A Case of Urinary Bladder Malakoplakia in a Young French Bulldog: Diagnostic and Therapeutic Issues

A 3-month-old female French Bulldog presented with hematuria, severe pollakiuria, and urinary incontinence lasting for 1.5 months. Broad-spectrum empirical antibiotic therapy and nonsteroidal anti-inflammatory drugs were initiated by the referring veterinarian. Due to a lack of improvement, the dog was referred. At referral examination, urinary clinical signs persisted (hematuria, severe pollakiuria) and a firm bladder was noted. Abdominal ultrasonography revealed severe, diffuse bladder wall thickening with a significant reduction in the bladder lumen. Urinary tract endoscopy showed whitish exophytic proliferations throughout the entire bladder wall. Histological bladder wall analysis led to a diagnosis of bladder malakoplakia. Prolonged antibiotic therapy with fluoroquinolones was prescribed and resulted in clinical remission despite persistent bacteria in the bladder wall. This report describes a case of successfully medically managed bladder malakoplakia, a very rare condition in veterinary medicine, well documented in humans.

Metastatic urothelial carcinoma of the urinary bladder in a Sumatran tiger (Panthera tigris sondaica)

A 15-year-old spayed female Sumatran tiger (Panthera tigris sondaica) was presented with a short history of haematuria and dysuria, non-responsive to antibiotics, and a gradual decline to inappetence over a period of 2-3 months. Ultrasound examination showed a thickened urinary bladder wall and the renal pelvis of right kidney was dilated and cystic. A presumptive diagnosis of renal failure was made, and the tigress was euthanised due to deteriorating quality of life and pronounced weight loss. Histopathology revealed extensive erosion of the urinary bladder wall and marked congestion of the submucosal vasculature, a potential cause of the haematuria observed clinically. Numerous foci of neoplastic cells were also observed throughout the lung parenchyma as well as within lymphatic vessels of the lung, the liver and the kidney. A diagnosis of a metastatic non-papillary high-grade urothelial carcinoma (UC) of the urinary bladder was made. Consistent with this diagnosis, immunohistochemistry revealed the neoplastic cells were negative for uroplakin III, as has been reported for a subset of high-grade, infiltrative urinary bladder UCs of canines and humans. This is the first report of a primary tumour of the urinary bladder in a tiger and the first report of UC in a tiger.

Bladder wall adhesion causing a vesicular septum in a dog following surgical cystotomy

CASE DESCRIPTION

An 8-year-old spayed female Yorkshire Terrier-Poodle dog was evaluated for persistent pollakiuria and stranguria following routine cystotomy for calcium oxalate cystoliths.

CLINICAL FINDINGS

The dog presented for a cystotomy with intermittent hematuria. Postoperative radiographs revealed no remaining cystoliths. Urine, cystolith, and bladder mucosal aerobic cultures were negative. Pollakiuria, stranguria, and hematuria developed immediately after surgery and persisted despite antibiotics. Ultrasound revealed suspected fibrous adhesions within the urinary bladder lumen connecting the dorsal and ventral bladder wall creating a septum. This was confirmed cystoscopically 4 weeks after surgery.

TREATMENT AND OUTCOME

Cystoscopic-guided laser ablation was performed to incise abnormal tissue connecting the ventral and dorsal bladder wall using a holmium:yttrium-aluminum-garnet laser. Three weeks later, ultrasound revealed adhesion resolution though mild pollakiuria and stranguria persisted. Oxybutynin was prescribed and clinical signs resolved. At 27 months after ablation, hematuria occurred with recurrent cystoliths. These cystoliths were removed by percutaneous cystolithotomy, documenting a cystoscopically normal bladder wall. The patient had normal urination for 55.5 months after ablation, with normal bladder wall thickness on ultrasound repeated at 27 and 36 months after ablation.

CLINICAL RELEVANCE

To the authors' knowledge, an adhesion creating a septum between the dorsal and ventral bladder wall has not been previously reported as a complication after cystotomy in any species and should be considered as a cause of persistent lower urinary signs after surgery. Ultrasound identified the lesion in this dog. Because bladder abnormalities can develop quickly after surgery, ultrasound might be considered if urine testing is not supportive of infection. Cystoscopic-guided laser ablation was a successful minimally invasive treatment in this case.

Hematuria in a 3-month-old filly with an internal umbilical abscess and internal iliac artery aneurysm

A 3-month-old foal with a history of acute hematuria was evaluated. Hydronephrosis and hydroureter were visualized upon renal ultrasonography of the left kidney. Cystoscopy identified a blood clot occluding the left ureter. Computed tomography (CT) revealed a large retroperitoneal abscess at the level of the aortic bifurcation and a left internal iliac aneurysm. Due to the severity of the lesions and the poor prognosis, the filly was euthanized and the clinical findings were confirmed by post-mortem examination. This report emphasizes the value of obtaining a precise diagnosis via CT in order to avoid unviable treatment approaches when confronted with this unusual secondary complication of omphaloarteritis. Key clinical message: Umbilical complications are routinely diagnosed in equine neonatal medicine, and commonly lead to septicemia, physitis, and septic arthritis; severe internal umbilical abscessation, and subsequent vascular and urinary disorders are uncommon sequelae.

