3-year-old castrated male Domestic Short Hair

Positive Contrast Cystogram

• Thickening of the cranial and ventral urinary bladder wall with irregular cyst-like structure extending into the thickened wall at the vertex
• Reflux of contrast into the right kidney with mild dilation of the renal pelvis

Double Contrast Cystogram

• Marked thickening of the apex of the bladder with retention of positive contrast on irregular mucosa.
• Retention of positive contrast in cyst-like lesion in the wall of the bladder

• Urachal remnant/diverticulum
• Chronic cystitis

• Surgery
• Culture (may be affected by contrast medium)
• Cystoscopy

• This case was handled well by most candidates with a good overall score.
• Reflux of contrast into the right ureter and right renal pelvis secondary to the cystogram was frequently interpreted as occurring from a previous excretory urogram despite clearly labeled images and lack of contrast in the renal parenchyma, and lack of visualization of the left kidney.
• Reflux was also frequently interpreted as abnormal due to pyelonephritis or reabsorption of contrast systemically.
• The thickened bladder wall was occasionally not seen and not interpreted as cystitis
• Management did not always address the primary and secondary problems