cystitis/distended bladder + overflow incontinence

Re: cystitis/distended bladder + overflow incontinence

Kate Richardson — Mon, 28 Jan 2013 16:37:48 GMT

[quote user="CatherineThomas"]I spoke to a specialist about the case and he seemed to think that FNA would be the best way to sample the mass. In his opinion he wouldn't worry about seeding as he felt that the neoplasia usually becomes terminal before the seeding becomes a problem.[/quote]

My experience with prostatic carcinomas would be consistent with this opinion. The 2 I have seen in the past year (one diagnosed by FNA, the other by trucut biopsies) both deteriorated quickly anyway due to progressively uncontrollable pain, and difficulty defaecating and urinary incontinence in one.

Re: cystitis/distended bladder + overflow incontinence

Andrew Kent — Mon, 28 Jan 2013 16:29:53 GMT

Because there is a risk of seeding disease into the abdomen which obviously isn't significant if the dog will be pts but if they consider palliative stenting (which can give a survival of many months) it becomes a bit of a problem and difficult to explain.

Re: cystitis/distended bladder + overflow incontinence

Thomas Johnson — Mon, 28 Jan 2013 16:01:29 GMT

[quote user="Andrew Kent"][quote user="CatherineThomas"]

Thanks. He did seem much better yesterday after 24hrs with the urinary catheter plus some IV fluids and pain relief. I've also put him on a high dose of synulox. So he's at home today and we'll see how he is tomorrow and if he's been able to empty his bladder. I spoke to a specialist about the case and he seemed to think that FNA would be the best way to sample the mass. In his opinion he wouldn't worry about seeding as he felt that the neoplasia usually becomes terminal before the seeding becomes a problem.

Well I'll see him tomorrow and we'll discuss further investigation if he's not improving.

[/quote] That method of sampling would be contrary to general opinion but that aside catheter sampling is easier as you can't really miss!

[/quote]

I diagnosed a prostatic carcimona by FNA a couple of months ago, if the prostate is accessible I see no reason not to FNA it if there appears to be prostatic disease.

Re: cystitis/distended bladder + overflow incontinence

Kate Richardson — Mon, 28 Jan 2013 15:41:09 GMT

[[quote user="Andrew Kent"][quote user="CatherineThomas"]

Well I'll see him tomorrow and we'll discuss further investigation if he's not improving.

[/quote] That method of sampling would be contrary to general opinion but that aside catheter sampling is easier as you can't really miss!

[/quote]

Why not sample this way?

Re: cystitis/distended bladder + overflow incontinence

Gerry Henry — Sun, 27 Jan 2013 21:00:04 GMT

his bladder seemed very painful .. the owner refused blood samples and pain relief

Not an option he'd be given in my practice I have to say.

Re: cystitis/distended bladder + overflow incontinence

Andrew Kent — Sun, 27 Jan 2013 16:27:53 GMT

[quote user="CatherineThomas"]

Well I'll see him tomorrow and we'll discuss further investigation if he's not improving.

[/quote] That method of sampling would be contrary to general opinion but that aside catheter sampling is easier as you can't really miss!

Re: cystitis/distended bladder + overflow incontinence

CatherineThomas — Sun, 27 Jan 2013 15:15:11 GMT

Well I'll see him tomorrow and we'll discuss further investigation if he's not improving.

Re: cystitis/distended bladder + overflow incontinence

Andrew Kent — Sun, 27 Jan 2013 12:16:41 GMT

If he is neutered and has prostatic disease then neoplasia is high up the list and often leads to urinary obstruction but i can't make out much on the ultrasound image. If this region does look abnormal then I would do a suction biopsy using a urinary catheter under ultrasound guidance or palpation.

if neoplastic then not much you can do unless they would consider urethral stenting or diversion.

but with his history and breed then still urolithiasis is possible and ultrasound is not that sensitive a way to assess this. Ultimately if the owner does not have the finances/inclination to investigate further its unlikely there will be a positive outcome.

Andy