Use of cystoscopy or cystourethroscopy in treating benign macroscopic hematuria caused by lower urinary tract hemorrhage in three dogs

CASE DESCRIPTION

A 5-year-old 11.5-kg (25.3-lb) castrated male Boston Terrier (dog 1), an 8-year-old 27.8-kg (61.2-lb) castrated male Boxer (dog 2), and a 10.5-year-old 15.9-kg (35.0-lb) spayed female Pembroke Welsh Corgi (dog 3) were evaluated because of severe, gross hematuria and suspected idiopathic renal hematuria.

CLINICAL FINDINGS

All 3 dogs had hematuria, anemia, blood clots in their urinary bladders, and unremarkable findings on coagulation and mucosal bleeding time assessments. With cystourethroscopy, lower urinary tract hemorrhage originating from a small lesion in the urinary bladder (n = 2) or urethra (1) and normal-appearing yellow urine jetting from both ureterovesicular junctions were visualized in each dog.

TREATMENT AND OUTCOME

Cystoscopically guided surgical resection of a hemorrhagic lesion of the urinary bladder was performed on dog 1, and histologic evaluation of the resected tissue confirmed urinary bladder telangiectasia. Dogs 2 and 3 each underwent cystourethroscopically guided laser ablation of a hemorrhagic lesion (presumptively diagnosed as hemangioma, angioma, or telangiectasia) in the urinary bladder (dog 2) or urethra (dog 3). The longest follow-up duration was 7 years, and none of the 3 dogs had subsequent recurrence of gross hematuria.

CLINICAL RELEVANCE

Findings suggested that cystourethroscopy should be considered part of the diagnostic plan for hematuria in dogs before pursuing major surgical treatment or when results of conventional diagnostic procedures do not indicate the underlying cause. In addition, histologic results for dog 1 indicated urinary bladder telangiectasia, previously an unreported cause of severe, chronic lower urinary tract hematuria in dogs.

Salmonella enterica and Theileria co-infection in dromedary camels (Camelus dromedarius) in UAE

BACKGROUND

Despite a steady increase in camel husbandry worldwide, pathology of camel diseases is still relatively under-investigated. Clinical hematuria is generally indicative of either acute or chronic urogenital inflammations, traumatic calculous injuries, cancers, corrosive poisonings. Infectious agents are not typically implicated in urinary tract infection of camels.

AIM

This study aims to explore possible causes in camels clinically suffered from acute febrile disease with severe hematuria.

METHODS

To achieve aims of the study culturing of urine samples, microscopic examination for detection of blood parasites, phenotypic and genotypic characterization for the identification of isolated bacteria were followed.

RESULTS

Conventional bacteriology enabled identification of Salmonella enterica subsp. enterica serovar typhimurium which further genotyped by 16S rRNA gene sequencing. Microscopic examination of Giemsa stained blood smears from both infected dromedary camels revealed the presence of pleomorphic Theileria piroplasms. The results suggest that the clinical symptoms were as coinfection induced by salmonellosis and theileriosis.

CONCLUSION

Given these remarkable findings, further research should aim to better characterize the opportunistic pathogens associated with camel theileriosis, as well as to determine other possible infectious agents of the camel urinary tract.

Evaluation of three herbal compounds used for the management of lower urinary tract disease in healthy cats: a pilot study

OBJECTIVES

Lower urinary tract disease (LUTD) occurs commonly in cats, and idiopathic cystitis (FIC) and urolithiasis account for >80% of cases in cats <10 years of age. Although several strategies have been recommended, a common recommendation is to induce dilute urine resulting in more frequent urination and to dilute calculogenic constituents. In addition to conventional therapy using modified diets, traditional Chinese and Western herbs have been recommended, although only one - choreito - has published data available. We evaluated three commonly used herbal treatments recommended for use in cats with LUTD: San Ren Tang, Wei Ling Tang and Alisma. We hypothesized that these three Chinese herbal preparations would induce increased urine volume, decreased urine saturation for calcium oxalate and struvite, and differences in mineral and electrolyte excretions in healthy cats.

METHODS

Six healthy spayed female adult cats were evaluated in a placebo-controlled, randomized, crossover design study. Cats were randomized to one of four treatments, including placebo, San Ren Tang, Wei Ling Tang or Alisma. Treatment was for 2 weeks each with a 1 week washout period between treatments. At the end of each treatment period, a 24 h urine sample was collected using modified litter boxes.

RESULTS

Body weights were not different between treatments. No differences were found in 24 h urinary analyte excretions, urine volume, urine pH or urinary saturation for calcium oxalate or struvite between treatments.

CONCLUSIONS AND RELEVANCE

The results of this study do not support the hypothesis; however, evaluation of longer-term and different dosage studies in cats with LUTD is warranted.

