© 2013
Kravchenko S. O., Candidate of Veterinary Science
Poltava State Agrarian Academy
METHOD OF THE BLADDER PERFUSION IN ULTRASONIC DIAGNOSIS OF
UROLITHIASIS OF DOMESTIC CATS
Reviewer – Candidate of Veterinary Science P. I. Lokes
Research has established that the use of perfusion of the bladder during ultrasound can increase
the informativeness of diagnosis of urolithiasis in domestic cats. Introducing isotonic sodium chloride
into the bladder provides its content and improves visualization of urolites and urinary sediment. In
difficult cases (stones adhesion to the mucosa, empty bladder) this method improves the efficiency of
diagnosis of disease.
Keywords: cats, urolithiasis, imaging, catheterization, perfusion.
Statement of the problem. Due to changes in living conditions (due to urbanization) small animals
have previously not characterized for them diseases. In particular, the domestic cat metabolic disorders
lead to such pathologies as obesity, chronic renal failure, urolithiasis and others [2, 4, 8]. According to
foreign and domestic scientists (J. Simpson, 2003; P. I. Lokes, 2003; G. O. Yushchenko, O. P.
Timoshenko, 2005) exactly urolithiasis is one of the pathologies of the urinary system, which is often
registered and in the absence of timely diagnosis and adequate treatment leads to serious consequences [5,
7, 10]. Diagnosing the disease is complicated, insofar stones in the bladder did not appear in clinical trials
– instead, there are signs of urocystitis. This causes the necessity to use additional instrumental
techniques (ultrasound, radiography) for the correct choice of treatment. The combination of these factors
leads to an increase in the number of annual deaths from kidney stone disease, which leads to the
improvement of existing methods of diagnosis, treatment and prevention of urolithiasis in cats, as
indicated by C. A. Osborn, 2000 E. Chandler, 2002 [9, 11]. Therefore, exploring the ways of increasing
of informative of ultrasonographic diagnostics of urolithiasis of domestic cats is currently relevant.
Analysis of major studies and publications which discuss the problem. Ultrasonographic
diagnostic method – is relatively new and in the national veterinary medicine of small animals it is
recently used. Most ers indicate a high information content of ultrasonography in the diagnosis of
urolithiasis. However, ultrasound diagnostics is used, not in all veterinary clinics (primarily due to the
high cost of equipment) and cause difficulties insofar as the reliability of the results depends on the
configuration of the device and the level of training of the operator. Well-known researchers point at this
(F. Bar, 1999; P. I. Lokes, 2007) [1, 6]. In particular, visualization of urolites in the bladder is
complicated in cases where small stones or sand snug against the bladder wall or are attached to the
mucosa due to inflammation (called “soldered” calculus). However, in human medicine (humane
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medicine) the techniques that allow you to more clearly visualize the sand and small stones by moving
them inside the bladder are used [3]. One of these techniques is the bladder perfusion directly during
ultrasound study. Its use in domestic cats in the Soviet literature is hardly documented. Therefore, finding
ways to improve the informativeness of ultrasonography for stone disease in domestic cats is essential.
The purpose and objectives of the study. The purpose – the study of informative perfusion
bladder of domestic cats during ultrasound study in the diagnosis of urolithiasis.
The main objective was to perform perfusion of the bladder and to research the level of visualization
of urolites.
Materials and methods. The study was conducted in a veterinary clinic, the Department PSAA
therapy in the period from 2010 to 2012. Cats that came with signs of urinary disorders, were investigated
clinical and ultrasonographic, with the use of SonoScape A6 vet (production PRC) transducer of 2-6
MHz.
The material for the study were clinically healthy and sick of urolithiasis farm cats.
During the execution of applied research the results of 30 clinically healthy and 9 sick domestic cats
with urolithiasis were used.
All the animals that came to the clinic were the subject for clinical examination. In case of suspected
disease of the urinary system the ultrasonographic method of research was used, and in doubtful cases –
perfusion of the urinary bladder.
Perfusion was performed as follows. The bladder was catheterized through medical subclavian
catheter number 6. Sterile solution of sodium chloride 0.9% in a quantity sufficient for its content was
administered into the bladder, and ultrasonography was performed. If there are stones, their size, number
was determined and the decisions regarding the feasibility of surgical treatment were made.
Studies. During the research it was found that by the ultrasound without perfusion the urolites were
visualized at the bottom of the bladder as echogenic layers that visually merged with the wall of the
bladder and might be perceived as the artifact “comet tail” due to the accumulation of gases in the
intestine (Fig. 1).
However, during the perfusion the catheter in the bladder was visualized on the monitor as a thin
hyperechoic line, making it possible to adjust the depth of penetration. The jet solution was filling the
bladder, causing separation of urolites from mucosa and their movement, which allowed to study the
dynamics and visualize small concretions.
Due to this in the animal the urolites of 4,2 × 8 mm size, and three urolites of about 1.5 mm size
(Fig. 2) we found, whereas previously they were invisible (Fig. 1).
2
а
Figure 1. Ultrasonohrama of cat’s bladder in urolithiasis, a – urolites
а
б
в
Figure 2. Ultrasonohrama of cat’s bladder by urolithiasis: a – catheter; b, c – urolites
After ultrasonography the plunger of the syringe was pulled back, removing introduced solution
from the cavity of the bladder (along with urine and fine sand), the size of which does not exceed the
diameter of the catheter (0.6 mm).
Thus, ultrasonography is a highly informative method for diagnosing of urolithiasis of domestic
cats, that gives the possibility to find urolites and to establish their number and size. Application of
reception of bladder perfusion enhances ultrasound possibilities in complicated cases (stones adhesion to
the mucosa, the empty bladder), which improves the efficiency of diagnosis of urolithiasis.
Conclusion. The use of perfusion during ultrasonographic examination of the bladder increases the
information content of this method in the diagnosis of urolithiasis of domestic cats.
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