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Journal of veterinary internal medicine2018; 32(3); 1202-1209; doi: 10.1111/jvim.15121

Equine idiopathic hemorrhagic cystitis: Clinical features and comparison with bladder neoplasia.

Abstract: A new syndrome of hematuria in horses has been documented. Objective: Hemorrhagic cystitis is a novel cause of stranguria and hematuria in horses. This syndrome may be difficult to differentiate from bladder neoplasia because they share several clinical features. Methods: Eleven horses with idiopathic hemorrhagic cystitis and 7 horses with bladder neoplasia. Methods: Retrospective cohort study. Results: Hemorrhagic cystitis was detected on cystoscopy of affected horses, with hemorrhagic and thickened apical bladder mucosa. Clinical signs and endoscopic appearance of the bladder resolved within 3-8 weeks. Histopathology of bladder mucosal biopsy specimens featured neutrophilic and hemorrhagic cystitis. Histopathology was suggestive of dysplasia or neoplasia in 3 horses with hemorrhagic cystitis, yet the horses experienced complete resolution, suggesting that small biopsy specimens obtained by endoscopy can be difficult to interpret. Horses with bladder neoplasia had lower hematocrits, were older, more likely to be female, and more likely to have a mass detected on ultrasonographic examination of the bladder than horses with hemorrhagic cystitis syndrome. Conclusions: Hemorrhagic cystitis represents a novel differential diagnosis for horses with hematuria, and is associated with a favorable prognosis. Although histopathology may suggest a neoplastic process, affected horses should be monitored cystoscopically, because complete resolution of hemorrhagic cystitis occurs. The cause of this disease is unknown, and warrants investigation.
Publication Date: 2018-03-31 PubMed ID: 29604121PubMed Central: PMC5980356DOI: 10.1111/jvim.15121Google Scholar: Lookup
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  • Comparative Study
  • Journal Article

Summary

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The study investigates a newly found syndrome causing stranguria and hematuria in horses, named hemorrhagic cystitis. It examines the clinical signs and histopathology of this condition, reveals its differentiation from similar symptoms in bladder neoplasia, and underlines the full recovery chances of horses dealing with this disease.

Study Objects and Methodology

  • The study looked at 11 horses diagnosed with idiopathic hemorrhagic cystitis and compared them with 7 horses afflicted by bladder neoplasia.
  • The research methodology involved a retrospective cohort study to uncover the different symptoms and recovery patterns between these two groups.

Findings and Clinical Signs

  • Hemorrhagic cystitis was visible during a cystoscopy performed on the ill horses.
  • The symptoms included a bloody, thickened apical bladder mucosa.
  • These clinical symptoms alongside the endoscopic look of the bladder typically resolved within a time frame of 3 to 8 weeks.

Important Insights from Histopathology

  • The histopathology showed neutrophilic and hemorrhagic cystitis in bladder mucosal biopsy specimens.
  • Among the horses with hemorrhagic cystitis, there were signs suggesting dysplasia or neoplasia. However, due to the difficulty in interpreting small biopsy specimens obtained during an endoscopy, these signs were not clear.
  • Despite such signs, the afflicted horses had a complete recovery, indicating the favorable prognosis of the condition.

Differences with the Bladder Neoplasia Group

  • The horses suffering from bladder neoplastic conditions showed lower hematocrit levels, were generally older, more likely to be female, and often displayed a mass on ultrasonographic examinations of the bladder when compared to horses with the hemorrhagic cystitis syndrome.

Conclusion and Further Work

  • Hemorrhagic cystitis is a new additional diagnosis for horses showing signs of hematuria, and it has a promising prognosis.
  • Though some histopathological results may suggest a tumor, the affected horses can recover completely, hence constant cystoscopic monitoring is recommended.
  • The root cause of this disease is still unknown, necessitating further research.

Cite This Article

APA
Smith FL, Magdesian KG, Michel AO, Vaughan B, Reilly CM. (2018). Equine idiopathic hemorrhagic cystitis: Clinical features and comparison with bladder neoplasia. J Vet Intern Med, 32(3), 1202-1209. https://doi.org/10.1111/jvim.15121

Publication

ISSN: 1939-1676
NlmUniqueID: 8708660
Country: United States
Language: English
Volume: 32
Issue: 3
Pages: 1202-1209

Researcher Affiliations

Smith, Fauna L
  • William R. Pritchard Veterinary Medical Teaching Hospital, University of California Davis, Davis, California.
Magdesian, K Gary
  • Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, California.
Michel, Adam O
  • William R. Pritchard Veterinary Medical Teaching Hospital, University of California Davis, Davis, California.
Vaughan, Betsy
  • Department of Surgical and Radiological Sciences, University of California Davis, Davis, California.
Reilly, Christopher M
  • Department of Pathology, Microbiology and Immunology, University of California, Davis, California.

MeSH Terms

  • Animals
  • Cystitis / diagnosis
  • Cystitis / pathology
  • Cystitis / veterinary
  • Diagnosis, Differential
  • Female
  • Hematuria / diagnosis
  • Hematuria / pathology
  • Hematuria / veterinary
  • Horse Diseases / diagnosis
  • Horse Diseases / pathology
  • Horses
  • Male
  • Retrospective Studies
  • Urinary Bladder / pathology
  • Urinary Bladder Neoplasms / diagnosis
  • Urinary Bladder Neoplasms / pathology
  • Urinary Bladder Neoplasms / veterinary

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Citations

This article has been cited 2 times.
  1. Zakia LS, Gomez DE, Kenney DG, Arroyo LG. Sabulous cystitis in the horse: 13 cases (2013-2020). Can Vet J 2021 Jul;62(7):743-750.
    pubmed: 34219784
  2. Mohammadi Najafabadi M, Soleimani M, Ahmadvand M, Soufi Zomorrod M, Mousavi SA. Treatment protocols for BK virus associated hemorrhagic cystitis after hematopoietic stem cell transplantation. Am J Blood Res 2020;10(5):217-230.
    pubmed: 33224566