Ultrasound is extremely helpful for evaluating the urinary and reproductive tracts of our small animal patients. Sometimes the cause of blood in the urine is due to a fairly benign cause, such as a urinary tract infection or sterile cystitis (bladder wall inflammation). Other times it is can be secondary to prostate disease or kidneys / bladder stones.
For this patient with blood in the urine, the cause was more concerning. Ultrasound revealed a large suspected clot within the urinary bladder. Color Doppler did no show blood flow within the structure, although sampling would be needed to definitively determine if the structure was a mass or a clot.
The patient also had bilateral renal masses, most consistent with a cancerous process. Bilateraly kidneys are affected in about 10% of patients with kidney cancer. Renal cell adenocarcinoma and lymphoma are the most common kidney cancers in companion animals.
Ultrasound should be utilized sooner rather than later for patients with blood in the urine. Diagnosing conditions earlier will lead to better treatment outcomes and help improve patient comfort and quality of life.
They say bad things come in 3s...
The last two weeks have been full of all things gallbladder, including a suspected rupture. But 3 gallbladder mucoceles was an interesting find. Ultrasound is such a useful modality for working up elevated liver enzymes, anorexia and vomiting, and patients who have (or who are suspected to have) hyperadrenocorticism (Cushings). Imaging should include a thorough evaluation of the the liver, biliary tree including the common bile duct and duodenal papilla, pancreas, and adrenal glands.
All 3 of these cases had adrenal changes that could be seen with hyperadrenocorticism. And all three were smaller, absolutely adorable dogs. Fingers crossed they are all on their way to feeling better now that they have a diagnosis and are receiving specific care.
Surgery is the treatment of choice for mucoceles, preferably before the patient becomes sick with clinical signs. Unfortunately, there is a high mortality rate once the gallbladder ruptures.
If you own a Boxer, either as a companion or with the intent of breeding, please consider having him or her tested for ARVC by the NC State College of Veterinary Medicine. The test can be performed on whole blood or by using special swabs (available by request from NC State) to collect samples of cheek cells inside the mouth.
ARVC is an adult-onset cardiac disease that can lead to sudden death and heart failure. It most commonly affects the Boxer breed but can affect other breeds as well, including the English Bulldog and American Staffordshire. It is recommended that Boxers undergo Holter monitoring beginning at age 3. Dogs which may be used for breeding should have genetic testing performed prior to breeding. Any patient with a heart murmur, substantial arrhythmia (>100 VPCs/24 hr or more complex VPCs), fainting, weakness, or heart enlargement should be further evaluated with an echocardiogram.
Please contact us if you would like our assistance with any aspect of your Boxer's heart health. We can provide Holter testing and rhythm evaluation, genetic testing submission, and echocardiography.
More information about genetic testing in boxer dogs can be found HERE.
A great summary from the University Federations for Animal Welfare can be found HERE.