bladder wall hypoxia • Common bacteria: Proteus mirabilis (all 4 dogs in Petite article), Escherichia coli, Aerobacteraerogenes, Clostridium sp. (more specifically perfringens)

  8. Emphysematous cystitis • Treatment  effective treatment of UTI and control of glucosuria

  9. References • Adams LG, Syme HM. Canine Lower Urinary Tract Diseases. In Ettinger SJ, Feldman EC, eds. Textbook of Veterinary Internal Medicine, 6thed (St. Louis, MO: Elsevier Saunders, 2005) p. 1872. • Nyland TG, et al. Urinary Tract. In Nyland TG, Mattoon JS, eds. Small Animal Diagnostic Ultrasound, 2nded (Philadelphia, PA: Saunders Elsevier, 2002) p. 183. • Petite A, et al. Radiographic and ultrasonagraphic findings of emphysematous cystitis in four nondiabetic female dogs. Veterinary Radiology & Ultrasound 2006;47(1):90-3.

More Related