Polypoid Cystitis in Dogs
Polypoid cystitis is a condition marked by a chronically inflamed and/or infected urinary bladder. This disease is characterized by polypoid (round and fleshy) protrusions scattered over the surface of the bladder. These protrusions can lead to ulcers in the lining of the urinary bladder, which will result in occasional blood in the urine.
Symptoms and Types
- Bloody urine
- Frequent urination
- Difficulty urinating
- Urethral obstruction from polyps (pet stops urinating and becomes very ill)
- Lack of appetite – not eating or drinking
- Recurrent urinary tract infections
Dogs suffering from chronic urinary tract infections, or urinary bladder stones, are most at risk for developing polypoid cystitis.
Your veterinarian will perform a complete physical exam, including a blood chemical profile, a complete blood count, a urinalysis and an electrolyte panel. You will need to give a thorough history of your pet's health leading up to the onset of symptoms.
Cystoscopy (going into the bladder with a small camera), or cystotomy (surgery to open the bladder) is essential for obtaining a diagnosis of polypoid cystitis. Cystotomy or cystoscopy will show bloody, polypoid lesions over the bladder surface that cannot be visually differentiated from transitional cell carcinoma (TCC), a grave cancer of the bladder. A biopsy (tissue removal for examination) of the polyps will need to be performed for differentiation, and will be obtained during the cystoscopic procedure.
A sample of urine from the bladder will also need to be cultured, and will be removed by sterile catheterization, or at the time of cystoscopy. Another procedure that can be used to draw urine out of the bladder is cystocentesis, which uses a needle to perform the task, but it will not be used unless TCC has been ruled out.
Double-contrast cystography, and positive contrast cystography (both methods use injection of a dye that shows up on x-ray examination), are the best methods for visually examining the interior of the bladder. This method may reveal irregular polyploid masses in the bladder, and/or a thickened bladder wall. Ultrasound imaging can also be used for this purpose, and may show polypoid/mass-like lesions along the lining of the bladder.
Treatment will involve removal of the polyps, either by entering the bladder through the urinary tract (cystoscopy), or through surgically opening the bladder (cystotomy). Polyps can be individually removed using one of these methods. Partial surgical removal of the bladder may be required to remove the affected area of the bladder, and further treatment of the underlying cause for the chronic inflammation may prevent recurrence of the polyps. If a urinary tract infection is occurring at the same time, this condition will also be resolved with antibiotics, which will be prescribed based on a culture of urine and polyp tissue. Antibiotics should be administered for at least four to six weeks.
Living and Management
Your veterinarian will schedule a follow-up appointment with you seven to ten days after antibiotic therapy has begun in order to culture your pet’s urine. Again, seven days after antibiotic therapy has ended, urine should be removed from your pet via cystocentesis (using a sterile needle) for urinalysis and culturing. This should be repeated again one month after antibiotic therapy has ended. Your veterinarian will want to follow your dog’s progress by examining the urinary tract by ultrasound at one, three, and six months after the initial treatment. The prognosis for this condition is generally favorable.