Renal epithelial proliferation and its clinical expression in Brown Norway (BN) rats

Renal epithelial proliferation has previously been found to be a common condition in a colony of Lewis × Brown Norway (BN) F2 hybrid rats. The aim of this study was to investigate the prevalence and clinical consequences of this condition in pure inbred BN and Lewis rats. Renal epithelial proliferation was found in 29 of 49 BN rats (59%) examined and in four of 50 Lewis rats (8%) examined. Serum creatinine and serum corticosterone was not influenced by the condition. Haematuria was more common in BN rats with (74%) than without renal papillary proliferation (35%, P < 0.05), but it may not be used to diagnose renal epithelial proliferation, as we found rats having renal epithelial proliferation without showing haematuria and rats showing haematuria without having renal epithelial proliferation. Haematuria was also common in Lewis rats (16-56% dependent of age and gender), in which renal epithelial proliferation were found in only 8%. Fluctuating asymmetry, which was used as a measure of developmental instability, was found to be increased in rats with renal epithelial proliferation ( P < 0.05). Haematuria was also found to be related to the degree of fluctuating asymmetry ( P < 0.01). Although the prevalence of renal epithelial proliferation is clearly higher in BN rats than in Lewis rats ( P < 0.01), and although in previous reports the condition was found in F2 BN × Lewis hybrids and not in F1 BN × Lewis hybrids it cannot clearly be defined as having been caused by a single Mendelian gene, as we found it in both inbred strains. Futhermore, we found that morphologically the proliferations could be placed on the papillary as well as the medullary wall of the renal pelvis, while previously it has only been described on the papillary wall.

Management of bilateral idiopathic renal hematuria in a dog with silver nitrate

Renal hematuria has limited treatment options. This report describes management of bilateral idiopathic renal hematuria in a dog with surgically assisted installation of 0.5% silver nitrate solution. Initial treatment resulted in freedom from clinical signs or recurrent anemia for 10 months; however, recurrence of bleeding following a nephrectomy resulted in euthanasia.

The environmental and human effects of ptaquiloside-induced enzootic bovine hematuria: a tumorous disease of cattle

In this review, we address the major aspects of enzootic bovine hematuria and have placed special emphasis on describing the etiology, human health implications, and advanced molecular diagnosis of the disease.Enzootic bovine hematuria (EBH) is a bovine disease characterized by the intermittent presence of blood in the urine and is caused by malignant lesions in the urinary bladder. This incurable disease is a serious malady in several countries across many continents. Accurate early-stage diagnosis of the disease is possible by applying advanced molecular techniques, e.g., detection of genetic mutations in the urine of cows from endemic areas. Use of such diagnostic approaches may help create an effective therapy against the disease.There is a consensus that EBH is caused primarily by animals consuming bracken fern (P. aquilinum) as they graze. The putative carcinogen in bracken is ptaquiloside(PT), a glycoside. However, other bracken constituents like quercetin, isoquercetin,ptesculentoside, caudatoside, astragalin, and tannins may also be carcinogenic.Studies are needed to identify the role of other metabolites in inducing urinary bladder carcinogenesis.The bovine papilloma virus is also thought to be an associated etiology in causing EBH in cattle. There is growing alarm that these fern toxins and their metabolites reach and contaminate the soil and water environment and that the carcinogen (PT)is transmitted via cow's milk to the human food chain, where it may now pose a threat to human health. An increased incidence of gastric and esophageal cancer has been recorded in humans consuming bracken ferns, and among those living for long periods in areas infested with bracken ferns.Although preliminary therapeutic vaccine trials with inactivated BPV-2 against EBH have been performed, further work is needed to standardize and validate vaccine doses for animals.

Ureteral fibroepithelial polyp in a dog

Haematuria in a dog occurred secondarily to a unilateral ureteral fibroepithelial polyp. The diagnostic techniques, gross pathology and histopathological findings of this unusual benign tumour are reported. Complete resolution of clinical signs occurred following ureteronephrectomy.

Sialic Acid and GM3 Ganglioside Expression in Papillomavirus-associated Urinary Bladder Tumours of Cattle with Chronic Enzootic Haematuria

This study was based on 30 papillomavirus-associated urinary bladder tumours from cattle with chronic haematuria, the animals having been kept since birth on pasture rich in bracken fern. The ganglioside content was assessed and compared with that of normal bovine urinary bladders, which was shown to be 28.6+/-3.3 (mean+/-SD) microg of lipid-bound sialic acid per gram of fresh tissue. In neoplastic bladder samples this value was higher but variable (120.9+/-80.6 in benign tumours, and 94.7+/-45.7 in malignant tumours). The main ganglioside, GM3, represented ca 75% of the total ganglioside mixture in normal tissues and 50-80% in tumour samples. GM1, GM2, GD1a, GD3 and FucGM1 were found as minor components. The study suggested that GM3 ganglioside may have a crucial role in "downregulation" of the metastatic potential of bovine urothelial cancers.

Reconstruction of the urethra by use of an inverse tubed bipedicle flap in a dog with hypospadias

CASE DESCRIPTION

A 1-year-old castrated male German Shepherd Dog was evaluated because of a history of hematuria and stranguria secondary to recurrent urinary tract infections.

CLINICAL FINDINGS

Physical examination revealed hypospadias with penile and preputial aplasia. The urethral orifice was just ventral to the ventral aspect of the anocutaneous junction. Ascending urinary tract infections, secondary to fecal contamination of the urethral orifice, were the presumed source of recurrent bouts of cystitis that developed despite periodic antimicrobial treatment.

TREATMENT AND OUTCOME

A 1-cm-diameter urethral extension was constructed from the urethral mucosal remnant located along the midline of the perineum (urethral trough). Two parallel 4-cm incisions (3 cm apart) were made lateral to that urethral trough. The borders were sutured to form an inverted, epithelium-lined tube (bipedicled flap) attached to the dorsal urethral orifice. The lateral skin margins were sutured over the reconstructed urethral extension, completing the procedure. Postoperative swelling necessitated temporary catheterization of the urinary bladder. After closure of a small fistula from the reconstructed urethral segment, the dog subsequently had only 2 episodes of cystitis during a 3-year period. To minimize skin irritation secondary to urine exposure, the dog's owner regularly trimmed the hair around the new urethral orifice.

