HISTORY: 3 year old male neutered Domestic Shorthair Cat. Chronic urinary tract infections.
IMAGING STUDIES: Positive Contrast and Double Contrast Cystogram.
Positive Contrast Cystogram
Thickening of the cranial and ventral urinary bladder wall with irregular cyst-like structure extending into the thickened wall at the vertex
Reflux of contrast into the right kidney with mild dilation of the renal pelvis
Double Contrast Cystogram
Marked thickening of the vertex of the bladder with retention of positive contrast on irregular mucosa.
Retention of positive contrast in cyst-like lesion in the wall of the bladder
Culture (may be affected by contrast medium)
This case was handled well by most candidates with a good overall score.
Reflux of contrast into the right ureter and right renal pelvis secondary to the cystogram was frequently interpreted as occurring from a previous excretory urogram despite clearly labeled images and lack of contrast in the renal parenchyma, and lack of visualization of the left kidney.
Reflux was also frequently interpreted as abnormal due to pyelonephritis or reabsorption of contrast systemically.
The thickened bladder wall was occasionally not seen and not interpreted as cystitis
Management did not always address the primary and secondary problems.