Radiology Packet 36

Urinary Tract II

3-year old Shih Tzu“Maggie”

• Hx: Presented because of straining to urinate.

3-year old Shih Tzu“Maggie”

• RF– Two large radiopaque cystic calculi are noted in the midportion of the bladder.– Multiple smaller cystic calculi are seen.– There is a large calculus within the trigone region.– The bladder is large.

• RD– Multiple cystic calculi, one is lodged in the trigone or proximal urethra causing

acute bladder outflow obstruction

5-year old F Collie“Mira”

• Hx: Hit by car the previous day.

5-year old F Collie“Mira”

• RF– Lateral survey film

• The urinary bladder is not visible and there is decrease in abdominal detail in the caudal abdominal cavity.

• The retroperitoneal detail is normal.

• A small, triangular mineral opacity structures is present at the ventral body wall.

• Fracture of the ilial body is apparent.

– Lateral film of IV pyelogram• There is no evidence of leakage of contrast material into the retroperitoneal space.• The termination of the ureters at the bladder is not defined by the study.• Contrast is present free within the abdominal cavity.

5-year old F Collie“Mira”

• RD– Rupture of the urinary tract– Ilial body fracture– Small bone fragment at the ventral aspect of the abdominal wall

• R/O– Rupture of the bladder or at the junction of the ureters with the bladder.– Small bone fragment suggests partial avulsion of the prepubic tendon at its

attachment to the pubis.

• Next– Exploratory laparotomy

10-year old Yorkshire Terrier“Berty”

• Hx: Presented for evaluation of dysuria and pollakiuria.

10-year old Yorkshire Terrier“Berty”

• RF– The liver is enlarged and has rounded margins.– The urinary bladder is distended. 3 large and multiple small calculi are present.– There is a calculus present in the urethra at the base of the os penis.– Large amount of intra-abdominal fat.

• RD– Hepatomegaly– Cystic calculi– Urethral calculus

• R/O– Hepatomegaly

• Hyperadrenocorticism

• Next– ACTH stimulation test and abdominal ultrasound.– Lateral radiograph with legs pulled cranially to further evaluate urethra.

14-year old FS Sheltie“Flame”

• Hx: Presented with stranguria and dysuria. Some blood has be noted in the urine.

14-year old FS Sheltie“Flame”

• RF– Urinary bladder is moderately distended.

– There is calcific rimmed oval structure just caudal to the liver margin on the lateral view . This corresponds to an incidental finding of fat mineralization.

– 8 Lumbar vertebrae are noted.

• RD– Moderately distended urinary bladder

• Next– Abdominal ultrasound

5-year old Pug“China”

• Hx: Presented for evaluation of urethral obstruction.

5-year old Pug“China”

• RF– The liver extends beyond the costal arches but the borders are sharp and clear.– The stomach wall appears mildly thick.– There are multiple mineral opacity structures noted in the urinary bladder

consistent with calculi.– There is an incidental finding of bilateral coxofemoral degenerative joint disease.

• RD– Cystic calculi

• Next– Abdominal ultrasound

12-year old FS Sheltie“Mindy”

• Hx: Presented with hematuria.

12-year old FS Sheltie“Mindy”

• RF– Two discrete, roughly marginated opaque structures are present overlying the

urinary bladder in both views.– The craniolateral margin of the left kidney is slightly flattened.– Mild arthritis of the right hip.

• RD– Two cystic calculi

• Next– Ultrasound

M DSH“Scooter”

• Hx: Two films are provided. The first was taken in 1999 prior to a perineal urethrostomy. The second was taken in 2001 because the patient presented with signs of urinary tract obstruction.

M DSH“Scooter”

• RF– 1999

• The urinary bladder contains a single 2mm round mineral opacity structure.• There is a granular appearance to the ventral aspect of the bladder suggesting that mineralized

sediment is present.• Irregular mineral opacity material is present in the pelvic and proximal penile urethra.• There is an incidental finding of mild spondylosis at the lumbosacral junction.

– 2001• There are multiple variably-sized mineral opacity structures within the bladder and extending into the

bladder neck.• The bladder neck appears elongated.• A gas bubble is also present within the bladder lumen.

• RD– 1999

• Cystic calculi with evidence of mineralized bladder sediment• Mineralized sediment/small calculi within the urethra

– 2001• Multiple cystic calculi• Air bubble is the result of previous catheterization