CLINICAL RELEVANCE

In dogs, correction of perineal (subanal) hypospadias via urethral reconstruction should be considered among treatment options. By use of an inverse tubed urethral extension, direct fecal contamination to the lower urinary tract may be effectively eliminated, dramatically reducing the incidence of ascending urinary tract infections in dogs with hypospadias.

Chromosome fragility in cattle with chronic enzootic haematuria

Chronic enzootic haematuria (CEH) is a severe syndrome due to prolonged ingestion of toxic principles of bracken fern, such as quercetin and ptaquiloside. Little information is available on chromosomal instability of cattle with access to bracken fern and suffering from CEH. In the present study, 45 cattle, aged from 7 to 12 years and pastured in the south of Italy, were cytogenetically investigated for the first time in search of both chromosomal aberrations (aneuploidy, gaps, chromatid breaks, chromosome breaks and fragments) and sister chromatid exchanges (SCEs). Of these animals, 30 (group 1) had access to bracken fern and showed signs of CEH, and 15 (group 2; control) did not. Percentage of abnormal cells (aneuploidy, chromatid breaks, chromosome breaks and fragments) was higher in animals affected by CEH (34.7%, group 1) than that (24.3%) reached in the control (group 2). The same results were achieved when including gaps. Indeed, the mean number of cells with structural aberrations excluding gaps (chromatid breaks, chromosome breaks and fragments) per cell was higher (P<0.001) in animals affected by CEH (0.16+/-0.36) than that (0.09+/-0.29) found in the control. Chromosome fragility in cells of animals affected by CEH was also confirmed when applying the SCE test: statistically higher levels (P<0.001) of SCEs were observed in animals with CEH (7.35+/-3.59 SCE/cell, group 1) than those in the control (5.40+/-2.68 SCE/cell).

Bovine papillomavirus type 2 detection in the urinary bladder of cattle with chronic enzootic haematuria

The bovine papillomavirus type 2 (BPV-2) involvement in the aetiology of chronic enzootic haematuria associated to bracken fern ingestion has been suggested for a long time. However, a few reports have shown the presence of the BPV-2 in urinary bladder tumors of cattle. The aim of this study was to investigate the presence of the BPV-2 infection in the urinary bladder of cattle with chronic enzootic haematuria in Brazilian cattle herds. Sixty-two urinary bladders were collected from adult cattle in beef herds from the north region of the state of Paraná, Brazil. According to clinical and pathological finds the specimens were distributed in three groups: the group A was constituted by 22 urinary bladders with macroscopic lesions collected at necropsy of cattle with clinical signs of chronic enzootic haematuria; the group B by 30 urinary bladders with macroscopic lesions collected in a slaughterhouse of cows coming from bracken fern-endemic geographical region; and the group C (control) by 10 urinary bladders without macroscopic lesions collected from asymptomatic cattle in a bracken fern-free geographical region. By a semi-nested polymerase chain reaction (PCR) assay, with an internal control, a fragment of the BPV-2 L1 gene with 386 bp length was amplified in 36 (58%) urinary bladder. The rate of BPV-2 positive urinary bladders was 50% (11/22) for group A, 80% (24/30) for group B, and 10% (1/10) for group C (control). The rate of the positive results found in groups A and B that included urinary bladder samples with macroscopic lesions was 67% (35/52) and the detection of the BPV-2 in both groups was significantly higher (P < 0.05) than in the control group. RFLP with Rsa I and Hae III enzymes evaluated the specificity of the BPV-2 amplicons. The PCR internal control that amplified a 626 bp fragment of the ND5 gene of the bovine mitochondrial genome was amplified in all analyzed samples and excluded false-negatives or invalid results in the semi-nested PCR. These results suggest the BPV-2 involvement in the chronic enzootic haematuria aetiology and open the perspective of the development of new strategies for the control of this disease that is the major cause of economical losses in beef herds from many Brazilian geographical regions.

Clinico-pathological findings in cattle exposed to chronic bracken fern toxicity

AIM

To describe changes in blood and urine analytes in a large group of cattle exposed to chronic bracken fern toxicity, in order to identify parameters of potential diagnostic value.

METHODS

The study was conducted on two livestock farms on which bovine enzootic haematuria (BEH) was known to occur; Farm A grazed a local breed of cows and Farm B grazed Friesians. Group A1 comprised 66 cows from Farm A, Group B 54 cows from Farm B, and Group A2 13 heifers from Farm A. Ten healthy cows were used as controls. A complete physical examination was performed (Group A1), and blood (all groups) and urine (Groups A1 and B) samples were collected. Necropsies and histopathology were undertaken on four cows.

RESULTS

Anaemia, leucopenia, monocytosis, thrombocytopenia, hypergammaglobulinaemia, microhaematuria and proteinuria were detected. Multivariate statistical analyses established three phases of the disease of increasing severity; an initial phase, characterised by an extremely high monocytosis and otherwise normal parameters; an intermediate phase, characterised by monocytosis and moderate changes to other analytes; and a final phase, characterised by normal levels of monocytes and many changes to other analytes.

