The patient is an 8 year old, MN, canine Queensland Healer Cross that presented for hematuria. Clinical exam was uneventful. CBC and chemistry panel was unremarkable. Hematuria and evidence of UTI was present in the urinalysis.
Clinical Differential Diagnosis
(Lobetti) Bladder - neoplasia, uroliths, bacterial cystitis, trauma Prostate - neoplasia, abscess Kidney - neoplasia, renolith, pyelonephritis, trauma
Sonographic Differential Diagnosis
(Lindquist): Obstructive right ureteral mass with extension into right renal pelvis and secondary hydronephrosis. Potential pelvic blood clot. Mass appears resectable with right nephro-ureterectomy. Suspect transitional cell carcinoma or sarcoma.
(Dr. Doug Casey): US-guided FNA of the ureteral mass revealed epithelial atypia. Surgical biopsy of the right ureteral mass revealed ureteral sarcoma with hemorrhage. Right kidney: Hydronephrosis, pelvic hemorrhage, parenchymal atrophy, fibrosis, mild interstitial lymphoplasmacytic nephrosis.
The patient recovered uneventfully. Oncology consultation pending.
Special thanks to Dr. Doug Casey of English Bay Ultrasound, Vancouver, BC, Canada and Dr Phil Anderson and Staff Animal Care Clinic (http://animalcareclinicvancouver.com) for the excellent management of this case