Encrusted cystitis secondary to Corynebacterium matruchotii infection in a horse

Imaging of the Urinary Tract

This article provides a comprehensive review of imaging techniques used to evaluate the equine urinary tract. This overview includes officially recognized modalities and new applications reported in the most current literature. Technical aspects and indications for use of endoscopy and ultrasonography are highlighted. Normal endoscopic and ultrasonographic appearance of the upper and lower urinary tract is described, with characterization of common abnormalities found in patients with hematuria, stranguria, and renal failure. Visual examples of several pathologic conditions from clinical cases are provided. An outline of the main features, potentials, and limitations of radiography, nuclear scintigraphy, and computed tomography is provided.

Equine idiopathic hemorrhagic cystitis: Clinical features and comparison with bladder neoplasia

BACKGROUND

A new syndrome of hematuria in horses has been documented.

HYPOTHESIS/OBJECTIVES

Hemorrhagic cystitis is a novel cause of stranguria and hematuria in horses. This syndrome may be difficult to differentiate from bladder neoplasia because they share several clinical features.

ANIMALS

Eleven horses with idiopathic hemorrhagic cystitis and 7 horses with bladder neoplasia.

METHODS

Retrospective cohort study.

RESULTS

Hemorrhagic cystitis was detected on cystoscopy of affected horses, with hemorrhagic and thickened apical bladder mucosa. Clinical signs and endoscopic appearance of the bladder resolved within 3-8 weeks. Histopathology of bladder mucosal biopsy specimens featured neutrophilic and hemorrhagic cystitis. Histopathology was suggestive of dysplasia or neoplasia in 3 horses with hemorrhagic cystitis, yet the horses experienced complete resolution, suggesting that small biopsy specimens obtained by endoscopy can be difficult to interpret. Horses with bladder neoplasia had lower hematocrits, were older, more likely to be female, and more likely to have a mass detected on ultrasonographic examination of the bladder than horses with hemorrhagic cystitis syndrome.

CONCLUSIONS AND CLINICAL IMPORTANCE

Hemorrhagic cystitis represents a novel differential diagnosis for horses with hematuria, and is associated with a favorable prognosis. Although histopathology may suggest a neoplastic process, affected horses should be monitored cystoscopically, because complete resolution of hemorrhagic cystitis occurs. The cause of this disease is unknown, and warrants investigation.

Blood culture status in mature horses with diarrhoea: a possible association with survival

REASONS FOR PERFORMING STUDY

The incidence and implications of positive blood cultures in mature horses with diarrhoea is unknown. The diagnosis of bacteraemia may alter treatment and prognosis.

HYPOTHESIS

The proportion of horses with diarrhoea that are blood culture positive is higher than previously assumed and a positive blood culture has a negative impact on survival.

METHODS

Blood cultures were taken at admission and 24 h after admission from 31 mature horses with diarrhoea.

RESULTS

Nine (29%) horses were blood culture positive within 24 h of admission. Organisms isolated included Corynebacterium spp. (n = 6), Streptococcus spp. (n = 2), Pantoea agglomerans (n = 1), Gram-negative rod (n = 1), Bacillus spp. (n = 1) and yeast (n = 1). Horses with positive blood cultures were significantly less likely to survive. Prior treatment with antimicrobial drugs had no significant effect on blood culture status. Horses with positive blood cultures had a significantly higher heart rate, packed cell volume (PCV) and plasma potassium concentration at admission, and a higher PCV and lower total plasma protein concentration 24 h after admission.

CONCLUSIONS

Positive blood cultures occur more frequently than previously reported, and may have a negative impact on survival in horses with diarrhoea.

POTENTIAL RELEVANCE

Results of blood cultures may be useful in formulating a prognosis for horses with diarrhoea. Further research is required to determine the effect of antimicrobial treatment on outcome.

Poorly differentiated leiomyosarcoma of the urogenital tract in a horse

CASE DESCRIPTION

A 2-year-old Thoroughbred filly was evaluated because of hemorrhage from the vulva and suspected hematuria of 5 days' duration.

CLINICAL FINDINGS

A primary coagulopathy was ruled out on the basis of results of hematologic testing. Vaginoscopy and cystoscopy revealed a large bleeding mass in the bladder that extended into the vagina, causing marked obliteration of normal urogenital structures and difficulty in urination. Histologic examination of endoscopic and surgical biopsy specimens revealed a poorly differentiated neoplasia likely of mesenchymal origin. Chronic suppurative cystitis caused by Streptococcus zooepidemicus was also diagnosed.

TREATMENT AND OUTCOME

The tumor continued to grow despite treatment with doxorubicin and, within 45 days, was causing substantial discomfort and stranguria. Given the grave prognosis, the horse was euthanized. At necropsy, the tumor was found to have caused widespread destruction of the urinary bladder and to have invaded the broad ligament of the uterus. The mass was identified as a poorly differentiated leiomyosarcoma on the basis of results of histologic examination and immunohistochemical staining for alpha-actin.

CLINICAL RELEVANCE

Findings suggested that leiomyosarcoma should be considered in the differential diagnosis when examining horses with urogenital bleeding.