CONCLUSIONS AND CLINICAL RELEVANCE

Monocytosis, detected in 31% of the younger animals, could represent an initial response to consumption of bracken fern and might be useful as an early haematological marker of BEH.

Evaluation of the effects of stress in cats with idiopathic cystitis

OBJECTIVE

To determine the effects of stress in cats with feline idiopathic cystitis (FIC) by evaluating bladder permeability, sympathetic nervous system function, and urine cortisol:creatinine (C:Cr) ratios during periods of stress and after environmental enrichment.

DESIGN

Prospective study.

ANIMALS

13 cats with FIC and 12 healthy cats.

PROCEDURE

Cats subjected to an acute-onset moderate stressor for 8 days received IV injections of fluorescein. Serum fluorescein concentrations were determined and compared with those of controls to evaluate bladder permeability, and urine C:Cr ratios were compared to evaluate function of the hypothalamic-pituitary-adrenal (HPA) axis. Plasma catecholamine concentrations were analyzed in a subset of cats. After 8 days of moderate stress, cats were moved to an enriched environment, and tests were repeated after 21 days.

RESULTS

Serum fluorescein concentrations were significantly higher in cats with FIC at all time points. In the cats in which plasma catecholamine concentrations were determined, concentrations of dihydroxyphenylalanine, norepinephrine, and dihyroxyphenylglycol were significantly higher in cats with FIC at all time points, whereas no differences in urine C:Cr ratio between groups were observed.

CONCLUSION AND CLINICAL RELEVANCE

Cats with FIC appeared to have altered bladder permeability, most notably during the period of initial stress. The increase in plasma dihydroxyphenylalanine concentration suggests that there may be stress-induced increase in the activity of tyrosine hydroxylase, which catalyzes the rate-limiting step in catecholamine synthesis. In contrast, no effects of stress on C:Cr ratios were observed, which suggests there was dissociation between the sympathetic nervous system and HPA-axis responses to stress.

Urinary Bladder Lesions in Bovine Enzootic Haematuria

In cattle, bracken fern chronic toxicity is characterized by the presence of multiple tumours in the bladder (bovine enzootic haematuria). From October 1999 to March 2003, 433 urinary bladders with macroscopical lesions were collected in the slaughterhouse of São Miguel Island (Azores, Portugal), an endemic area where Pteridium aquilinum infestation in pastures is high. Bladder lesions were divided into three main categories (inflammatory lesions, non-neoplastic epithelial abnormalities and tumours) and described in detail. In some cases, neoplastic growth was confined to a single site, but in most cases multiple tumours developed within the same bladder. Epithelial tumours alone were present in 51.2% of the affected bladders, mesenchymal tumours alone in 17.4%, and both epithelial and mesenchymal tumours in the remaining 31.4%. The large number of tumours examined (870) revealed new categories not yet included in other veterinary classification systems, namely, inverted papilloma, papillary neoplasm of apparent low malignant potential, and haemangioendothelioma.

Identification of Facklamia sourekii from a Lactating Cow

A gram-positive, catalase-negative, facultatively anaerobic coccus was isolated from a lactating cow with hematuria and urodynia in Japan. The isolate was identified by 16S rRNA gene sequence analysis as Facklamia sourekii. The biochemical and culture characteristics of the isolate were well consistent with those of F. sourekii type strain. Since all F. sourekii strains reported so far were isolated from human clinical specimens, this is the first reported case of F. sourekii isolated from veterinary clinical specimen.

Hematuria associated with cystic hematomas in three neonatal foals

Cystic hematomas were diagnosed in 3 neonatal foals. In all 3 foals, cystic hematomas resulted from umbilical trauma or thrombocytopenia. Findings in these foals suggest that cystic hematoma should be included in the differential diagnosis of hematuria in neonatal foals. Management of cystic hematomas includes both medical and surgical options.

Semi-nested PCR for detection and typing of bovine Papillomavirus type 2 in urinary bladder and whole blood from cattle with enzootic haematuria

Bovine Papillomavirus type 2 (BPV-2) and chronic intoxication by bracken fern ingestion were associated with urinary bladder lesions and the clinical signs of enzootic haematuria in adult cattle. Clinically enzootic haematuria is characterized by intermittent haematuria followed by animal death. Enzootic haematuria causes considerable economical impact on extensive cattle breeding worldwide. The demonstration of BPV-2 participation in the etiology of bovine urinary bladder carcinoma by conventional virological methods is not easy and the integrity of epidemiological studies relies on methods that are sensitive and specific for BPV-2 detection and typing. A multiplex-PCR was evaluated for BPV-2 L1 gene and bovine mitochondrial genome ND5 gene (internal control) detection followed by a second round of BPV-2 amplification by a semi-nested PCR (SN-PCR). Six skin papilloma samples were used for PCR technique development. Twenty-two urinary bladder samples from symptomatic (n = 12) and asymptomatic (n = 10, control group) cows and 25 blood samples from cows grazed on enzootic haematuria-endemic (n = 14) and enzootic haematuria-free (n = 11, control group) geographical regions of Parana State, Brazil were analyzed. The SN-PCR detected BPV-2 in seven urinary bladder and 10 whole blood samples collected from cows with enzootic haematuria and in one urinary bladder and one whole blood samples of asymptomatic cows. The specificity of the amplicon was performed by restriction fragment length polymorphism and sequence analysis. The SN-PCR technique developed in this study will make possible the realization of diagnosis and comparative epidemiological studies to evaluate BPV-2 infection rates in cattle, and the association of this infection with bracken fern chronic intoxication in the etiology of enzootic haematuria and opens the possibility of ante mortem studies by lymphocytes analysis.

