Angel - another UTI and possible mass

[k9Karen]

Angel started showing symptoms of a UTI this past week. I did a UA and culture, which of course were both positive. Culture grew >100,000 cfu/mL E.coli - a wimpy one - sensitive to everything. Because of her history and the fact that he saw what looked like it could be small stones/"sand" at the time of her last infection a few months ago, the vet wanted to do another bladder ultrasound tp rule out stones. No evidence of stones or "sand", but there appeared to be a mass in the bladder. He felt it was "floating" - possibly held to the bladder wall by a small stalk. He ordered a Bladder Tumor Antigen, which was negative and placed her on 14 days of Clavimox.

Traci, etc. - any idea what this could be? Treatment? He mentioned "lasering" it as a possibility, along with just watching it to see if it enlarged further. If he did 'laser it', would that be through a cystoscope or abdominal? Since she had a history of a benign bladder tumor that was removed at the time of her spay (at least that's what I was told by rescue), he thought it could be a residual from that - scar tissue or maybe they didn't get it all, since it was removed from the external wall of the bladder. The vet seems to think that this could be a breeding ground for the bacteria, which makes sense, especially if it's dead or scar tissue. He also said it could just be some sort of invagination of the bladder wall that was inflamed due to the infection. Whatever this is, it didn't show on the previous ultrasound, but he did say that his view could have been blocked by all the 'junk' that was there. He wants to repeat the ultrasound in a couple of weeks to see if there is any change.

Anybody had to deal with something like this? How did it turn out?

[Traci]

Do you happen to have any record of the first benign tumor during the spay? (i.e., was it biopsied to confirm benign?)

My first thought (and only my opinion), agree with your vet, this could be scar tissue, but the 'floating' description is something I would want to further investigate, as your vet wants to by getting a recheck with ultrasound to monitor for changes in size, shape, location.

You mentioned a prior ultrasound, how long ago was that? One concern would be the rate of growth since that last ultrasound as compared to the recent one.

Also, during the diagnostics, did Angel require a catheterization due to any blockages? I assume he found the sand and grit on the urine sediment during urinalysis?

As for surgery, I'm honestly not sure, it would depend on your vet's experience with lasers, if he feels it is in an area not compromised by rupturing the bladder, it probably could be done using a cystoscope (or laparotomy)

I think at this point, I would just monitor it, follow up with the next ultrasound, but if Angel develops problems with normal urination, seems painful in the area, or if you notice blood in the urine, etc...don't hesitate to notify your vet and go from there.

[k9Karen]

I don't recall the date of the previous ultrasound, but it was within the past 6 - 9 months, which was part of the concern. There were triple phosphate crystals in her urine when the first ultrasound was performed. Because of timing, I did not do that UA myself, so I don't know how many. I do think that first infection had been going on for a while without me knowing it. There was visible blood in her urine with that infection, but not with the current one (although the strip was positive and there were a few RBC in the microscopic.) There were also no crystals present this time, and the pH was 6.0,

As for the previous tumor, I was given a very poor, almost illegible, copy of her hand-written chart, which was also given to my vet. There was no pathology report given to me, but I am confident that the rescue group would not have adopted her out knowing she had a malignant condition unless they informed me. I've had her over 4 years with no problems until this past year. If this were the same tumor, I would think it would be much larger and have caused problems before now.

She did not require catheterization and has no history of blockage. I do think this vet has considerable experience with lasers. He is their diagnostics expert and has special training in ultrasound and other procedures. He indicated that the location of this mass made it a good candidate for lasering.

[Traci]

Well if it were me, I think I would wait and see if the next ultrasound reveals anything. In the meantime, I would watch her closely for any newly developing symptoms, and not just your typical urinary tract problems, but those such as decreased appetite, painful abdomen, vomiting, lethargy, or any sign that you know is not typical of her.

Since your vet is experienced with lasers, you have that on your side, as opposed to abdominal surgery...recovery time would be so much quicker. But, hopefully, it won't even be necessary.

[k9Karen]

I'm with you 100% on this one. He seemed to be wanting to take a somewhat conservative approach, but was also letting me know 'worst case scenario'. He's pretty confident that the negative tumor antigen along with the location of the tumor rules out the transitional cell malignancy and I could tell he was uncertain what we were dealing with and wanted to watch it. Hopefully, antibiotic treatment will cause it to shrink if it's in any way due to the inflammation caused by the infection.

I'll let you know what the outcome of the next ultrasound is in a couple of weeks.