Pseudomembranous Cystitis: An Uncommon Ultrasound Appearance of Cystitis in Cats and Dogs

Abstract

In veterinary medicine, pseudomembranous cystitis (PC) is a rare condition described only in cats. The purposes of this retrospective study were to describe ultrasound features of PC in cats and dogs, predisposing factors, comorbidities and outcomes. Cats and dogs with an ultrasonographic diagnosis of PC were included in the study. The bladder ultrasound findings that were recorded were: pseudomembranes’ characteristics, abnormalities of the bladder’s wall and content and anomalies of the pericystic peritoneal space. Ten cats and four dogs met the inclusion criteria. Four pseudomembrane adhesion patterns were described. The presence of pseudomembrane acoustic shadowing was observed in the 60% of cats. A total of 80% of the cats included were presented for urethral obstruction (UO) and/or had at least one episode of UO in the previous 2 months. Thirteen patients out of fourteen received only medical therapy, and all of them survived. PC is a rare disorder in cats and dogs and there are some ultrasonographic differences between the two species, suggesting a greater severity of the pathology in cats. Chronic cystitis and UO may have a potential role in the development of feline PC. Finally, the medical approach can be a non-invasive and effective approach for PC.

Diagnosis and management of rare sequels to feline lower urinary tract disease in two cats

“…An ultrasonographic examination was performed, which revealed intraluminal structures formed by hyperechoic septa transecting the bladder lumen causing compartmentalisation, with some adhesion to the bladder wall. This was similar to Type 4 of pseudomembraneous cystitis; mixed partial adhesion 8 (Figure 2b).…”

“…An abdominal ultrasound was then performed, which revealed a hyperechoic septum floating in the bladder lumen, without causing compartmentalisation (Figure 2a). This appearance was similar to Type 3 of pseudomembraneous cystitis; partial adhesion without compartmentalisation 8 . The urinary catheter was blocked on Day 3 by a similar caseous substance and the bladder was non‐compressible.…”

“…Cases of FPC so far have reported a good prognosis, and medical treatment provides a non‐invasive approach when diagnosis is made early. Delayed diagnosis may require surgical intervention, but does not affect the prognosis greatly 8 …”

“…Delayed diagnosis may require surgical intervention, but does not affect the prognosis greatly. 8 The presence of unique ultrasonographic findings make diagnosis of these conditions possible, thus encouraging diagnostic imaging workup, specially in early stages of FLUTD. Ultrasonography of the urinary tract should be considered an essential diagnostic workup in animals presented with signs of FLUTD.…”

“…This appearance was similar to Type 3 of pseudomembraneous cystitis; partial adhesion without compartmentalisation. 8 The urinary catheter was blocked on Day 3 by a similar caseous substance and the bladder was non-compressible. An ultrasonographic examination was performed, which revealed intraluminal structures formed by hyperechoic septa transecting the bladder lumen causing compartmentalisation, with some adhesion to the bladder wall.…”