Renal osteosarcoma in a dog

A seven-and-a-half-year-old dog presented with anorexia, lethargy and haematurla. A 1.8 kg abdominal mass was excised and determined to be a primary renal osteosarcoma. Haematuria was observed five months after surgery and the tumour was radiographically determined to have recurred locally. The dog was euthanased 12 days later due to refractory pain and anorexia. Although osteosarcomas are expected to develop distant metastases, this dog was euthanased due to clinical evidence of local tumour recurrence. Haematuria was an indication both of initial tumour development and later recurrence.

TRANSITIONAL CELL CARCINOMAS IN FOUR FISHING CATS (PRIONAILURUS VIVERRINUS)

Transitional cell carcinomas (TCC) of the urinary bladder were diagnosed in four related fishing cats (Prionailurus viverrinus). The major clinical sign in each case was persistent hematuria unresponsive to medical therapy. Cystotomy and biopsy provided an antemortem diagnosis in three of the fishing cats before euthanasia because of progression of clinical signs. The diagnosis was made in the fourth cat after euthanasia because of renal failure. Hematuria improved temporarily in one of the cats diagnosed antemortem and treated with piroxicam and carboplatin. Attempts to isolate a herpesvirus in two of the cats failed. Histopathologic appearance of the TCC was similar to that described for other species. TCC metastasis to the lungs was noted at necropsy in one cat; metastatic disease was not noted in the other fishing cats on gross or histopathologic examination. TCC of the urinary bladder appears to be more prevalent in fishing cats than in other species of domestic or nondomestic felids.

Chromosome Aberrations in Cattle with Chronic Enzootic Haematuria

Chromosomal aberrations were investigated in 56 cattle with chronic enzootic haematuria (CEH) raised on pastures giving access to bracken fern. Of these animals, 27 were slaughtered and showed neoplastic lesions of the urinary bladder. Tumour tissue from 11 of the 27 cattle contained bovine papillomavirus type 2 (BPV-2) DNA. Increased numbers of chromosomal aberrations were seen in all animals with CEH, as compared with 30 control cattle that had had no access to bracken fern. The highest clastogenic effect was observed in cattle with urinary bladder cancer and evidence of BPV-2 DNA, suggesting that BPV-2 and bracken fern act synergistically in the production of chromosomal instability. In 19 of 20 animals with CEH, two bracken fern toxic compounds (quercitin and ptaquiloside) were demonstrated in urine, serum and milk.

Diagnostic approach to hematuria in dogs and cats

Hematuria indicates the presence of urogenital disease in dogs and cats. Persistent hematuria (macroscopic or microscopic) should be evaluated to determine the source of bleeding and the underlying cause so that appropriate treatment can be recommended. Results of the history and physical examination often help to localize disease to the urinary tract (either upper or lower) or genital tract. Additional diagnostic evaluation, including laboratory testing(eg, urinalysis, urine culture), diagnostic imaging (eg, abdominal radiographs, ultrasound), and collection of tissues for cytologic or histopathologic evaluation, may be needed to identify the underlying cause. If a thorough evaluation fails to reveal the source or cause of hematuria, exploratory celiotomy should be considered,especially if idiopathic renal hematuria is possible.

Effects of urinary tract inflammation and sample blood contamination on urine albumin and total protein concentrations in canine urine samples

BACKGROUND

Urinary tract inflammation and hemorrhage are believed to be common causes of proteinuria in dogs based on results of studies that measured total urine protein concentration. A method to quantify urine albumin (UAlb) concentration in dogs recently has become available; however, the effect of inflammation on albuminuria is unknown.

OBJECTIVES

The goals of this study were to determine the effects of urinary tract inflammation, as indicated by pyuria and sample blood contamination, on UAlb concentration and on urine protein:creatinine (UPC) ratio in dogs.

METHODS

Urine samples were obtained from dogs with pyuria that were presented to a veterinary teaching hospital or were part of a laboratory colony. To mimic the effects of hematuria, canine whole blood was added to a microscopically normal canine urine sample that had baseline albumin and total protein concentrations below the limits of detection. UAlb concentration was measured using a canine albumin-specific competitive ELISA. UPC ratio was determined using routine methods.

RESULTS

Of 70 samples with pyuria, 67% had negligible UAlb concentrations and 81% had normal UPC ratios. UAlb concentration but not UPC ratio was significantly higher (P < 0.05) in samples with concurrent hematuria or bacteriuria. When whole blood was added to normal urine, UAlb concentration did not exceed 1 mg/dL until the sample became visibly pink; the UPC did not exceed 0.4 at any dilution.

CONCLUSIONS

Many dogs with pyuria do not have albuminuria or proteinuria; however, albuminuria may be more likely in dogs with pyuria and concurrent hematuria or bacteriuria. Hematuria may not cause an increase in UAlb concentration until it becomes macroscopic and even then may not increase the UPC ratio.

