Page 466 - Feline diagnostic imaging

478 27 Urinary Disease

(a) (b)

(c) (d)

Figure 27.26 (a) Lateral projection of the caudal abdomen of a 7-year-old Ragdoll with chronic cystitis of more than eight months
duration. The cranial aspect of the urinary bladder has a pointed appearance consistent with a urachal diverticulum. (b) An excretory
urogram was performed. During the cystogram phase of the excretory urogram, calculi (small arrows) are seen as filling defects in the
contrast within the bladder. Notice that the bladder wall is thickened and the urachal diverticulum is visible. (c) At 45 minutes, margins
of the contrast in the urinary bladder are irregular. (d) Ultrasound image of one of the calculi measured at 0.93 cm.

27.4.3 Cystitis
resulting from trauma five years earlier and prolonged
Cystitis is not apparent on survey radiography unless antibiotic therapy were considered to be predisposing
there is increased or decreased opacity in the area of the causes. On ultrasonography, the bladder wall was thick-
bladder. Gas in the wall, ligaments, or lumen of the ened and irregular. It was mainly hypoechoic but there
urinary bladder indicates emphysematous cystitis was a thick hyperechoic mucosal surface. Postmortem
(Figure 27.30), which is most likely to be associated with examination revealed a thick granular crust adhering to
diabetes mellitus although it has been reported in a cat the bladder wall.
caused by Escherichia coli [38]. The presence of gas could Double contrast cystography can help detect cystitis
also be iatrogenic due to prior catheterization or cysto- when the bladder wall is thickened (Figure 27.31).
centesis. Mineralization in the bladder is usually Positive contrast coats the mucosal border of the blad-
associated with neoplasia but in rare cases can be der, allowing detection of focal or uniform thickening
associated with cystitis. Increased opacity attributed to of the wall adjacent to the air‐filled lumen. The bladder
mineralization was seen in the urinary bladder of a cat wall in patients with chronic cystitis is not as distensi-
with an unusual case of encrusting cystitis secondary to ble as a normal bladder. It is better to do multiple test
Corynebacterium urealyticum [39]. Neurologic problems injections than to rupture the bladder. The mucosa may