Case of the week 8.7.23
Publication Date: 2023-08-07
History
5 year old female mixed breed dog. At 1am the owner noticed that the patient was dripping urine and crying in pain.
3 images
Diagnosis
Retroperitoneal detail is markedly reduced, with fluid opaque striations obscuring the renal margins. Peritoneal serosal margin detail is mildly reduced in the caudal abdomen, along the cranial margin of the urinary bladder.
There is a large, ovoid, mineral opaque structure located just cranial to the pelvic inlet in the region of the urinary bladder trigone/ proximal urethra with mildly irregular margins (3.6 cm in length and 2.5 cm in diameter). The urinary bladder is moderately to markedly distended and otherwise homogenously fluid opaque. The liver, spleen, and gastrointestinal tract are normal.
The T8 vertebral body is shortened and wedge-shaped.
Discussion
- Large cystolith/ proximal urethrolith, highly suspected to be resulting in lower urinary tract obstruction. Concurrent retroperitoneal effusion and regional peritoneal effusion may represent steatitis from acute kidney injury secondary to lower urinary tract obstruction, pyelonephritis, or ureteral/bladder rupture. Abdominal ultrasound is recommended for further evaluation of the kidneys. Surgical intervention is warranted for removal of the large cystolith.
- Incidental thoracic hemivertebra.
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