Surgical removal of a mammary adenocarcinoma and a granulosa cell tumor in an African pygmy hedgehog

A 3-year-old, female African pygmy hedgehog (Atelerix albiventris) was referred with a history of hematuria. Hyperglycemia and glucosuria were found at presentation. Mammary adenocarcinoma and a granulosa cell tumor were found and removed surgically. Glucosuria and hematuria resolved, and the hedgehog has done well for 10 mo postoperatively.

Treatment of renal nephroblastoma in an adult dog

An 8-year-old Labrador retriever was diagnosed with a unilateral malignant nephroblastoma and hypertrophic osteopathy. The histopathologically malignant tumor was confined to the renal capsule, but the sarcomatous component was anaplastic, resulting in its classification as a Stage I tumor with unfavorable histopathology. The dog was treated with unilateral nephrectomy, vincristine, and doxorubicin. This dog has remained disease free for >25 months. Reported treatments of renal nephroblastoma in the dog have not described disease-free intervals of >8 months.

Bracken fern (Pteridium aquilinum) poisoning in cattle in southern Brazil

Epidemiological data on Pteridium aquilinum intoxication in cattle the state of Santa Catarina were obtained by review of diagnostic records from 1987 to 2001. Of 3,407 necropsied cattle, 244 (7.16%) were diagnosed as intoxicated by Paquilinum; 122 of those were of the hemorrhagic form, 103 had tumors in the upper digestive tract, 19 were cases of chronic hematuria. Annual losses due to this intoxication in this State are estimated at 10,657 cattle. The highest incidence of the hemorrhagic form occurs in 1-3-y-old cattle between March and July, and most cases of tumors of the upper digestive tract affect cattle older than Sy. The highest incidence of digestive tract tumors is at the base of the tongue and pharynx, and the lowest frequency is in the rumen and esophagus. The large economic losses caused PaQuilinum in Santa Catarina call for improved control measures for the disease.

Ultrasonographic evaluation of urinary bladder in normal, fern fed and enzootic bovine haematuria-affected cattle

A total of 19 adult hill cattle of both sexes were subjected to trans-rectal ultrasound scanning of urinary bladder to evaluate bladder wall thickness and the presence of space-occupying lesions. The animals were divided into four groups. Eight apparently healthy hill cattle maintained under standard ration served as control (group I) and the remaining II animals were divided into three groups (II, III and IV). Group II animals (n = 8) were fed with different type of ferns which were further divided into subgroups II-P, -D and -B and fed with Polystichum squarrosom (n = 2). Dryopteris juxtaposita (n = 2) and Pteridium aquilinum (n = 4) ferns, respectively. The one animal in group III was a natural case of enzootic bovine haematuria (EBH) and the two animals in group IV were natural cases of microscopic EBH fed with Polystichum squarrosum fern. In group I animals, the average bladder wall thickness was 1.45 mm. The delineation of the bladder wall was uniformly smooth and the echo pattern of the bladder was homogeneously black, which was suggestive of clear urine content. In group II (P, D and B) the average bladder wall thickness of the six animals was 1.87 mm and the sonographic features were within normal limit when compared with controls. In two of the animals of group II-B, the bladder wall was apparently thick (4.36 mm) and there was no intraluminal mass except at one or two focal elevated points. Animals of groups III and IV showed the average bladder wall thickness of 4.86 mm and were characterized by the presence of irregular sessile masses extending into the bladder lumen. The homogeneous anechoic area was reduced centrally due to the presence of a hypoechoic soft tissue mass all around the bladder wall. Post-sonographic urinalysis, biopsy and necropsy of selected cases further confirmed the sonographic findings.

[Bladder infection with Capillaria plica in a male dog]

In a male dog with symptoms of haematuria an infection with C. plica was established. During the first urine examination large numbers of erythrocytes and leucocytes were seen. The dog was treated with antibiotics. After 10 days a second urine examination revealed several eggs of C. plica, accompanied by leucocytes and erythrocytes. The infection was eliminated with fenbendazole treatment (50 mg/kg/day, for 10 days).

Hematuria and a complex congenital heart defect in a newborn foal

A 16-hour-old foal was referred for evaluation of hematuria. A pansystolic heart murmur and left thoracic thrill were detected; laboratory diagnostics and ultrasonography identified a complex congenital heart defect. The diagnosis was confirmed at postmortem.

A renal hemangiosarcoma causing hematuria in a dog

A 14.5-year-old male dog was presented with stranguria and hematuria of 1-month duration. Hematology and blood chemistry revealed a neutrophilia, mild azotemia and a mild decrease in the packed cell volume. Urinalysis showed high specific gravity (> 1.040 g/mL), hematuria, proteinuria and mild bilirubinuria. On physical examination, a firm oval mass located caudal to the distended urinary bladder, was palpated. Differential diagnoses included prostatitis, prostatic neoplasm, prostatic hyperplasia, and abscess. The enlarged prostate was suspected to be the cause of hematuria, and a total prostatectomy was performed. Histologically, the prostate was affected by a prostatitis with cystic papillary hyperplasia of the epithelium. The dog's condition continued to deteriorate, and death occurred 1 week later. Necropsy showed a tumor mass, approximately 5 x 4 x 3 cm in size, between the abdominal aorta and the left kidney, where the adrenal glands were embedded. Lesions were found in the kidneys, adrenal gland, lungs, heart, liver, intestine, and serosa of viscera, while the spleen was spared. This hemangiosarcoma most likely arose from the renal arteries, resulting in diffuse lesions in the kidneys thought to be the cause of hematuria.

