1887

Bladder and urethra

image of Bladder and urethra
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Abstract

Common indications for ultrasonography of the bladder in the dog and cat include: dysuria/haematuria/stranguria; acute, chronic or recurrent urinary tract infections; abnormalities identified on urinalysis; urinary incontinence; evaluation of suspected ectopic ureters; assessment of bladder integrity following trauma; palpable caudal abdominal mass; evaluation of perineal or inguinal repture/hernia; as part of an abdominal ultrasound examination; as a crude assessment of urine output; and to obtain a urine sample by cystocentesis. This chapter explains the value of ultrasonography compared with radiography and computed tomography before focusing on intraluminal material, mural masses, bladder rupture and ectopic ureters. This chapter contains three video clips.

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Figures

Image of 14.3
14.3 The three layers of the normal bladder wall (between the arrows) are clearly seen using a high frequency linear probe in this Domestic Shorthaired cat. (Sagittal plane; cranial is to the left of the image.)
Image of 14.4
14.4 A jet of urine from the left ureter is seen as a burst of colour on colour Doppler. (Transverse plane; right is to the left of the image.) (Courtesy of the University of Bristol)
Image of 14.5
14.5 Multiple echoes are seen within the bladder lumen of a Golden Retriever due to secondary lobe artefacts. Note the multiple focal zones depicted by the yellow arrowheads to the right of the image. The bladder imaged with a single focal zone (yellow arrowhead) aligned with the middle of the lumen. The secondary echoes are no longer present. (Sagittal plane; cranial is to the left of the image.)
Image of 14.6
14.6 ‘Pseudosludge’ due to slice thickness artefacts. This can be differentiated from genuine sediment by the curved interface with the urine (arrowed) and the fact that this ‘pseudosludge’ does not move with gravity. A similar band of echoes due to slice thickness artefacts is seen within the superficial part of the bladder lumen (arrowheads). Genuine sediment settled dependently within the bladder of a crossbred dog. Note the straight interface (arrowed) between the urine and sediment. (Sagittal plane; cranial is to the left of the image.) (Courtesy of the University of Bristol)
Image of 14.7
14.7 The colon (arrowed) lies immediately adjacent to the bladder and can mimic the appearance of a large calculus. This dog also had a large bladder mass. A genuine calculus (C) lying against the bladder wall, casting a strong acoustic shadow. The calculus moves position with gravity. (Transverse plane; right is to the left of the image.) (Courtesy of the University of Bristol)
Image of 14.8
14.8 Emphysematous cystitis. The air is seen as a brightly echogenic line (arrowed) with distal reverberation artefacts located within the highest (non-dependent) part of the bladder. (Sagittal plane; cranial is to the left of the image.) (Courtesy of the University of Liverpool)
Image of 14.9
14.9 Haemorrhage settled dependently in the bladder of an adult dog due to a coagulopathy caused by warfarin toxicity. (Sagittal plane; cranial is to the left of the image.) (Courtesy of the University of Liverpool)
Image of 14.10
14.10 A urinary catheter is recognized as parallel echogenic lines passing through the urethra into the bladder lumen. (Sagittal plane; cranial is to the left of the image.) (Courtesy of the University of Bristol)
Image of 14.11
14.11 Irregular broad-based mass, confirmed as a transitional cell carcinoma, located at the bladder trigone in a 7-year-old bitch. Colour Doppler ultrasonography demonstrated the mass to be well vascularized. (Transverse plane; right is to the left of the image.) (Courtesy of the University of Liverpool) Cystic appearing mass identified arising from the bladder wall in a female neutered Domestic Shorthaired cat. (Sagittal plane; cranial is to the left of the image.) (Courtesy of the University of Bristol)
Image of 14.12
14.12 Multiple polypoid masses seen in a male neutered Cocker Spaniel with polypoid cystitis. Note the adjacent thickened bladder wall. (Sagittal plane; cranial is to the left of the image.) (Courtesy of the University of Bristol)
Image of 14.13
14.13 An irregular broad-based mass in an entire male dog extending beyond the bladder neck (arrowed) to involve the proximal urethra. (Sagittal plane; cranial is to the left of the image.) (Courtesy of the University of Liverpool)
Image of 14.14
14.14 Positive contrast retrograde urethrogram in a male neutered dog demonstrating the presence of a filling defect (arrowed) within the urethra consistent with a urethral mass. Ultrasonogram using a high frequency linear transducer confirming the presence of the mass (arrowed). The parallel echogenic lines (arrowheads) seen deep to the mass lesion are echoes from the urethral catheter. A diagnosis of undifferentiated carcinoma was made from an ultrasound-guided fine needle aspirate. (Courtesy of the University of Bristol)
Image of 14.15
14.15 Ureterocele (arrowed) seen as a ‘cyst within a cyst’. (Transverse plane; right is to the left of the image.) (Courtesy of the University of Bristol)
Image of 14.16
14.16 Irregular cranioventral and craniodorsal wall thickening in a neutered bitch with cystitis. (Sagittal plane; cranial is to the left of the image.) (Courtesy of the University of Bristol)
Image of 14.17
14.17 An ectopic ureter seen as an anechoic tubular structure (arrowed) running dorsal to the bladder before it converges with the urethra just beyond the bladder neck. (Sagittal plane; cranial is to the left of the image.) (Courtesy of the University of Liverpool)

Supplements

Ureteric jet.

A transverse plane through the bladder is shown in this clip, with the right side of the bladder displayed on the left-hand side of the screen. A jet of urine entering the bladder from the left ureter is seen as a burst of red with colour Doppler ultrasonography. (Courtesy of the University of Bristol).

Cystic calculi.

This clip shows a sagittal plane through the bladder, with cranial displayed on the left-hand side of the screen. Multiple small calculi are resuspended in the lumen following gentle agitation of the bladder. (Courtesy of the Willows Veterinary Centre)

Ectopic ureter.

This clip shows a sagittal plane through the bladder neck, with cranial displayed on the left-hand side of the screen. An ectopic ureter seen as an anechoic tubular structure (arrowed) running dorsal to the bladder before it converges with the urethra just beyond the bladder neck. (Courtesy of the University of Liverpool)

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