Emphysematous cystitis

From Dog
Emphysematous cystitis in a dog[1]

Emphysematous cystitis is a rare canine disorder caused by bacterial infection and characterized by gas accumulation within the bladder wall accompanied by cyst formation[2].

The gas is thought to be produced by gas-producing bacteria as a result of fermentation of either glucose or albumin[3].

In dogs, gram-negative bacteria, particularly Escherichia coli[4], but also Klebsiella spp, Pseudomonas spp, Proteus mirabilis[5] and Enterobacter spp are known to be causal gas-forming bacteria produced by fermentation of glucose[6].

Cases of emphysematous cystitis have been reported in dogs associated with diabetes mellitus[7][8] and prolonged chemotherapy[9], but some are idiopathic in origin[10].

In diabetic dogs, the glucosuria, lowered resistance to infection and dysuria are thought to contribute to bacterial infection in the urinary bladder[11].

Symptoms associated with this disease are usually none specific, including stranguria, pollakiuria, and hematuria.

Clinical diagnosis of emphysematous cystitis is usually based on evidence of gas accumulation within the bladder lumen and wall found with radiography and ultrasonography[12].

Histologically, multiple cyst-like structures varying in size are observed in the area from the lamina propria to the muscle layer. Diffuse polypoid cystitis is usually observed in more chronic cases[13].

Dogs usually recover well following administration of broad-spectrum antimicrobials. Severe cases may require intravesical instillation of dilute formalin[14].

References

  1. Matsuo S et al (2009) Emphysematous cystitis in a chemically-induced diabetic dog. J Toxicol Pathol 22(4):289-292
  2. Holesh S (1969) Gas in the bladder. Cystitis emphysematosa. Clin Radiol 20:234–236
  3. Aizenberg I & Aroch I (2003) Emphysematous cystitis due to Escherichia coli associated with prolonged chemotherapy in a non-diabetic dog. J Vet Med B Infect Dis Vet Public Health 50:396–398
  4. Pekárková M et al (2008) Infectious endocarditis caused by gas-producing Escherichia coli in a diabetic dog. J Small Anim Pract 49(1):44-46
  5. Petite A et al (2006) Radiographic and ultrasonographic findings of emphysematous cystitis in four nondiabetic female dogs. Vet Radiol Ultrasound 47(1):90-93
  6. Lobetti RG & Goldin JP (1998) Emphysematous cystitis and bladder trigone diverticulum in a dog. J Small Anim Pract 39:144–147
  7. Peli A et al(2003) Emphysematous cystitis in two glycosuric dogs. Vet Res Commun 27(1):419-423
  8. Root CR & Scott RC. Emphysematous cystitis and other radiographic manifestations of diabetes mellitus in dogs and cats. J Am Vet Med Assoc 15:721–728
  9. Aizenberg I & Aroch I (2003) Emphysematous cystitis due to Escherichia coli associated with prolonged chemotherapy in a non-diabetic dog. J Vet Med B Infect Dis Vet Public Health 50(8):396-398
  10. Thomas AA et al (2007) Emphysematous cystitis: a review of 135 cases. BJU Int 100:17–20
  11. <Lobetti RG & Goldin JP (1998) Emphysematous cystitis and bladder trigone diverticulum in a dog. J Small Anim Pract 39:144–147
  12. Besley WM (2004) What is your diagnosis? Emphysematous cystitis. J Small Anim Pract 45(6):283
  13. Wolfe TM et al(2010) Surgical management of diffuse polypoid cystitis using submucosal resection in a dog. J Am Anim Hosp Assoc 46(4):281-284
  14. Henrikson TD et al (2004) Intravesical instillation of dilute formalin for the treatment of severe hemorrhagic emphysematous cystitis in a diabetic dog. J Am Anim Hosp Assoc 40(1):64-68