Pteridium aquilinum (bracken fern) toxicity in cattle in the humid Chaco of Tarija, Bolivia

We studied the toxicity caused by chronic ingestion of Pteridium aquilinum (bracken) in cattle in the humid Chaco of Tarija, Bolivia. Bovine enzootic haematuria (BEH) and Carcinoma of the esophagus (CE) affected the herds. Sick animals showed caquexia, anemia, leucopenia and urine that turned from pink to intense red color with the presence of blood clots. Cattle grazed in the humid forests of the mountains where P aquilinum represented more than 50% of the plants. P aquilinum var arachnoideum and P aquilinum var Caudatum were present. Toxic norsesquiterpene, ptaquiloside, was identified in both varieties. Carcinomas were in the urinary bladders and esophagus of 100% and 50% of the cattle, respectively. Control of the intoxication could be difficult due to geographic characteristics of this Bolivian region.

The pagetoid variant of urothelial carcinoma in situ of urinary bladder in a cow

A case of urothelial carcinoma in situ of urinary bladder is reported in a 10-year-old cow naturally grazing on bracken-infested land. The cow suffered from enzootic hematuria for more than 5 years. The presence of bovine papillomavirus type 2 (BPV-2) DNA sequences was detected by polymerase chain reaction. The carcinoma in situ was characterized by the presence of anaplastic cells with amphophilic cytoplasm and pleomorphic nuclei containing granular, irregularly dispersed chromatin. Focal areas within the tumor contained large isolated and/or clustered cells. These cells had pale acidophilic cytoplasm, large nuclei with single or multiple nucleoli, and well-defined borders resembling Paget's cells. Immunohistochemically, all malignant cells were negative for vimentin and S-100 and positive for cytokeratins. In addition, normal and neoplastic cells expressed fragile histidine triad (FHIT) protein; surprisingly, some pagetoid cells did not. FHIT, the tumor suppressor gene at 3p14.2, encodes a protein of 147 amino acids (16.8 kd) with diadenosine triphosphate hydrolase activity and is a common target of deletions in human cancers of epithelial origin. Antibody to laminin detected a continuous epithelial basement membrane, thus clearly showing that neoplastic changes were limited to urothelial cells without invading stromal tissue. To our knowledge, this is the first report of an unusual pattern of spread of urothelial carcinoma in situ in a cow.

Congenital cystic disease of the liver and kidney in a pygmy goat

A 1-month-old pygmy goat was presented with abdominal distension and hematuria. Anemia, leukocytosis, and increased bilirubin and blood urea nitrogen levels suggested renal and hepatic disease. Radiographs revealed bilateral renomegaly, and ultrasound confirmed bilateral hydronephrosis. Necropsy findings determined that the renomegaly was due in part to edema and marked cystic tubular distension. Similarly, intrahepatic bile ducts were ectatic. The character and distribution of the gross and histologic lesions were consistent with a polycystic disorder, presumably congenital, affecting the liver and the kidney.

Diagnosis and treatment of obstructive urolithiasis in a captive Rocky Mountain wapiti (Cervus elaphus nelsoni)

A captive 5-yr-old castrated male Rocky Mountain wapiti (Cervus elaphus nelsoni) developed stranguria. Rectal palpation and physical examination indicated urethral obstruction that was subsequently relieved by urethrostomy and required only minimal aftercare. The wapiti was able to urinate freely after surgery; however, the obstruction recurred 27 mo later. Urethral catheterization relieved the second obstruction, which was caused by a large calculus composed of calcium carbonate and magnesium carbonate. Urolithiasis may have been associated with a diet high in calcium, and urethral obstruction may have been associated with castration at an early age. The wapiti continued to urinate freely 9 mo after relief of the second obstruction and 3 yr after the initial surgery.

Use of human recombinant erythropoietin for the treatment of nonregenerative anemia in a rough-toothed dolphin (Steno bredanensis)

Erythropoietin, a glycoprotein growth hormone that is produced primarily in the kidneys, promotes mitosis and survival of erythroid progenitors. The recent synthesis of the human form of the hormone by recombinant technology has provided a new therapeutic option, which is being used in both human and veterinary medicine for treatment of various anemias. A mature male rough-toothed dolphin, Steno bredanensis, was treated with human recombinant erythropoietin in an attempt to resolve a nonregenerative anemia. Two i.m. injections 48 hr apart were associated with an almost immediate increase in circulating immature reticulocytes, total reticulocytes, and nucleated erythrocytes. Over the next several weeks, the hematocrit, hemoglobin, and erythrocyte counts returned to normal, and the animal was subsequently released back into the wild. Endogenous erythropoietin concentrations were determined for this animal as well as three other conspecifics by an enzyme-linked immunosorbent assay for human erythropoietin. These measurements showed circulating erythropoietin concentrations (5-20+ mU/ml) similar to those of most other mammals. This study suggests that human recombinant erythropoietin can be safely and effectively used in this species and may have applicability to other cetacean species for the treatment of nonregenerative anemia. Caution should be exercised during long-term use because production of antibodies to human recombinant and endogenous erythropoietin may lead to potentially serious side effects.