Journal of Cell and Tissue Research Vol.

16(3) 5843-5849 (2016) Original Article

(Available online at www. Tcrjournals.com)
ISSN: 0973-0028; E-ISSN: 0974-0910

CLINICAL AND ULTRASONOGRAPHIC EVALUATION OF

URINARY BLADDER DISEASES IN DOG
?
RAJKUMAR, K. AND ANSAR KAMRAN, C.

Department of Veterinary Medicine, Veterinary College, KVAFSU, Bangaluru 560024

(Karnataka). E. mail: rajvet10@gmail.com, Cell: 09894671682

Received: September 1, 2016; Revised: September 7, 2016; Accepted: September 25, 2016

Abstract: The ultrasonographic changes recorded in urinary bladder diseases recognize a high
degree of specificity in accordance with the type and degree of the medical condition. Dogs with
clinical signs of pollakiuria, dysuria-stranguria, hematuria, urinary incontinence, and polydipsia
and polyuria were selected for investigation. In the present study twenty-two dogs were selected
having urinary bladder diseases. Bladder wall thickness more than 3 mm were diagnosed as
cystitis in a fully distended bladder. In non-distended bladder, subjective evaluation of the wall
thickness was made according to the amount of distension. In the present study majority of the
cases showed bladder wall thickness more than 4 mm. Cytological examination was performed in
cystitis cases and neoplasm was ruled out. Transitional cell carcinoma was diagnosed in five dogs
with hematuria, pollakiuria, and dysuria and was reported only in older dogs. Ultrasonographic
findings in transitional cell carcinoma were irregular bladder wall mass with a broad-based
attachment projecting into the urinary bladder lumen. It is concluded that ultrasonography is
often recommended as the first diagnostic imaging modality in patients with hematuria or dysuria.

Key words: Ultrasonography, urinary bladder, Dog

INTRODUCTION bladder diseases. The ultrasound examination confirms

The clinical expression and specific ultrasonogra-
phic evaluation of urinary bladder diseases in dogs
comprise an obvious and constant professional chall-
enge for the veterinary clinician. The ultrasono-
graphic changes recorded in urinary bladder diseases
recognize a high degree of specificity in accordance
with the type and degree of the medical condition.
The ultrasound diagnosis allows the identification
and understanding of the parietal elements and any
changes especially correlated with the uniform/non-
uniform thickening which can be easily diagnosed in
accordance with the position, echogenicity changes or
echo structure. In such cases, the presence and degree
of micturition disturbances and correlated urine
abnormalities allow to diagnose the various urinary
the presumed diagnosis based on the accurate results
about the bladder topography, type and quantity of the
content (corpuscular elements in suspension and/or
in sediment, stones and clots), degree of distension,
parietal tonus, wall thickness, uniformity and ratio of
the parietal constituents. The advantages offered by
the accuracy and noninvasiv-eness of the ultrasound
examination makes it a recommended valuable
harmonising method of diagnosis for urinary bladder
changes in the dog. The present study was undertaken
to evaluate the various pathological conditions
associated with urinary bladder diseases in dogs.
MATERIALS AND METHODS
In the present study twenty-two dogs with clinical

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Fig 1: Cystic calculi in a 6 year

old male dog. Hyperechoic focal
echogenicity that shadow in the
dependent portion of the bladder

Fig 2: Bladder sediments in a 6 year

old female dog.

