History: The patient presented for difficulty walking and not drinking water. Occasional dysuria present as well.
The urinary bladder is delineated by a thin rim of irregular gas opacity.
There is no evidence of urolithiasis.
The liver may be reduced in volume, but the patient is rotated, and this could be artifactual.
Serosal and retroperitoneal contrast are poor, likely due to minimal intra-abdominal fat.
Musculoskeletal changes are spondylosis, lumbar articular process osteoarthritis of various degrees, stifle osteoarthritis and mild coxofemoral osteoarthritis.
Multifocal skeletal degenerative changes. Whether these are associated with the patient’s difficulty walking cannot be evaluated from survey radiographs.
Routine hematology and serum chemistry.
Urinalysis with sediment evaluation and culture and sensitivity testing.
Avoid cystographic procedures due to likely fragility of urinary bladder.
The following comes from a review of emphysematous cystitis in 27 dogs.1
Clinical signs:Hematuria predominates
Gas location: Wall and lumen 14/27; wall only 9/27; lumen only 4/27.
Most frequent bacterial isolates : Eschericia coli, Enterococcus spp., Klebsiella pneumoniae, Proteus mirabilis, Streptoccus spp., Actinomyces spp.
Most common comorbidities:
Diabetes mellitus 9/27; neurologic disease 7/27; adrenal disease 5/27. Note: although glucosuria is considered the most important risk factor for emphysematous cystitis, most dogs in this review were not diabetic.
In humans without glucosuria, gas production without glucosuria is thought to be related to fermentation of albumin.2
A general review is also available.3
1.Merkel LK et al. Clinicopathologic and microbiologic findings associated with emphysematous cystitis in 27 dogs. J Am Anim Hosp Assoc 53:313, 2017.
2.Grupper M et al. Emphysematous cystitis: illustrative case report and review of the literature. Medicine (Baltimore) 86:47, 2007.
3.Fumeo M et al. Emphysematous cystitis: review of current literature, diagnosis and management challenges. Veterinary Medicine: Research and Reports 10:77, 2019.