Use of radiography, ultrasonography, and computed tomography in the diagnosis of a pyogranulomatous ureteral mass in a cat

Abstract

An 8-year-old, spayed female, domestic short haired cat, with diabetes mellitus, was presented to the University of Florida Veterinary Medical Center for an acute onset of vomiting and inappetence. Abdominal radiographs showed mild retroperitoneal effusion and asymmetric left-sided renomegaly. Subsequently, on abdominal ultrasound, a hypoechoic left ureteral mass with left hydronephrosis and hydroureter was identified. An abdominal computed tomography revealed a heterogeneously contrast-enhancing mass circumferentially surrounding the mid to distal left ureter, mild retroperitoneal effusion, left-sided hydronephrosis and hydroureter, and a distally located ureteral calculus at the level of the ureterovesicular junction. The patient was diagnosed with left-sided pyogranulomatous ureteritis via surgical biopsy and histopathology.

Ultrasound diagnosis and medical management of presumed segmental ureteritis in a cat

“…To our knowledge, this is the second case report of presumed feline segmental ureteritis and the first report of medical management of this condition in a cat without diabetes mellitus 3 . Interestingly, the cat in this report had previously had perineal urethrostomy surgery performed.…”

“…To our knowledge, this is the second case report of presumed feline segmental ureteritis and the first report of medical management of this condition in a cat without diabetes mellitus. 3 Interestingly, the cat in this report had previously had perineal urethrostomy surgery performed. The most frequently reported complications of this procedure include bacterial urinary tract infections and urethral stricture, which are often due to an underlying uropathy or improper surgical technique.…”

“…It has been reported that ureteral calculi can predispose to pyogranulomatous ureteritis. 3 Widening and shortening of the urethra, or trauma to the striated muscle of the urethral sphincter leading to decreased intra-urethral pressure, may also facilitate ascending bacterial urinary tract infection. 4 Urinary tract infections are uncommon in cats and usually develop as a complicating factor of an underlying comorbidity, such as diabetes mellitus chronic kidney disease or gastrointestinal disease.…”

“…Equally, the previously identified ureteral calculi may have been serving as a nidus for infection and partial intraluminal ureteral obstruction. It has been reported that ureteral calculi can predispose to pyogranulomatous ureteritis 3 . Widening and shortening of the urethra, or trauma to the striated muscle of the urethral sphincter leading to decreased intra‐urethral pressure, may also facilitate ascending bacterial urinary tract infection 4 .…”

“…1 There are two reports of ureteritis in dogs and cats causing mural ureteral obstruction: proliferative ureteritis in a dog, 2 and a pyogranulomatous mass in a cat. 3 This case report describes an alternative approach, using medical management instead of surgery, to treat presumed segmental ureteritis in a cat.…”