Fig 3: Fully distended urinary bladder

with sediments in 5 year old male dog

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 Rajkumar and Ansar Kamran
signs of pollakiuria, dysuria-stranguria, hematuria,
urinary incontinence, and polydipsia and polyuria
were selected for the present study. Among these,
six dogs had only calculi in the urinary bladder
and predominant clinical signs were haematuria.
Radiopaque or radiolucent calculi were detected as
hyperehoic focal echogenicities that shadowed in the
dependent portion of the bladder. They were usually
spherical, with a hyperechoic curvilinear interface
with variety of sizes and shapes. Two dogs had
only urinary sediments and had complete urinary
obstruction. One dog had sediment with calculi and
the clinical sign includes haematuria. Cystitis was
diagnosed in six dogs with signs of haematuria,
dysuria associated with stranguria and two dogs
had cystic calculi. Ultrasonographic examination
of cystitis revealed irregular hypoechoic thickening
of the urinary bladder wall. Bladder wall thickness
more than 3 mm were diagnosed as cystitis in a
fully distended bladder. Transitional cell carcinoma
(TCC) was diagnosed in five cases of which one
cases had TCC with sediments. The dogs brought
for other organ examination without any urinary
bladder problem were selected as control.
The ultrasonographic examination was done using
a 6 to 10 MHz Curvilinear-Array Sector Doppler
probe and 2 to 5 MHz curvilinear-Array Sector
abdominal probe (GE Logic Book XP). The ventral
abdominal hair was clipped to the level of the
pubic bone, and ultrasonic gel was applied to the
skin. A transabdominal approach with the animal
in dorsal recumbency was preferred, but left or right
lateral recumbency or a standing position also used
in confirming the presence of intraluminal calculi
or sediment, in which calculi will fall toward the
gravity-dependent wall. If the penile urethra is to be
imaged, then hair was clipped for the perineum and
the region cranial to the scrotum.
RESULTS
Ultrasonographic findings for the twenty-two dogs,
diagnosed urinary bladder diseases, are summarized
in Table 1. Six dogs had calculi in the urinary bladder;
radiopaque calculi are detected as hyperehoic focal
echogenicities that shadow in the dependent portion
of the bladder (Fig. 1). Cystic calculi were usually
mobile and collected in the dependent portion of
the lumen. They were usually spherical, with a
hyperechoic curvilinear interface with variety of
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sizes and shapes. Urinary sediments were seen in
6 years old female dog and in 5 year old male dog
(Figs. 2,3). Seven year old male dog had sediments
with calculi. Cystitis was diagnosed in six dogs and
cystic calculi were diagnosed in 6 years and 7 years
old male dogs. Ultrasonographic examination of
cystitis revealed irregular hypo echoic thickening
of the urinary bladder wall. Bladder wall thickness
more than 3 mm was diagnosed as cystitis in a fully
distended bladder (Figs. 4-7). In non-distended
bladder, subjective evaluation of the wall thickness
was made according to the amount of distension.
In the present study majority of the cases showed
bladder wall thickness more than 4 mm. Cytological
examination was performed in cystitis cases and
neoplasm was ruled out. Transitional cell carcinoma
(TCC) was diagnosed in five dogs with hematuria,
pollakiuria, and dysuria and 12 years old male dog
had TCC with urinary sediments. TCC was reported
only in older dogs.Ultrasonographic findings in
TCC were irregular bladder wall mass with a
broad-based attachment projecting into the urinary
bladder lumen. The echogenicity is often mixed and
has an overall appearance that was hyperechoic,
hypoechoic or isoechoic compared with the bladder
wall. The masses were most commonly seen in the
bladder neck (trigone) region and dorsal bladder
wall (Figs. 8-10).
DISCUSSION
High-frequency bladder trans-abdominal ultrasound
may have a parallel accuracy as radiographic
contrast procedures in calculi detection [1]. In
urethral or cystic calculi distal shadow is more
likely seen with a higher transducer frequency and
with calculi of a greater thickness. A collection of
many small calculi or mineralized sediment may
generate a linear interface and usually suspends
with gentle agitation of the urinary bladder [2].
The hyper echoic interface and shadowing artefact
generated by the colon can mimic cystic calculi,
further descending colon can indent and appear
confluent with dorsal wall of the urinary bladder.
Rotation of the ultrasound transducer into the
longitudinal plane will reveal the colon as a linear
interface running the length of the image, whereas
the calculi should remain approximately spherical.
Moreover, repositioning the animal into a standing
or lateral position should cause any calculi to fall to
the dependent wall, whereas the colon remains in a
J. Cell Tissue Research

Fig 4: Cystitis in a 9 year old female dog.

Irregular bladder wall mass thickening
(0.49 cm)

Fig 5: Cystitis in 6 year old male dog.

Hypoechoic thickening (0.5) of the
urinary bladder wall

Fig 6: Cystic calculi in a 6 year old male

dog. Hyperechoic focal echogenicity that
shadow in the dependent portion of the
bladder and hypoechoic thickening of the
urinary bladder wall.

