Polypoid cystitis as a cause of haematuria in a pony mare

Abstract

Summary A 15‐year‐old pony mare was presented for investigation of haematuria of 2 weeks' duration. On cystoscopy, multiple small pedunculated soft tissue structures were observed on the bladder mucosa. Histopathological analysis of the masses was consistent with chronic polypoid cystitis. The polypoid lesions and associated haematuria resolved following prolonged antibiotic treatment. Polypoid cystitis has not previously been described in horses. This condition should be considered a differential for haematuria, requiring cystoscopy and biopsy to confirm a diagnosis.

Bloody urine – the list of differential diagnoses lengthens, but diagnostics remain the same

“…) and polypoid cystitis (Rosales et al . ) can be identified during cystoscopy. Immunohistochemical examination of endoscopically obtained tissue from a cystic carcinoma can identify whether the neoplastic cells express COX‐2 receptors, thereby determining if treating the horse with a COX‐2 selective NSAID might be effective (Lisowski et al .…”

“…There are not many reported causes of haematuria in horses, but with the report by Rosales et al . () in this issue of Equine Veterinary Education describing a horse with haematuria caused by polyps in the bladder, the list becomes a bit longer.…”

“…A urethral rent should be suspected as the cause of haematuria of a gelding even when no rent is observed during urethroscopy, if the results of examination have eliminated all other possible sites of haemorrhage (Glass et al 2016). Urolithiasis, primary cystitis (Fig 2) (Smith et al 2016), mucosal ulceration associated with chronic administration of a NSAID (Aleman et al 2011), exercise-induced mucosal erosions in the bladder (Schott 2002), cystic neoplasia (Fischer et al 1985;Patterson-Kane et al 2000;Hurcombe et al 2008;Serena et al 2009;Busechian et al 2016) and polypoid cystitis (Rosales et al 2019) can be identified during cystoscopy. Immunohistochemical examination of endoscopically obtained tissue from a cystic carcinoma can identify whether the neoplastic cells express COX-2 receptors, thereby determining if treating the horse with a COX-2 selective NSAID might be effective (Lisowski et al 2015;Busechian et al 2016).…”

Endoscopic treatment of a ureteral inflammatory polyp in a 15-year-old Warmblood gelding

“…As far as the authors are aware there are no case reports of ureteral fibroepithelial polyps in adult horses. Only a description of a chronic polypoid cystitis in a mare was found, where the clinical symptoms were similar (Rosales et al 2017).…”

Haematuria caused by transitional cell carcinoma in the urinary bladder of a warm-blooded gelding

“…Zystitis kann entweder verursacht werden durch anatomische und physiologische Störungen, die zu einer unphysiologischen Entleerung der Harnblase führen(Knight 1968, Morgan et al 1990, Goehring et al 2010, oder durch Harnblasensteine(DeBowes et al 1984, Holt und Pearson 1984, Frei et al 2016, und zuletzt durch chemische Reizung oder die Aufnahme von reizenden Pflanzen wie Sorghum(Knight 1968). Darüber hinaus wurde vor kurzem ein Fall polypoider Zystitis bei einem weiblichen Pony mit unklarer Ursache beschrieben(Rosales et al 2019). Diese Veränderung ist bekanntlich bei Hunden aufgetreten und wird mit Hämaturie in Verbindung gebracht(Martinez et al 2003, Eo Jin et al 2009).…”