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Rajkumar and Ansar Kamran

Fig 7: Cystitis in a 10 year old male dog.

Irregular hypoechoic thickening(0.89) of
the urinary bladder wall

Fig 8: Bladder tumor in a 9 year old

female dog. Irregular bladder wall mass
thickening (0.98 cm)

Fig 9: Bladder tumor in 10 year old female

dog. Irregular bladder wall mass with a
broad – based attachment projecting into
the urinary bladder lumen

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Fig 10: Bladder tumor in a 7 year old

male dog. Irregular bladder wall mass
(1.80) with a broad – based attachment
projecting into the urinary bladder lumen

Table 1: Ultrasonographic findings in 22 dogs with urinary bladder diseases

Sl. Cases Clinical signs Ultrasonographic findings Diagnosis
No. Breed, Age (years), Sex
1 Labrador, 7 y, M; Mongrel, 11y, Haematuria Hyperechoic focal echogenicity that Calculi
M; Mongrel Cross breed, 10y, M; shadow in the dependent portion of the
Mongrel, 8y, M; West Island terrier, bladder (Fig 1)
5y, M; German Shepard, 6y, M
2. Dalmatian, 7, M Haematuria Hyperechoic focal echogenicity that Calculi and
shadow in the dependent portion of the Sediments
bladder with urinary sediments
3. Doberman, 5y, M; German Shepard, Complete urinary Fully distended urinary bladder with Sediment
6y, F obstruction sediments (Fig 2 & 3)
4. Cocker spaniel 5y, M: Labrador, Haematuria, Hypoechoic thickening of the urinary Cystitis
6y, M; Mongrel Cross breed, 5y, M; Dysuria associated bladder wall (Fig 4, 5, & 6)
Pug, 9y, F; Labrador, 6y, M; German with stranguria;
Shepard, 10y, F Pollakiuria
5. Dalmatian, 7y, M; Italian bull dog, Haematuria Hyperechoic focal echogenicity that Calculi and
6y, M shadow in the dependent portion of the Cystitis
bladder and Hypoechoic thickening of the
urinary bladder wall (Fig 7)
6. Cross bred, 10y, F; Mongrel, 9y, F; Haematuria, Dysuria Irregular bladder wall mass with a broad – Transitional cell
Dalmatian, 7y, M; Great Dane, 7y, M associated with based attachment projecting into the urinary carcinoma
stranguria bladder lumen (Fig 8, 9 & 10)
7. Doberman, 12y, M Persistent Irregular bladder wall mass with a broad – Sediments and
Haematuria based attachment projecting into the urinary Transitional cell
bladder lumen with urinary sediments carcinoma

dorsal location. In the present study, in majority of the cases urinary

Chronic cystitis causes wall thickening that is usually
most pronounced cranioventrally, but in severe cases
it can become generalized. Cystitis most commonly
causes widespread irregular hypoechoic thickening
of the urinary bladder wall. Normal wall thickness
in a fully distended bladder is approximately 1 to
2 mm. In a non-distended bladder, evaluation
of bladder wall thickness requires subjective
evaluation according to the amount of distension.
bladder wall thickness was more than 4 mm in some
cases thickness was up to 89 mm. Most common
clinical signs in cystis were haematuria, dysuria
associated with stranguria. Lower urinary tract
inflammation usually results in increased frequency
of urination (pollakiuria) and difficult urination
(dysuria) associated with straining (stranguria).
Transitional cell carcinoma is the most common
malignant bladder tumor in dogs and should

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 Rajkumar and Ansar Kamran

be suspected in aged dogs with hematuria, REFERENCES

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It is concluded that ultrasonography is often reco-

mmended as the first diagnostic imaging modality
in patients with hematuria or dysuria. It can provide
information relative to the capacity of the urinary
bladder, changes in bladder outline and in wall
thickness, identification of luminal and mural
masses, and identification of extrinsic lesions that
may displace the bladder wall causing changes in
its shape. Ultrasonography allows an evaluation of
the entire urinary tract (except distal urethra) in both
female and male dogs.

ACKNOWLEDGMENTS

The authors are thankful to the Dean, Bangalore

Veterinary College for providing the necessary
facilities and fund for this study.

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